Role of water-soluble amyloid-beta in the pathogenesis of Alzheimer's disease.

Water-soluble amyloid-beta (wsAbeta) is present in cerebral cortex of subjects at risk of Alzheimer's disease (AD) as well as in normal elderly subjects as a mixture of three major amyloid-beta (Abeta) species: 1-42, py3-42 and py11-42. The three wsAbeta species are nondetectable in brains of young people, free of immunohistochemically detectable amyloid plaques. In the brains of Down's syndrome and APP-mutant transgenic mice, wsAbeta appears long time before amyloid deposition, indicating that it represent the first form of Abeta aggregation and accumulation. In normal brain, wsAbeta is bound to apolipoprotein E that favours its degradation by proteases. The composition of wsAbeta, in terms of the ratio between the full-length 1-42 and the py3-42 peptides, correlates with the severity of clinical and pathological phenotype in familial early onset AD. Water-soluble Abeta is the native counterpart of the Abeta small aggregates (soluble oligomers) that show in vitro an early and high neuronal toxicity.