Autophagy inhibition promotes SNCA/alpha-synuclein release and transfer via extracellular vesicles with a hybrid autophagosome-exosome-like phenotype
Open accessAbstract
The autophagy-lysosome pathway (ALP) regulates intracellular homeostasis of the cytosolic protein SNCA/alpha-synuclein and is impaired in synucleinopathies, including Parkinson disease and dementia with Lewy bodies (DLB). Emerging evidence suggests that ALP influences SNCA release, but the underlying cellular mechanisms are not well understood. Several studies identified SNCA in exosome/extracellular vesicle (EV) fractions. EVs are generated in the multivesicular body compartment and either released upon its fusion with the plasma membrane, or cleared via the ALP. We therefore hypothesized that inhibiting ALP clearance 1) enhances SNCA release via EVs by increasing extracellular shuttling of multivesicular body contents, 2) alters EV biochemical profile, and 3) promotes SNCA cell-to-cell transfer. Indeed, ALP inhibition increased the ratio of extra- to intracellular SNCA and upregulated SNCA association with EVs in neuronal cells. Ultrastructural analysis revealed a widespread, fused multivesicular body-autophagosome compartment. Biochemical characterization revealed the presence of autophagosome-related proteins, such as LC3-II and SQSTM1. This distinct "autophagosome-exosome-like" profile was also identified in human cerebrospinal fluid (CSF) EVs. After a single intracortical injection of SNCA-containing EVs derived from CSF into mice, human SNCA colocalized with endosome and neuronal markers. Prominent SNCA immunoreactivity and a higher number of neuronal SNCA inclusions were observed after DLB patient CSF EV injections. In summary, this study provides compelling evidence that a) ALP inhibition increases SNCA in neuronal EVs, b) distinct ALP components are present in EVs, and c) CSF EVs transfer SNCA from cell to cell in vivo. Thus, macroautophagy/autophagy may regulate EV protein composition and consequently progression in synucleinopathies.
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Because tunneling nanotube formation relies on actin-dependent machinery and ciliary Sonic Hedgehog signaling regulates neuronal actin dynamics, ciliary dysfunction may promote tunneling nanotube formation, while impaired autophagy increases extracellular vesicle loading, collectively enhancing α-synuclein dissemination.
“Because TNT formation relies on actin-dependent machinery (e.g., M-Sec/RalA/exocyst) and ciliary Shh signaling regulates neuronal actin dynamics, ciliary dysfunction may promote TNT formation, while impaired autophagy increases EV loading, collectively enhancing α-syn dissemination (Figure 3B) [102,149,150,153,154,155].”
From The Impact of Neurotoxin Proteins Trafficked by Primary Cilia and Extracellular Vesicles in Neurodegenerative Diseases (2025) · cites this paper as [149]
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Experimental — accuracy not yet measuredDisruption of cilia-autophagy crosstalk in Parkinson's disease causes neurons to redirect α-synuclein into extracellular vesicles, increasing its intercellular transfer, while autophagy inhibition further amplifies α-synuclein-containing extracellular vesicle release and spread.
“Similar to AD, disruption of cilia–autophagy crosstalk in PD has been shown to cause neurons to redirect α-syn into EVs, increasing its intercellular transfer, while autophagy inhibition further amplifies α-syn-containing EV release and spread [149,150].”
From The Impact of Neurotoxin Proteins Trafficked by Primary Cilia and Extracellular Vesicles in Neurodegenerative Diseases (2025) · cites this paper as [149]
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- Authors
- Minakaki, G., Menges, S., Kittel, A., Emmanouilidou, E., Schaeffner, I., Barkovits, K., Bergmann, A., Rockenstein, E., Adame, A., Marxreiter, F., Mollenhauer, B., Galasko, D., Buzás, E. I., Schlötzer-Schrehardt, U., Marcus, K., Xiang, W., Lie, D. C., Vekrellis, K., Masliah, E., Winkler, J., & Klucken, J.
- Affiliations
- Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
- Semmelweis University
- Biomedical Research Foundation of the Academy of Athens (GR)
- Ruhr University Bochum (DE)
- University of California System (US)
- Universitätsmedizin Göttingen (DE)
- Semmelweis University (HU)
- Universitätsklinikum Erlangen (DE)
- Corresponding author
- Klucken, Jochen
- ORCID
- Venue
- Autophagy
- Publisher
- Informa UK Limited
- Published
- 2018-01-02
- Volume
- 14
- Issue
- 1
- Pages
- 98-119
- ISSN
- 1554-8627 (ISSN-L)
- 1554-8635
- PMC
- PMC5846507
- OpenAlex
- W2774564892
- Cited by
- 272
- References
- 97
- Citations by year
- 2026: 32 · 2025: 24 · 2024: 34 · 2023: 26 · 2022: 41 · 2021: 41 · 2020: 38 · 2019: 22 · 2018: 14
- FWCI
- 14.28
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Autophagy (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- GoeScholar The Publication Server of the Georg-August-Universität Göttingen (Georg-August-Universität Göttingen) (submittedVersion, cc-by)
- Funders
- Interdisciplinary Center of Clinical Research (IZKF) of the University Hospital Erlangen, Germany (IZKF no. E21 and E11)
- deutsche Forschungsgemeinschaft/German Research Foundation (DFG, no. KL1395/8-1)
- Johannes und Frieda Marohn-Stiftung (Alpha-synuclein)
- H2020 project NISCI (GA no. 681094)
- National Institutes of Health (NIH AGO5131 and NIH AG18440)
- Topics
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Extracellular vesicles in disease
- Health Sciences › Medicine › Epidemiology › Autophagy in Disease and Therapy
- Keywords
- autophagy inhibition, alpha-synuclein, extracellular vesicles, exosomes, autophagy-lysosome pathway, multivesicular bodies, cell-to-cell transmission, cerebrospinal fluid, dementia with Lewy bodies, Parkinson's disease, synucleinopathies, LC3-II, p62, neuronal inclusions
- MeSH terms
- Autophagosomes, Animals, Autophagy, Cells, Cultured, Chloroquine, Humans, Lysosomes, Neurons, Parkinson Disease, Biomarkers, Rats, Sprague-Dawley, Macrolides, Lewy Body Disease, Protein Transport, Mice, alpha-Synuclein, Exosomes
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