The formation of Aβ amyloid fibrils is a neuropathological hallmark of Alzheimer’s disease and cerebral amyloid angiopathy. However, the structure of Aβ amyloid fibrils from brain tissue is poorly understood. Here we report the purification of Aβ amyloid fibrils from meningeal Alzheimer’s brain tissue and their structural analysis with cryo-electron microscopy. We show that these fibrils are polymorphic but consist of similarly structured protofilaments. Brain derived Aβ amyloid fibrils are right-hand twisted and their peptide fold differs sharply from previously analyzed Aβ fibrils that were formed in vitro. These data underscore the importance to use patient-derived amyloid fibrils when investigating the structural basis of the disease.

We performed mass-per-length (MPL) measurements and electron cryomicroscopy (cryo-EM) with 3D reconstruction on an A␤(1-42) amyloid fibril morphology formed under physiological pH conditions. The data show that the examined A␤(1-42) fibril morphology has only one protofilament, although two protofilaments were observed with a previously studied A␤(1-40) fibril. The latter fibril was resolved at 8 Å resolution showing pairs of ␤-sheets at the cores of the two protofilaments making up a fibril. Detailed comparison of the A␤(1-42) and A␤(1-40) fibril structures reveals that they share an axial twofold symmetry and a similar protofilament structure. Furthermore, the MPL data indicate that the protofilaments of the examined A␤(1-40) and A␤(1-42) fibrils have the same number of A␤ molecules per cross-␤ repeat. Based on this data and the previously studied A␤(1-40) fibril structure, we describe a model for the arrangement of peptides within the A␤(1-42) fibril.Alzheimer's disease ͉ electron microscopy ͉ prion ͉ protein folding A myloid fibrils are fibrillar polypeptide aggregates that consist of a cross-␤ structure (1, 2). They accumulate inside the human body in the course of aging and are associated with several debilitating conditions such as Alzheimer disease (AD) (1, 2). AD amyloid fibrils are formed from A␤ peptide, which occurs in isoforms of different length. The 40-residue peptide A␤(1-40) represents the most abundant A␤ isoform in the brain (3), while the 42-residue A␤(1-42) shows a significant increase with certain forms of AD (4). A␤ amyloid fibrils have been analyzed with various biophysical and biochemical techniques, such as solid-state NMR (NMR) spectroscopy, solution state NMR spectroscopy coupled with hydrogen/deuterium exchange, or mutagenesis (5-8). These analyses have provided a wealth of information about specific structural details of the peptide in the fibril, for example dihedral torsional angles, protection factors or distances between specific atoms. Atomic models for A␤ peptides and their assembly in different amyloid fibrils have been constructed based on such data (6, 8-10) but these models have not been confirmed by more direct 3D imaging methods.A hallmark of A␤ amyloid fibrils is their substantial polymorphism (11)(12)(13)(14). We have recently shown by transmission electron cryomicroscopy (cryo-EM) and 3D reconstruction that A␤(1-40) fibrils form a range of morphologies with almost continuously altering structural properties (13). Despite their different morphologies, the cross-sectional areas of the reconstructed fibrils were similar. The study suggested that the observed polymorphism may be the result of different packing of protofilaments that have the same basic structure. To obtain an image of a fibril at higher resolution, we established growth conditions that promote a specific A␤(1-40) fibril morphology (15) and selected fibrils with this morphology from electron micrographs for further processing. Using newly developed image processing tools (16), we obtained a 3D image at 8 Å...

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PurposeGallium-68 (Ga-68)-labeled tracers for imaging expression of the prostate-specific membrane antigen (PSMA) such as the [68Ga]Ga-PSMA-HBED-CC have already demonstrated high potential for the detection of recurrent prostate cancer. However, compared to Ga-68, a labeling with fluorine-18 (F-18) would offer advantages with respect to availability, production amount, and image resolution. [18F]DCFPyL is a promising F-18-labeled candidate for PSMA-positron emission tomography (PET) imaging that has been recently introduced. In the current study, we aimed to compare [68Ga]Ga-PSMA-HBED-CC and [18F]DCFPyL for clinical use in biochemically relapsed prostate cancer.ProceduresIn 14 selected patients with PSA relapse of prostate cancer, [18F]DCFPyL PET/X-ray computed tomography (CT) was performed in addition to [68Ga]Ga-PSMA-HBED-CC PET/CT. A systematic comparison was carried out between results obtained with both tracers with regard to the number of detected PSMA-positive lesions, the standardized uptake value (SUV)max and the lesion to background ratios.ResultsAll suspicious lesions identified by [68Ga]Ga-PSMA-HBED-CC were also detected with [18F]DCFPyL. In three patients, additional lesions were observed using [18F]DCFPyL PET/CT. The mean SUVmax in the concordant [18F]DCFPyL PSMA-positive lesions was significantly higher as compared to [68Ga]Ga-PSMA-HBED-CC (14.5 vs. 12.2, p = 0.028, n = 15). The mean tumor to background ratios (n = 15) were significantly higher for [18F]DCFPyL compared to [68Ga]Ga-PSMA-HBED-CC using kidney, spleen, or parotid as reference organs (p = 0.006, p = 0.002, p = 0.008), but no significant differences were found using the liver (p = 0.167) or the mediastinum (p = 0.363) as reference organs.Conclusion[18F]DCFPyL PET/CT provided a high image quality and visualized small prostate lesions with excellent sensitivity. [18F]DCFPyL represents a highly promising alternative to [68Ga]Ga-PSMA-HBED-CC for PSMA-PET/CT imaging in relapsed prostate cancer.

Among patients referred for their first x-ray coronary angiogram, three-dimensional coronary magnetic resonance angiography allows for the accurate detection of coronary artery disease of the proximal and middle segments. This noninvasive approach reliably identifies (or rules out) left main coronary artery or three-vessel disease.

Alzheimer's disease (AD) is a fatal neurodegenerative disorder in humans and the main cause of dementia in aging societies. The disease is characterized by the aberrant formation of β-amyloid (Aβ) peptide oligomers and fibrils. These structures may damage the brain and give rise to cerebral amyloid angiopathy, neuronal dysfunction, and cellular toxicity. Although the connection between AD and Aβ fibrillation is extensively documented, much is still unknown about the formation of these Aβ aggregates and their structures at the molecular level. Here, we combined electron cryomicroscopy, 3D reconstruction, and integrative structural modeling methods to determine the molecular architecture of a fibril formed by Aβ(1-42), a particularly pathogenic variant of Aβ peptide. Our model reveals that the individual layers of the Aβ fibril are formed by peptide dimers with face-to-face packing. The two peptides forming the dimer possess identical tilde-shaped conformations and interact with each other by packing of their hydrophobic C-terminal β-strands. The peptide C termini are located close to the main fibril axis, where they produce a hydrophobic core and are surrounded by the structurally more flexible and charged segments of the peptide N termini. The observed molecular architecture is compatible with the general chemical properties of Aβ peptide and provides a structural basis for various biological observations that illuminate the molecular underpinnings of AD. Moreover, the structure provides direct evidence for a steric zipper within a fibril formed by full-length Aβ peptide.protein aggregation | protein folding | cross-β | Frealix

Several studies outlined the sensitivity of Ga-labeled PET tracers against the prostate-specific membrane antigen (PSMA) for localization of relapsed prostate cancer in patients with renewed increase in the prostate-specific antigen (PSA), commonly referred to as biochemical recurrence. Labeling of PSMA tracers withF offers numerous advantages, including improved image resolution, longer half-life, and increased production yields. The aim of this study was to assess the PSA-stratified performance of the F-labeled PSMA tracerF-DCFPyL and the Ga-labeled referenceGa-PSMA-HBED-CC. We examined 191 consecutive patients with biochemical recurrence according to standard acquisition protocols usingF-DCFPyL ( = 62, 269.8 MBq, PET scan at 120 min after injection) or Ga-PSMA-HBED-CC ( = 129, 158.9 MBq, 60 min after injection). We determined PSA-stratified sensitivity rates for both tracers and corrected our calculations for Gleason scores using iterative matched-pair analyses. As an orthogonal validation, we directly compared tracer distribution patterns in a separate cohort of 25 patients, sequentially examined with both tracers. After prostatectomy ( = 106), the sensitivity of both tracers was significantly associated with absolute PSA levels ( = 4.3 × 10). Sensitivity increased abruptly, when PSA values exceeded 0.5 μg/L ( = 2.4 × 10). For a PSA less than 3.5 μg/L, most relapses were diagnosed at a still limited stage ( = 3.4 × 10). For a PSA of 0.5-3.5 μg/L, PSA-stratified sensitivity was 88% (15/17) for F-DCFPyL and 66% (23/35) forGa-PSMA-HBED-CC. This significant difference was preserved in the Gleason-matched-pair analysis. Outside of this range, sensitivity was comparably low (PSA < 0.5 μg/L) or high (PSA > 3.5 μg/L). After radiotherapy ( = 85), tracer sensitivity was largely PSA-independent. In the 25 patients examined with both tracers, distribution patterns of F-DCFPyL andGa-PSMA-HBED-CC were strongly comparable ( = 2.71 × 10). However, in 36% of the PSMA-positive patients we detected additional lesions on the F-DCFPyL scan ( = 3.7 × 10). Our data suggest thatF-DCFPyL is noninferior to Ga-PSMA-HBED-CC, while offering the advantages ofF labeling. Our results indicate that imaging with F-DCFPyL may even exhibit improved sensitivity in localizing relapsed tumors after prostatectomy for moderately increased PSA levels. Although the standard acquisition protocols, used forF-DCFPyL and Ga-PSMA-HBED-CC in this study, stipulate different activity doses and tracer uptake times after injection, our findings provide a promising rationale for validation ofF-DCFPyL in future prospective trials.

Systemic AA amyloidosis is a worldwide occurring protein misfolding disease of humans and animals. It arises from the formation of amyloid fibrils from the acute phase protein serum amyloid A. Here, we report the purification and electron cryo-microscopy analysis of amyloid fibrils from a mouse and a human patient with systemic AA amyloidosis. The obtained resolutions are 3.0 Å and 2.7 Å for the murine and human fibril, respectively. The two fibrils differ in fundamental properties, such as presence of right-hand or left-hand twisted cross-β sheets and overall fold of the fibril proteins. Yet, both proteins adopt highly similar β-arch conformations within the N-terminal ~21 residues. Our data demonstrate the importance of the fibril protein N-terminus for the stability of the analyzed amyloid fibril morphologies and suggest strategies of combating this disease by interfering with specific fibril polymorphs.