Our data provide strong evidence that Aβ is generated in AVs during macroautophagy. Moreover, macroautophagy is both induced and impaired in AD brain and PS1/APP mice, leading to the pathological accumulation of Aβ-containing AVs within affected neurons. Macroautophagy induction was evidenced by an appearance of autophagosomes, which are only rarely detectable in normal brain (
Nixon et al., 2005), and by elevated levels and cytosol-to-vesicle translocation of LC3-II, which is a specific marker of autophagosome formation. These changes are evident at the earliest stage of AD and in 8–9-wk-old PS1/APP mice before Aβ deposition, which suggests that macroautophagy induction is an early response in disease development, although it is not necessarily independent of Aβ influences. The specific pathologic events that induce macroautophagy in predepositing PS1/APP mice are not known, but sources of oxidative stress, including intracellular forms of Aβ (
Billings et al., 2005), are possible factors contributing to macroautophagy induction or to later dysfunction of the pathway. The induction of macroautophagy at early stages of AD is consistent with the expected need for increased protein/organelle turnover in injured and regenerating neurites as well as for protection against apoptotic stimuli, such as damaged mitochondria, that are turned over by macroautophagy (
Brunk and Terman, 2002).
The most striking feature of the macroautophagy-related pathology in PS1/APP mouse brains was a grossly abnormal accumulation of autophagosomes and other AV subtypes in dystrophic neurites of the cortex and hippocampus, as also seen in AD brain (
Nixon et al., 2005). Lysosome-related multilamellar and dense bodies have been described previously in neurological disease states (
Suzuki and Terry, 1967;
Masliah et al., 1993) and, in part, represent late stages of macroautophagic activity and lysosomal digestion (
Nixon et al., 2005). In contrast, we found that dystrophic neurites contain very high proportions of autophagosomes and other immature AVs, implying impairment in the normal maturation of these nascent AVs to lysosomes. During normal neurite outgrowth or regeneration, immature AVs move retrogradely and fuse with lysosomes in the neurite or are more likely near or within the cell body (
Hollenbeck, 1993). After this fusion event, the contents of the AV are rapidly degraded, and the AV becomes a lysosome (
Overly and Hollenbeck, 1996). This process is normally highly efficient, with little evidence of AV buildup. In dystrophic neurites, however, the striking buildup of autophagosomes and late AVs implies a defect in AV transport, maturation to lysosomes, or both, which is likely to impede lysosomal degradation through this pathway (
Nixon et al., 2005).
Our data provide strong evidence that Aβ is generated in one or more subtypes of AVs that build up abnormally in affected neurons. AVs not only contain immunoreactive Aβ and βCTF but are also enriched in PS-dependent γ-secretase activity. Senile plaques in AD and PS1/APP mouse brains are also abundantly immunoreactive for these components. Our data confirm findings that PS1 and nicastrin are enriched in lysosomes (
Pasternak et al., 2003) and indicate that AVs, which were not distinguished from lysosomes in these earlier studies, are a more concentrated source of these γ-secretase components. Our findings also explain and are supported by observations that inclusion body myositis, which is the only known condition in which Aβ deposits occur outside the nervous system, involves the accumulation of macroautophagy-related “rimmed” vacuoles containing elevated APP, Aβ, and PS1 (
Askanas et al., 1998). Previous studies have identified intracellular Aβ accumulation in endosomes (
Cataldo et al., 2004a) and multivesicular bodies (
Takahashi et al., 2002) in AD and Down syndrome (
Gyure et al., 2001). Macroautophagy could substantially increase pools of intracellular Aβ and contribute to the formation of Aβ oligomers and protofibrils, which is a process that is promoted in the acidic environment of lysosome-related organelles (
Vassar and Citron, 2000).
We have also demonstrated, for the first time, that Aβ is generated during macroautophagy. Aβ production rises when macroautophagy is acutely stimulated, and AVs proliferate and fall when macroautophagy is inhibited. AVs are depleted by blocking either of the two independent signaling pathways for macroautophagy that converge on mTOR kinase activity: amino acid–mediated signaling and the PI3-kinase–dependent pathway. Conditions that either stimulate AV production and delay or impair maturation of AVs to lysosomes might be expected to increase the number of AVs and raise intracellular Aβ levels (). Aβ is believed to be generated at several sites within neurons, including endosomes, Golgi, and ER (
Cataldo et al., 2004a), and this multiplicity of APP processing routes would account for our observations that considerable Aβ is still secreted from L/APP, SH-SY5Y, and N2a cells when macroautophagy is inhibited. Endocytic and autophagic pathways communicate extensively, and both Golgi and ER are turned over by macroautophagy (
Dunn, 1990a), raising the possibility that each of these organelles could contribute to Aβ generation, in part, via macroautophagy. This communication between the macroautophagy and endosomal systems also provides one possible avenue for Aβ that is generated during macroautophagy to be released from cells, because late endosomes also communicate with endocytic recycling compartments (for review see
Luzio et al., 2005). Extracellular release of some Aβ from AVs is also possible from exosomes, which is a mechanism proposed for prion release (
Fevrier et al., 2005), or from the direct fusion of AVs with the plasma membrane (
Jackson et al., 2005). It is worth noting, however, that the inefficient extracellular elimination of autophagy-generated Aβ may imply greater pathogenicity of this pool than the Aβ that is normally secreted because intracellular Aβ appears to be more cytotoxic than extracellular Aβ.
Based on the low number of AVs that were detected in normal brain, macroautophagy may play a relatively minor role in constitutive Aβ generation (). At low levels of macroautophagy induction, Aβ that was generated in AVs would be subsequently degraded within lysosomes, which contain the necessary proteases (
Bendiske and Bahr, 2003). In damaged or regenerating neurites, however, where more APP-rich substrates are diverted into the macroautophagy pathway and AV–lysosome fusion may be delayed, intracellular Aβ is generated within specific subtypes of AVs that accumulate ( B). AV accumulation that is associated with any significant neuritic injury could stimulate local Aβ production, as seen, for example, in traumatic brain injury (
Smith et al., 2003). Moreover, in AD, in which large numbers of AVs accumulate and persist without maturing within dystrophic neurites, macroautophagy could contribute substantially to β-amyloidogenesis and especially to intracellular Aβ accumulation. In addition, several risk factors for AD, including aging (
Cuervo and Dice, 2000) and PS mutations (unpublished data), impair AV maturation to lysosomes. This accounts, in part, for the aging-related accentuation of autophagic–lysosomal system pathology and β-amyloidogenesis in familial forms of AD that are caused by PS mutations and in PS/APP mice relative to mice overexpressing mutant APP alone (
Cataldo et al., 2004b).
Collectively, these studies identify AVs as Aβ-generating compartments that accumulate pathologically in AD brain (
Nixon et al., 2005), accounting for a significant source of intracellular Aβ in AD. Macroautophagy, as a pathway for Aβ generation and a mediator of both cell survival and degenerative phenomena (
Nixon et al., 2001), represents a new direction for investigations into the pathogenesis and possible therapy of AD.