Acceleration of amyloid β-peptide aggregation by physiological concentrations of calcium

Alzheimer disease is characterized by the accumulation of aggregated amyloid beta-peptide (A beta) in the brain. The physiological mechanisms and factors that predispose to A beta aggregation and deposition are not well understood. In this report, we show that calcium can predispose to A beta aggregation and fibril formation. Calcium increased the aggregation of early forming protofibrillar structures and markedly increased conversion of protofibrils to mature amyloid fibrils. This occurred at levels 20-fold below the calcium concentration in the extracellular space of the brain, the site at which amyloid plaque deposition occurs. In the absence of calcium, protofibrils can remain stable in vitro for several days. Using this approach, we directly compared the neurotoxicity of protofibrils and mature amyloid fibrils and demonstrate that both species are inherently toxic to neurons in culture. Thus, calcium may be an important predisposing factor for A beta aggregation and toxicity. The high extracellular concentration of calcium in the brain, together with impaired intraneuronal calcium regulation in the aging brain and Alzheimer disease, may play an important role in the onset of amyloid-related pathology.