How Alzheimer's Abeta propagates and triggers tau pathology in intact neurons

Alzheimers disease begins with A{beta} accumulation, progresses to tau aggregates and results in widespread neurodegeneration1-3. Simultaneous propagation of A{beta} aggregates from very limited to wide and distant brain regions is one of the outstanding events in the early stage. Here, we demonstrate that the neurovascular unit4,5 comprising capillaries and pericytes, the machinery supplying oxygen and glucose to neurons, is also the machinery for propagating effector molecules that impose Alzheimers pathologies on intact neurons. We discovered two distinct signaling cascades, one activated in capillary endothelial cells and the other in pericytes. At the origin of either cascade, we identified amylospheroid (ASPD)6,7, a highly toxic 30-mer assembly of A{beta}, and its sole target NKA38, a neuron-specific isoform of Na+,K+-ATPase9,10 but present in endothelial cells and pericytes. In endothelial cells, ASPD binding to NKA3 releases angiotensin II, which increases {beta}-secretase in intact neurons, causing a huge increase of A{beta}42and resultant accumulation. In pericytes, ASPD binding to NKA3 releases an unknown effector molecule that activates {delta}-secretase in intact neurons, further augmenting A{beta}42and producing pathogenic tau1-368 fragment. Thus, A{beta} and tau pathologies are directly linked. Stopping the signaling cascades near the origin by inhibiting ASPD-NKA3 interaction8 may provide a new therapeutic approach.