6 The discovery of BYL719 mouse amyloid deposits in both diffuse and neuritic plaques as a major characteristic of Alzheimer’s disease pathology has been interpreted to mean that there is increased amyloid production. However, deposition could clearly be the result of decreased clearance, degradation, or of some other process occurring in the tissue. Recent data from three different groups has suggested that most of the familial Alzheimer’s disease mutations in APP and presenilins

1 and 2 actually result in reductions in the rate of cleavage of the APP, and reduced rates of β-amyloid production.7-9 This is clearlydifficult Inhibitors,research,lifescience,medical to reconcile with the huge increase in amyloid deposits in brain tissue, and has led to modifications in the original pathogenic cascade model. Indeed, over the last 10 years, more and more groups have moved away from the original formulation of the amyloid cascade hypothesis, in large measure because it is clear that there is only very limited neurotoxicity associated with deposition of β-amyloid. This is especiallytrue in mice. Inhibitors,research,lifescience,medical A large number of transgenic mice Inhibitors,research,lifescience,medical have been made in which overexpression

of mutant human APP (sometimes combined with a mutant presenilinl gene) drives deposition of large amounts of β-amyloid in the brain. The vast majority of these transgenic mice do not have evidence of neuronal degeneration or cell death, nor do they feature neurofibrillary tangle formation. This result is not what would be expected if the original proposal of the amyloid

cascade hypothesis were correct. These and other results have led to modifications of the original hypothesis Inhibitors,research,lifescience,medical that propose that it is not deposition of β-amyloid that is the initiating event in pathology, but the formation of a soluble “toxic species” of βamyloid peptides.10,11 Along this line of reasoning, some have suggested that the deposition of β-amyloid may Inhibitors,research,lifescience,medical in fact be neuroprotective,12,13 with resultant sequestration of potentially toxic species. These toxic species are proposed to be oligomers, small aggregates of 2 to 12 peptide molecules, usually of the 42 amino acid long β-amyloid peptide.11,14 There remains considerable controversy about the precise molecular nature of the toxic species, and oxyclozanide about the mechanism by which this species produces detrimental effects on neurons. The most common explanation is that synaptic disruption is the immediate toxic event,15 although precisely how this happens in the Alzheimer’s disease brain remains poorly understood. Whether amyloid deposits or some soluble species is considered to be the initiating factor in the disease, these approaches are considered as “toxic gain of function models,” in which disease is proposed to be caused by the formation of novel molecular entities that cause toxicity. There is now a fairly vocal minority of researchers who have proposed that it is not actually the formation of any β-amyloid species that is the problem.