Biochemical, epidemiological, and genetic findings demonstrate a link between cholesterol levels, processing of the amyloid precursor protein (APP), and Alzheimer's disease. In the present report, we identify the ␣-secretase ADAM 10 (a disintegrin and metalloprotease) as a major target of the cholesterol effects on APP metabolism. Treatment of various peripheral and neural cell lines with either the cholesterol-extracting agent methyl--cyclodextrin or the hydroxymethyl glutaryl-CoA reductase inhibitor lovastatin resulted in a drastic increase of secreted ␣-secretase cleaved soluble APP. This strong stimulatory effect was in the range obtained with phorbol esters and was further increased in cells overexpressing ADAM 10. In cells overexpressing APP, the increase of ␣-secretase activity resulted in a decreased secretion of A peptides. Several mechanisms were elucidated as being the basis of enhanced ␣-secretase activity: increased membrane fluidity and impaired internalization of APP were responsible for the effect observed with methyl--cyclodextrin; treatment with lovastatin resulted in higher expression of the ␣-secretase ADAM 10. Our results demonstrate that cholesterol reduction promotes the nonamyloidogenic ␣-secretase pathway and the formation of neuroprotective ␣-secretase cleaved soluble APP by several mechanisms and suggest approaches to prevention of or therapy for Alzheimer's disease.A myloid- peptides (A), the principal proteinaceous components of amyloid plaques in brains of Alzheimer's disease (AD) patients, are derived from proteolytic cleavage of the amyloid precursor protein (APP), a type I integral membrane protein that is ubiquitously expressed. Both during and after its transport through the secretory pathway to the surface of cultured cells, a fraction of APP molecules undergoes specific endoproteolytic cleavage, most frequently by a scission between amino acids 16 and 17 of the A region (1). This principal secretory cleavage is effected by (a) protease(s) designated as ␣-secretase(s). Soluble N-terminal APP fragments of 105-125 kDa are released into vesicle lumens and from the cell surface; similar species are readily detected in human plasma and cerebrospinal fluid (2). Recently, evidence has been provided that members of the ADAM family (a disintegrin and metalloprotease) act as ␣-secretases (3-5). For ADAM 10, basal and protein kinase C-stimulated ␣-secretase activity and many properties expected for the proteolytic processing of APP have been found (4).The stimulation of ␣-secretase activity and an increase of ␣-secretase cleaved soluble APP (APPs␣) might be beneficial for the treatment of AD for several reasons. In principle, proteolytic cleavage of APP within the A sequence precludes the formation of the amyloid peptides derived from alternative proteolysis of APP with the -secretase cleaving at the N terminus and the ␥-secretase(s) at the C terminus of A peptides (for a recent review of APP processing, see ref. 6). On the other hand, APPs␣ has trophic effects on cerebral neuro...