The mechanism of neurodegeneration caused by -amyloid in Alzheimer disease is controversial. Neuronal toxicity is exerted mostly by various species of soluble -amyloid oligomers that differ in their N-and C-terminal domains. However, abundant accumulation of -amyloid also occurs in the brains of cognitively normal elderly people, in the absence of obvious neuronal dysfunction. We postulated that neuronal toxicity depends on the molecular composition, rather than the amount, of the soluble -amyloid oligomers. Here we show that soluble -amyloid aggregates that accumulate in Alzheimer disease are different from those of normal aging in regard to the composition as well as the aggregation and toxicity properties.A series of evidence indicates that progressive cerebral accumulation of -amyloid (A), 2 a proteolytic product of transmembrane protein APP, is the primary pathogenic event of Alzheimer disease (AD) (1). Recent clues indicate that small, soluble A aggregates produce more severe synaptic dysfunction and neuronal damage than do A polymers (2-5). This behavior is common to all known pathogenic and nonpathogenic amyloidogenic peptides (6, 7). Soluble A is detectable early in the cerebral cortex of subjects at risk for AD pathology, several years before the formation and deposition of amyloid fibrils (8). Hence, the analysis of soluble A in brain tissue allows the characterization of the toxic form of the peptide.A strong argument against the amyloid hypothesis is the abundant and constant deposition of A in the brains of elderly subjects, in the absence of signs of neuronal degeneration and dementia (9 -11). The reasons for the absence of pathogenic effect exerted by A in normal aging are unknown. The issue has important therapeutic implications, because the major strategies to prevent and cure AD are focused on halting A accumulation (12).In brains from Alzheimer disease (AD) and Down syndrome patients, three major species of soluble A have been identified by mass spectrometry: the full-length form, A1-42, which has a relative molecular mass of 4.5 kDa, and two N-terminal peptides truncated at residue 3 (A3-42) and residue 11 (A11-42) with relative molecular masses of 4.2 and 3.5 kDa, respectively (13, 14). The 4.2-and 3.5-kDa bands are more prominent in familial AD carrying presenilin 1 mutations than in sporadic AD, suggesting that the ratio of soluble A species may dictate the toxicity of the aggregates (15).We predicted that the composition of soluble A underlies the different effect exerted by the molecule in AD and in normal aging. To investigate this hypothesis, we studied the composition and properties of aggregation and toxicity as well as the damage produced on artificial membranes of soluble A, comparing these areas in sporadic AD and cognitively normal elderly subjects with abundant amyloid plaques in cerebral cortex.
MATERIALS AND METHODSTissues-We used frozen blocks and formalin-fixed sections of frontal cortex from 14 cases with late onset sporadic AD (mean age at death 80 Ϯ ...