Evidence of oxidative stress and the accumulation of fibrillar amyloid  proteins (A) in senile plaques throughout the cerebral cortex are consistent features in the pathology of Alzheimer disease. To define a mechanistic link between these two processes, various aspects of the relationship between oxidative lipid membrane damage and amyloidogenesis were characterized by chemical and physical techniques. Earlier studies of this relationship demonstrated that oxidatively damaged synthetic lipid membranes promoted amyloidogenesis. The studies reported herein specify that 4-hydroxy-2-nonenal (HNE) is produced in both synthetic lipids and human brain lipid extracts by oxidative lipid damage and that it can account for accelerated amyloidogenesis. A promotes the copper-mediated generation of HNE from polyunsaturated lipids, and in turn, HNE covalently modifies the histidine side chains of A. HNE-modified A have an increased affinity for lipid membranes and an increased tendency to aggregate into amyloid fibrils. Thus, the prooxidant activity of A leads to its own covalent modification and to accelerated amyloidogenesis. These results illustrate how lipid membranes may be involved in templating the pathological misfolding of A, and they suggest a possible chemical mechanism linking oxidative stress with amyloid formation.
Alzheimer disease (AD)3 is an age-related neurodegenerative disorder characterized by misfolded and aggregated fibrillar amyloid  proteins (A) in the brain. Among the factors associated with the pathogenesis of AD, oxidative stress is one of the most closely scrutinized (1, 2). It has been shown, for example, that the brain in AD has increased susceptibility to oxidative stress (3-5) and that isoprostanes, markers of oxidative stress, are specifically elevated (6 -8). Isoprostanes are chemically stable and nonreactive compounds that arise nonenzymatically from the spontaneous decomposition of lipid hydroperoxides. These hydroperoxides may decompose along other pathways, however, yielding highly reactive short chain alkenals such as 4-oxo-2-nonenal and 4-hydroxy-2-nonenal (HNE) (9 -17). HNE concentrations in human ventricular fluid are 8 -15 M and elevated in AD (3,18,19). HNE has a well known propensity to react with the side chains of various amino acid residues, and HNE-protein adducts have been used as biomarkers of oxidative stress (15).In light of these observations, it is noteworthy that lipid oxidation products such as HNE modify A and increase A misfolding (20 -25). Moreover, the immunoreactivity of antibodies to HNE-modified His residues localizes to amyloid plaques (26,27). This suggests that not only does A promote lipid oxidation but that there may also be a mechanistic link between the lipid oxidation products formed during oxidative stress and A misfolding (21). Conversely, several lines of evidence suggest that A contribute to oxidative stress. For example, the overexpression of A in transgenic mice, in Caenorhabditis elegans, and in cell culture results in an increase in...