Abstract

Two key pathological hallmarks of neurodegenerative diseases, including Alzheimer’s disease (AD) and Parkinson’s disease (PD), are the accumulation of misfolded protein aggregates and the chronic progressive neuroinflammation that they trigger. Numerous original research and reviews have provided a comprehensive understanding of how aggregated proteins (amyloid β, pathological tau, and α-synuclein) contribute to the disease, including driving sterile inflammation, in part, through the aggregation of multi-protein inflammasome complexes and the ASC speck [composed of NOD-, LRR-, and pyrin domain-containing protein 3 (NLRP3), Apoptosis-associated speck-like protein containing a C-terminal caspase activation and recruitment domain (ASC), and inflammatory caspase-1] involved in innate immunity. Here, we provide a unique perspective on the crosstalk between the aggregation-prone proteins involved in AD/PD and the multi-protein inflammasome complex/ASC speck that fuels feed-forward exacerbation of each other, driving neurodegeneration. Failed turnover of protein aggregates (both AD/PD related aggregates and the ASC speck) by protein degradation pathways, prionoid propagation of inflammation by the ASC speck, cross-seeding of protein aggregation by the ASC speck, and pro-aggregatory cleavage of proteins by caspase-1 are some of the mechanisms that exacerbate disease progression. We also review studies that provide this causal framework and highlight how the ASC speck serves as a platform for the propagation and spreading of inflammation and protein aggregation that drives AD and PD.

Highlights

  • Alzheimer’s disease (AD) is the leading cause of dementia and is in the top 10 causes of death worldwide (Lane et al, 2018; Breijyeh and Karaman, 2020)

  • The goal of this review is not to expand on the inflammasome in neurodegenerative disease, but to highlight our current understanding of this emerging paradigm of the inflammasome/ASC speck as an active contributor to AD/Parkinson’s disease (PD) pathology through three key topics: (1) How failed protein aggregate clearance and regulation mechanisms contribute to the accumulation of microglial inflammasome protein aggregates and neuronally derived (AD/PD related) misfolded protein aggregates in parallel; (2) How prionoid activity, cross-talk, and cross-seeding of these aggregates contributes to a viscous feedforward cycle resulting in AD/PD disease progression; and (3) How targeting the microglial inflammasome protein aggregates for therapeutics shows potential in breaking this cycle for the treatment of AD and PD

  • Within the last 5 years, several groups have begun to elucidate the active role that the NLRP3 inflammasome and ASC speck play in exacerbating misfolded protein aggregation and damaging neuroinflammation that drives disease progression and spreading throughout the brain (Figure 4)

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Summary

Introduction

Alzheimer’s disease (AD) is the leading cause of dementia and is in the top 10 causes of death worldwide (Lane et al, 2018; Breijyeh and Karaman, 2020). It is characterized clinically by progressive memory loss, functional, and cognitive impairment (Lane et al, 2018; Breijyeh and Karaman, 2020). The pathophysiology of PD is characterized by the accumulation of intracellular α-synuclein (α-syn) aggregates known as Lewy bodies and chronic inflammation with degeneration of dopaminergic neurons in the basal ganglia (Cacabelos, 2017)

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