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Endo-lysosomal dysregulations and late-onset Alzheimer’s disease: impact of genetic risk factors
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Increasing evidence supports that cellular dysregulations in the degradative routes contribute to the initiation and progression of neurodegenerative diseases, including Alzheimer's disease. Autophagy and endolysosomal homeostasis need to be maintained throughout life as they are major cellular mechanisms involved in both the production of toxic amyloid peptides and the clearance of misfolded or aggregated proteins. As such, alterations in endolysosomal and autophagic flux, as a measure of degradation activity in these routes or compartments, may directly impact as well on disease-related mechanisms such as amyloid-β clearance through the blood-brain-barrier and the interneuronal spreading of amyloid-β and/or Tau seeds, affecting synaptic function, plasticity and metabolism. The emerging of several genetic risk factors for late-onset Alzheimer's disease that are functionally related to endocytic transport regulation, including cholesterol metabolism and clearance, supports the notion that in particular the autophagy/lysosomal flux might become more vulnerable during ageing thereby contributing to disease onset. In this review we discuss our current knowledge of the risk genes APOE4, BIN1, CD2AP, PICALM, PLD3 and TREM2 and their impact on endolysosomal (dys)regulations in the light of late-onset Alzheimer's disease pathology.
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![Fig. 1 Spatial regulation of non-amyloidogenic and amyloidogenic processing of APP. Dysregulated amyloid precursor protein (APP) trafficking and processing underlies the most prominent hallmark of disease in AD affected areas, represented by an abundance of Aβ soluble oligomers, fibrils and plaques. Non-amyloidogenic processing starts with APP shedding by ADAM10, mainly at the cell surface but as well in the trans-Golgi network [10]. Hereafter, the remaining carboxyterminal fragments (CTFs), C83, are processed by γ-secretase to produce harmless p3 peptides and an intracellular domain (inset a). In the amyloidogenic pathway (inset b for details), which occurs more dominantly in neurons, APP is cleaved first by BACE1 preferentially in endosomes. This endosomal encountering is spatially regulated as BACE1 and APP are found to follow distinct internalization itineraries, the former mediated through ARF6 and GGA3 [11]. C99 is further processed by γ-secretase in recycling and degradative endosomes. It is first cut at position 48 or 49 of the Aβ sequence (ε-cleavage), followed by a carboxypeptidase-like trimming every three amino acids. This results in the production of different Aβ peptides of which the longer ones, like Aβ42 and Aβ43, are more aggregation-prone. γ-Secretase assembly is thought to occur stepwise during ER-Golgi recycling [12]. Assembled PSEN1 complexes (PSEN1/γ) are active at the cell surface and in sorting/recycling endosomes, while PSEN2 complexes (PSEN2/γ) reside in late endosomes/lysosomes due to an aminoterminal sorting motif that selectively binds AP-1. PICALM may mediate internalization of PSEN1/γ, while CD2AP in neurons sorts APP into intraluminal vesicles of MVBs for degradation in lysosomes, instead of through secretase-mediated processing pathways. BIN1 intervenes in recycling BACE1 to the cell surface as well as to lysosomes. BACE1 and APP sorting between distinct compartments involves several other sorting proteins and adaptor complexes of which some are depicted in this figure: such as GGA1, SNX17, retromer and SorLA](/paper-figures/34aad17fa53147d6bd71489a5b996847/endo-lysosomal-dysregulations-and-late-onset-alzheimers-disease-impact-of-figure-1.jpg)





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“multiple genetic risk alleles associated with AD are thought to be active in this pathway [34].”
From Microglia specific deletion of miR-155 in Alzheimer’s disease mouse models reduces amyloid-β pathology but causes hyperexcitability and seizures (2023) · cites this paper as [34]
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“Aβ results from the proteolysis of APP, a type I transmembrane protein targeted first at the plasma membrane, then rapidly endocytosed to endosomes to be metabolized to Aβ or subsequently sent to the lysosomal compartment for degradation (Wang X. et al., 2017; Van Acker et al., 2019).”
From Emerging Alternative Proteinases in APP Metabolism and Alzheimer’s Disease Pathogenesis: A Focus on MT1-MMP and MT5-MMP (2019) · cites this paper as Van Acker et al., 2019
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Variant of TREM2 Associated with the Risk of Alzheimer's Disease
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Depletion of microglia and inhibition of exosome synthesis halt tau propagation
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Brain Infarction and the Clinical Expression of Alzheimer Disease<subtitle>The Nun Study</subtitle>
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ApoE in Alzheimer’s disease: pathophysiology and therapeutic strategies
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Metadata
- Authors
- Van Acker, Z. P., Bretou, M., & Annaert, W.
- Affiliations
- VIB-KU Leuven Center for Brain & Disease Research (BE)
- Corresponding author
- Annaert, Wim
- Venue
- Molecular Neurodegeneration
- Published
- 2019-06-03
- Volume
- 14
- Issue
- 1
- Pages
- 20-20
- ISSN
- 1750-1326 (ISSN-L)
- PMC
- PMC6547588
- OpenAlex
- W2948656839
- Cited by
- 222
- References
- 171
- Citations by year
- 2026: 10 · 2025: 31 · 2024: 53 · 2023: 26 · 2022: 26 · 2021: 40 · 2020: 31 · 2019: 5
- FWCI
- 3.00
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Molecular Neurodegeneration (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Lirias (KU Leuven) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Onderzoeksraad, KU Leuven (C16/15/073)
- FWO (S006617N, G078117N, G05601N)
- Hercules (AKUL/11/30, AKUL/13/39)
- SAO (2917/033, S#20180020)
- Alzheimer Association (AARF-18-564825)
- Topics
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Autophagy in Disease and Therapy
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Cellular transport and secretion
- Keywords
- late-onset Alzheimer's disease, endolysosomal dysfunction, autophagy, autophagic flux, lysosomal homeostasis, genetic risk factors, APOE ε4, BIN1, CD2AP, PICALM, PLD3, TREM2, amyloid-beta clearance, blood-brain barrier, cholesterol metabolism, endocytic transport, aging, neurodegeneration
- MeSH terms
- Alzheimer Disease, Animals, Autophagy, Humans, Lysosomes, Membrane Glycoproteins, Risk Factors, Amyloid beta-Protein Precursor
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