Authors: Sara Linse, Tom Scheidt, Katja Bernfur, Michele Vendruscolo, Christopher M. Dobson, Samuel I. A. Cohen, Eimantas Sileikis, Martin Lundqvist, Fang Qian, Tiernan O'Malley, Thierry Bussiere, Paul H. Weinreb, Catherine K. Xu, Georg Meisl, Sean R. A. Devenish, Tuomas P. J. Knowles & Oskar Hansson
Nature Struct. Mol. Biol., 2020, 27, 1125–1133. DOI: 10.1038/s41594-020-0505-6
The amyloid cascade hypothesis, according to which the self-assembly of amyloid-β peptide (Aβ) is a causative process in Alzheimer’s disease, has driven many therapeutic efforts for the past 20 years. Failures of clinical trials investigating Aβ-targeted therapies have been interpreted as evidence against this hypothesis, irrespective of the characteristics and mechanisms of action of the therapeutic agents, which are highly challenging to assess.
Here, Linse et al. combine kinetic analyses with quantitative binding measurements to address the mechanism of action of four clinical stage anti-Aβ antibodies, aducanumab, gantenerumab, bapineuzumab and solanezumab. They quantify the influence of these antibodies on the aggregation kinetics and on the production of oligomeric aggregates and link these effects to the affinity and stoichiometry of each antibody for monomeric and fibrillar forms of Aβ. Their results reveal that, uniquely among these four antibodies, aducanumab dramatically reduces the flux of Aβ oligomers.