The genetic landscape for amyloid beta fibril nucleation accurately discriminates familial Alzheimer's disease mutations.

ABSTRACT

Plaques of the amyloid beta (Aß) peptide are a pathological hallmark of Alzheimer's disease (AD), the most common form of dementia. Mutations in Aß also cause familial forms of AD (fAD). Here, we use deep mutational scanning to quantify the effects of >14,000 mutations on the aggregation of Aß. The resulting genetic landscape reveals mechanistic insights into fibril nucleation, including the importance of charge and gatekeeper residues in the disordered region outside of the amyloid core in preventing nucleation. Strikingly, unlike computational predictors and previous measurements, the empirical nucleation scores accurately identify all known dominant fAD mutations in Aß, genetically validating that the mechanism of nucleation in a cell-based assay is likely to be very similar to the mechanism that causes the human disease. These results provide the first comprehensive atlas of how mutations alter the formation of any amyloid fibril and a resource for the interpretation of genetic variation in Aß.

Alzheimer's disease is the most common form of dementia, affecting more than 50 million people worldwide. Despite more than 400 clinical trials, there are still no effective drugs that can prevent or treat the disease. A common target in Alzheimer's disease trials is a small protein called amyloid beta. Amyloid beta proteins are 'sticky' molecules. In the brains of people with Alzheimer's disease, they join to form first small aggregates and then long chains called fibrils, a process which is toxic to neurons. Specific mutations in the gene for amyloid beta are known to cause rare, aggressive forms of Alzheimer's disease that typically affect people in their fifties or sixties. But these are not the only mutations that can occur in amyloid beta. In principle, any part of the protein could undergo mutation. And given the size of the human population, it is likely that each of these mutations exists in someone alive today. Seuma et al. reasoned that studying these mutations could help us understand the process by which amyloid beta forms new aggregates. Using an approach called deep mutational scanning, Seuma et al. mutated each point in the protein, one at a time. This produced more than 14,000 different versions of amyloid beta. Seuma et al. then measured how quickly these mutants were able to form aggregates by introducing them into yeast cells. All the mutations known to cause early-onset Alzheimer's disease accelerated amyloid beta aggregation in the yeast. But the results also revealed previously unknown properties that control how fast aggregation occurs. In addition, they highlighted a number of positions in the amyloid beta sequence that act as 'gatekeepers'. In healthy brains, these gatekeepers prevent amyloid beta proteins from sticking together. When mutated, they drive the protein to form aggregates. This comprehensive dataset will help researchers understand how proteins form toxic aggregates, which could in turn help them find ways to prevent this from happening. By providing an 'atlas' of all possible amyloid beta mutations, the dataset will also help clinicians interpret any new mutations they encounter in patients. By showing whether or not a mutation speeds up aggregation, the atlas will help clinicians predict whether that mutation increases the risk of Alzheimer's disease.