二甲双胍降低肥胖大鼠海马内PPARγ、IDE表达伴随TNF-α和Aβ42表达上调

二甲双胍（metformin,MET）常用于肥胖胰岛素抵抗患者改善胰岛素抵抗降低血糖,但MET可增加脑内β-淀粉肽（β-amyloid,Aβ）表达,目前机制不清.Aβ沉积作为阿尔茨海默病（Alzheimer's disease, AD)始发病理生理学改变,在AD中发挥重要作用. 为研究MET对脑内Aβ表达的影响及机制,采用饮食诱导肥胖大鼠模型 （OB组）予MET灌胃4 W后（MET组）,观察海马内Aβ42及相关因子肿瘤坏死因子α （TNF-α）、过氧化物酶体增殖物激活受体γ(peroxisome proliferator-activated receptor γ, PPARγ)、胰岛素降解酶（insulin degrading enzyme, IDE）的表达. 结果显示,OB组大鼠血糖水平较对照组（CTL组）无明显差异,胰岛素含量明显升高（P<0.01), 并存在胰岛素抵抗;OB组大鼠海马内TNF-α、 Aβ42 水平较CTL组上调,PPARγ、IDE表达下降(P<0.05). MET组胰岛素及胰岛素抵抗均较OB组降低(P<0.05),海马内TNF-α、Aβ42表达增加(P<0.01);PPARγ,IDE表达较OB组减少(P<0.01). 上述结果提示,二甲双胍作为治疗肥胖胰岛素抵抗的一线用 药,可改善胰岛素抵抗,但增加海马内炎性因子TNF-α表达、减少PPARγ水平,降低其调控IDE转录作用,使IDE表达减少,伴随Aβ42降解减少沉积增加,从而可能增加AD发病风险.     

阿尔茨海默病中β淀粉样蛋白的生成及清除的调节

阿尔茨海默病（Alzheimer’s disease, AD）是一种慢性退行性神经系统疾病,临床主要表现为进行性认知能力下降、记忆力衰退、人格改变等。AD的标志性病理特征包括脑细胞外β淀粉样蛋白（β-amyloid protein,Aβ）沉积形成老年斑、细胞内神经纤维缠结(neurofibrillary tangles,NFT)、神经炎症增加以及神经元凋亡。β淀粉样蛋白主要在神经元产生,是淀粉样前体蛋白经过一系列酶解反应生成的由39～42个氨基酸组成的多肽,调节Aβ的生成和清除能够有效延缓甚至逆转阿尔茨海默病的进程,因而具有重大的研究价值。β-分泌酶（β-site APP cleaving enzyme 1,BACE1）为Aβ产生过程中的关键酶,其含量及活性的改变均能影响Aβ产生,在阿尔茨海默病的发生发展中发挥至关重要的作用;老年斑周围炎性细胞的聚集提示,AD与神经炎症高度相关,神经炎症相关细胞能够参与Aβ的清除,多种炎性因子也能调节Aβ的生成;非编码RNA虽很少直接参与Aβ的产生、沉积和清除,但其可以通过多种途径调节Aβ的产生。本文从β淀粉样蛋白生成及清除的机制着手,重点阐述了BACE1、神经炎症、非编码RNA对Aβ调控的重要作用,以期为AD发病机制的进一步研究提供思路,并对阿尔茨海默病早期干预及治疗提供理论参考。     

谷氧还蛋白rbGrx可延缓CL4176秀丽隐杆线虫中β淀粉样蛋白诱导的毒性

阿尔茨海默病（Alzheimer’s disease,AD）是一种与衰老相关的神经退行性疾病,其中β-淀粉样蛋白（β-amyloid,Aβ）诱导的细胞毒性被认为是其发病的主要原因。本文以Aβ转基因秀丽隐杆线虫CL4176为模型,研究了重组荞麦谷氧还蛋白（recombinant buckwheat glutaredoxin, rbGrx）对Aβ诱导的毒性和氧化应激的影响。结果显示,4 μmol/L rbGrx可以延长CL4176线虫平均寿命达20%左右,并增加衰老虫体运动能力约43.6%,延迟产卵高峰期1 d,同时可以有效延缓Aβ毒性诱导的瘫痪表型。进一步研究发现,在正常条件和Aβ诱导毒性时,rbGrx均能降低CL4176线虫体内活性氧（reactive oxygen species,ROS）水平,并上调SOD活性和GSH含量。另外,rbGrx下调Aβ mRNA水平44.1％,减少Aβ沉积量,并且明显上调热激因子1 hsf-1（2.01倍）和hsp-16.2（2.65倍）mRNA表达水平。这表明,rbGrx通过降低CL4176线虫体内的ROS水平和上调热激蛋白质的转录表达水平,降低CL4176秀丽隐杆线虫中Aβ诱导的毒性。结果提示,rbGrx可能具有预防AD的潜力。     

藏药七十味珍珠丸改善APP/PS1小鼠学习记忆能力

藏药七十味珍珠丸（ratanasampil,RNSP）可改善大脑氧化应激水平,改善大脑功能,有安神和促进学习记忆的功效,然而RNSP是否可改善阿尔茨海默症（AD）小鼠的学习记忆功能,尚缺乏系统研究。本研究采用APP/PS 1转基因小鼠为研究对象,并随机将其分为实验组和对照组。对实验组进行为期12周的RNSP灌胃给药,对照组进行12周的蒸馏水灌胃,采用Morris水迷宫与开场实验评价小鼠学习记忆能力,比较小鼠体重与相关器官质量,并比较器官质量指数,通过分子生物学检测指标评价小鼠脑内老年斑数量,Aβ生成量及BACE1表达水平。本研究证实,与对照组相比,给药组小鼠定位航行潜伏期明显缩短（22.60±13.26 vs. 46.44±8.41, P<0.01, day 5）,穿越平台次数明显增加（1.29±0.37 vs. 0.54±0.29, P<0.01）,探洞次数明显增加（32.11±9.85 vs. 20.89±8.78, P<0.05）,表明RNSP提高了APP/PS 1小鼠的学习记忆能力和空间探索能力。与对照组相比,给药组小鼠大脑重量及脑质量指数均增高（0.4135±0.0102 vs. 0.3833±0.0254, P<0.05;2.04±0.08 vs. 1.84±0.15, P<0.05）,脑内老年斑数量减少（18.70±7.88 vs. 38.83±6.15, P<0.05）,Aβ1- 42水平及BACE1表达均显著降低（0.19±0.08 vs. 0.41±0.12, P<0.05; 0.136±0.04 vs. 0.206±0.02, P<0.05）,表明RNSP延缓了APP/PS 1小鼠的脑萎缩进程,降低脑内老年斑的形成,下调脑内Aβ1-42水平和BACE1裂解酶的蛋白质表达量。本研究提示,RNSP可改善APP/PS 1小鼠的学习记忆能力,其机制可能和RNSP抑制脑萎缩,降低BACE1蛋白表达以及减少脑内Aβ沉积有关。     

二维纳米材料抗β-淀粉样蛋白治疗阿尔茨海默病

阿尔茨海默病（Alzheimer’s disease, AD）是一种老年人群中高发的进行性神经退行性疾病。β-淀粉样蛋白（β-amyloid,Aβ）假说是目前科学界广泛支持的AD发病机制。清除Aβ、阻止Aβ聚集和解聚Aβ纤维的策略有望给AD的治疗提供有效途径。然而,目前已报道的抗Aβ治疗AD的药物存在的诸多缺点,限制了其临床应用。随着纳米技术的飞速发展,二维纳米材料在医学上的应用逐渐受到研究人员的关注。二维纳米材料不仅理化特性优异,而且生物相容性良好,还易于穿越细胞膜及血脑屏障。近年来研究发现,多种二维纳米材料能通过分子间相互作用力、近红外光热效应、光催化氧化、Cu2 +螯合以及药物负载等机制来抑制Aβ聚集,或使Aβ纤维解聚,在治疗AD方面有着很大的潜力。本文将围绕石墨烯和类石墨烯二维纳米材料,例如二硫化钼、石墨相氮化碳、黑磷等用于抗Aβ治疗AD方面的研究进行综述。     

Deoxygedunin对D-半乳糖联合AlCl3诱导大鼠阿尔茨海默病病理性改变的影响

目的：观察Deoxygedunin对D-半乳糖联合AlCl₃诱导的阿尔茨海默病模型大鼠Aβ沉积、学习记忆和氧化应激的影响及其可能机制。方法：健康成年雄性SD大鼠随机分为3组（n=12）：对照组（Control）、模型组（AD）和干预组（AD+Deo）。Morris水迷宫实验检测大鼠学习记忆和认知功能;采用酶联免疫吸附法（ELISA）检测大鼠海马组织匀浆中谷胱甘肽过氧化物酶（GSH-Px）、超氧化物歧化酶（SOD）和丙二醛（MDA）含量;免疫组织化学检测大鼠大脑皮层tau蛋白表达情况;Western blot实验用于检测TrkB信号通路上ERK1、AKT和TrkB蛋白的表达。结果：水迷宫结果显示,与对照组相比,D-半乳糖联合AlCl₃诱导的大鼠逃避潜伏期显著增加（P<0.05）。Deoxygedunin可逆转模型组逃避潜伏期的增加（P<0.05）。在去除平台的第7日,与对照组和干预组相比,模型组大鼠表现出逃避潜伏期增加（P<0.01）,穿越平台次数较少（P<0.05）;免疫组织化学和ELISA实验结果显示,与对照组相比,模型组Aβ、tau蛋白表达显著增加（P<0.01）,SOD、GSH-Px活性显著降低,MDA含量明显升高。与模型组相比,Deoxygedunin可逆转模型组Aβ、tau蛋白表达的增多（P<0.01）,SOD、GSH-Px活性显著降低（P<0.05）,MDA含量明显升高（P<0.05）;Western blot结果显示,Deoxygedunin干预可逆转模型组海马TrkB、AKT和ERK1的磷酸化水平的降低。结论：Deoxygedunin可通过激活TrkB信号转导通路显著逆转Aβ沉积,氧化应激和认知缺陷,提示Deoxygedunin可能作为减轻D-半乳糖联合AlCl₃诱导AD样病理功能障碍潜在的治疗备选药物。     

不同寡聚形式的Aβ42与细胞膜作用显示毒性差异

β-淀粉样蛋白（β-amyloid peptide, Aβ）与神经细胞膜的相互作用是阿尔茨海默症（Alzheimer’s disease, AD）发病的重要事件,但不同寡聚形式的Aβ与细胞膜相互作用的差异仍缺乏直接比较。本文通过膜天平、透射电子显微镜、Thioflavin T(ThT)和细胞毒性实验等方法,检测Aβ42单体、ADDL、原纤维等形式的β-淀粉样蛋白与磷脂膜的作用方式,分析不同形式淀粉样蛋白对细胞的毒性作用。结果显示,（1）单层膜的实验数据可以判断Aβ42单体和寡聚体插膜能力存在差异,Aβ42单体能插入磷脂单层膜内,而Aβ42 ADDL不具备插膜能力;（2）透射电镜和ThT荧光检测,定性定量地分析出不同聚集形式的Aβ42具有不同的纤维化能力,Aβ42单体纤维化能力最强,而Aβ42原纤维的纤维化能力次之,Aβ42ADDL很难形成纤维;（3）Aβ42单体细胞毒性较弱,而Aβ42 ADDL和原纤维的细胞毒性较强。由以上结果可以得出结论：在磷脂膜存在的条件下,Aβ42单体可以插入膜内并迅速形成无毒性的Aβ42纤维,因此,细胞毒性较弱。而ADDL及原纤维不能插入膜内,纤维化能力较弱,从而以寡聚体的形式发挥细胞毒性。将单体、ADDL及原纤维形式的Aβ42与细胞膜相互作用进行分析,将为Aβ42在AD中的毒性机制研究提供一定的参考。但各种寡聚体入胞的方式及毒性机制仍需要进一步研究。     

胰岛素降解酶在阿尔茨海默病发病机制中的研究进展

阿尔茨海默病（Alzheimer’s disease,AD）是一种以进行性认知功能减退为特征的神经退行性疾病。发病的确切机制尚未完全清楚。目前认为胰岛素抵抗与胰岛素信号系统受损是加速AD发病的危险因素,胰岛素降解酶（insulin-degrading enzyme,IDE）在糖代谢异常促使AD发病的过程中发挥重要的作用。除调节β淀粉样蛋白降解和清除之外,还可能通过调节tau蛋白磷酸化水平,协同载脂蛋白Ee4（ApoEe4）及影响胰岛素信号传导等参与AD的发病机制。本文就IDE生物学特性及在AD发病机制中的作用作一综述。     

TGF-β1对Aβ1-42诱导海马神经元-小胶质细胞共培养体系中细胞因子表达和分泌的影响

目的：探讨在海马神经元和小胶质细胞共培养体系中转化生长因子-β1（TGF-β1）对β淀粉样肽1-42（Aβ_1-42）诱导的小胶质细胞激活表达和分泌细胞因子的影响。方法：将大鼠海马神经元和小胶质细胞进行共同培养,于共同培养后第5日,加入TGF-β1（5 or 20 ng/ml）,1 h后加入Aβ_1-42（5 μmol/L）,继续培养72 h后用于后续实验,Western blot法检测诱导型一氧化氮合酶（iNOS）的蛋白表达;Real-time PCR和ELISA法检测肿瘤坏死因子-α（TNF-α）、白介素-1β（IL-1β）和胰岛素样生长因子（IGF-1）的mRNA表达和分泌。结果：在共同培养的海马神经元与小胶质细胞体系中,Aβ_1-42诱导炎症因子iNOS、TNF-α和IL-1β的表达和/或分泌上调,神经营养因子IGF-1表达下调,TGF-β1预处理削弱上述Aβ_1-42的作用。结论：TGF-β1明显抑制Aβ_1-42诱导的小胶质细胞激活引起的炎性细胞因子的增加和神经营养因子的减少。     

老年性痴呆抗体药物研究进展

老年性痴呆(Alzhimer's disease,AD)是一种渐进性神经退化性疾病,其主要表现为记忆功能衰减及识别能力障碍,同时伴有各种神经症状和行为障碍,具有非常高的发病率,目前还没有特异性治疗药物。随着世界人口老龄化,AD发病率逐年增高,成为本世纪威胁人类健康最严重的疾病之一。近年来AD的发病机理和药物研究方面都有突破性进展,尤其是制备针对β淀粉样蛋白（amyloid beta protein,Aβ）特异性抗体药物成为AD治疗极具价值的途径。本文主要对以Aβ为主的AD发病机理和针对Aβ的抗体药物的治疗机制、研究现状及进展进行综述,为进一步研发AD治疗药物提供参考。     

Decreased catalytic activity of the insulin-degrading enzyme in chromosome 10-linked Alzheimer disease families

Insulin-degrading enzyme (IDE) is a zinc metalloprotease that degrades the amyloid beta-peptide, the key component of Alzheimer disease (AD)-associated senile plaques. We have previously reported evidence for genetic linkage and association of AD on chromosome 10q23-24 in the region harboring the IDE gene. Here we have presented the first functional assessment of IDE in AD families showing the strongest evidence of the genetic linkage. We have examined the catalytic activity and expression of IDE in lymphoblast samples from 12 affected and unaffected members of three chromosome 10-linked AD pedigrees in the National Institute of Mental Health AD Genetics Initiative family sample. We have shown that the catalytic activity of cytosolic IDE to degrade insulin is reduced in affected versus unaffected subjects of these families. Further, we have shown the decrease in activity is not due to reduced IDE expression, suggesting the possible defects in IDE function in these AD families. In attempts to find potential mutations in the IDE gene in these families, we have found no coding region substitutions or alterations in splicing of the canonical exons and exon 15b of IDE. We have also found that total IDE mRNA levels are not significantly different in sporadic AD versus age-matched control brains. Collectively, our data suggest that the genetic linkage of AD in this set of chromosome 10-linked AD families may be the result of systemic defects in IDE activity in the absence of altered IDE expression, further supporting a role for IDE in AD pathogenesis.     

The catalytic domain of insulin-degrading enzyme forms a denaturant-resistant complex with amyloid beta peptide: implications for Alzheimer disease pathogenesis

Insulin-degrading enzyme (IDE) is central to the turnover of insulin and degrades amyloid beta (Abeta) in the mammalian brain. Biochemical and genetic data support the notion that IDE may play a role in late onset Alzheimer disease (AD), and recent studies suggest an association between AD and diabetes mellitus type 2. Here we show that a natively folded recombinant IDE was capable of forming a stable complex with Abeta that resisted dissociation after treatment with strong denaturants. This interaction was also observed with rat brain IDE and detected in an SDS-soluble fraction from AD cortical tissue. Abeta sequence 17-27, known to be crucial in amyloid assembly, was sufficient to form a stable complex with IDE. Monomeric as opposed to aggregated Abeta was competent to associate irreversibly with IDE following a very slow kinetics (t(1/2) approximately 45 min). Partial denaturation of IDE as well as preincubation with a 10-fold molar excess of insulin prevented complex formation, suggesting that the irreversible interaction of Abeta takes place with at least part of the substrate binding site of the protease. Limited proteolysis showed that Abeta remained bound to a approximately 25-kDa N-terminal fragment of IDE in an SDS-resistant manner. Mass spectrometry after in gel digestion of the IDE .Abeta complex showed that peptides derived from the region that includes the catalytic site of IDE were recovered with Abeta. Taken together, these results are suggestive of an unprecedented mechanism of conformation-dependent substrate binding that may perturb Abeta clearance, insulin turnover, and promote AD pathogenesis.     

BRI2 protein regulates β-amyloid degradation by increasing levels of secreted insulin-degrading enzyme (IDE)

The amyloid precursor protein (APP) is one of the major proteins involved in Alzheimer disease (AD). Proteolytic cleavage of APP gives rise to amyloid-β (Aβ) peptides that aggregate and deposit extensively in the brain of AD patients. Although the increase in levels of aberrantly folded Aβ peptide is considered to be important to disease pathogenesis, the regulation of APP processing and Aβ metabolism is not fully understood. Recently, the British precursor protein (BRI2, ITM2B) has been implicated in influencing APP processing in cells and Aβ deposition in vivo. Here, we show that the wild type BRI2 protein reduces plaque load in an AD mouse model, similar to its disease-associated mutant form, ADan precursor protein (ADanPP), and analyze in more detail the mechanism of how BRI2 and ADanPP influence APP processing and Aβ metabolism. We find that overexpression of either BRI2 or ADanPP reduces extracellular Aβ by increasing levels of secreted insulin-degrading enzyme (IDE), a major Aβ-degrading protease. This effect is also observed with BRI2 lacking its C-terminal 23-amino acid peptide sequence. Our results suggest that BRI2 might act as a receptor protein that regulates IDE levels that in turn influences APP metabolism in a previously unrecognized way. Targeting the regulation of IDE may be a promising therapeutic approach to sporadic AD.     

Insulin-degrading enzyme secretion from astrocytes is mediated by an autophagy-based unconventional secretory pathway in Alzheimer disease

The secretion of proteins that lack a signal sequence to the extracellular milieu is regulated by their transition through the unconventional secretory pathway. IDE (insulin-degrading enzyme) is one of the major proteases of amyloid beta peptide (Aβ), a presumed causative molecule in Alzheimer disease (AD) pathogenesis. IDE acts in the extracellular space despite having no signal sequence, but the underlying mechanism of IDE secretion extracellularly is still unknown. In this study, we found that IDE levels were reduced in the cerebrospinal fluid (CSF) of patients with AD and in pathology-bearing AD-model mice. Since astrocytes are the main cell types for IDE secretion, astrocytes were treated with Aβ. Aβ increased the IDE levels in a time- and concentration-dependent manner. Moreover, IDE secretion was associated with an autophagy-based unconventional secretory pathway, and depended on the activity of RAB8A and GORASP (Golgi reassembly stacking protein). Finally, mice with global haploinsufficiency of an essential autophagy gene, showed decreased IDE levels in the CSF in response to an intracerebroventricular (i.c.v.) injection of Aβ. These results indicate that IDE is secreted from astrocytes through an autophagy-based unconventional secretory pathway in AD conditions, and that the regulation of autophagy is a potential therapeutic target in addressing Aβ pathology.     

The irreversible binding of amyloid peptide substrates to insulin-degrading enzyme

Insulin-degrading enzyme (IDE) is a conserved Zn2+metalloendopeptidase involved in insulin degradation and in the maintenance of brain steady-state levels of amyloid β peptide (Aβ) of Alzheimer’s disease (AD). Our recent demonstration that IDE and Aβ are capable of forming a stoichiometric and extremely stable complex raises several intriguing possibilities regarding the role of this unique protein-peptide interaction in physiological and pathological conditions. These include a protective cellular function of IDE as a “dead-end chaperone” alternative to its proteolytic activity and the potential impact of the irreversible binding of Aβ to IDE upon its role as a varicella zoster virus receptor. In a pathological context, the implications for insulin signaling and its relationship to AD pathogenesis are discussed. Moreover, our findings warrant further research regarding a possible general and novel interaction between amyloidogenic peptides and other Zn2+metallopeptidases with an IDE-like fold and a substrate conformation-dependent recognition mechanism.     

Roles of amyloid beta-peptide-associated oxidative stress and brain protein modifications in the pathogenesis of Alzheimer's disease and mild cognitive impairment

Oxidative stress has been implicated to play a crucial role in the pathogenesis of a number of diseases, including neurodegenerative disorders, cancer, and ischemia, just to name a few. Alzheimer disease (AD) is an age-related neurodegenerative disorder that is recognized as the most common form of dementia. AD is histopathologically characterized by the presence of extracellular amyloid plaques, intracellular neurofibrillary tangles, the presence of oligomers of amyloid beta-peptide (Abeta), and synapse loss. In this review we discuss the role of Abeta in the pathogenesis of AD and also the use of redox proteomics to identify oxidatively modified brain proteins in AD and mild cognitive impairment. In addition, redox proteomics studies in in vivo models of AD centered around human Abeta(1-42) are discussed.     

The irreversible binding of amyloid peptide substrates to insulin-degrading enzyme: A biological perspective

Insulin-degrading enzyme (IDE) is a conserved Zn²⁺metalloendopeptidase involved in insulin degradation and in the maintenance of brain steady-state levels of amyloid β peptide (Aβ) of Alzheimer''s disease (AD). Our recent demonstration that IDE and Aβ are capable of forming a stoichiometric and extremely stable complex raises several intriguing possibilities regarding the role of this unique protein-peptide interaction in physiological and pathological conditions. These include a protective cellular function of IDE as a “dead-end chaperone” alternative to its proteolytic activity and the potential impact of the irreversible binding of Aβ to IDE upon its role as a varicella zoster virus receptor. In a pathological context, the implications for insulin signaling and its relationship to AD pathogenesis are discussed. Moreover, our findings warrant further research regarding a possible general and novel interaction between amyloidogenic peptides and other Zn²⁺metallopeptidases with an IDE-like fold and a substrate conformation-dependent recognition mechanism.Key words: amyloid, insulin-degrading enzyme, peptides, alzheimer''s disease, irreversible binding, metalloproteases     

Reduced amyloid‐β degradation in early Alzheimer's disease but not in the APPswePS1dE9 and 3xTg‐AD mouse models

Alzheimer's disease (AD) is hallmarked by amyloid‐β (Aβ) peptides accumulation and aggregation in extracellular plaques, preceded by intracellular accumulation. We examined whether intracellular Aβ can be cleared by cytosolic peptidases and whether this capacity is affected during progression of sporadic AD (sAD) in humans and in the commonly used APPswePS1dE9 and 3xTg‐AD mouse models. A quenched Aβ peptide that becomes fluorescent upon degradation was used to screen for Aβ‐degrading cytoplasmic peptidases cleaving the aggregation‐prone KLVFF region of the peptide. In addition, this quenched peptide was used to analyze Aβ‐degrading capacity in the hippocampus of sAD patients with different Braak stages as well as APPswePS1dE9 and 3xTg‐AD mice. Insulin‐degrading enzyme (IDE) was found to be the main peptidase that degrades cytoplasmic, monomeric Aβ. Oligomerization of Aβ prevents its clearance by IDE. Intriguingly, the Aβ‐degrading capacity decreases already during the earliest Braak stages of sAD, and this decline correlates with IDE protein levels, but not with mRNA levels. This suggests that decreased IDE levels could contribute to early sAD. In contrast to the human data, the commonly used APPswePS1dE9 and 3xTg‐AD mouse models do not show altered Aβ degradation and IDE levels with AD progression, raising doubts whether mouse models that overproduce Aβ peptides are representative for human sAD.     

Tau Proteins and Tauopathies in Alzheimer’s Disease

Alzheimer’s disease (AD) is characterized by progressive memory loss and cognitive function deficits. There are two major pathological hallmarks that contribute to the pathogenesis of AD which are the presence of extracellular amyloid plaques composed of amyloid-β (Aβ) and intracellular neurofibrillary tangles composed of hyperphosphorylated tau. Despite extensive research that has been done on Aβ in the last two decades, therapies targeting Aβ were not very fruitful at treating AD as the efficacy of Aβ therapies observed in animal models is not reflected in human clinical trials. Hence, tau-directed therapies have received tremendous attention as the potential treatments for AD. Tauopathies are closely correlated with dementia and immunotherapy has been effective at reducing tau pathology and improving cognitive deficits in animal models. Thus, in this review article, we discussed the pathological mechanism of tau proteins, the key factors contributing to tauopathies, and therapeutic approaches for tauopathies in AD based on the recent progress in tau-based research.