Abstract

Breakthroughs in molecular medicine have positioned the amyloid-β (Aβ) pathway at the center of Alzheimer’s disease (AD) pathophysiology. While the detailed molecular mechanisms of the pathway and the spatial-temporal dynamics leading to synaptic failure, neurodegeneration, and clinical onset are still under intense investigation, the established biochemical alterations of the Aβ cycle remain the core biological hallmark of AD and are promising targets for the development of disease-modifying therapies. Here, we systematically review and update the vast state-of-the-art literature of Aβ science with evidence from basic research studies to human genetic and multi-modal biomarker investigations, which supports a crucial role of Aβ pathway dyshomeostasis in AD pathophysiological dynamics. We discuss the evidence highlighting a differentiated interaction of distinct Aβ species with other AD-related biological mechanisms, such as tau-mediated, neuroimmune and inflammatory changes, as well as a neurochemical imbalance. Through the lens of the latest development of multimodal in vivo biomarkers of AD, this cross-disciplinary review examines the compelling hypothesis- and data-driven rationale for Aβ-targeting therapeutic strategies in development for the early treatment of AD.

Keywords

NeuroscienceNeurodegenerationNeurochemicalDiseaseAlzheimer's diseaseBiomarkerMechanism (biology)MedicineBiologyPathologyGenetics

MeSH Terms

Alzheimer DiseaseAmyloid beta-PeptidesBiomarkersHumanstau Proteins

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Publication Info

Year
2021
Type
review
Volume
26
Issue
10
Pages
5481-5503
Citations
1463
Access
Closed

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Social media, news, blog, policy document mentions

Citation Metrics

1463
OpenAlex
35
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Cite This

Harald Hampel, John Hardy, Kaj Blennow et al. (2021). The Amyloid-β Pathway in Alzheimer’s Disease. Molecular Psychiatry , 26 (10) , 5481-5503. https://doi.org/10.1038/s41380-021-01249-0

Identifiers

DOI
10.1038/s41380-021-01249-0
PMID
34456336
PMCID
PMC8758495

Data Quality

Data completeness: 90%