The amyloid b-protein precursor (APP) of Alzheimer's disease (AD) is cleaved either by a-secretase to generate an N-terminally secreted fragment, or by b-and g-secretases to generate the b-amyloid protein (Ab). The accumulation of Ab in the brain is an important step in the pathogenesis of AD. Alternative mRNA splicing can generate isoforms of APP which contain a Kunitz protease inhibitor (KPI) domain. However, little is known about the physiological function of this domain. In the present study, the metabolic turnover of APP was examined in cultured chick sympathetic neurons. APP was labelled by incubating neurons for 5 h with [ 35 S]methionine and [ 35 S]cysteine. Intracellular labelled APP decayed in a biphasic pattern suggesting that trafficking occurs through two metabolic compartments. The half-lives for APP in each compartment were 1.5 and 5.7 h, respectively. A small fraction (10%) of the total APP was secreted into the culture medium where it was degraded with a half-life of 9 h. Studies using specific protease inhibitors demonstrated that this extracellular breakdown was due to cleavage by a trypsin-like serine protease that was secreted into the culture medium. Significantly, this protease was inhibited by a recombinant isoform of APP (sAPP 751 ), which contains a region homologous to the Kunitz protease inhibitor (KPI) domain. These results suggest that KPI forms of APP regulate extracellular cleavage of secreted APP by inhibiting the activity of a secreted APP-degrading protease.Keywords: Alzheimer; amyloid; protease; Kunitz protease inhibitor; proteolytic processing. [19,20].Alternative splicing of the APP mRNA generates three major proteins containing 695, 751 or 770 amino acid residues [3,21±23]. Isoforms of APP which possess 751 or 770 residues (APP 751 and APP 770 ) contain a domain that is homologous to the Kunitz family of protease inhibitors (KPI). The function of the KPI domain is unknown. However, KPI containing isoforms may be important in the pathogenesis of AD, as studies have shown that the expression of these isoforms is increased in AD [24,25]. KPI-containing isoforms are also increased following focal ischaemia in rat brain [26]. KPI-containing APP has been shown to inhibit serine proteases involved in the coagulation cascade, leading to the suggestion that it may act as an intracerebral anticoagulant [27±29].APP can be cleaved by b and g-secretases at the N-and C-terminus of the amyloid sequence to generate Ab [3], which is released from the cell and may be cleaved by an insulin-degrading enzyme [30]