Shuko Takeda1, Caitlin Commins2, Sarah L DeVos2, Chloe K Nobuhara2, Susanne Wegmann2, Allyson D Roe2, Isabel Costantino2, Zhanyun Fan2, Samantha B Nicholls2, Alexis E Sherman2, Ana T Trisini Lipsanopoulos3, Clemens R Scherzer4, George A Carlson5, Rose Pitstick5, Elaine R Peskind6,7, Murray A Raskind6,7, Ge Li6,8, Thomas J Montine9, Matthew P Frosch2, Bradley T Hyman2. 1. Alzheimer's Disease Research Laboratory, Department of Neurology, MassGeneral Institute for Neurodegenerative Disease, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA. takeda@cgt.med.osaka-u.ac.jp. 2. Alzheimer's Disease Research Laboratory, Department of Neurology, MassGeneral Institute for Neurodegenerative Disease, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA. 3. Ann Romney Center for Neurological Diseases, Brigham and Women's Hospital, Boston, MA. 4. Neurogenomics Lab and Parkinson Personalized Medicine Program, Harvard Medical School and Brigham & Women's Hospital, Cambridge, MA. 5. McLaughlin Research Institute, Great Falls, MT. 6. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA. 7. Mental Illness Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA. 8. Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA. 9. Department of Pathology, University of Washington School of Medicine, Seattle, WA.
Abstract
OBJECTIVE: Cerebrospinal fluid (CSF) tau is an excellent surrogate marker for assessing neuropathological changes that occur in Alzheimer's disease (AD) patients. However, whether the elevated tau in AD CSF is just a marker of neurodegeneration or, in fact, a part of the disease process is uncertain. Moreover, it is unknown how CSF tau relates to the recently described soluble high-molecular-weight (HMW) species that is found in the postmortem AD brain and can be taken up by neurons and seed aggregates. METHODS: We have examined seeding and uptake properties of brain extracellular tau from various sources, including interstitial fluid (ISF) and CSF from an AD transgenic mouse model and postmortem ventricular and antemortem lumbar CSF from AD patients. RESULTS: We found that brain ISF and CSF tau from the AD mouse model can be taken up by cells and induce intracellular aggregates. Ventricular CSF from AD patients contained a rare HMW tau species that exerted a higher seeding activity. Notably, the HMW tau species was also detected in lumbar CSF from AD patients, and its levels were significantly elevated compared to control subjects. HMW tau derived from CSF of AD patients was seed competent in vitro. INTERPRETATION: These findings suggest that CSF from an AD brain contains potentially bioactive HMW tau species, giving new insights into the role of CSF tau and biomarker development for AD. Ann Neurol 2016;80:355-367.
OBJECTIVE: Cerebrospinal fluid (CSF) tau is an excellent surrogate marker for assessing neuropathological changes that occur in Alzheimer's disease (AD) patients. However, whether the elevated tau in AD CSF is just a marker of neurodegeneration or, in fact, a part of the disease process is uncertain. Moreover, it is unknown how CSFtau relates to the recently described soluble high-molecular-weight (HMW) species that is found in the postmortem AD brain and can be taken up by neurons and seed aggregates. METHODS: We have examined seeding and uptake properties of brain extracellular tau from various sources, including interstitial fluid (ISF) and CSF from an ADtransgenicmouse model and postmortem ventricular and antemortem lumbar CSF from ADpatients. RESULTS: We found that brain ISF and CSFtau from the ADmouse model can be taken up by cells and induce intracellular aggregates. Ventricular CSF from ADpatients contained a rare HMW tau species that exerted a higher seeding activity. Notably, the HMW tau species was also detected in lumbar CSF from ADpatients, and its levels were significantly elevated compared to control subjects. HMW tau derived from CSF of ADpatients was seed competent in vitro. INTERPRETATION: These findings suggest that CSF from an AD brain contains potentially bioactive HMW tau species, giving new insights into the role of CSFtau and biomarker development for AD. Ann Neurol 2016;80:355-367.
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