Clusterin in Alzheimer’s Disease: Mechanisms, Genetics, and Lessons From Other Pathologies
Open accessAbstract
Clusterin (CLU) or APOJ is a multifunctional glycoprotein which has been implicated in several physiological and pathological states, including Alzheimer’s disease (AD). With a prominent extracellular chaperone function, additional roles have been discussed for clusterin, including lipid transport and immune modulation, and it is involved in pathways common to several diseases such as cell death and survival, oxidative stress, and proteotoxic stress. Although clusterin is normally a secreted protein, it has also been found intracellularly under certain stress conditions. Multiple hypotheses have been proposed regarding the origin of intracellular clusterin, including specific biogenic processes leading to alternative transcripts and protein isoforms, but these lines of research are incomplete and contradictory. Current consensus is that intracellular clusterin is most likely to have exited the secretory pathway at some point or to have re-entered the cell after secretion. Clusterin’s relationship with amyloid beta (Aβ) has been of great interest to the AD field, including clusterin’s apparent role in altering Aβ aggregation and/or clearance. Additionally, clusterin has been more recently identified as a mediator of Aβ toxicity, as evidenced by the neuroprotective effect of CLU knockdown and knockout in rodent and human iPSC-derived neurons. CLU is also the third most significant genetic risk factor for late onset AD and several variants have been identified in CLU. Although the exact contribution of these variants to altered AD risk is unclear, some have been linked to altered CLU expression at both mRNA and protein levels, altered cognitive and memory function, and altered brain structure. The apparent complexity of clusterin’s biogenesis, the lack of clarity over the origin of the intracellular clusterin species, and the number of pathophysiological functions attributed to clusterin have all contributed to the challenge of understanding the role of clusterin in AD pathophysiology. Here we highlight clusterin’s relevance to AD by discussing the evidence linking clusterin to AD, as well as drawing parallels on how the role of clusterin in other diseases and pathways may help us understand its biological function(s) in association with AD.
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Aβ catabolism genes RAB5A, RAB11A, CLU, and LRP2 are down-regulated in AD monocytes, suggesting impaired Aβ catabolism in AD monocytes.
“Similarly, several genes reported to be involved in Aβ catabolism, such as RAB5A, RAB11A, CLU, and LRP2 (49–53), were also down-regulated in AD monocytes, suggesting the impaired Aβ catabolism in AD monocytes.”
From Understanding monocyte-driven neuroinflammation in Alzheimer’s disease using human cortical organoid microphysiological systems (2025) · cites this paper as [52]
The review’s “Clusterin and Aβ Metabolism” section (page unavailable) links CLU and LRP2 to Aβ uptake, transport, and clearance. It does not establish the claimed roles of RAB5A or RAB11A. The down-regulation in AD monocytes appears to be the citing authors’ own finding, rather than a finding attributed to this review. (LLM, conf=0.85)
Experimental — accuracy not yet measuredGenetic variants of many differentially expressed genes identified in this study, such as CLU and APOE, have been associated with increased Alzheimer's disease risk.
“Genetic variants of many of the differentially expressed genes identified in this study, such as CLU and APOE, have been associated with increased Alzheimer’s disease risk58,59.”
From mTORC1 drives cell-autonomous astrocyte reactivity in tuberous sclerosis (2026) · cites this paper as [58]
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- Authors
- Foster, E. M., Dangla-Valls, A., Lovestone, S., Ribe, E. M., & Buckley, N. J.
- Affiliations
- University of Oxford (GB)
- Corresponding author
- Buckley, Noel J.
- Venue
- Frontiers in Neuroscience
- Publisher
- Frontiers Media SA
- Published
- 2019-02-28
- Volume
- 13
- Pages
- 164-164
- ISSN
- 1662-453X (ISSN-L)
- PMC
- PMC6403191
- OpenAlex
- W2920516237
- Cited by
- 381
- References
- 343
- Citations by year
- 2026: 41 · 2025: 50 · 2024: 56 · 2023: 62 · 2022: 54 · 2021: 52 · 2020: 55 · 2019: 11
- FWCI
- 4.10
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Neuroscience (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- AstraZeneca
- Fundación Alfonso Martín Escudero
- South London and Maudsley NHS Foundation Trust
- Wellcome Trust
- Alzheimer's Society
- National Institute for Health and Care Research
- Bupa Foundation
- Medical Research Council (1246016)
- Topics
- Health Sciences › Medicine › Oncology › Clusterin in disease pathology
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- clusterin, Alzheimer's disease, amyloid-beta, protein isoforms, late-onset Alzheimer's disease, amyloid-beta aggregation, amyloid-beta clearance, neuroprotection, oxidative stress, proteotoxic stress, extracellular chaperones, lipid transport, immunomodulation, secretory pathway
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