Neurofibrillary tangles (NFTs), which consist of highly phosphorylated tau, are hallmarks of neurodegenerative diseases including Alzheimer disease (AD). In neurodegenerative diseases, neuronal dysfunction due to neuronal loss and synaptic loss accompanies NFT formation, suggesting that a process associated with NFT formation may be involved in neuronal dysfunction. To clarify the relationship between the tau aggregation process and synapse and neuronal loss, we compared two lines of mice expressing human tau with or without an aggregation-prone P301L mutation. P301L tau transgenic (Tg) mice exhibited neuronal loss and produced sarcosyl-insoluble tau in old age but did not exhibit synaptic loss and memory impairment. By contrast, wild-type tau Tg mice neither exhibited neuronal loss nor produced sarcosyl-insoluble tau but did exhibit synaptic loss and memory impairment. Moreover, P301L tau was less phosphorylated than wild-type tau, suggesting that the tau phosphorylation state is involved in synaptic loss, whereas the tau aggregation state is involved in neuronal loss. Finally, increasing concentrations of insoluble tau aggregates leads to the formation of fibrillar tau, which causes NFTs to form.
NFTs2 are commonly observed in neurodegenerative disorders. Brain regions containing NFTs also exhibit neuronal loss. The rate of neuron loss is much greater than the rate of NFT formation, suggesting that NFT formation and neuronal death share a common mechanism (1, 2). This hypothesis is strongly supported by the discovery of tau gene mutations in individuals with frontotemporal dementia with parkinsonism linked to chromosome 17 (FTDP-17) (3, 4). A single tau gene mutation induces NFT formation and neuronal loss with 100% penetration. Moreover, overexpression of human FTDP-17 tau induces NFT formation, neuronal loss, and behavioral deficits in mice (5-12).Mice that overexpress P301L mutant tau under the regulation of a tetracycline-inducible promoter display age-related NFTs, neuronal death, and behavioral deficits (13,14). Although inhibiting mutant tau overexpression in these mice blocks neuronal death and improves memory, NFTs continue to form (13,15). This suggests that NFTs are not themselves toxic but, instead, that NFT formation and neuronal death and neuronal dysfunction share a common underlying mechanism.The P301L tau mutation is known as an "aggregation-prone mutation" in that individuals harboring this mutation produce mutant tau that readily aggregates (16 -18). The NFTs of one patient with an aggressive FTDP-17 phenotype consisted of only P301L mutant tau (19), indicating that P301L mutant tau itself may possess a toxic function by forming aggregated tau.The formation of tau fibrils is believed to involve three sequential steps (20,21). First, monomeric tau binds together to form oligomers that are soluble in sarcosyl solution. The structure of these oligomers, however, is not discernible under atomic force microscopy. Second, as soluble tau oligomers take on a -sheet structure, they form tau aggregat...