-Amyloid (A) is the primary protein component of senile plaques associated with Alzheimer's disease and has been implicated in the neurotoxicity associated with the disease. A variety of evidence points to the importance of A-membrane interactions in the mechanism of A neurotoxicity and indicates that cholesterol and gangliosides are particularly important for A aggregation and binding to membranes. We investigated the effects of cholesterol and sialic acid depletion on A-induced GTPase activity in cells, a step implicated in the mechanism of A toxicity, and A-induced cell toxicity. Cholesterol reduction and depletion of membraneassociated sialic acid residues both significantly reduced the A-induced GTPase activity. In addition, cholesterol and membrane-associated sialic acid residue depletion or inhibition of cholesterol and ganglioside synthesis protected PC12 cells from A-induced toxicity. These results indicate the importance of A-membrane interactions in the mechanism of A toxicity. In addition, these results suggest that control of cellular cholesterol and/or ganglioside content may prove useful in the prevention or treatment of Alzheimer's disease.An important pathological hallmark of Alzheimer's disease (AD) 1 is the formation and progressive deposition of insoluble amyloid fibrils within the cerebral cortex (1). The key constituent of these amyloid deposits has been identified as a 39 -43-amino acid long polypeptide, -amyloid peptide (A), which is derived primarily from the proteolytic cleavage of a much larger amyloid precursor protein (2). Presenilin 1 and 2 are believed to be involved in the proteolytic processing of the A fragment (3-6). Evidence for the causative role of A in the pathogenesis of AD partly comes from genetic studies, which linked mutations in the amyloid precursor protein and in the presenilins to inheritable forms of AD (7-9). Further evidence originates from in vitro toxicity studies with synthetic A peptides, which have shown that A, in an aggregated state (fibril, protofibril, low molecular weight oligomer, or diffusible, nonfibrillar ligand), is toxic to neurons in culture (10 -17). Although it seems certain that A plays a role in neurotoxicity associated with AD, the molecular mechanism of A neurotoxicity remains unclear.Increasing evidence indicates that the neuronal cell membrane is important in the mechanism of A toxicity. Studies (18 -21) have indicated that membrane components such as cholesterol and gangliosides alter the affinity of A for phospholipid membranes. Once associated with the membranes, negatively charged phospholipids, cholesterol, and gangliosides have been shown to increase the -sheet content and/or rate of aggregation of A (19,(21)(22)(23)(24). Both in vivo and in vitro, alterations in soluble cholesterol and/or cholesterol biosynthesis have also been shown to affect the normal processing of amyloid precursor protein (25)(26)(27). In these studies, the inhibition of cholesterol synthesis led to decreased A formation (25,27). In...