Investigating the Role of the Amyloid Precursor Protein in the Pathogenesis of Alzheimer's Disease

Alzheimer's disease (AD) is the most prevalent neurodegenerative disorder characterized by a progressive loss of cognition. Histopathologically, AD is defined by the presence of two lesions, senile plaques (SP) and neurofibrillary tangles (NFT), which result from the accumulation and deposition of the amyloid-β peptide (Aβ) and the aggregation of hyperphosphorylated tau protein, respectively. Aβ is formed upon sequential cleavage of the amyloid precursor protein (APP) by β- and γ-secretases and is secreted extracellularly. The accumulation of extracellular Aβ is thought to initiate a pathogenic cascade resulting in synaptic dysfunction in neurons, followed by the their eventual demise through apoptosis. However, while Aβ has been shown to be increased in AD patients' brains, little is known about how the cleavage of APP and the subsequent generation of Aβ is influenced or if the cleavage process changes over time. Moreover, while the effects of Aβ on neurons are known, the exact mechanism remains unclear. Many have postulated that Aβ exerts its effects by binding a putative receptor, but the search for an Aβ receptor has so far remained inconclusive. Interestingly, one of the proposed potential receptor for Aβ is APP itself. In this model, soluble oligomeric Aβ binds cell-surface APP, inducing its dimerization leading to all the downstream effects of Aβ in cells -- e.g. cell death and/or synaptic dysfunction. Moreover, it has been proposed that Aβ can promote its own production in neurons, thereby initiating a pathogenic loop. However, isolating Aβ-induced APP signaling has remained challenging due to the promiscuous nature of Aβ binding. To work around this problem, we used an antibody-mediated approach to artificially trigger the dimerization of cell-surface APP in cells. We found that dimerization of APP could recapitulate all of the effects of oligomeric Aβ in hippocampal neurons, triggering neuronal death at high concentrations and interfering with normal synaptic functions low concentrations. We also found that dimerization of APP is sufficient to promote the amyloidogenic pathway, by increasing levels of the β-secretase BACE1, resulting in increased Aβ production. Finally, we found that dimerization of APP triggered caspase-dependent cleavage of APP and the formation of a second neurotoxic fragment, termed C31, which also mimics the effects of Aβ in hippocampal neurons. Taken together, our data provides support for the occurrence of a positive pathogenic feedback loop involving Aβ, APP and C31 in neurons.