Molecular dissection of Alzheimer's disease neuropathology by depletion of serum amyloid P component

Simon E. Kolstoe, Basil H. Ridha, Vittorio Bellotti, Nan Wang, Carol V. Robinson, Sebastian J. Crutch, Geoffrey Keir, Riitta Kukkastenvehmas, J. Ruth Gallimore, Winston L. Hutchinson, Philip N. Hawkins, Stephen P. Wood, Martin N. Rossor, Mark B. Pepys

Research output: Contribution to journalArticlepeer-review


New therapeutic approaches in Alzheimer's disease are urgently needed. The normal plasma protein, serum amyloid P component (SAP), is always present in cerebrospinal fluid (CSF) and in the pathognomonic lesions of Alzheimer's disease, cerebrovascular and intracerebral Aβ amyloid plaques and neurofibrillary tangles, as a result of its binding to amyloid fibrils and to paired helical filaments, respectively. SAP itself may also be directly neurocytotoxic. Here, in this unique study in Alzheimer's disease of the bis(d-proline) compound, (R)-1-[6-[(R)-2-carboxy-pyrrolidin-1-yl]-6-oxo-hexanoyl]pyrrolidine-2-carboxylic acid (CPHPC), we observed depletion of circulating SAP and also remarkable, almost complete, disappearance of SAP from the CSF. We demonstrate that SAP depletion in vivo is caused by CPHPC cross-linking pairs of SAP molecules in solution to form complexes that are immediately cleared from the plasma. We have also solved the structure of SAP complexed with phosphothreonine, its likely ligand on hyperphosphorylated τ protein. These results support further clinical study of SAP depletion in Alzheimer's disease and potentially other neurodegenerative diseases.
Original languageEnglish
Pages (from-to)7619-7623
JournalProceedings of the National Academy of Sciences
Issue number18
Publication statusPublished - 5 May 2009


  • bis(D-proline)
  • clinical study
  • neurodegenerative disease


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