Fibrillar amyloid- protein (A)1 deposition in senile plaques in the neuropil and in the walls of cerebral blood vessels is a common pathologic feature of patients with Alzheimer's disease (AD) and certain related disorders including Down's syndrome and hereditary cerebral hemorrhage with amyloidosis of the Dutch type (1). A is a 39 -43-amino acid peptide that has the propensity to self-assemble into insoluble, -sheet-containing fibrils (1, 2). A is proteolytically derived from a large type I integral membrane precursor protein, termed the amyloid -protein precursor (APP), encoded by a gene located on chromosome 21 (3-6). In this regard, full-length APP is proteolytically cleaved by an enzyme, termed -secretase, at the amino terminus of the A domain. A novel aspartyl proteinase named BACE (for -site APP-Cleaving Enzyme) has been identified as the -secretase enzyme (7-10). Subsequent cleavage of the remaining amyloidogenic membrane spanning APP carboxyl-terminal fragment by an enzyme termed ␥-secretase liberates the 40-or 42-amino acid residue A peptide. Although the exact identity of ␥-secretase remains unclear studies suggest that the presenilin proteins may function as this enzyme or as a required cofactor for ␥-secretase function (11-13). Alternatively, full-length APP can be proteolytically processed by an enzyme termed ␣-secretase through the A domain. This cleavage event generates a non-amyloidogenic membrane spanning carboxyl-terminal fragment and truncated secretory forms of APP␣ (sAPP␣) that are released into the extracellular environment (14,15).Cerebrovascular A deposition, known as cerebral amyloid angiopathy, is accompanied by smooth muscle cell degeneration suggesting a toxic effect of A to these cells in vivo (16 -18). These degenerating smooth muscle cells have been implicated in the overproduction of APP and A in the cerebral vessel wall further suggesting the active involvement of these cells in the progression of this cerebrovascular pathology (17-19). Similar to these in vivo observations, we have reported that A-(1-42), the more pathogenic form of the wild-type peptide, causes severe cellular degeneration accompanied by a marked increase in the level of cell-associated APP in cultured human cerebrovascular smooth muscle (HCSM) cells (20 -22). In more recent studies we demonstrated that mutations associated with familial forms of cerebral amyloid angiopathy (E22Q Dutch, E22K Italian, and D23N Iowa) markedly enhance both the fibrillogenic and cerebrovascular pathogenic properties of A toward cultured HCSM cells (23)(24)(25)(26). These experiments showed that these pathogenic forms of A assemble into an