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Amyloid beta

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Amyloid beta

Amyloid beta (, Abeta or beta-amyloid) denotes peptides of 36–43 amino acids that are the main component of the amyloid plaques found in the brains of people with Alzheimer's disease. The peptides derive from the amyloid-beta precursor protein (APP), which is cleaved by beta secretase and gamma secretase to yield Aβ in a cholesterol-dependent process and substrate presentation. Both neurons and oligodendrocytes produce and release Aβ in the brain, contributing to formation of amyloid plaques. Aβ molecules can aggregate to form flexible soluble oligomers which may exist in several forms. It is now believed that certain misfolded oligomers (known as "seeds") can induce other Aβ molecules to also take the misfolded oligomeric form, leading to a chain reaction akin to a prion infection. The oligomers are toxic to nerve cells. The other protein implicated in Alzheimer's disease, tau protein, also forms such prion-like misfolded oligomers, and there is some evidence that misfolded Aβ can induce tau to misfold.

A study has suggested that APP and its amyloid potential is of ancient origins, dating as far back as early deuterostomes.

The normal function of Aβ is not yet known. Though some animal studies have shown that the absence of Aβ does not lead to any obvious loss of physiological function, several potential activities have been discovered for Aβ, including activation of kinase enzymes, protection against oxidative stress, regulation of cholesterol transport, functioning as a transcription factor, and anti-microbial activity (potentially associated with Aβ's pro-inflammatory activity).

The glymphatic system clears metabolic waste from the mammalian brain, and in particular amyloid beta. A number of proteases have been implicated by both genetic and biochemical studies as being responsible for the recognition and degradation of amyloid beta; these include insulin degrading enzyme and presequence protease. The rate of removal is significantly increased during sleep. However, the significance of the glymphatic system in Aβ clearance in Alzheimer's disease is unknown.

Aβ is the main component of the kind of amyloid plaques that form in the brains of people with Alzheimer's disease. Aβ can also form the deposits that line cerebral blood vessels in cerebral amyloid angiopathy. The plaques are composed of aggregated Aβ oligomers called amyloid fibrils, a protein fold shared by other peptides such as the prions associated with protein misfolding disease, also known as proteinopathy.

The "amyloid hypothesis" — that Aβ, either already in plaques, or as oligomers that may act outside of plaques, is responsible for the pathology of Alzheimer's disease — has been the dominant hypothesis for around thirty years as of 2025, but is not conclusively established, especially because over time it has become clear that there are many causes of Alzheimer's (outside of people who develop early-onset Alzheimer's disease which is clearly driven by Aβ), and because many people who have plaques never develop Alzheimer's. Scientists in the field have wondered if plaques may be a response to the disease process, rather than the cause of it.

Research suggests that soluble oligomeric forms of the amyloid beta may be causative agents in the development of Alzheimer's disease. It is generally believed that Aβ oligomers are the most toxic. Several genetic, cell biology, biochemical and animal studies using experimental models support the concept that Aβ plays a central role in the development of Alzheimer's disease pathology.

Brain Aβ is elevated in people with sporadic Alzheimer's disease. Aβ is the main constituent of brain parenchymal and vascular amyloid; it contributes to cerebrovascular lesions and is neurotoxic. It is unresolved how Aβ accumulates in the central nervous system and subsequently initiates the disease of cells. Significant efforts have been focused on the mechanisms responsible for Aβ production, including the proteolytic enzymes gamma- and β-secretases which generate Aβ from its precursor protein, APP (amyloid precursor protein). Aβ circulates in plasma, cerebrospinal fluid (CSF) and brain interstitial fluid (ISF) mainly as soluble Aβ40. Amyloid plaques contain both Aβ40 and Aβ42, while vascular amyloid is predominantly the shorter Aβ40. Several sequences of Aβ were found in both lesions.

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