The microtubule-associated protein
tau (MAPT) has a critical
role
in the development and preservation of the nervous system. However,
tau’s dysfunction and accumulation in the human brain can lead
to several neurodegenerative diseases, such as Alzheimer’s
disease, Down’s syndrome, and frontotemporal dementia. The
microtubule binding (MTB) domain plays a significant, important role
in determining the tau’s pathophysiology, as the core of paired
helical filaments PHF6* (275VQIINK280) and PHF6
(306VQIVYK311) of R2 and R3 repeat units, respectively,
are formed in this region, which promotes tau aggregation. Post-translational
modifications, and in particular lysine acetylation at K280 of PHF6*
and K311 of PHF6, have been previously established to promote tau
misfolding and aggregation. However, the exact aggregation mechanism
is not known. In this study, we established an atomic-level nucleation-extension
mechanism of the separated aggregation of acetylated PHF6* and PHF6
hexapeptides, respectively, of tau. We show that the acetylation of
the lysine residues promotes the formation of β-sheet enriched
high-ordered oligomers. The Markov state model analysis of ac-PHF6*
and ac-PHF6 aggregation revealed the formation of an antiparallel
dimer nucleus which could be extended from both sides in a parallel
manner to form mixed-oriented and high-ordered oligomers. Our study
describes the detailed mechanism for acetylation-driven tau aggregation,
which provides valuable insights into the effect of post-translation
modification in altering the pathophysiology of tau hexapeptides.