(American Journal of Pathology. 1999;154:1-6.)
© 1999 American Society for Investigative Pathology
The Tauopathies
Toward an Experimental Animal Model
Michel Goedert and
Masato Hasegawa
From the Medical Research Council Laboratory of Molecular Biology,
Cambridge, United Kingdom
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Introduction
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Abundant intraneuronal neurofibrillary lesions within
certain brain regions constitute a defining neuropathological
characteristic of Alzheimer's disease.1
Ultrastructurally,
the neurofibrillary lesions consist of abnormal filamentous deposits in
the form of paired helical filaments (PHFs) and the related straight
filaments (SFs). These filaments are made of the microtubule-associated
protein tau in a hyperphosphorylated state. In normal brain, tau
protein is soluble and nonfilamentous. Its ordered assembly into
filaments is therefore a pathological event. Tau pathology is not
limited to Alzheimer's disease but is also present in a number of
other dementing disorders, such as Pick's disease, progressive
supranuclear palsy, and corticobasal degeneration.2,3
In
these disorders, as in Alzheimer's disease, the hyperphosphorylated
tau protein is filamentous. However, the filament morphologies and tau
isoform compositions differ from those of Alzheimer's disease. The
good correlation between the presence of tau pathology and the degree
of cognitive impairment has suggested that the events leading to the
formation of tau filaments or the mere presence of these filaments are
sufficient to produce nerve cell degeneration. Recently, this view has
been significantly reinforced by the discovery of mutations in the tau
gene in familial frontotemporal dementia and parkinsonism linked to
chromosome 17 (FTDP-17).4-8
The new work will no doubt
lead to increased efforts aimed at producing experimental animal models
of the tau pathology of Alzheimer's disease and other tauopathies.
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Tau Protein and its Assembly into Filaments
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Tau protein promotes microtubule assembly and binds to
microtubules, which are thus stabilized. In adult human brain six tau
isoforms are expressed; they are produced by alternative mRNA splicing
from a single gene located on the long arm of chromosome 17 (Figure 1)
. They differ by the presence of three
or four tandem repeats of 31 or 32 amino acids each located in the
carboxyl-terminal region in conjunction with 0, 29, or 58 amino acid
inserts located in the amino-terminal region.9,10
There is
also a larger tau isoform, with an additional insert in the
amino-terminal region, which is mainly expressed in the peripheral
nervous system.11,12
Eleven exons contribute to the longest
human brain tau isoform, with exons 2, 3, and 10 being subject to
alternative mRNA splicing.9,10,13
Tau expression is
developmentally regulated in that only the tau isoform with three
repeats and no amino-terminal inserts is present in fetal brain. There
exist true species differences in the expression of tau isoforms in
adult brain. Thus, only four-repeat tau isoforms are
expressed in rodent brain. By contrast, all six tau isoforms are
expressed in adult human brain, where tau isoforms with three repeats
are slightly more abundant than tau isoforms with four repeats. The
repeat regions of tau and sequences flanking the repeats constitute
microtubule-binding domains.14,15
Tau is expressed
predominantly in nerve cells, with lower levels in some glial cells.
Within nerve cells, it is found mainly in axons.16
Inactivation of the tau gene by homologous recombination leads to no
overt phenotype, indicating that tau is not an essential
protein.17

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Figure 1. Isoforms of human brain tau. The region common to all isoforms is shown
in blue, with the amino-terminal inserts encoded by exons 2 and 3 shown
in red and green, respectively. The alternatively spliced repeat
encoded by exon 10 is in yellow. The three or four tandem repeats are
indicated by black bars. The tau isoforms range from 352 to 441 amino
acids in length. Isoform A is expressed in fetal brain, whereas all six
isoforms (A-F) are
expressed in adult human brain. Transgenic mouse models based on the
expression of isoform F48
or isoform A49
have
been described.
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Tau is a phosphoprotein and phosphorylation is also developmentally
regulated. Thus, tau from developing brain is phosphorylated more than
tau from adult brain. Tau from the PHFs and SFs of Alzheimer's disease
brain is hyperphosphorylated and abnormally phosphorylated on all six
isoforms compared to tau from normal adult human
brain.18,19
This contrasts with progressive supranuclear
palsy and corticobasal degeneration, where only four-repeat tau
isoforms are found in the abnormal filaments.20-22
In
Pick's disease, the tau filaments consist only of three-repeat
isoforms.23
Hyperphosphorylation and abnormal
phosphorylation are major biochemical abnormalities of filamentous tau.
They are early events in the development of tau filaments and as a
result tau is unable to bind to microtubules.24-26
However, it is unclear whether hyperphosphorylation and abnormal
phosphorylation are sufficient for the assembly of tau into filaments.
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Tau Mutations in FTDP-17
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Over the past few years, familial frontotemporal dementias, some
with parkinsonism, have been recognized as FTDP-17, a previously
unknown group of dementia disorders.27
Their unifying
pathological characteristic is the presence of abundant filamentous
hyperphosphorylated tau deposits in the absence of Aß amyloid
plaques. In some of these families tau deposits are found in both nerve
cells and glial cells, whereas in others only nerve cells are
affected.28
Besides having a filamentous tau pathology in common, the familial
frontotemporal dementias also share linkage to chromosome 17q21-22, the
same region that contains the tau gene.29
Recently, the
first mutations in the tau gene have been identified in several of
these families.4-8
They are either missense mutations in
the microtubule-binding repeat region and the carboxy-terminal region
or intronic mutations that change the ratio of three-repeat to
four-repeat tau isoforms. Missense mutations have been found in exons
9, 10, 12, and 13 of the tau gene; they change glycine residue 272 to
valine (G272V), asparagine residue 279 to lysine (N279K), proline
residue 301 to leucine (P301L), valine residue 337 to methionine
(V337M), and arginine residue 406 to tryptophan (R406W) (numbering
accords with the 441-amino acid isoform of human tau). The N279K and
P301L mutations lie in the extra repeat of tau, thus affecting only
four-repeat tau isoforms. By contrast, the other three missense
mutations are found in all six brain tau isoforms. Four different
intronic mutations are found in the region of the exon 10 splice-donor
site, where they disrupt a predicted stem-loop. This disruption leads
to increased splicing of exon 10, resulting in the overproduction of
four-repeat tau isoforms and reduced levels of tau isoforms with three
repeats.5,6
The functional consequences of missense mutations in tau have been
studied in microtubule assembly experiments.30
All the
mutations investigated showed a markedly reduced ability to promote
microtubule assembly. The P301L mutation produced the largest effect,
the R406W mutation the smallest effect, and the G272V and V337M
mutations intermediate reductions. This partial loss of function may be
the primary effect of these missense mutations in tau. It may be
followed by the hyperphosphorylation of tau and, through interaction
with other cellular factors, by assembly into filaments. Similarly,
overproduction of four-repeat tau isoforms in cases with intronic
mutations may result in the inability of some of the excess tau to bind
to microtubules, leading to its hyperphosphorylation and assembly into
filaments. Most missense mutations are likely to lead to a reduced
ability of tau to interact with microtubules. The N279K mutation may be
an exception, since it creates an exon splice enhancer sequence, which
may lead to increased splicing of exon 10.8
There may be
mutations in tau that produce effects on both microtubule assembly and
on mRNA splicing of exon 10.
In Seattle family A (with the V337M mutation), in familial
multiple-system tauopathy with presenile dementia (with the +3 mutation
in the intron following exon 10), in the Iowa family (with the R406W
mutation), in pallido-ponto-nigral degeneration (with the N279K
mutation), and in Dutch family 1 (with the P301L mutation), tau is
hyperphosphorylated at the same sites as in Alzheimer's
disease.31-35
Pick-like bodies have been described in
Dutch family 2 (with the G272V mutation) that show tau staining
characteristics similar to those of classical Pick
bodies.35,36
The balance between tau protein levels and available binding sites on
microtubules appears to be critical for determining whether or not tau
assembles into filaments. Thus, a reduced ability to interact with
microtubules appears to be the shared primary abnormality in tau
protein resulting from the different exonic and intronic mutations
described thus far. A partial loss of function may be necessary for the
assembly of tau into filaments.
The locations of the tau mutations appear to determine the nature of
the pathology. Mutations in exon 10 or in the intron following exon 10
lead to a filamentous neuronal and glial cell tau
pathology.32,34,35
For exon 10 mutations, the filaments are
narrow twisted ribbons consisting predominantly of tau isoforms with
four microtubule-binding repeats.35
In the case of the
intronic mutations, the filaments are wide twisted ribbons consisting
exclusively of four-repeat tau isoforms.32
This is
reminiscent of progressive supranuclear palsy and corticobasal
degeneration, suggesting that these largely sporadic diseases may also
result from abnormalities in the splicing of exon 10 of the tau gene.
Missense mutations located outside exon 10 lead to a predominantly
neuronal pathology.31,33
The tau filaments are PHFs and SFs
and consist of all six tau isoforms. In the case of the V337M mutation
in exon 12, the tau filaments have been shown to be indistinguishable
from those of Alzheimer's disease.31
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Synthetic Tau Filaments
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Phosphorylated full-length recombinant tau has consistently failed
to assemble into PHF-like filaments in in vitro experiments.
By contrast, incubation of recombinant tau with sulphated
glycosaminoglycans, such as heparin and heparan sulphate, results in
the bulk assembly of tau into Alzheimer-like
filaments.37-42
Tau isoforms with three repeats assemble
into twisted paired helical-like filaments, whereas tau isoforms with
four repeats assemble into straight filaments.37
Immunoelectron microscopy shows that the paired helical-like filaments
are decorated by antibodies directed against the amino- and
carboxy-termini of tau, but not by an antibody directed against the
microtubule-binding repeat region.37
These results, which
indicate that in the filaments the repeat region of tau is inaccessible
to the antibody, are identical to those previously obtained with PHFs
from the brains of Alzheimer's disease patients.18
They
establish that the microtubule-binding repeat region of tau is
essential for sulphated glycosaminoglycan-induced filament formation.
Three microtubule-binding repeats of tau are also believed to form the
core of the PHFs found in the brains of Alzheimer's disease patients,
supporting the evidence for a similar organization of the two types of
filament. Previous experiments had shown that three recombinant
microtubule-binding repeats of tau assemble into twisted filaments
in vitro.43,44
This assembly is
phosphorylation-independent and occurs in the absence of sulphated
glycosaminoglycans. It confirms that three repeats are required to give
the morphology of the PHF. However, these experiments do not shed light
on the mechanisms that lead to tau filament formation in the brains of
Alzheimer's disease patients, because PHF-tau is made of full-length
tau. The dimensions of tau filaments formed in the presence of
sulphated glycosaminoglycans are similar to those of filaments
extracted from brains of Alzheimer's disease patients, with diameters
of approximately 20 nm for twisted and 15 nm for straight filaments and
a crossing-over spacing of approximately 80 nm for paired helical-like
filaments, although their twist is in general less regular than that
found in Alzheimer's disease filaments.
Sulphated glycosaminoglycans also stimulate phosphorylation of tau by a
number of protein kinases, prevent the binding of tau to
taxol-stabilized microtubules, and disassemble microtubules assembled
from tau and tubulin.37,40
Moreover, heparan sulphate has
been detected in nerve cells in the early stages of neurofibrillary
degeneration.37,45
Sulphated glycosaminoglycans stimulate
tau phosphorylation at lower concentrations than those required for
filament formation. The pathological presence of heparan sulphate
within the cytoplasm of some nerve cells, perhaps as a result of
leakage from membrane-bound compartments, would first lead to
hyperphosphorylation of tau, resulting in its inability to bind to
microtubules. At higher concentrations of heparan sulphate, tau would
then assemble into PHFs and SFs.
Formation of tau filaments is also observed after incubation of
recombinant tau with RNA, which has been shown to be sequestered in the
neurofibrillary lesions of Alzheimer's disease.40,46,47
Whether the presence of RNA is an early event remains to be determined.
Sulphated glycosaminoglycans and RNA share a repeat sugar backbone and
negative charges in the form of sulphates or phosphates. Tau protein is
thought to be an extended molecule with little secondary structure that
becomes partially structured upon binding to microtubules. Binding of
sulphated glycosaminoglycans or RNA to tau may induce or stabilize a
conformation of tau that brings the microtubule-binding repeats of
individual tau molecules into close proximity, creating sites which
favor polymerization into filaments.
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Transgenic Mice
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The work on synthetic tau filaments has provided the first robust
method for producing Alzheimer-like filaments from full-length tau. The
same cannot yet be said of tau filaments in nerve cells. To date, there
has been no demonstration of Alzheimer-like filaments in transgenic
mice. Two studies have directly addressed this issue by expressing
wild-type human tau in the brains of transgenic mice.48,49
It has been indirectly addressed in the transgenic mouse models of Aß
amyloid deposition, which are based on the expression of mutated
amyloid precursor protein (APP).50-52
Although some
staining for hyperphosphorylated tau has been described in nerve cell
processes around Aß deposits in transgenic mice expressing mutated
APP,52,53
no somatodendritic staining of
hyperphosphorylated tau was observed in these mice. Two of these mouse
lines did not exhibit nerve cell loss,54,55
whereas a third
showed a 17% reduction in the number of nerve cells in layer CA1 of
the hippocampus.56
However, it remains to be seen whether
this cell loss is mechanistically related to the nerve cell loss
observed in Alzheimer's disease hippocampus. Mutated APP is expressed
at high levels in these mice and this could in itself result in
degeneration of some nerve cells. It is well established that in
Alzheimer's disease brain there exists an inverse correlation between
the number of extracellular tangles and the number of surviving nerve
cells in the hippocampus,57-59
suggesting that nerve cell
loss is due to the formation of neurofibrillary lesions.
The first study expressing human tau protein in transgenic mice was
published in 1995 and described the expression of the longest human
brain tau isoform (four repeats and the 58-amino acid amino-terminal
insert) under the control of the human Thy1 promoter48
(Figure 1)
. The new study, which describes expression of the shortest
human brain tau isoform (three repeats and no amino-terminal inserts)
under the control of the mouse 3-hydroxy-methyl-glutaryl CoA reductase
promoter, is published in this issue of the
Journal49
(Figure 1)
.
Both studies describe broadly similar results with some minor
differences. They show strong somatodendritic and axonal staining for
hyperphosphorylated tau of subpopulations of nerve cells. The
somatodendritic staining is pathological, because in control mouse
brain tau staining is largely axonal. Götz et al described only
nerve cell staining,48
whereas Brion et al also describe
some astrocytic staining,49
presumably reflecting the use
of a different promoter. The presence of hyperphosphorylated human tau
in mouse brain astrocytes is interesting in view of the extensive glial
tau pathology seen in some FTDP-17 pedigrees, as well as in progressive
supranuclear palsy and corticobasal degeneration. Both studies show
somatodendritic staining of nerve cells with a number of
phosphorylation-dependent anti-tau antibodies that also stain the
neurofibrillary pathology of Alzheimer's disease and other
tauopathies. These antibodies also recognize tau from normal adult
human brain, albeit more weakly than PHF-tau. Brion et al show that
antibodies which are entirely specific for PHF-tau, such as AP422 and
AT100,60-62
do not stain transgenic mouse brain, a
finding in agreement with the lack of tau filaments. By electron
microscopy, they show that transgenic human tau is associated with
microtubules in axons and dendrites, but not in nerve cell bodies,
where it is associated with ribosomes or distributed more
diffusely.49
Overexpression of human tau in lamprey neurons
has also been shown to lead to the presence of hyperphosphorylated
human tau in the somatodendritic compartment.63
It thus
appears that an excess of tau over available binding sites on
microtubules results in the accumulation of tau in nerve cell bodies.
The same may be true of the FTDP-17 cases with intronic mutations in
the tau gene.
Somatodendritic staining for hyperphosphorylated tau has been described
as an early pathological change in human brain, where it is
characteristic of the so-called pre-tangle stage of Alzheimer's
disease.24
In human brain, the pre-tangle pathology
progresses to the tangle stage, which is followed by nerve cell
degeneration and death. In the case of the classical
neurofibrillary tangle, thick bundles of tau filaments survive the
death of affected nerve cells and are found in the extracellular space
in the form of ghost tangles.1
The presence of
neurofibrillary tangles does not appear to be a necessary prerequisite
for nerve cell degeneration, because they are absent from a number of
FTDP-17 brains.28
The invariant feature of the various
tauopathies is the presence of filaments made of hyperphosphorylated
tau protein. So far, such filaments have not been observed in the
brains of mice transgenic for tau protein. There is no evidence to
suggest nerve cell loss in the mice, indicating that the prolonged
presence of hyperphosphorylated tau in the somatodendritic compartment
of nerve cells is not sufficient to lead to nerve cell degeneration.
The current transgenic mouse models thus go only part of the way
towards establishing a filamentous tau pathology.
The levels of expression of human tau protein in the transgenic mouse
lines were relatively modest, ranging between 1020% of total mouse
brain tau. Adult mouse brain tau consists of three four-repeat
isoforms, whereas only one human tau isoform was expressed in each of
the transgenic mouse studies. However, human tau appeared to be
concentrated in a relatively small number of nerve cells, suggesting
that the levels of human tau per cell may be much higher. Nevertheless,
the failure to form tau filaments in mouse brain may be due to
insufficient levels of human tau. From the experiments on synthetic tau
filaments, it is clear that the assembly of recombinant tau in presence
of sulphated glycosaminoglycans is strongly concentration-dependent, as
befits a nucleation-dependent process.37-40,42
Other
differences between mice and humans may also play a role. Mice express
only three four-repeat tau isoforms in adult brain, whereas humans
express an additional three isoforms with three repeats. If cellular
factors are needed to induce tau filament formation, they may not be
present in sufficient concentrations in mouse brain. Finally,
differences may be a function of the very different life spans of mouse
and human.
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Outlook
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The discovery of missense mutations in tau in FTDP-17 has
demonstrated that tau dysfunction produces neurodegeneration. The
existence of mutations in the intron following exon 10 of the tau gene
has shown that the simple overproduction of four-repeat tau is
sufficient to lead to a filamentous pathology and to produce a dementia
disorder. This knowledge will be invaluable for future efforts aimed at
producing mouse lines transgenic for tau. Higher expression levels of
human transgenic tau than have been achieved so far may be the key to
success. Animal models of FTDP-17, Pick's disease, progressive
supranuclear palsy, and corticobasal degeneration are eagerly awaited.
Perhaps most importantly, there will be no true transgenic mouse model
of Alzheimer's disease without a filamentous tau pathology.
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Footnotes
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Address reprint requests to Michel Goedert, Medical Research Council Laboratory of Molecular Biology, Hills Road, Cambridge CB2 2QH, UK. E-mail: mg{at}mrc-lmb.cam.ac.uk
Accepted for publication November 16, 1998.
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