Abstract

The timing and characteristics of neuronal death in Alzheimer’s disease (AD) remain largely unknown. Here we examine AD mouse models with an original marker, myristoylated alanine-rich C-kinase substrate phosphorylated at serine 46 (pSer46-MARCKS), and reveal an increase of neuronal necrosis during pre-symptomatic phase and a subsequent decrease during symptomatic phase. Postmortem brains of mild cognitive impairment (MCI) rather than symptomatic AD patients reveal a remarkable increase of necrosis. In vivo imaging reveals instability of endoplasmic reticulum (ER) in mouse AD models and genome-edited human AD iPS cell-derived neurons. The level of nuclear Yes-associated protein (YAP) is remarkably decreased in such neurons under AD pathology due to the sequestration into cytoplasmic amyloid beta (Aβ) aggregates, supporting the feature of YAP-dependent necrosis. Suppression of early-stage neuronal death by AAV-YAPdeltaC reduces the later-stage extracellular Aβ burden and cognitive impairment, suggesting that preclinical/prodromal YAP-dependent neuronal necrosis represents a target for AD therapeutics.

Highlights

  • The timing and characteristics of neuronal death in Alzheimer’s disease (AD) remain largely unknown

  • mild cognitive impairment (MCI) and AD were diagnosed by ICD-10, and the patients were categorized as having amnestic MCI

  • There was no significant difference in age between the different patient groups, but the proportion of female patients was slightly higher in the AD group than in the other groups

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Summary

Introduction

The timing and characteristics of neuronal death in Alzheimer’s disease (AD) remain largely unknown. We performed a comprehensive phosphoproteome analysis of four strains of AD model mice and human postmortem AD brains, and discovered three proteins whose phosphorylation state is altered at a very early stage before extracellular amyloid aggregates[20] One such protein is MARCKS, which anchors the actin cytoskeleton to the plasma membrane and plays a critical role in stabilizing the post-synaptic structure of dendritic spines[21]. We showed that the observed necrosis was caused by a deficiency of YAP, resulting in suppression of the transcriptional activity of TEAD, the final effector molecule of the Hippo pathway[11,12,13], in mouse AD models, human AD iPS neuron models and human postmortem MCI brains These findings unravel the occurrence of cell death at the early stage in AD, which could be a therapeutic target that prevents progression of AD

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