I-C, Heyser CJ, et al. Appoptosin-mediated caspase cleavage of tau contributes to progressive supranuclear palsy pathogenesis. Neuron. 2015;87:963-975. This study recently published in Neuron by Yingjun Zhao and colleagues has revealed the link between progressive supranuclear palsy (PSP) and the single-nucleotide polymorphism (SNP) rs1768208. The exciting discovery uncovers new pathogenic mechanisms upstream in the cascade of tau aggregation and opens doors for new treatment approaches.Previous studies have laid important groundwork: In 2011, a genome-wide association study identified several new SNPs associated with PSP, including the T allele of rs1768208.1 Subsequently, the latter has been linked to other tauopathies, including corticobasal degeneration, 2 Alzheimer s disease (AD), 3 and tau-positive frontotemporal lobar degeneration. 4 Although located near the myelin-associated oligodendrocyte basic protein gene in chromosome 3, rs1768208 was found to have a major influence on the expression of SLC25A38 70 kb away.1 In 2012, Zhang and colleagues characterized SLC25A38 as a proapoptotic, and ß-amyloid precursor protein-interacting protein.According to these properties, SLC25A38 was designated appoptosin. Overexpression of appoptosin resulted in caspasedependent cell apoptosis and was associated with neuronal cell death in rodent models for AD and brain ischemia.5 In PSP and other tauopathies, intracellular aggregation of hyperphosphorylated tau is considered the immediate cause of neurodegeneration.But how does appoptosin influence tau pathology? This missing piece in the puzzle has now been revealed. In brief, the group of Yingjun Zhao demonstrated that appoptosin (1) induces caspase-3-mediated tau cleavage, (2) reduces the ability of tau to bind to microtubule, (3) promotes tau aggregation, (4) causes synaptic dysfunction in neuronal cells, and (5) induces PSP-like motor dysfunction in transgenic mutant tau mice. The susceptibility of the rs1768208 T allele to PSP was confirmed by genotyping of postmortem brain samples of PSP and control patients: A significantly higher incidence of the rs1768208 T allele in PSP (77%) was found, compared with controls (32%). In cases carrying the T allele, expression of appoptosin was higher than in non-T-allele PSP and controls. Levels of appoptosin, activated caspase-3, caspasecleaved c-tau fragment, and hyperphosphorylated tau were significantly increased in the frontal cortex of PSP brains. Furthermore, the authors found increased levels and caspase-3-cleaved tau in brains of patients with AD and tau-positive frontotemporal lobar degeneration. Appoptosin transduction of rat cortical neuronal cultures resulted in elevation of caspase-3 and c-tau fragments, disabled tau to bind to microtubule, and increased levels of insoluble tau. The functional effects of appoptosin on neurons were clearly induced by tau dysfunction, because synaptotoxic effects were absent in tau-deficient neurons, and appoptosin-induced motor dysfunction was present in mutant tau transgenic mice, ...