Afflicted neurons in Alzheimer disease have been shown to display an imbalance in the expression of TrkA and p75NTR at the cell surface, and administration of nerve growth factor (NGF) has been considered and attempted for treatment. However, wild-type NGF causes extensive elaboration of neurites while providing survival support. This study was aimed at developing recombinant NGF muteins that did not support neuritogenesis while maintaining the survival response. Critical residues were identified at the ligand-receptor interface by point mutagenesis that played a greater importance in neuritogenesis versus survival. By combining point mutations, two survival-selective recombinant NGF muteins, i.e./7-84-103 and KKE/7-84-103, were generated. Both muteins reduced neuritogenesis in PC12 (TrkA ؉ /p75 NTR؉ ) cells by >90%, while concurrently retaining near wild-type survival activity in MG139 (TrkA Neurotrophins are a family of closely related proteins that have diverse functions ranging from neuronal survival and differentiation to regulation of axonal and dendritic outgrowth, synapse formation, cell migration, and cellular proliferation (1-5). The family of neurotrophins was established with the discovery of its founding member, nerve growth factor (NGF) 3 (3, 6, 7). Brain-derived neurotrophic factor (BDNF), neurotrophin 3 (NT-3), and neurotrophin 4/5 (NT-4/5) possess a high sequence homology (ϳ50%) and adopt similar tertiary structures (7-12). Neurotrophins bind selectively to a family of 140-kDa Tropomyosin-receptor-kinases (Trk), i.e. NGF to TrkA, brain-derived neurotrophic factor and NT-4 to TrkB, and NT-3 to TrkC, via interactions with a nanomolar affinity (K d ϳ10 Ϫ9 M) (13-16). All neurotrophins can also bind a 75-kDa common neurotrophin receptor, p75 NTR , via similar affinity interactions (17, 18).NGF is a target-derived polypeptide synthesized by the hippocampus and retrogradely transported within axons of cholinergic interneurons (striatum), magnocellular cholinergic neurons (basal forebrain), and Purkinje cells (cerebellum) (19 -22). NGF is secreted as a propeptide of 305 residues (ϳ35 kDa), pro-NGF, and subsequently cleaved at the N terminus by serine proteases to generate a smaller 120-amino acid mature polypeptide (ϳ13 kDa) (23,24). The folded monomer is stabilized by three disulfide bridges that form the core cystine-knot motif, characteristic of all neurotrophins (25,26). Each monomer is composed of two pairs of antiparallel -strands connected by four -hairpin loops (25). NGF possesses highly conserved hydrophobic residues along the elongated central axis of the molecule, which facilitates its tight association into a noncovalent homodimer (K d Ͻ10 Ϫ13 M) (25,27). The solvent-exposed -hairpin loops (I-V), along with the N and C termini, are highly variable across neurotrophins and play a functional role in establishing specificity in receptor activation (12, 17, 26, 28 -31).The crystal structure of a symmetric complex of dimeric NGF bound to a pair of TrkA-d 5 domains identified two critical pat...