Accumulation of the amyloid  peptide in the cortical and hippocampal regions of the brain is a major pathological feature of Alzheimer disease. Amyloid  peptide is generated from the sequential protease cleavage of the amyloid precursor protein (APP). We reported previously that copper increases the level of APP at the cell surface. Here we report that copper, but not iron or zinc, promotes APP trafficking in cultured polarized epithelial cells and neuronal cells. In SH-SY5Y neuronal cells and primary cortical neurons, copper promoted a redistribution of APP from a perinuclear localization to a wider distribution, including neurites. Importantly, a change in APP localization was not attributed to an up-regulation of APP protein synthesis. Using live cell imaging and endocytosis assays, we found that copper promotes an increase in cell surface APP by increasing its exocytosis and reducing its endocytosis, respectively. This study identifies a novel mechanism by which copper regulates the localization and presumably the function of APP, which is of major significance for understanding the role of APP in copper homeostasis and the role of copper in Alzheimer disease.
The neuropathology of Alzheimer disease (AD)3 includes the accumulation of extracellular plaques containing amyloid  peptide (A) in the cortical and hippocampal regions of the brain, intracellular neurofibrillary tangles, and trace metal dyshomeostasis. The trace metals copper, zinc, and iron are significantly enriched in the amyloid plaques of AD patients compared with age-matched subjects (1, 2). Interaction between A and copper or zinc promotes peptide oligomerization and aggregation, eventually leading to further amyloid deposition (3-7). In addition, A is able to catalyze the reduction of Cu(II) and Fe(III), generating reactive oxygen species that contribute to the oxidative stress observed in the AD brain (8 -14). Paradoxically, there is evidence of copper deficiency in neighboring cells (15-18), compromising the activity of copper-dependent enzymes, such as cytochrome c-oxidase and copper/zinc-superoxide dismutase (SOD1), which are essential for cellular respiration and as antioxidant defense, respectively (19 -21). Restoration of copper balance using ionophores (22), such as clioquionol and PBT-2, has shown promising results in both animal and human trials (23)(24)(25)(26). A proposed mechanism of action of these drugs is to bind to extracellular copper and restore intracellular copper levels, hence correcting copper dyshomeostasis. Importantly, these ionophores are capable of reducing amyloid load and attenuate cognitive decline (23-26).Amyloid precursor protein (APP) is differentially processed by the ␣-, -, and ␥-secretases in two alternative processing pathways, commonly referred to as the nonamyloidogenic and amyloidogenic pathways (supplemental Fig. S1). In the non-amyloidogenic pathway, APP is initially cleaved by an ␣-secretase that is predominantly localized to the plasma membrane (27, 28), generating an N-terminal ectodomain (s...