Factors influencing the processing and function of the amyloid beta precursor protein--a potential therapeutic target in Alzheimer's disease?

The amyloid beta precursor protein (AbetaPP), which plays a pivotal role in Alzheimer's disease (AD), can exist as either a membrane-bound or soluble protein. The former is cleaved at the level of the plasma membrane to generate the soluble form of the protein (AbetaPP(s)). An alternative pathway exists, however, for the cleavage of AbetaPP to generate a 40-42 amino acid peptide termed amyloid beta (Abeta), either within the lysosomal or the endoplasmic reticulum/Golgi compartments of the cell. In AD, there is an increase in the ratio of the 42 amino acid form of the Abeta peptide (Abeta(42)) to Abeta(40). The Abeta(42) form is the more amyloidogenic form and has an increased potential to form the insoluble amyloid deposits characteristic of AD pathology. Studies on the familial form of the disease, with mutations in AbetaPP or in the presenilin proteins, have confirmed an increase in Abeta(42) generation associated with the early stages of the disease. This review will examine the factors that influence AbetaPP processing, how they may act to modulate the biological effects of AbetaPP(s) and Abeta, and if they provide a viable target for therapeutic intervention to modify the rate of progression of the disease.