Introduction
The conspicuous phenotypic variability of AD
3The abbreviations used are:
AD
Alzheimer’s disease
q- and h-FTAA
tetra- and heptameric formyl-thiophene acetic acid, respectively
LCO
luminescent conjugated oligothiophene
CU-AP
cognitively unaffected, amyloid-positive
Aβ
amyloid-β
s-AD
sporadic AD
LMPC
laser microdissection with pressure catapulting
IP
immunoprecipitation
CR
Congo red
pE
pyroglutamate
IMS
imaging mass spectrometry
CAA
cerebral amyloid angiopathy
CSF
cerebrospinal fluid
APP
amyloid precursor protein
AUC
area under curve.
remains poorly understood, which makes it challenging to establish a common molecular basis of AD pathology. AD heterogeneity was previously linked to molecular and morphological traits of individual β-amyloid (Aβ) deposits (
1- Huang T.H.
- Yang D.S.
- Fraser P.E.
- Chakrabartty A.
Alternate aggregation pathways of the Alzheimer β-amyloid peptide: an in vitro model of preamyloid.
,
2- Jiang D.
- Rauda I.
- Han S.
- Chen S.
- Zhou F.
Aggregation pathways of the amyloid β(1–42) peptide depend on its colloidal stability and ordered β-sheet stacking.
). The formation of extracellular Aβ plaques has been identified as a major pathological hallmark of AD and a critical trigger of AD pathogenesis (
3The amyloid cascade hypothesis: are we poised for success or failure?.
). According to the amyloid cascade hypothesis, it was suggested that the phenotypic heterogeneity of AD pathology is induced by polymorphic Aβ fibrils that precipitate as heterogeneous plaque pathology, including (formation of) diffuse plaques and cored, mature plaques (
4- Dickson T.C.
- Vickers J.C.
The morphological phenotype of β-amyloid plaques and associated neuritic changes in Alzheimer’s disease.
5- Ikeda S.
- Allsop D.
- Glenner G.G.
Morphology and distribution of plaque and related deposits in the brains of Alzheimer’s disease and control cases: an immunohistochemical study using amyloid β-protein antibody.
,
6- Thal D.R.
- Capetillo-Zarate E.
- Del Tredici K.
- Braak H.
The development of amyloid beta protein deposits in the aged brain.
,
7- Yamaguchi H.
- Hirai S.
- Morimatsu M.
- Shoji M.
- Ihara Y.
A variety of cerebral amyloid deposits in the brains of the Alzheimer-type dementia demonstrated by β protein immunostaining.
8- Tagliavini F.
- Giaccone G.
- Frangione B.
- Bugiani O.
Preamyloid deposits in the cerebral cortex of patients with Alzheimer's disease and nondemented individuals.
).
Morphologic heterogeneity of Aβ plaques has been linked to the structural and chemical diversity of amyloid fibrils that consist of different Aβ peptide isoforms (
9- Portelius E.
- Bogdanovic N.
- Gustavsson M.K.
- Volkmann I.
- Brinkmalm G.
- Zetterberg H.
- Winblad B.
- Blennow K.
Mass spectrometric characterization of brain amyloid β isoform signatures in familial and sporadic Alzheimer’s disease.
). These polymorphic fibrils are formed through structural transitions of different Aβ peptide isoforms during the aggregation process (
1- Huang T.H.
- Yang D.S.
- Fraser P.E.
- Chakrabartty A.
Alternate aggregation pathways of the Alzheimer β-amyloid peptide: an in vitro model of preamyloid.
,
2- Jiang D.
- Rauda I.
- Han S.
- Chen S.
- Zhou F.
Aggregation pathways of the amyloid β(1–42) peptide depend on its colloidal stability and ordered β-sheet stacking.
).
Plaque polymorphism, attributed to differing fibrillary components, has been shown to correspond to distinct spectral emission upon luminescent conjugated oligothiophene (LCO)-based fluorescent amyloid staining (
10- Nyström S.
- Psonka-Antonczyk K.M.
- Ellingsen P.G.
- Johansson L.B.
- Reitan N.
- Handrick S.
- Prokop S.
- Heppner F.L.
- Wegenast-Braun B.M.
- Jucker M.
- Lindgren M.
- Stokke B.T.
- Hammarström P.
- Nilsson K.P.
Evidence for age-dependent in vivo conformational rearrangement within Aβ amyloid deposits.
,
11- Klingstedt T.
- Blechschmidt C.
- Nogalska A.
- Prokop S.
- Häggqvist B.
- Danielsson O.
- Engel W.K.
- Askanas V.
- Heppner F.L.
- Nilsson K.P.
Luminescent conjugated oligothiophenes for sensitive fluorescent assignment of protein inclusion bodies.
12- Psonka-Antonczyk K.M.
- Hammarström P.
- Johansson L.B.
- Lindgren M.
- Stokke B.T.
- Nilsson K.P.
- Nyström S.
Nanoscale structure and spectroscopic probing of Aβ1–40 fibril bundle formation.
). Specifically, plaque diversity, as delineated by differential amyloid dye staining, was previously attributed to distinct amyloid traits that were found to be specific for different familial forms of AD as well as in genetic mouse models of AD carrying the same mutations (
13- Rasmussen J.
- Mahler J.
- Beschorner N.
- Kaeser S.A.
- Häsler L.M.
- Baumann F.
- Nyström S.
- Portelius E.
- Blennow K.
- Lashley T.
- Fox N.C.
- Sepulveda-Falla D.
- Glatzel M.
- Oblak A.L.
- Ghetti B.
- et al.
Amyloid polymorphisms constitute distinct clouds of conformational variants in different etiological subtypes of Alzheimer’s disease.
,
14- Watts J.C.
- Condello C.
- Stöhr J.
- Oehler A.
- Lee J.
- DeArmond S.J.
- Lannfelt L.
- Ingelsson M.
- Giles K.
- Prusiner S.B.
Serial propagation of distinct strains of Aβ prions from Alzheimer’s disease patients.
15- Condello C.
- Lemmin T.
- Stöhr J.
- Nick M.
- Wu Y.
- Maxwell A.M.
- Watts J.C.
- Caro C.D.
- Oehler A.
- Keene C.D.
- Bird T.D.
- van Duinen S.G.
- Lannfelt L.
- Ingelsson M.
- Graff C.
- Giles K.
- DeGrado W.F.
- Prusiner S.B.
Structural heterogeneity and intersubject variability of Aβ in familial and sporadic Alzheimer’s disease.
). On the histopathological level, this comprised varying patterns of both diffuse and cored Aβ plaque pathologies (
16- McGowan E.
- Pickford F.
- Kim J.
- Onstead L.
- Eriksen J.
- Yu C.
- Skipper L.
- Murphy M.P.
- Beard J.
- Das P.
- Jansen K.
- DeLucia M.
- Lin W.L.
- Dolios G.
- Wang R.
- et al.
Aβ42 is essential for parenchymal and vascular amyloid deposition in mice.
17- Lendel C.
- Bjerring M.
- Dubnovitsky A.
- Kelly R.T.
- Filippov A.
- Antzutkin O.N.
- Nielsen N.C.
- Härd T.
A hexameric peptide barrel as building block of amyloid-β protofibrils.
,
18- Bitan G.
- Kirkitadze M.D.
- Lomakin A.
- Vollers S.S.
- Benedek G.B.
- Teplow D.B.
Amyloid β-protein (Aβ) assembly: Aβ40 and Aβ42 oligomerize through distinct pathways.
19- Esbjörner E.K.
- Chan F.
- Rees E.
- Erdelyi M.
- Luheshi L.M.
- Bertoncini C.W.
- Kaminski C.F.
- Dobson C.M.
- Kaminski Schierle G.S.
Direct observations of amyloid β self-assembly in live cells provide insights into differences in the kinetics of Aβ(1–40) and Aβ(1–42) aggregation.
). Importantly, predominantly diffuse Aβ plaque pathology with almost no cored plaques has also been identified in cognitively unaffected amyloid-positive (CU-AP) individuals (
20- Dickson D.W.
- Crystal H.A.
- Mattiace L.A.
- Masur D.M.
- Blau A.D.
- Davies P.
- Yen S.H.
- Aronson M.K.
Identification of normal and pathological aging in prospectively studied nondemented elderly humans.
,
21- Jack Jr., C.R.
- Bennett D.A.
- Blennow K.
- Carrillo M.C.
- Dunn B.
- Haeberlein S.B.
- Holtzman D.M.
- Jagust W.
- Jessen F.
- Karlawish J.
- Liu E.
- Molinuevo J.L.
- Montine T.
- Phelps C.
- Rankin K.P.
- et al.
NIA-AA research framework: toward a biological definition of Alzheimer's disease.
). This suggests that both the differing Aβ plaque morphotypes and also molecular polymorphism at the Aβ fibril level and the associated Aβ peptide isoforms are of importance for explaining the heterogeneity of AD pathology. Whereas previous efforts have established that phenotypic heterogeneity of AD subtypes is reflected in morphological traits of individual plaque structures, associated biochemical characteristics, including Aβ peptide pattern, could not be delineated. We hypothesize that Aβ plaque polymorphism is associated with a plaque-specific Aβ peptide truncation pattern.
A major limitation in delineating amyloid pathology has been the lack of imaging techniques to concomitantly acquire chemical and structural information of individual Aβ aggregates. To test our hypothesis, we therefore developed a multimodal chemical imaging paradigm for delineating plaque polymorphism and the associated Aβ peptide signatures in post-mortem human brain from sporadic AD (s-AD) and CU-AP individuals as well as in a transgenic AD mouse model (tgAPP
SWE) (
22- Lord A.
- Kalimo H.
- Eckman C.
- Zhang X.-Q.
- Lannfelt L.
- Nilsson L.N.G.
The Arctic Alzheimer mutation facilitates early intraneuronal Aβ aggregation and senile plaque formation in transgenic mice.
).
The results obtained here provide evidence for a relationship between Aβ peptide species ratio and Aβ plaque morphotypes (diffuse and cored), as indicated by conformational characteristics of Aβ plaques and the underlying peptide aggregates. Furthermore, as revealed by experiments in transgenic tgAPPSWE mice, such structural transition of the fibrils underlying those Aβ plaques likely reflects plaque maturation.
Discussion
In this study, we investigated whether structural polymorphism of Aβ plaque morphotypes is associated with distinct Aβ chemistry. Our results show that cored plaques in s-AD are characterized by deposition of Aβ1–40, whereas diffuse plaques in both s-AD and CU-AP are characterized by deposition of Aβ1–42. Further, our data show that diffuse plaques in s-AD show increased levels of pyroglutamate-modified N-terminally truncated Aβ1–42 species (N-pyro-E-Aβ; AβpE3–42, AβpE11–42) as compared with diffuse plaques in CU-AP. Imaging MS identified a specific Aβ1–40 localization to the center of cored plaques, suggesting that Aβ1–40 is associated with mature amyloid structures and dense fibrils, respectively, within cored plaques in s-AD. In contrast, diffuse areas of cored deposits as well as diffuse plaques in both s-AD and CU-AP were largely composed of Aβ1–42. The corresponding pyro-E peptides AβpE3–42 and AβpE11–42 localized to diffuse structures as well.
Because plaques in CU-AP show primarily a diffuse morphology, these results suggest that full-length Aβ1–42, while being indicative of general amyloidosis, is not the primary neurochemical trait associated with Aβ pathogenicity and toxicity in AD.
These findings appear to stand in contrast to the current perception that Aβ1–42 is the most relevant Aβ species associated with AD pathogenesis as suggested by CSF biomarker findings, where decreased Aβ1–42 levels, but not Aβ1–40, point toward brain wide accumulation of Aβ1–42 (
33- Blennow K.
- Hampel H.
- Weiner M.
- Zetterberg H.
Cerebrospinal fluid and plasma biomarkers in Alzheimer disease.
,
34- Fagan A.M.
- Mintun M.A.
- Mach R.H.
- Lee S.Y.
- Dence C.S.
- Shah A.R.
- LaRossa G.N.
- Spinner M.L.
- Klunk W.E.
- Mathis C.A.
- DeKosky S.T.
- Morris J.C.
- Holtzman D.M.
Inverse relation between in vivo amyloid imaging load and cerebrospinal fluid Aβ42 in humans.
35- Strozyk D.
- Blennow K.
- White L.R.
- Launer L.J.
CSF Aβ42 levels correlate with amyloid-neuropathology in a population-based autopsy study.
).
Plaque pathology in CU-AP with diffuse Aβ deposits could therefore represent prodromal AD pathology that, given enough time, would progress toward formation of mature, cored amyloid plaques, as observed here and also previously reported for tgAPP
SWE (
23- Nilsson K.P.
- Aslund A.
- Berg I.
- Nyström S.
- Konradsson P.
- Herland A.
- Inganäs O.
- Stabo-Eeg F.
- Lindgren M.
- Westermark G.T.
- Lannfelt L.
- Nilsson L.N.
- Hammarström P.
Imaging distinct conformational states of amyloid-β fibrils in Alzheimer’s disease using novel luminescent probes.
) as well as APP23 and APP/PS1 mice (
10- Nyström S.
- Psonka-Antonczyk K.M.
- Ellingsen P.G.
- Johansson L.B.
- Reitan N.
- Handrick S.
- Prokop S.
- Heppner F.L.
- Wegenast-Braun B.M.
- Jucker M.
- Lindgren M.
- Stokke B.T.
- Hammarström P.
- Nilsson K.P.
Evidence for age-dependent in vivo conformational rearrangement within Aβ amyloid deposits.
). Our data on both human and mouse samples suggest that this maturation and core formation involve deposition of Aβ1–40 at the core.
Indeed, previous investigations on
in situ Aβ quantification showed 20-fold higher levels of fibrillar Aβ1–40 and only 2-fold higher Aβ1–42 levels in brain tissue from AD patients, as compared with CU-AP patients (
36- Wang J.
- Dickson D.W.
- Trojanowski J.Q.
- Lee V.M.
The levels of soluble versus insoluble brain Aβ distinguish Alzheimer’s disease from normal and pathologic aging.
,
37- Mori H.
- Takio K.
- Ogawara M.
- Selkoe D.J.
Mass spectrometry of purified amyloid β protein in Alzheimer’s disease.
). Further, in immunohistochemistry-based studies, Aβ1–40 was suggested to be associated with cored plaque formation in s-AD along with predominant Aβ1–42 staining of diffuse plaques both in AD and CU-AP (
38- Fukumoto H.
- Asami-Odaka A.
- Suzuki N.
- Iwatsubo T.
Association of Aβ40-positive senile plaques with microglial cells in the brains of patients with Alzheimer’s disease and in non-demented aged individuals.
). Whereas pronounced CAA formation, characterized by predominant deposition of Aβ1–40, was shown to result in decreased CSF levels of Aβ1–40 in patients with severe CAA (
39- Verbeek M.M.
- Kremer B.P.
- Rikkert M.O.
- Van Domburg P.H.
- Skehan M.E.
- Greenberg S.M.
Cerebrospinal fluid amyloid β(40) is decreased in cerebral amyloid angiopathy.
), no such results have been reported for AD-associated Aβ plaque pathology.
One could therefore speculate that the effect of this plaque-specific Aβ1–40 deposition is difficult to detect in CSF. Presumably, this is due to the general high abundance of Aβ1–40 in the brain, where the change in equilibrium of deposited and soluble Aβ1–40 as a consequence of plaque maturation (and Aβ1–40 deposition) is too minor to be reflected in the periphery.
An increase of Aβ1–42 in the brain, as indicated by decreased CSF levels, points to a general increased plaque load irrespective of plaque morphology and can be explained with Aβ1–42 being spherically accumulated in all plaques, including cored plaques, and thereby accounts for a significantly larger part of the plaque volume. Indeed, by comparing relative values, an increase in Aβ1–40/Aβ1–42 ratio seems to originate from increased Aβ1–40. Because Aβ1–40 is confined to the core structures that are smaller in volume relative to the total plaque volume, the amount may be underestimated by histological, antibody-based staining techniques. This is also consistent with Western blotting–based results reported on laser-microdissected plaques in s-AD, CU-AP, and tgAPP/PS2 mice, which showed that cored and diffuse plaques were found to contain predominantly Aβ1–42, whereas the Aβ1–40/Aβ1–42 ratio was higher in cored plaques as compared with diffuse plaques owing to a higher content of Aβ1–40 (
40- Güntert A.
- Döbeli H.
- Bohrmann B.
High sensitivity analysis of amyloid-β peptide composition in amyloid deposits from human and PS2APP mouse brain.
).
In line with this, our observations in tgAPP
SWE mice show an increased q-FTAA–staining pattern and Aβ1–40/Aβ1–42 ratio in cored plaques compared with diffuse plaques, which was demonstrated with LCO/LMPC and IP-MS as well as with imaging MS. These data are supported by previous, immunohistochemistry-based studies on plaque polymorphism in transgenic mice that demonstrated a prominent Aβx-40 immunoreactivity within plaque cores, whereas Aβx-42 was found to stain mostly the radial periphery of cored plaques as well as diffuse deposits (
25- Philipson O.
- Hammarström P.
- Nilsson K.P.
- Portelius E.
- Olofsson T.
- Ingelsson M.
- Hyman B.T.
- Blennow K.
- Lannfelt L.
- Kalimo H.
- Nilsson L.N.
A highly insoluble state of Abeta similar to that of Alzheimer’s disease brain is found in Arctic APP transgenic mice.
,
27- Kuo Y.M.
- Beach T.G.
- Sue L.I.
- Scott S.
- Layne K.J.
- Kokjohn T.A.
- Kalback W.M.
- Luehrs D.C.
- Vishnivetskaya T.A.
- Abramowski D.
- Sturchler-Pierrat C.
- Staufenbiel M.
- Weller R.O.
- Roher A.E.
The evolution of Aβ peptide burden in the APP23 transgenic mice: implications for Aβ deposition in Alzheimer disease.
,
38- Fukumoto H.
- Asami-Odaka A.
- Suzuki N.
- Iwatsubo T.
Association of Aβ40-positive senile plaques with microglial cells in the brains of patients with Alzheimer’s disease and in non-demented aged individuals.
,
41- Kawarabayashi T.
- Younkin L.H.
- Saido T.C.
- Shoji M.
- Ashe K.H.
- Younkin S.G.
Age-dependent changes in brain, CSF, and plasma amyloid β protein in the Tg2576 transgenic mouse model of Alzheimer’s disease.
). The chemical and spectroscopic properties of diffuse parts of cored plaques as well as diffuse plaques in s-AD and diffuse plaques in CU-AP were consistent with respect to h-FTAA emission and Aβ1–42 content.
Given previous data on LCO-delineated plaque maturation in transgenic mice (
10- Nyström S.
- Psonka-Antonczyk K.M.
- Ellingsen P.G.
- Johansson L.B.
- Reitan N.
- Handrick S.
- Prokop S.
- Heppner F.L.
- Wegenast-Braun B.M.
- Jucker M.
- Lindgren M.
- Stokke B.T.
- Hammarström P.
- Nilsson K.P.
Evidence for age-dependent in vivo conformational rearrangement within Aβ amyloid deposits.
) and cross-seeded amyloidosis (
42- Heilbronner G.
- Eisele Y.S.
- Langer F.
- Kaeser S.A.
- Novotny R.
- Nagarathinam A.
- Aslund A.
- Hammarström P.
- Nilsson K.P.
- Jucker M.
Seeded strain-like transmission of β-amyloid morphotypes in APP transgenic mice.
) and the here identified Aβ correlates, this suggests that diffuse plaques are precursors of cored plaques and that this maturation is associated with AD pathogenesis. This plaque maturation process is characterized by increased q-FTAA binding, and the corresponding chemical correlate is Aβ1–40 that accumulates within the core region of mature plaques upon nucleation.
This is further supported by our results from tgAPP
SWE mice, where we followed Aβ plaque pathology over time. Whereas the general sample size was not large, these data showed clear trends and statistically significant changes in chemical plaque pathology that were tantamount to the findings in human tissue. In detail, early compact plaques observed in 12-month-old mice show higher relative amounts of Aβ1–42 and h-FTAA staining as compared with cored plaques in 18-month-old animals. Chemically, the early compact plaques at 12 months were similar to diffuse plaques observed in older mice that also contain relatively higher amounts of Aβ1–42 as compared with cored plaques. This suggests again that an increase in Aβ1–40/Aβ1–42 ratio is associated with plaque maturation of diffuse plaques into cored plaques via recruitment and deposition of Aβ1–40. Based on our observations, a possible pathological mechanism of plaque formation suggests initial seeding of extracellular Aβ aggregation through accumulation of soluble Aβ1–42 that is predominantly secreted during rising amyloid (
43- Cummings D.M.
- Liu W.
- Portelius E.
- Bayram S.
- Yasvoina M.
- Ho S.H.
- Smits H.
- Ali S.S.
- Steinberg R.
- Pegasiou C.M.
- James O.T.
- Matarin M.
- Richardson J.C.
- Zetterberg H.
- Blennow K.
- et al.
First effects of rising amyloid-β in transgenic mouse brain: synaptic transmission and gene expression.
). This is followed by nucleation and maturation upon recruitment of Aβ1–40, which is in line with previous observations in tgAPP
SWE mice (
44- Terai K.
- Iwai A.
- Kawabata S.
- Sasamata M.
- Miyata K.
- Yamaguchi T.
Apolipoprotein E deposition and astrogliosis are associated with maturation of β-amyloid plaques in βAPPswe transgenic mouse: implications for the pathogenesis of Alzheimer’s disease.
).
Along that line, a prominent role of Aβ1–42 for initial plaque deposition has been suggested previously based on data in human AD brain (
26- Iwatsubo T.
- Odaka A.
- Suzuki N.
- Mizusawa H.
- Nukina N.
- Ihara Y.
Visualization of Aβ42(43) and Aβ40 in senile plaques with end-specific Aβ monoclonals: evidence that an initially deposited species is Aβ42(43).
) and transgenic mice (
16- McGowan E.
- Pickford F.
- Kim J.
- Onstead L.
- Eriksen J.
- Yu C.
- Skipper L.
- Murphy M.P.
- Beard J.
- Das P.
- Jansen K.
- DeLucia M.
- Lin W.L.
- Dolios G.
- Wang R.
- et al.
Aβ42 is essential for parenchymal and vascular amyloid deposition in mice.
) as well as for seeded Aβ pathology in different transgenic mice, including tgAPP/PS1 and tgAPP23 (
42- Heilbronner G.
- Eisele Y.S.
- Langer F.
- Kaeser S.A.
- Novotny R.
- Nagarathinam A.
- Aslund A.
- Hammarström P.
- Nilsson K.P.
- Jucker M.
Seeded strain-like transmission of β-amyloid morphotypes in APP transgenic mice.
). Aβ1–42 has been shown to rapidly form oligomers and subsequently fibrils, as compared with other C-terminally truncated Aβ species (
45- Ahmed M.
- Davis J.
- Aucoin D.
- Sato T.
- Ahuja S.
- Aimoto S.
- Elliott J.I.
- Van Nostrand W.E.
- Smith S.O.
Structural conversion of neurotoxic amyloid-β(1–42) oligomers to fibrils.
). In contrast, independent mechanisms for cored plaque formation have been suggested based on experiments in different transgenics, where cored plaques are also observed in younger mice (
31- Sturchler-Pierrat C.
- Abramowski D.
- Duke M.
- Wiederhold K.H.
- Mistl C.
- Rothacher S.
- Ledermann B.
- Bürki K.
- Frey P.
- Paganetti P.A.
- Waridel C.
- Calhoun M.E.
- Jucker M.
- Probst A.
- Staufenbiel M.
- Sommer B.
Two amyloid precursor protein transgenic mouse models with Alzheimer disease-like pathology.
,
46- Lord A.
- Philipson O.
- Klingstedt T.
- Westermark G.
- Hammarström P.
- Nilsson K.P.
- Nilsson L.N.
Observations in APP bitransgenic mice suggest that diffuse and compact plaques form via independent processes in Alzheimer’s disease.
,
47- Meyer-Luehmann M.
- Spires-Jones T.L.
- Prada C.
- Garcia-Alloza M.
- de Calignon A.
- Rozkalne A.
- Koenigsknecht-Talboo J.
- Holtzman D.M.
- Bacskai B.J.
- Hyman B.T.
Rapid appearance and local toxicity of amyloid-β plaques in a mouse model of Alzheimer’s disease.
). This is in line with our observations for younger mice, where only small compact/cored plaques were observed. However, it is still under debate whether this is a consequence of massive APP overexpression and Aβ production leading to rapid plaque formation and nucleation in neocortical areas, which might not be representative for how Aβ pathology is initiated in human AD.
Together with the data on C-terminal Aβ species, our observations on increased pyroglutamate-modified N-terminally truncated Aβ42 (N-pyro-E-Aβ; AβpE3–42, AβpE11–42) in diffuse plaques in AD but not in CU-AP further suggest a prominent role of Aβ1–42 functionalization in seeding Aβ pathology in AD. Indeed, N-pyro-E-Aβ42 truncation has previously been identified to be prominent in brain extracts (
37- Mori H.
- Takio K.
- Ogawara M.
- Selkoe D.J.
Mass spectrometry of purified amyloid β protein in Alzheimer’s disease.
) and senile plaques in AD following initial Aβ1–42 aggregation (
38- Fukumoto H.
- Asami-Odaka A.
- Suzuki N.
- Iwatsubo T.
Association of Aβ40-positive senile plaques with microglial cells in the brains of patients with Alzheimer’s disease and in non-demented aged individuals.
,
48- Saido T.C.
- Iwatsubo T.
- Mann D.M.
- Shimada H.
- Ihara Y.
- Kawashima S.
Dominant and differential deposition of distinct β-amyloid peptide species, AβN3(pE), in senile plaques.
). Interestingly, AβpE3–42 has been suggested to be the dominating Aβ species in senile and diffuse plaques in AD, Downs syndrome, and CU-AP (
38- Fukumoto H.
- Asami-Odaka A.
- Suzuki N.
- Iwatsubo T.
Association of Aβ40-positive senile plaques with microglial cells in the brains of patients with Alzheimer’s disease and in non-demented aged individuals.
,
49- Kuo Y.M.
- Emmerling M.R.
- Woods A.S.
- Cotter R.J.
- Roher A.E.
Isolation, chemical characterization, and quantitation of Aβ3-pyroglutamyl peptide from neuritic plaques and vascular amyloid deposits.
,
50- Harigaya Y.
- Saido T.C.
- Eckman C.B.
- Prada C.M.
- Shoji M.
- Younkin S.G.
Amyloid β protein starting pyroglutamate at position 3 is a major component of the amyloid deposits in the Alzheimer’s disease brain.
). In contrast, our data clearly show that the dominating species in all plaques is Aβ4–42 and that this truncation is not differing in between plaque types and disease state and is therefore rather a nonspecific metabolite of Aβ1–42. One explanation for this discrepancy is that all previous data were based on detection
in situ or in brain extracts using an antibody toward Aβ pE3–42 that could be cross-reactive for Aβ4–42, something that has not been studied in these publications. Nevertheless, N-pyro-E-Aβ42 species have mechanistically been implicated in AD pathogenesis by accelerating Aβ aggregation kinetics because N-pyro-E-Aβ are more hydrophobic than the full-length species and are more potent for self- and co-aggregation of less hydrophobic Aβ species, including Aβ1–40 (
51- D’Arrigo C.
- Tabaton M.
- Perico A.
N-terminal truncated pyroglutamyl β amyloid peptide Aβpy3–42 shows a faster aggregation kinetics than the full-length Aβ1–42.
52- Wirths O.
- Bethge T.
- Marcello A.
- Harmeier A.
- Jawhar S.
- Lucassen P.J.
- Multhaup G.
- Brody D.L.
- Esparza T.
- Ingelsson M.
- Kalimo H.
- Lannfelt L.
- Bayer T.A.
Pyroglutamate Aβ pathology in APP/PS1KI mice, sporadic and familial Alzheimer’s disease cases.
,
53- Schilling S.
- Zeitschel U.
- Hoffmann T.
- Heiser U.
- Francke M.
- Kehlen A.
- Holzer M.
- Hutter-Paier B.
- Prokesch M.
- Windisch M.
- Jagla W.
- Schlenzig D.
- Lindner C.
- Rudolph T.
- Reuter G.
- et al.
Glutaminyl cyclase inhibition attenuates pyroglutamate Aβ and Alzheimer’s disease-like pathology.
54The Aβ 3-pyroglutamyl and 11-pyroglutamyl peptides found in senile plaque have greater β-sheet forming and aggregation propensities in vitro than full-length Aβ.
). Therefore, higher levels of AβpE3–42 and AβpE11–42 in cored and diffuse plaques in AD, but not in diffuse plaques in CU-AP, likely reflect an important role of N-pyro-E-Aβ42 in seeding Aβ aggregation and early stages of plaque formation. This process likely involves hydrophobic priming that eventually leads to deposition of less hydrophobic species, including Aβ1–40, that remain otherwise in solution.
Overall, these data indicate that Aβ1–42 and N-pyro-E-Aβ42 are relevant species in seeding pathology and that diffuse plaques represent an early stage of Aβ deposits that mature into cored plaques and that this process involves the recruitment of more hydrophilic Aβ1–40 species over time. Here aggregation and functionalization of Aβ1–42 via N-terminal pyroglutamation are critical for seeding Aβ pathology in AD, whereas Aβ1–40 was shown to be associated with mature amyloid fibril formation (
55- Shin R.-W.
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Amyloid β-protein (Aβ) 1–40 but not Aβ1–42 contributes to the experimental formation of Alzheimer disease amyloid fibrils in rat brain.
). Further, Aβ1–40 was demonstrated to be significantly less potent for seeding amyloid fibril formation as compared with Aβ1–42 (
45- Ahmed M.
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,
56- Schmidt M.
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Comparison of Alzheimer Aβ(1–40) and Aβ(1–42) amyloid fibrils reveals similar protofilament structures.
).
This notion is further supported by our observations for cerebrovascular amyloid pathology. Here, a strong localization of Aβ1–40 peptide along with dominating q-FTAA binding was demonstrated for CAA in s-AD as well as in tgAPPSWE. Further, in mice, similar to plaques, predominant Aβ1–40 deposition in CAA was found to increase with age. This suggests that CAA maturation is characterized by increased Aβ1–40 deposition.
This is in line with previous data, where development of CAA pathology has been shown to be associated with increased AD-associated mutations that result in increased secretion of total Aβ, such as due to the Swedish mutation in tgAPP
SWE mice (
32- Kumar-Singh S.
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Dense-core plaques in Tg2576 and PSAPP mouse models of Alzheimer's disease are centered on vessel walls.
,
57- Mann D.M.
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Predominant deposition of amyloid-β42(43) in plaques in cases of Alzheimer’s disease and hereditary cerebral hemorrhage associated with mutations in the amyloid precursor protein gene.
).
Further, Aβ1–42 as well as N-terminal Aβ truncations that are both prone to aggregation have previously been shown to readily deposit as fibrillary diffuse plaques while having no relevance in already seeded CAA or plaque nucleation (
38- Fukumoto H.
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Association of Aβ40-positive senile plaques with microglial cells in the brains of patients with Alzheimer’s disease and in non-demented aged individuals.
,
58- Pike C.J.
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Amino-terminal deletions enhance aggregation of β-amyloid peptides in vitro.
). Similar to our findings, these previous studies suggest that with progressing pathology, Aβ species less prone to aggregation, dominated by Aβ1–40, do deposit on the preseeded aggregation sites, both in amyloid plaques (leading to core formation) and in the vasculature (resulting in aggravated CAA pathology).
Importantly, the age-associated blue shift observed in CAA, caused by q-FTAA binding, along with increased Aβ1–40 deposition, indicates higher-order aggregation represented by denser fibrillary structures, such as bundled multifilamentous fibrils (
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Nanoscale structure and spectroscopic probing of Aβ1–40 fibril bundle formation.
). These denser fibril structures might be associated with other physiological consequences, including stroke and hemorrhages. Indeed, CAA is associated with vascular Aβ clearance (
59- Weller R.O.
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Cerebral amyloid angiopathy: amyloid beta accumulates in putative interstitial fluid drainage pathways in Alzheimer's disease.
), and severe CAA pathology with frequent and spontaneous cerebral and lobar hemorrhages was described for both humans and transgenic AD mice (
60- Levy E.
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Mutation of the Alzheimer's disease amyloid gene in hereditary cerebral hemorrhage, Dutch type.
61- Nilsberth C.
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The “Arctic” APP mutation (E693G) causes Alzheimer’s disease by enhanced Aβ protofibril formation.
,
62- Grabowski T.J.
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- Greenberg S.M.
Novel amyloid precursor protein mutation in an Iowa family with dementia and severe cerebral amyloid angiopathy.
,
63- Cai X.D.
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Release of excess amyloid β protein from a mutant amyloid β protein precursor.
64- Citron M.
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Mutation of the β-amyloid precursor protein in familial Alzheimer’s disease increases β-protein production.
). Given that hemorrhages occur due to decreasing flexibility in the endothelium of blood vessels (
65The emerging concept of vascular remodeling.
), this suggests that differences in CAA-associated hemorrhage between different AD mutations are a consequence of higher rigidity of Aβ1–40–containing, mature fibrils. Indeed, Aβ1–40 fibrils were shown to be over 50 times less elastic than the Aβ1–42 fibrils (
66- Dong M.
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Structural and material properties of amyloid Aβ40/42 fibrils.
), and this has been attributed to different β-sheet organization within each fibrillary layer of mature Aβ fibrils (
66- Dong M.
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Structural and material properties of amyloid Aβ40/42 fibrils.
).
In summary, we identified that Aβ plaque polymorphism is associated with distinct Aβ peptide patterns. Specifically, we found that Aβ1–40 and not Aβ1–42 is the dominating species in mature senile plaques with cored morphology that have been implicated in AD pathogenesis. Further, this plaque maturation was found to be associated with increased levels of Aβ3pE-42, which could indicate a hydrophobic priming of diffuse plaque morphotypes in AD through pyroglutamate modification of N-terminally truncated Aβ42.
A limitation of our study is the relatively small number of patients analyzed. These cross-sectional data provide initial molecular insight into heterogeneous plaque pathology on a chemical scale, not previously possible, and are largely verified by the longitudinal mouse data. However, there is a strong motivation in using the here-described technologies for expanded follow-up studies both for longitudinal human studies and mechanistic studies in mice.
Taken together, our data suggest that diffuse deposits are immature precursors of cored plaques and that pyroglutamation of N-terminal Aβx-42 and Aβ1–40 deposition are potentially critical events in priming and maturation of pathogenic Aβ from diffuse into cored plaques. These processes could underlie development of neurotoxic plaque pathology in AD and could hence provide a mechanistic target for potential intervention.
Article info
Publication history
Published online: February 27, 2019
Received in revised form:
February 21,
2019
Received:
November 7,
2018
Edited by Paul E. Fraser
Footnotes
This work was supported by Swedish Research Council VR Grants 2014-6447 and 2018-02181 (to J. H.), 2012-1593 (to S. S.), 2013-2546 (to H. Z.), 2017-00915 (to K.B.), and 2016-00748 (to K. P. R. N.); European Research Council Grant 681712 (to H. Z.); Alzheimerfonden (to J. H., S. S., K. B., S. N., D. S., and P. H.); Demensfonden (to J. H. and W. M.); Hjärnfonden (to S. S., K. B., and P. H.); Jeanssons Stiftelsen (to J. H.); Ahlén Stiftelsen (to J. H., S. S., and D. S.); Stiftelsen Gamla Tjänarinnor (to J. H., K. B., W. M., D. S., and G. B.); Stohnes Stiftelse (to J. H., G. B., S. S., and D. S.); Torsten Söderberg Foundation (to K. B. and S. S.); the Swedish Foundation for Strategic Research (SSF) (to K. P. R. N.); and the Göran Gustafsson Foundation (to P. H.). The authors declare that they have no conflicts of interest with the contents of this article.
This article contains Table S1 and Figs. S1–S7.
Copyright
© 2019 Michno et al.