Neuronal cell death, neurofibrillary tangles, and amyloid  peptide (A) deposition depict Alzheimer's disease (AD) pathology, but neuronal loss correlates best with dementia. We have shown that increased production of A is a consequence of neuronal apoptosis, suggesting that apoptosis activates proteases involved in amyloid precursor protein (APP) processing. Here, we investigate key effectors of cell death, caspases, in human neuronal apoptosis and APP processing. We find that caspase-6 is activated and responsible for neuronal apoptosis by serum deprivation. Caspase-6 activity precedes the time of commitment to neuronal apoptosis by 10 h, indicating possible activity without subsequent apoptosis. Inhibition of caspase-6 activity prevents serum deprivation-mediated increase of A. Caspase-6 directly cleaves APP at the C terminus and generates a C-terminal fragment of 3 kDa (Capp3) and an A-containing 6.5-kDa fragment, Capp6.5, that increases in serum-deprived neurons. A pulse-chase experiment reveals a precursor-product relationship between Capp6.5, intracellular A, and secreted A, indicating a potential alternate amyloidogenic pathway. Caspase-6 proenzyme is present in adult human brain tissue, and the p10 active caspase-6 fragment is detected in AD brain tissue. These results indicate a possible alternate pathway for APP amyloidogenic processing in human neurons and a potential implication for this pathway in the neuronal demise of AD.
Neuronal loss distinguishes Alzheimer's disease (AD)1 from normal aging and correlates best with cognitive decline in AD individuals (Ref. 1, and reviewed in Ref. 2). In mild cases of AD, there is already a 50% loss of neurons in the entorhinal cortex, which forms the connections necessary for memory and learning between the hippocampus and the neocortex (3). Neuronal loss in AD is accompanied by the deposition of amyloid  peptide (A) in senile plaques and cerebrovascular tissue and the presence of neurofibrillary tangles. Generally, A deposition is considered important in AD. Increased production of an A of 40 (A1-40) or 42 (A1-42) amino acids in length, which arises through proteolytic processing of the amyloid precursor protein (APP), is common to all familial forms of AD whether caused by mutations of APP, presenilin I, or presenilin II genes (reviewed in Ref. 4). The etiology of the most common sporadic form of the disease, which includes approximately 90% of AD cases, remains unknown. Whereas the pathology of sporadic cases of AD is identical to that of familial AD, the reason for increased A in sporadic AD is unclear. We have previously shown that human primary neuron cultures committed to apoptosis produce 2-4-fold more A than healthy neurons (5). Therefore, in sporadic AD, initiation of a neuronal cell death program may contribute significantly to the increased production of A. It is also possible that neuronal apoptosis contributes to increased A in familial AD cases because overexpression of APP, and mutations of APP or presenilin, induce neuronal cell...