Frame-shifted amyloid precursor protein (APP +1 ), which has a truncated out-of-frame C-terminus, accumulates in the neuropathological hallmarks of patients with Alzheimer's disease pathology. To study a possible involvement of APP +1 in the pathogenesis of Alzheimer's disease, we expressed APP 695 and APP +1 in the HEK293 cell-line and studied whether the processing of APP 695 was affected. APP +1 is a secretory protein, but high expression of APP 695 and APP +1 results in the formation of intracellular aggregate-like structures containing both proteins and Fe65, an adaptor protein that interacts with APP 695 . APP +1 is shown to interact with APP 695 , suggesting that these structures consist of functional protein complexes. Such an interaction can also be anticipated in post-mortem brains of young Down's syndrome patients without any sign of neuropathology. Here we observed APP +1 immunoreactivity in beaded fibres. Additional support for functional consequences on the processing of APP 695 comes from a 1.4-fold increase in levels of secreted amyloid b 40 in cells co-expressing APP 695 and APP +1 , although APP +1 itself does not contain the amyloid b sequence. Taken together, these data show that co-expression of APP 695 and APP +1 affects the processing of APP 695 in a pro-amyloidogenic way and this could gradually contribute to Alzheimer's disease pathology, as has been implicated in Down's syndrome patients. Keywords: Alzheimer's disease, amyloid b, amyloid precursor protein, Down's syndrome, Fe65, protein interactions.