What is the evidence that tau pathology spreads through prion-like propagation?
Open accessAbstract
Emerging experimental evidence suggests that the spread of tau pathology in the brain in Tauopathies reflects the propagation of abnormal tau species along neuroanatomically connected brain areas. This propagation could occur through a "prion-like" mechanism involving transfer of abnormal tau seeds from a "donor cell" to a "recipient cell" and recruitment of normal tau in the latter to generate new tau seeds. This review critically appraises the evidence that the spread of tau pathology occurs via such a "prion-like" mechanism and proposes a number of recommendations for directing future research. Recommendations for definitions of frequently used terms in the tau field are presented in an attempt to clarify and standardize interpretation of research findings. Molecular and cellular factors affecting tau aggregation are briefly reviewed, as are potential contributions of physiological and pathological post-translational modifications of tau. Additionally, the experimental evidence for tau seeding and "prion-like" propagation of tau aggregation that has emerged from cellular assays and in vivo models is discussed. Propagation of tau pathology using "prion-like" mechanisms is expected to incorporate several steps including cellular uptake, templated seeding, secretion and intercellular transfer through synaptic and non-synaptic pathways. The experimental findings supporting each of these steps are reviewed. The clinical validity of these experimental findings is then debated by considering the supportive or contradictory findings from patient samples. Further, the role of physiological tau release in this scenario is examined because emerging data shows that tau is secreted but the physiological function (if any) of this secretion in the context of propagation of pathological tau seeds is unclear. Bona fide prions exhibit specific properties, including transmission from cell to cell, tissue to tissue and organism to organism. The propagation of tau pathology has so far not been shown to exhibit all of these steps and how this influences the debate of whether or not abnormal tau species can propagate in a "prion-like" manner is discussed. The exact nature of tau seeds responsible for propagation of tau pathology in human tauopathies remains controversial; it might be tightly linked to the existence of tau strains stably propagating peculiar patterns of neuropathological lesions, corresponding to the different patterns seen in human tauopathies. That this is a property shared by all seed-competent tau conformers is not yet firmly established. Further investigation is also required to clarify the relationship between propagation of tau aggregates and tau-induced toxicity. Genetic variants identified as risks factors for tauopathies might play a role in propagation of tau pathology, but many more studies are needed to document this. The contribution of selective vulnerability of neuronal populations, as an alternative to prion-like mechanisms to explain spreading of tau pathology needs to be clarified. Learning from the prion field will be helpful to enhance our understanding of propagation of tau pathology. Finally, development of better models is expected to answer some of these key questions and allow for the testing of propagation-centred therapies.
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Pathogenic tau can be released from diseased neurons, taken up by previously unaffected normal neurons, and induce pathogenic tau production in normal neurons.
“The pathogenic tau can be released from diseased neurons, then uptake by previously unaffected normal neurons, inducing pathogenic tau production in normal neurons.”
From Tau and neuroinflammation in Alzheimer’s disease: interplay mechanisms and clinical translation (2023) · cites this paper as [41]
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Self-citationIdentification of the Tau phosphorylation pattern that drives its aggregation
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Self-citationAmyloid accelerates tau propagation and toxicity in a model of early Alzheimer’s disease
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Ectosomes: A New Mechanism for Non-Exosomal Secretion of Tau Protein
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Self-citationProteostasis of tau. Tau overexpression results in its secretion via membrane vesicles
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Self-citationHyperphosphorylation and Cleavage at D421 Enhance Tau Secretion
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Peripheral administration of tau aggregates triggers intracerebral tauopathy in transgenic mice
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Widespread tau seeding activity at early Braak stages
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Self-citationRemoving endogenous tau does not prevent tau propagation yet reduces its neurotoxicity
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Hyperphosphorylation determines both the spread and the morphology of tau pathology
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Acetylated Tau Neuropathology in Sporadic and Hereditary Tauopathies
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Tau isoform composition influences rate and extent of filament formation
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Are Tangles as Toxic as They Look?
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Three Repeat Isoforms of Tau Inhibit Assembly of Four Repeat Tau Filaments
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17q21.31 duplication causes prominent tau-related dementia with increased MAPT expression
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Self-citationExtracellular association of APP and tau fibrils induces intracellular aggregate formation of tau
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Self-citationThe ordered assembly of tau is the gain‐of‐toxic function that causes human tauopathies
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Co-expression of truncated and full-length tau induces severe neurotoxicity
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Self-citationThe self-perpetuating tau truncation circle
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Mislocalization of neuronal tau in the absence of tangle pathology in phosphomutant tau knockin mice
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Self-citationAD genetic risk factors and tau spreading
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Tau PTM Profiles Identify Patient Heterogeneity and Stages of Alzheimer’s Disease
Wesseling, H., Mair, W., Kumar, M., Schlaffner, C. N., Tang, S., Beerepoot, P., Fatou, B., Guise, A. J., Cheng, L., Takeda, S., et al. (2020) · Cell · doi:10.1016/j.cell.2020.10.029 · Cited by 688 · see citing works
“…of Tau pathology with cognitive decline in AD (Arriagada et al., 1992; Bierer et al., 1995; Giannakopoulos et al., 2003; Gómez-Isla et al., 1997) have led to several mechanistic studies whose outcomes have underscored the importance of Tau in AD and other dementias (Mudher et al., 2017).”
ResultSelf-citationSelective vulnerability in neurodegenerative diseases
Fu, H., Hardy, J., & Duff, K. E. (2018) · Nature Neuroscience · doi:10.1038/s41593-018-0221-2 · Cited by 585 · see citing works
Tau and neuroinflammation in Alzheimer’s disease: interplay mechanisms and clinical translation
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“This property of pathogenic tau leads to disease progression and broader clinical symptoms [41, 42].”
BackgroundStancu, I.-C., Cremers, N., Vanrusselt, H., Couturier, J., Vanoosthuyse, A., Kessels, S., Lodder, C., Brône, B., Huaux, F., Octave, J.-N., et al. (2019) · Acta Neuropathologica · doi:10.1007/s00401-018-01957-y · Cited by 447 · see citing works
Self-citationHyperphosphorylation of Tau Associates With Changes in Its Function Beyond Microtubule Stability
Alonso, A. D., Cohen, L. S., Corbo, C., Morozova, V., ElIdrissi, A., Phillips, G., & Kleiman, F. E. (2018) · Frontiers in Cellular Neuroscience · doi:10.3389/fncel.2018.00338 · Cited by 278 · see citing works
The human connectome in Alzheimer disease — relationship to biomarkers and genetics
Yu, M., Sporns, O., & Saykin, A. J. (2021) · Nature Reviews Neurology · doi:10.1038/s41582-021-00529-1 · Cited by 265 · see citing works
Tau activates microglia via the PQBP1-cGAS-STING pathway to promote brain inflammation
Jin, M., Shiwaku, H., Tanaka, H., Obita, T., Ohuchi, S., Yoshioka, Y., Jin, X., Kondo, K., Fujita, K., Homma, H., et al. (2021) · Nature Communications · doi:10.1038/s41467-021-26851-2 · Cited by 223 · see citing works
Intersection of pathological tau and microglia at the synapse
Vogels, T., Murgoci, A.-N., & Hromádka, T. (2019) · Acta Neuropathologica Communications · doi:10.1186/s40478-019-0754-y · Cited by 197 · see citing works
Tau Proteolysis in the Pathogenesis of Tauopathies: Neurotoxic Fragments and Novel Biomarkers
Quinn, J. P., Corbett, N. J., Kellett, K. A. B., & Hooper, N. M. (2018) · Journal of Alzheimer's Disease · doi:10.3233/jad-170959 · Cited by 170 · see citing works
Braak, H., & Del Tredici, K. (2018) · Cerebral Cortex · doi:10.1093/cercor/bhy152 · Cited by 148 · see citing works
Astroglia and Tau: New Perspectives
Kovacs, G. G. (2020) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2020.00096 · Cited by 115 · see citing works
Genetic determinants of survival in progressive supranuclear palsy: a genome-wide association study
Jabbari, E., Koga, S., Valentino, R. R., Reynolds, R. H., Ferrari, R., Tan, M. M. X., Rowe, J. B., Dalgard, C. L., Scholz, S. W., Dickson, D. W., et al. (2021) · The Lancet Neurology · doi:10.1016/s1474-4422(20)30394-x · Cited by 111 · see citing works
Filamentous recombinant human Tau activates primary astrocytes via an integrin receptor complex
Wang, P., & Ye, Y. (2021) · Nature Communications · doi:10.1038/s41467-020-20322-w · Cited by 93 · see citing works
Tau immunotherapies: Lessons learned, current status and future considerations
Sandusky-Beltran, L. A., & Sigurdsson, E. M. (2020) · Neuropharmacology · doi:10.1016/j.neuropharm.2020.108104 · Cited by 90 · see citing works
Ten Years of Tau-Targeted Immunotherapy: The Path Walked and the Roads Ahead
Novak, P., Kontsekova, E., Zilka, N., & Novak, M. (2018) · Frontiers in Neuroscience · doi:10.3389/fnins.2018.00798 · Cited by 87 · see citing works
“Seeding-capable tau molecules (“tauons”) convert healthy tau into pathological forms, and propagate tau pathology from cell to cell via multiple pathways (Novak et al., 2011; Mudher et al., 2017).”
BackgroundThe <scp>NLRP3</scp> inflammasome modulates tau pathology and neurodegeneration in a tauopathy model
Stancu, I. C., Lodder, C., Botella Lucena, P., Vanherle, S., Gutiérrez de Ravé, M., Terwel, D., Bottelbergs, A., & Dewachter, I. (2022) · Glia · doi:10.1002/glia.24160 · Cited by 72 · see citing works
Self-citationSeidler, P. M., Boyer, D. R., Murray, K. A., Yang, T. P., Bentzel, M., Sawaya, M. R., Rosenberg, G., Cascio, D., Williams, C. K., Newell, K. L., et al. (2019) · Journal of Biological Chemistry · doi:10.1074/jbc.ra119.009688 · Cited by 70 · see citing works
Microglia: Friend and foe in tauopathy
Odfalk, K. F., Bieniek, K. F., & Hopp, S. C. (2022) · Progress in Neurobiology · doi:10.1016/j.pneurobio.2022.102306 · Cited by 60 · see citing works
Mallucci, G. R., Klenerman, D., & Rubinsztein, D. C. (2020) · Annual Review of Cell and Developmental Biology · doi:10.1146/annurev-cellbio-040320-120625 · Cited by 62 · see citing works
Malpetti, M., Jones, P. S., Cope, T. E., Holland, N., Naessens, M., Rouse, M. A., Rittman, T., Savulich, G., Whiteside, D. J., Street, D., et al. (2023) · Annals of Neurology · doi:10.1002/ana.26543 · Cited by 53 · see citing works
Seizures are a druggable mechanistic link between TBI and subsequent tauopathy.
Alyenbaawi, H., Kanyo, R., Locskai, L. F., Kamali-Jamil, R., DuVal, M. G., Bai, Q., Wille, H., Burton, E. A., & Allison, W. T. (2021) · eLife · doi:10.7554/elife.58744 · Cited by 40 · see citing works
The Effects of Amyloid and Tau on Functional Network Connectivity in Older Populations
Wales, R. M., & Leung, H.-C. (2021) · Brain Connectivity · doi:10.1089/brain.2020.0902 · Cited by 26 · see citing works
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Continuous Monitoring of Tau-Induced Neurotoxicity in Patient-Derived iPSC-Neurons
Oakley, D. H., Klickstein, N., Commins, C., Chung, M., Dujardin, S., Bennett, R. E., Hyman, B. T., & Frosch, M. P. (2021) · The Journal of Neuroscience · doi:10.1523/jneurosci.2590-20.2021 · Cited by 18 · see citing works
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- Authors
- Mudher, A., Colin, M., Dujardin, S., Medina, M., Dewachter, I., Alavi Naini, S. M., Mandelkow, E.-M., Mandelkow, E., Buée, L., Goedert, M., & Brion, J.-P.
- Affiliations
- Inserm (FR)
- Harvard University (US)
- Biomedical Research Networking Center on Neurodegenerative Diseases (ES)
- Hasselt University (BE)
- Center of Advanced European Studies and Research (DE)
- MRC Laboratory of Molecular Biology (GB)
- Université Libre de Bruxelles (BE)
- Corresponding author
- Brion, Jean-Pierre
- ORCID
- Venue
- Acta Neuropathologica Communications
- Published
- 2017-12
- Volume
- 5
- Issue
- 1
- Pages
- 99-99
- ISSN
- 2051-5960 (ISSN-L)
- PMC
- PMC5735872
- OpenAlex
- W2779322228
- Cited by
- 384
- References
- 153
- Citations by year
- 2026: 33 · 2025: 38 · 2024: 48 · 2023: 38 · 2022: 48 · 2021: 51 · 2020: 48 · 2019: 48 · 2018: 32
- FWCI
- 4.30
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Acta Neuropathologica Communications (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Document Server@UHasselt (UHasselt) (submittedVersion, cc-by)
- Max Planck Digital Library (submittedVersion, other-oa)
- DZNE Pub (submittedVersion, cc-by)
- MPG.PuRe (Max Planck Society) (submittedVersion, other-oa)
- Funders
- University of Southampton
- Agence Nationale de la Recherche (ANR-11-LABX-0009)
- Topics
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Prion Diseases and Protein Misfolding
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- tauopathy, prion-like propagation, tau seeding, tau aggregation, tau secretion, intercellular transfer, genetic risk variants, selective neuronal vulnerability, prion transmission, terminology standardization
- MeSH terms
- Brain, Humans, Models, Molecular, Prions, Tauopathies, Protein Aggregation, Pathological
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