A role for Cu 2؉ ions in Alzheimer disease is often disputed, as it is believed that Cu 2؉ ions only promote nontoxic amorphous aggregates of amyloid- (A). In contrast with currently held opinion, we show that the presence of substoichiometric levels of Cu 2؉ ions in fact doubles the rate of production of amyloid fibers, accelerating both the nucleation and elongation of fiber formation. We suggest that binding of Cu 2؉ ions at a physiological pH causes A to approach its isoelectric point, thus inducing self-association and fiber formation. We further show that Cu 2؉ ions bound to A are consistently more toxic to neuronal cells than A in the absence of Cu 2؉ ions, whereas Cu 2؉ ions in the absence of A are not cytotoxic. The degree of Cu-A cytotoxicity correlates with the levels of Cu 2؉ ions that accelerate fiber formation. We note the effect appears to be specific for Cu 2؉ ions as Zn 2؉ ions inhibit the formation of fibers. An active role for Cu 2؉ ions in accelerating fiber formation and promoting cell death suggests impaired copper homeostasis may be a risk factor in Alzheimer disease.
Alzheimer disease (AD)2 is characterized by extracellular amyloid plaques, composed predominantly of fibrillar amyloid- peptide (A), a 39 -43-residue peptide. Genetic alterations underlying familial AD are associated with mutations or increased production of A, indicating that A plays a central role in the disease (1).A notable characteristic of AD is altered metal ion concentrations in the brain and disrupted metal ion homeostasis (2). Cu 2ϩ ions are found concentrated within senile plaques of AD patients directly bound to A (3-5). Recent in vivo studies using a Drosophila model of AD have shown that impaired copper homeostasis enhances the toxic effects of A (6). Furthermore, copper in a cholesterol high diet induces amyloid plaques and learning deficits in a rabbit model of AD (7). Other in vivo studies have shown that copper homeostasis can influence AD pathology. In contrast to the Drosophila model, transgenic mice have shown a reduced AD pathology with increased intracellular copper levels (8 -10).Although studies of A neurotoxicity suggest that small diffusible oligomers, rather than mature amyloid fibers, are the more toxic form (11, 12), there remains strong evidence suggesting that amyloid plaques, or possibly intermediates of the fibrils, are critical in neuronal toxicity (13,14). A oligomers may be precursors of fiber formation and may also arise from fiber fragmentation. Alternatively, oligomers may be in competition with fiber formation. Both possibilities require the self-association of monomeric A, and thus factors that affect fibrillization will also influence oligomer generation.The mechanism by which A is toxic is hotly debated (11, 15). It has been proposed that A can form ion channels or pores or can thin the membrane, all of which will cause membrane leakage and loss of cellular Ca 2ϩ ion homeostasis. One popular hypothesis is that the membrane integrity is compromised by lipid peroxida...