In order to understand the mechanism for insoluble neurotoxic protein polymerization in Alzheimer's disease (AD) brain neurons, we examined protein and gene expression for transglutaminase (TGase 2; tissue transglutaminase (tTG)) in hippocampus and isocortex. We found co-localization of tTG protein and activity with tau-positive neurofibrillary tangles, whereas mRNA and sequence analysis indicated an absolute increase in tTG synthesized. Although apoptosis in AD hippocampus is now an established mode of neuronal cell death, no definite underlying mechanism(s) is known. Since TGasemediated protein aggregation is implicated in polyglutamine ((CAG) n /Q n expansion) disorder apoptosis, and expanded Q n repeats are excellent TGase substrates, a role for TGase in AD is possible. However, despite such suggestions almost 20 years ago, the molecular mechanism remained elusive. We now present one possible molecular mechanism for tTG-mediated, neurotoxic protein polymerization leading to neuronal apoptosis in AD that involves not its substrates (like Q n repeats) but rather the unique presence of alternative transcripts of tTG mRNA. In addition to a full-length (L) isoform in aged non-demented brains, we found a short isoform (S) lacking a binding domain in all AD brains. Our current results identify intron-exon "switching" between L and S isoforms, implicating G-protein-coupled signaling pathways associated with tTG that may help to determine the dual roles of this enzyme in neuronal life and death processes.Transglutaminases (TGases, 1 EC 2.3.3.13) are a gene family of transamidating enzymes that, under the influence of calcium, catalyze protein cross-linking through acyl transfer of specific glutamine residues to lysines. These enzymes are involved in a variety of key metabolic processes that range from blood coagulation to cell death. Expression for the most ubiquitous intracellular member, tissue TGase (tTG), is highly regulated. It is induced in cultured cells by various agents including cytokines, such as interleukin-6 (IL-6) (1, 2), cyclic AMP (3-5), activation of the transcription factor, NFB (6 -8), and DNA methylation (9). The most potent inducers of tTG gene expression are retinoids (10 -12), which also promote apoptosis in various cells (13,14), including neurons (15-17).In this context, the history of tTG in Alzheimer's disease (AD) pathogenesis began almost 20 years ago with the report that brain tTG catalyzed cross-linking of neurofilament molecules (18). A decade later, A†peptide (19,20) as well as the â€-amyloid precursor protein (21) were shown to be cross-linked by tTG. Subsequently, tTG protein was demonstrated within amyloid plaques in AD brains (22). By using immunohistochemistry and an antibody to coagulation factor XIII, an extracellular TGase that cross-reacts with tTG, co-localization with paired helical filaments, the major components of neurofibrillary tangles (NFTs) in AD neurons were reported further suggesting a role for tTG in AD pathogenesis (23). Consistent with this notion, the phosphor...