The role of beta-amyloid in the development of Alzheimer's disease.

Recent molecular biological, biochemical and immunohistochemical studies have revealed various novel facts about beta-amyloidosis including its role in the pathogenesis of Alzheimer's disease (AD). Such discoveries include the finding that beta/A4-amyloid protein (beta-AP) is the major component of the amyloid found in senile plaques (SPs) and amyloid angiopathy, the elucidation of the molecular structures of beta-AP and beta-amyloid protein precursor (APP), the finding that point mutations of APP are involved in some cases of familial AD (FAD), the location of genes for FAD, APP and Down's syndrome on chromosome 21, and of other genes relating to AD on chromosomes 19, 14 and 6, and the successful development of Alzheimer-type neuropathology in transgenic mice overexpressing V717F APP, a mutation of APP. Furthermore, the involvement of various proteases and their inhibitors in metabolism of beta-AP have been suggested by: the presence of Kunitz class serine protease and metalloprotease inhibitor domains on some APP, the presence of various proteases and inhibitors in SPs and neurofibrillary tangles (NFTs), the involvement of various proteases in the secretory and endosome/lysosome pathways of APP processing, mutation of the APP gene in hereditary cerebral haemorrhage with amyloidosis, Dutch type (HCHWA-D), mutation of the cysteine proteinase inhibitor cystatin C gene in HCHWA-I (Iceland type), and abnormal increases of some proteases or the inhibitors in dystrophic neurites of SP, amyloid of SP, and NFTs. Judging from these reports, dysfunction or deregulation of proteolytic systems may play an important role in beta-amyloid formation. Recent studies of beta-amyloid and various proteases and inhibitors in disorders associated with beta-amyloid formation are reviewed including our 'overload hypothesis' as an underlying event in the dysfunction of proteolytic systems. This information should be helpful to identify targets in the development of drugs for the treatment of AD or other age-related disorders.