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Editorial
Insights into Alzheimer disease pathogenesis from studies in transgenic animal models
Evelin L SchaefferI,
Corresponding author
schaffer@usp.br

Tel.: 55 11 3069-8011
, Micheli FigueiróI, Wagner F GattazI
I Laboratory of Neuroscience LIM27, Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="cesec10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle20">INTRODUCTION</span><p id="para10" class="elsevierStylePara elsevierViewall">Alzheimer disease &#40;AD&#41;&#44; a progressive neurodegenerative disorder&#44; is the most common cause of dementia among the elderly&#46; It accounts for &#8764;60-70&#37; of all dementia cases&#46; Prevalence increases with age from &#8764;1&#37; in the 60&#8211;64-year age group&#44; to 24-33&#37; in those aged &#62;85 years&#46;<a class="elsevierStyleCrossRef" href="#bib1">1</a> The neuropathological hallmarks of AD are the presence in the brain of extracellular senile plaques and intracellular neurofibrillary tangles&#44; along with neuronal loss&#46; Senile plaques mainly consist of fibrils of 39-42&#40;43&#41; amino acid &#946;-amyloid &#40;A&#946;&#41; peptide that are surrounded by dystrophic neurites and reactive glial cells&#46; The A&#946; peptide itself is derived from the processing of a larger precursor protein known as the amyloid precursor protein &#40;APP&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib2">2</a> The dysfunction of APP metabolism and the consequent accumulation of A&#946; peptides and their aggregation in the form of senile plaques in the brain parenchyma of individuals with AD&#44; have been considered crucial for neurodegeneration in the disease&#46; This is the so-called &#8220;amyloid cascade hypothesis&#8221;&#46;<a class="elsevierStyleCrossRefs" href="#bib3">3&#44;4</a> However&#44; more recently&#44; soluble oligomers of A&#946; peptide have been correlated with synaptic loss in the brain of AD subjects&#46;<a class="elsevierStyleCrossRefs" href="#bib5">5-7</a> Neurofibrillary tangles contain hyperphosphorylated and aggregated forms of Tau&#44; a microtubule-associated protein that normally promotes the assembly and stability of microtubules in neuronal cells&#46;<a class="elsevierStyleCrossRef" href="#bib2">2</a> Abnormally hyperphosphorylated Tau in AD brain accumulates in neurons into paired helical filaments&#44; which in turn aggregate into neurofibrillary tangles leading to neuronal death&#46;<a class="elsevierStyleCrossRef" href="#bib8">8</a> Therefore&#44; the neuropathological hallmarks of AD induce progressive neuronal dysfunction and degeneration&#44; resulting in severe brain atrophy and decline of memory and other cognitive functions&#46;<a class="elsevierStyleCrossRef" href="#bib2">2</a> Although not a criterion for diagnosis of AD&#44; the deposition of A&#946; in the cerebral vasculature&#44; named cerebral amyloid angiopathy &#40;CAA&#41;&#44; can be detected in 90&#37; of patients with AD&#46;<a class="elsevierStyleCrossRef" href="#bib9">9</a> However&#44; CAA can occur in the absence of AD pathology and vice versa&#46;<a class="elsevierStyleCrossRef" href="#bib10">10</a></p><p id="para20" class="elsevierStylePara elsevierViewall">Most cases of AD occur sporadically in people over 65 years old&#44; and are not genetically inherited&#46; Roughly 5&#37; of patients with AD have familial Alzheimer disease &#40;FAD&#41;&#44; an uncommon form that tends to strike sooner&#44; and is related to a genetic predisposition&#44; including mutations in the <span class="elsevierStyleItalic">APP</span> gene on chromosome 21&#44; <span class="elsevierStyleItalic">presenilin 1</span> &#40;<span class="elsevierStyleItalic">PS1</span>&#41; gene on chromosome 14&#44; and <span class="elsevierStyleItalic">presenilin 2</span> &#40;<span class="elsevierStyleItalic">PS2</span>&#41; gene on chromosome 1&#46;<a class="elsevierStyleCrossRef" href="#bib1">1</a> The etiology of AD is unclear and at present there is no effective treatment&#46; Given the prevalence and poor prognosis of the disease&#44; the development of animal models has been a research priority to understand pathogenic mechanisms and to test therapeutic strategies&#46; The discovery of genes for familial forms of AD has allowed transgenic models to be created that reproduce many critical aspects of the disease&#46; Initially&#44; before the discovery of FAD mutations&#44; attempts were made to overexpress wild-type APP in transgenic mice by pronuclear injection&#46; However&#44; none of these efforts produced anything that resembled an A&#946; plaque or any other recognizable AD-type pathology&#46; After the discovery of FAD mutations in APP&#44; a number of groups turned their attention to making AD models based on the overexpression of transgenes containing FAD mutations using a variety of promoters&#46;<a class="elsevierStyleCrossRef" href="#bib11">11</a> This review describes the main transgenic mouse models of AD which have been adopted in AD research&#44; and discusses the insights into AD pathogenesis from studies in transgenic models&#46;</p><span id="cesec20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle30">1&#46; Genetics implicated in Alzheimer disease pathogenesis</span><p id="para30" class="elsevierStylePara elsevierViewall">Mutations in <span class="elsevierStyleItalic">APP</span> linked to FAD include Dutch &#40;E693Q&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib10">10</a> London &#40;V717I&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib12">12</a> Indiana &#40;V717F&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib13">13</a> Swedish &#40;K670N&#47;M671L&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib14">14</a> Florida &#40;I716V&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib15">15</a> Iowa &#40;D694N&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib16">16</a> and Arctic &#40;E693G&#41;<a class="elsevierStyleCrossRef" href="#bib17">17</a> mutations&#46; To date&#44; more than 160 mutations in <span class="elsevierStyleItalic">PS1</span> linked to FAD have been discovered &#40;see <a href="http://www.molgen.ua.ac.be/ADMutations">http&#58;&#47;&#47;www&#46;molgen&#46;ua&#46;ac&#46;be&#47;ADMutations</a>&#41;&#46; Mutations in a related gene&#44; now called <span class="elsevierStyleItalic">PS2</span>&#44; were soon linked to FAD as well&#46;<a class="elsevierStyleCrossRef" href="#bib18">18</a> Most of FAD mutations cause aberrant APP processing toward the longer&#44; more amyloidogenic A&#946;<span class="elsevierStyleInf">1-42</span> species&#46;<a class="elsevierStyleCrossRef" href="#bib19">19</a> The A&#946; is located partially within the ectodomain &#40;N-terminal portion&#41; and partly within the transmembrane domain &#40;C-terminal portion&#41; of APP&#46; At least three enzymes are responsible for the processing of APP and have been called &#945;-&#44; &#946;- and &#947;-secretases&#46; The processing pathway by &#945;-secretase&#44; called non-amyloidogenic&#44; cleaves APP within the A&#946; domain in the C-terminal portion of the sequence of this peptide&#44; producing soluble APP&#945;&#44; which has neurotrophic and neuroprotective effects&#46; The processing pathway by &#946;- and &#947;-secretases&#44; called amyloidogenic&#44; cleaves APP in the N- and C-terminal portions of the A&#946; region&#44; respectively&#44; producing A&#946; peptide&#46; &#947;-Secretase cleaves APP at various adjacent sites to form species of A&#946; containing 39 to 43 amino acids&#46;<a class="elsevierStyleCrossRef" href="#bib20">20</a> Presenilins contribute to the catalytic activity of the &#947;-secretase complex&#46;<a class="elsevierStyleCrossRef" href="#bib1">1</a> Processing of APP by &#945;-&#44; &#946;- and &#947;-secretases is illustrated in <a class="elsevierStyleCrossRef" href="#fig1">Figure 1</a>&#46;</p><elsevierMultimedia ident="fig1"></elsevierMultimedia><p id="para40" class="elsevierStylePara elsevierViewall">The Swedish mutation&#44; which is located just outside the N-terminus of the A&#946; domain of APP&#44; favors &#946;-secretase cleavage <span class="elsevierStyleItalic">in vitro</span><a class="elsevierStyleCrossRef" href="#bib21">21</a> and is associated with an increased level and deposition of A&#946;<span class="elsevierStyleInf">1-42</span> in AD brain&#46;<a class="elsevierStyleCrossRef" href="#bib22">22</a> The Dutch and Iowa mutations&#44; which are located in the A&#946; domain of APP&#44; accelerate A&#946;<span class="elsevierStyleInf">1-40</span> fibril formation <span class="elsevierStyleItalic">in vitro</span>&#46;<a class="elsevierStyleCrossRefs" href="#bib23">23&#44;24</a> The Dutch mutation is associated with cerebrovascular A&#946; deposition&#8212;that is&#44; CAA&#44; resulting in cerebral hemorrhages and dementia in patients with AD&#44;<a class="elsevierStyleCrossRef" href="#bib10">10</a> whereas the Iowa mutation is associated with severe CAA&#44; widespread neurofibrillary tangles&#44; and unusually extensive distribution of A&#946;<span class="elsevierStyleInf">1-40</span> in plaques in AD brain&#46;<a class="elsevierStyleCrossRef" href="#bib16">16</a> The Arctic mutation&#44; which is also located inside the A&#946; domain&#44; makes APP less available to &#945;-secretase cleavage and increases &#946;-secretase processing of APP thus favoring intracellular A&#946; production <span class="elsevierStyleItalic">in vitro</span>&#46;<a class="elsevierStyleCrossRefs" href="#bib25">25&#44;26</a> The Arctic mutation is associated with severe CAA in the absence of hemorrhage&#44; abundant parenchymal A&#946; deposits&#44; and neurofibrillary tangles in AD brain&#46;<a class="elsevierStyleCrossRef" href="#bib27">27</a> The London mutation&#44; which is located in the transmembrane domain of APP&#44; as well as the PS1 and PS2 mutations alter &#947;-secretase cleavage and increase the A&#946;<span class="elsevierStyleInf">1-42</span> level and&#47;or the A&#946;<span class="elsevierStyleInf">1-42</span>&#47;A&#946;<span class="elsevierStyleInf">1-40</span> ratio <span class="elsevierStyleItalic">in vitro</span>&#46;<a class="elsevierStyleCrossRefs" href="#bib28">28-30</a> The London mutation is associated with extensive parenchymal A&#946; deposition and abundant senile plaques and neurofibrillary tangles&#44; as well as moderate CAA in AD brain&#46;<a class="elsevierStyleCrossRefs" href="#bib31">31&#44;32</a> The Indiana mutation&#44; which is also located in the transmembrane domain of APP&#44; is associated with large number of neurofibrillary tangles and senile plaques&#44; as well as mild CAA in AD brain&#46;<a class="elsevierStyleCrossRef" href="#bib33">33</a> The Florida mutation&#44; which is also located in the transmembrane domain of APP&#44; affects &#947;-secretase cleavage causing an increased A&#946;<span class="elsevierStyleInf">1-42</span> concentration and A&#946;<span class="elsevierStyleInf">1-42</span>&#47;A&#946;<span class="elsevierStyleInf">1-40</span> ratio <span class="elsevierStyleItalic">in vitro</span>&#46;<a class="elsevierStyleCrossRefs" href="#bib15">15&#44;30</a></p></span><span id="cesec30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle40">2&#46; Transgenic mouse models of Alzheimer disease</span><span id="cesec40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle50">Mouse Models with APP Mutation</span><p id="para50" class="elsevierStylePara elsevierViewall">Games et al<a class="elsevierStyleCrossRef" href="#bib34">34</a> reported the first transgenic AD model&#44; termed <span class="elsevierStyleBold">PDAPP mice</span>&#44; which overexpress a human APP transgene containing the Indiana mutation &#40;V717F&#41; under the control of the platelet-derived growth factor-&#946; promoter&#46; A&#946;<span class="elsevierStyleInf">1-42</span> constituted 27&#37; of the A&#946; present in the brain of young PDAPP mice&#44; and this percentage increased to 89&#37; in 12-month-old animals&#46; The mice developed senile plaques that were primarily composed of A&#946;<span class="elsevierStyleInf">1-42</span>&#46;<a class="elsevierStyleCrossRef" href="#bib35">35</a> PDAPP mice showed age-related A&#946; deposition in cortical and limbic regions that began at 8 months and progressed to cover 20-50&#37; of the neuropil in the cingulate cortex&#44; entorhinal cortex&#44; and hippocampus of 18-month-old animals&#46; A&#946; deposition was associated with dystrophic neurites and extensive gliosis &#40;reactive astrocytes and activated microglia&#41;&#44; however&#44; there was no overt neuronal loss in the entorhinal cortex&#44; hippocampal CA1 field&#44; or cingulate cortex through 18 months of age in PDAPP mice&#46;<a class="elsevierStyleCrossRef" href="#bib36">36</a> Dystrophic neurites immunoreactive for hyperphosphorylated Tau were observed near A&#946; plaques after 14 months of age&#44; although no paired helical filaments and neurofibrillary tangles were identified&#46;<a class="elsevierStyleCrossRef" href="#bib37">37</a> PDAPP mice showed significant and age-dependent synaptic loss&#44; and a rather marked hippocampal atrophy was observed as early as 3 months of age in these mice&#46;<a class="elsevierStyleCrossRef" href="#bib38">38</a> Young PDAPP mice showed deficits in spatial learning and memory&#44; which worsened with increasing age and A&#946; burden&#46;<a class="elsevierStyleCrossRef" href="#bib39">39</a></p><p id="para60" class="elsevierStylePara elsevierViewall">Similarly&#44; Hsiao et al&#46;<a class="elsevierStyleCrossRef" href="#bib40">40</a> overexpressed in mice a human APP transgene containing the Swedish mutation &#40;K670N&#47;M671L&#41; driven by a hamster prion protein promoter&#46; These mice&#44; termed <span class="elsevierStyleBold">Tg2576 mice</span>&#44; have been the most widely studied AD transgenic model&#46; Tg2576 mice exhibited age-dependent increase of A&#946;<span class="elsevierStyleInf">1-40</span> and A&#946;<span class="elsevierStyleInf">1-42</span> levels and A&#946; deposition&#44; resulting in senile plaques similar to those found in AD&#46; A&#946; plaques were first clearly seen by 11-13 months&#44; eventually becoming widespread in cortical and limbic structures&#46;<a class="elsevierStyleCrossRef" href="#bib40">40</a> A&#946; deposits were associated with prominent gliosis and neuritic dystrophy&#44; without overt neuronal loss in the hippocampal CA1 field or apparent synapse loss in the hippocampal dentate gyrus&#46;<a class="elsevierStyleCrossRef" href="#bib41">41</a> Tg2576 mice exhibited deficits in synaptic plasticity in the hippocampal CA1 field and dentate gyrus&#44; decreased dendritic spine density in the dentate gyrus&#44; and impaired spatial memory and contextual fear conditioning months before significant A&#946; deposition&#44; which was detectable at 18 months of age&#46;<a class="elsevierStyleCrossRefs" href="#bib42">42&#44;43</a> A decrease in spine density was detected as early as 4 months of age&#44; and synaptic dysfunction and memory impairment were observed by 5 months&#46; Moreover&#44; an increase in the ratio of soluble A&#946;<span class="elsevierStyleInf">1-42</span>&#47;A&#946;<span class="elsevierStyleInf">1-40</span> was first observed at these early ages&#8212;that is&#44; at &#8764;4-5 months of age&#46;<a class="elsevierStyleCrossRef" href="#bib43">43</a> Tg2576 mice also showed increased intraneuronal A&#946;<span class="elsevierStyleInf">1-42</span> accumulation with aging&#44; and this accumulation was associated with abnormal synaptic morphology before A&#946; plaque pathology&#46;<a class="elsevierStyleCrossRef" href="#bib44">44</a></p><p id="para70" class="elsevierStylePara elsevierViewall">Subsequently&#44; many other transgenic lines were developed with approaches similar to those used to develop PDAPP and Tg2576 mice&#44; typically relying on strong promoters to drive overexpression of APP transgenes containing single or multiple FAD mutations&#46; For example&#44; <span class="elsevierStyleBold">TgCRND8 mice</span>&#44; which express multiple human APP mutations&#8212;that is&#44; Swedish and Indiana mutations driven by the prion protein promoter&#44; exhibited an aggressive neuropathology with onset of parenchymal A&#946; deposition and cognitive deficits as early as 3 months of age&#44; and with dense A&#946; plaques and neuritic dystrophy evident from 5 months of age&#46; TgCRND8 mice exhibited an excess of brain A&#946;<span class="elsevierStyleInf">1-42</span> over A&#946;<span class="elsevierStyleInf">1-40</span>&#44; and the high-level production of A&#946;<span class="elsevierStyleInf">1-42</span> was associated with spatial learning impairment at 6 months of age&#46; Neurofibrillary tangles and neurodegeneration were absent&#46;<a class="elsevierStyleCrossRef" href="#bib45">45</a> The formation of plaques was concurrent with the appearance of activated microglia and shortly followed by the clustering of activated astrocytes around plaques at 3&#46;5 months of age in TgCRND8 mice&#46;<a class="elsevierStyleCrossRef" href="#bib46">46</a></p><p id="para80" class="elsevierStylePara elsevierViewall">Doubly transgenic mice which express human APP with the Swedish mutation driven by the platelet-derived growth factor-&#946; promoter combined with a PS1 mutation &#40;M146L&#41; under the control of the prion protein promoter&#44; termed <span class="elsevierStyleBold">APP&#47;PS1 mice</span>&#44; developed large numbers of fibrillar A&#946; deposits in the cerebral cortex and hippocampus that resembled compact A&#946; plaques&#46; These mice showed a selective increase in A&#946;<span class="elsevierStyleInf">1-42</span> in their brains and reduced performance in a spatial memory task before substantial A&#946; deposition was apparent&#46;<a class="elsevierStyleCrossRef" href="#bib47">47</a> The fibrillar A&#946; deposits were associated with dystrophic neurites and activated astrocytes and microglia in APP&#47;PS1 mice&#46;<a class="elsevierStyleCrossRef" href="#bib48">48</a></p><p id="para90" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">APP23 mice</span>&#44; which express human APP with only the Swedish mutation driven by a Thy1 promoter&#44; showed neuronal overexpression of APP&#46; At 6 months of age&#44; APP23 mice showed first rare A&#946; deposits&#44; which increased with age in size and number and occupied a substantial area of the neocortex and hippocampus in 24-month-old mice&#46; The A&#946; plaques were surrounded by gliosis &#40;activated microglia and astrocytes&#41; and dystrophic neurites that were immunoreactive for hyperphosphorylated Tau despite the lack of neurofibrillary tangles&#46;<a class="elsevierStyleCrossRef" href="#bib49">49</a> Determination of plaque-associated A&#946;<span class="elsevierStyleInf">1-42</span> peptides in brain revealed a fivefold increase in APP23 mice at 6 months&#46; In addition&#44; APP23 mice showed an age-dependent decline of spatial memory from the age of 3 months&#44; and locomotor activity and exploratory behavior deficits at 6 months&#46; Spatial memory deficits preceded plaque formation and the increase in plaque-associated A&#946;<span class="elsevierStyleInf">1-42</span> peptides&#44; but correlated negatively with brain soluble A&#946; concentration in 3-month-old APP23 mutants&#46;<a class="elsevierStyleCrossRef" href="#bib50">50</a> APP23 mice have often been used to study CAA pathogenesis&#46; Significant deposition of A&#946; in the cerebral vasculature&#8212;that is&#44; CAA was described in aging APP23 mice&#46; CAA in these mice was associated with local neuronal loss&#44; synaptic loss&#44; microglial activation&#44; and microhemorrhage&#46;<a class="elsevierStyleCrossRefs" href="#bib51">51&#44;52</a></p><p id="para100" class="elsevierStylePara elsevierViewall">Transgenic mice expressing human APP with the Dutch &#40;E693Q&#41; and Iowa &#40;D694N&#41; mutations combined with the Swedish mutation under the control of the Thy1&#46;2 promoter&#44; termed <span class="elsevierStyleBold">Tg-SwDI mice</span>&#44; developed largely diffuse&#44; A&#946; plaque-like deposits in the brain parenchyma starting at 3 months of age with high association with A&#946; accumulation in the cerebral microvasculature&#46; A&#946;<span class="elsevierStyleInf">1-40</span> peptides are largely the predominant species that accumulates in these mice&#46;<a class="elsevierStyleCrossRef" href="#bib53">53</a> Tg-SwDI mice were impaired in the performance of a spatial learning and memory task at 3&#44; 9&#44; and 12 months of age&#46;<a class="elsevierStyleCrossRef" href="#bib54">54</a></p><p id="para110" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">APPDutch mice</span>&#44; expressing human APP with only the Dutch mutation regulated by the Thy1 promoter&#44; showed neuronal overexpression of APP and increased ratio of A&#946;<span class="elsevierStyleInf">1-40</span>&#47;A&#946;<span class="elsevierStyleInf">1-42</span> in the brain that resulted in extensive vascular A&#946; deposition with essentially no parenchymal deposition&#46;<a class="elsevierStyleCrossRef" href="#bib55">55</a> These researchers also developed a transgenic line that expresses human APP-Dutch mutation crossed with mutant PS1 &#40;G384A&#41;&#44; termed <span class="elsevierStyleBold">APPDutch&#47;PS1 mice</span>&#46; These mice&#44; with about half the A&#946;<span class="elsevierStyleInf">1-40</span>&#47;A&#946;<span class="elsevierStyleInf">1-42</span> ratio of APPDutch mice brain&#44; developed parenchymal A&#946; plaques with little vascular deposition&#46; By contrast&#44; young transgenic mice harboring human APP with the Arctic mutation &#40;E693G&#41; combined with APP-Swedish and APP-Indiana mutations directed by the platelet-derived growth factor-&#946; promoter&#44; termed <span class="elsevierStyleBold">hAPP-Arc mice</span>&#44; developed prominent parenchymal A&#946; plaque deposits with little CAA despite a reduced proportion of A&#946;<span class="elsevierStyleInf">1-42</span>&#47;A&#946;<span class="elsevierStyleInf">1-40</span>&#46;<a class="elsevierStyleCrossRef" href="#bib56">56</a></p><p id="para120" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Tg-ArcSwe mice</span> with both APP-Swedish and APP-Arctic mutations driven by the Thy1 promoter were developed by two independent groups&#46;<a class="elsevierStyleCrossRefs" href="#bib57">57&#44;58</a> Tg-ArcSwe mice exhibited an age-dependent increase in intraneuronal A&#946; accumulation and deficits in spatial memory and contextual fear conditioning&#44; starting at the age of 6 months&#44; before the onset of A&#946; plaque formation as well as CAA&#46;<a class="elsevierStyleCrossRefs" href="#bib57">57-59</a> The cognitive impairments correlated inversely with soluble A&#946; levels in Tg-ArcSwe mice&#46;<a class="elsevierStyleCrossRef" href="#bib59">59</a> Recently&#44; a mouse model expressing human APP with only the Arctic mutation under the control of the Thy1 promoter&#44; termed <span class="elsevierStyleBold">APPArc mice</span>&#44; was reported by R&#246;nnb&#228;ck et al&#46;<a class="elsevierStyleCrossRef" href="#bib60">60</a> APPArc mice showed an age-dependent progression of parenchymal and vascular A&#946; deposition&#44; starting in the subiculum and spreading to the thalamus&#44; and deficits in hippocampus-dependent spatial learning and memory test&#46; In contrast to transgenic models with both the Swedish and Arctic mutations&#44;<a class="elsevierStyleCrossRefs" href="#bib57">57&#44;58</a> APPArc mice did not show any punctate intraneuronal A&#946; immunoreactivity&#46;<a class="elsevierStyleCrossRef" href="#bib60">60</a></p><p id="para130" class="elsevierStylePara elsevierViewall">APP transgenic mouse models have been troubled by the difficulty of inducing the characteristic cytoskeletal pathology of AD&#46; For example&#44; in PDAPP mice&#44; phosphorylated Tau sites do accumulate within dystrophic neurites in animals of 14 months of age or older&#44; but there are no paired helical filaments and no neurofibrillary tangle-like lesions&#46;<a class="elsevierStyleCrossRef" href="#bib37">37</a> Other models have been similar in their lack of any neurofibrillary tangle-like pathology&#44; such as TgCRND8<a class="elsevierStyleCrossRef" href="#bib45">45</a> and APP23 mice&#46;<a class="elsevierStyleCrossRef" href="#bib49">49</a></p></span><span id="cesec50" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle60">Mouse Models with Tau Mutation</span><p id="para140" class="elsevierStylePara elsevierViewall">Transgenic mice that exhibit neurofibrillary tangle-like lesions and A&#946; plaques have been produced by combining FAD mutations with mutant forms of Tau found in a distinct form of dementia known as frontotemporal dementia and parkinsonism linked to chromosome 17 &#40;FTDP-17&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib61">61</a> Lewis et al&#46;<a class="elsevierStyleCrossRef" href="#bib62">62</a> first crossed Tg2576 mice with a transgenic line known as JNPL3&#44; which expresses P301L mutant Tau associated with FTDP-17&#44; generating a bigenic transgenic model referred to as <span class="elsevierStyleBold">TAPP mice</span>&#46; Singly transgenic JNPL3 mice were known to develop neurofibrillary tangle-like lesions&#44; and TAPP mice exhibited both neurofibrillary tangles and A&#946; plaques&#46; TAPP mice aged 8 months and older displayed more neurofibrillary pathology in limbic regions&#44; most notably the amygdala&#44; than age-matched JNPL3 mice&#46;</p><p id="para150" class="elsevierStylePara elsevierViewall">Later&#44; Oddo et al&#46;<a class="elsevierStyleCrossRef" href="#bib63">63</a> generated a triple transgenic model of AD&#44; termed <span class="elsevierStyleBold">3xTg-AD mice</span>&#44; which expressed human APP-Swedish &#40;K670N&#47;M671L&#41; and FTDP-17 Tau &#40;P301L&#41; mutations from exogenous transgenes regulated by the Thy1 promoter combined with a PS1 mutation &#40;M146V&#41; from the endogenous mouse gene&#46; There was a progressive increase in A&#946; formation as a function of age in the 3xTg-AD brain and a particularly pronounced effect on A&#946;<span class="elsevierStyleInf">1-42</span> levels&#46; In 3xTg-AD mice&#44; intraneuronal A&#946; accumulation was apparent between 3 and 4 months of age in the neocortex&#44; and at 6 months of age in the hippocampal CA1 field and amygdala&#46; Extracellular A&#946; deposits first became apparent in 6-month-old mice in the frontal cortex and were readily evident by 12 months in other cortical regions and in the hippocampus&#46; A&#946; plaques preceded Tau pathology&#44; which was not evident until about 1 year of age&#46;<a class="elsevierStyleCrossRefs" href="#bib63">63&#44;64</a> Tau was conformationally altered and hyperphosphorylated at multiple residues in the brain of 3xTg-AD mice in an age-related manner&#46; Tau-reactive dystrophic neurites were also evident in older 3xTg-AD brain&#46; Functionally&#44; 3xTg-AD mice developed age-dependent synaptic plasticity deficits&#44; but before A&#946; plaque and neurofibrillary tangle pathologies&#59; synaptic dysfunction correlated with the accumulation of intraneuronal A&#946;<span class="elsevierStyleInf">1-42</span>&#46;<a class="elsevierStyleCrossRef" href="#bib63">63</a> In addition&#44; these mice manifested earliest retention impairment in spatial memory at 4 months of age that correlated with the accumulation of intraneuronal A&#946;<span class="elsevierStyleInf">1-42</span>&#46; At 6 months of age&#44; 3xTg-AD mice showed retention deficits in spatial memory and contextual fear conditioning tasks&#46;<a class="elsevierStyleCrossRef" href="#bib64">64</a></p><p id="para160" class="elsevierStylePara elsevierViewall">Another problem with the AD transgenic mouse models has been the general difficulty of producing neuronal loss&#46; For example&#44; neither PDAPP nor Tg2576 mice&#44; despite having extensive A&#946; deposition&#44; exhibit significant neuronal loss&#46;<a class="elsevierStyleCrossRefs" href="#bib36">36&#44;41</a> APP23 mice show only modest losses of pyramidal cells in hippocampal CA1 field &#40;about 15&#37;&#41;&#44; losses that are far less than those observed in AD&#46; No quantitative evidence of neuronal loss was observed in the neocortex as a whole&#46;<a class="elsevierStyleCrossRef" href="#bib65">65</a></p></span><span id="cesec60" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle70">Mouse Models with Presenilin Mutation</span><p id="para170" class="elsevierStylePara elsevierViewall">More substantial neuronal loss has been reported in mice expressing multiple APP and PS1 mutations&#46;<a class="elsevierStyleCrossRefs" href="#bib66">66-68</a> One model showing massive neuronal loss is <span class="elsevierStyleBold">APP<span class="elsevierStyleInf">SL</span>&#47;PS1 mice</span>&#44; which express human APP with the Swedish and London &#40;V717I&#41; mutations driven by the Thy1 promoter and human PS1 with the M146L mutation under the control of the HMG-CoA-reductase promoter&#46; In APP<span class="elsevierStyleInf">SL</span>&#47;PS1 mice&#44; intraneuronal A&#946;<span class="elsevierStyleInf">1-40</span> and A&#946;<span class="elsevierStyleInf">1-42</span> stainings preceded A&#946; plaque deposition&#44; which started at 3 months of age&#46; A&#946; was observed in the somatodendritic and axonal compartments of neurons in the subiculum&#44; hippocampal CA1 field&#44; as well as in cortical areas&#46;<a class="elsevierStyleCrossRef" href="#bib66">66</a> The A&#946;<span class="elsevierStyleInf">1-42</span>&#47;A&#946;<span class="elsevierStyleInf">1-40</span> ratio was increased in APP<span class="elsevierStyleInf">SL</span>&#47;PS1 mice&#46;<a class="elsevierStyleCrossRef" href="#bib69">69</a> A substantial loss &#40;about 30&#37;&#41; of pyramidal neurons in the hippocampal CA1-3 fields was detected in 17-month-old APP<span class="elsevierStyleInf">SL</span>&#47;PS1 mice&#46; The loss of neurons was observed at sites of A&#946; aggregation and surrounding astrocytes but&#44; most importantly&#44; was also clearly observed in areas of the parenchyma distant from A&#946; plaques&#46;<a class="elsevierStyleCrossRef" href="#bib70">70</a> Furthermore&#44; APP<span class="elsevierStyleInf">SL</span>&#47;PS1 mice displayed severe age-related synaptic loss within hippocampal dentate gyrus and CA1-3 fields at 17 months of age&#44; even in regions free of extracellular A&#946; deposits&#46;<a class="elsevierStyleCrossRef" href="#bib69">69</a></p><p id="para180" class="elsevierStylePara elsevierViewall">Another model showing marked neuronal loss expresses human APP-Swedish and APP-London mutations driven by the Thy1 promoter together with two PS1 knock-in &#40;KI&#41; mutations &#40;M233T&#47;L235P&#41; in the murine PS1 gene&#44; and is referred to as <span class="elsevierStyleBold">APP&#47;PS1KI mice</span>&#46; The APP&#47;PS1KI model is so far the model with the most aggressive pathology&#46; These animals showed early extracellular A&#946; deposition at the age of 2&#46;5 months&#44; which was preceded by strong intraneuronal A&#946; accumulation in the hippocampal CA1&#47;2 fields&#46; At 6 months of age&#44; widespread and numerous A&#946; deposits were found within the hippocampal&#44; cortical&#44; and thalamic areas&#46; A&#946;<span class="elsevierStyleInf">1-42</span> was the predominant &#40;85&#37;&#41; A&#946; isovariant produced in APP&#47;PS1KI mice&#44; and A&#946;<span class="elsevierStyleInf">1-42</span> oligomers were highly abundant in the APP&#47;PS1KI brain&#46;<a class="elsevierStyleCrossRef" href="#bib67">67</a> Further pathological features starting at the age of 6 months included severe axonal degeneration&#44; as well as reduced ability to perform working memory and motor tasks&#46;<a class="elsevierStyleCrossRefs" href="#bib71">71&#44;72</a> At this time point also synaptic dysfunction and loss became evident in APP&#47;PS1KI brain&#46; In addition&#44; at 6 months of age&#44; a loss of 33&#37; of hippocampal CA1 pyramidal neurons was demonstrated&#44; together with a decreased volume of the CA1 pyramidal cell layer of 30&#37;&#44; and an atrophy of the entire hippocampus of 18&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib73">73</a> Analysis of the frontal cortex revealed an early loss of cortical neurons starting at the age of 6 months which correlated with the transient intraneuronal A&#946; accumulation in contrast to extracellular A&#946; plaque pathology&#46;<a class="elsevierStyleCrossRef" href="#bib74">74</a> At 10 months of age&#44; an extensive neuronal loss &#40;&#62;50&#37;&#41; was present in the pyramidal cell layer of hippocampal CA1&#47;2 fields that correlated with strong accumulation of intraneuronal A&#946; but not with extracellular A&#946; deposits in APP&#47;PS1KI mice&#46; A very significant astrogliosis developed in the area of strong intraneuronal A&#946; accumulation and neuronal loss&#46;<a class="elsevierStyleCrossRef" href="#bib67">67</a></p><p id="para190" class="elsevierStylePara elsevierViewall">Finally&#44; <span class="elsevierStyleBold">5xFAD mice</span> expressing human APP with the Swedish&#44; Florida &#40;I716V&#41; and London mutations together with mutant PS1 &#40;M146L&#47;L286V&#41; regulated by the Thy1 promoter were generated&#44; and robust neuronal loss was observed&#46; 5xFAD mice exhibited dramatically higher levels of A&#946;<span class="elsevierStyleInf">1-42</span> than those of A&#946;<span class="elsevierStyleInf">1-40</span>&#44; and rapidly accumulated massive amounts of cerebral A&#946;<span class="elsevierStyleInf">1-42</span> at young ages&#46; A&#946; deposition began at 2 months of age in deep cortical layers and in the subiculum&#46; As mice aged&#44; A&#946; deposits spread to fill much of the cerebral cortex&#44; subiculum&#44; and hippocampus&#46; A&#946; plaques were also observed in the thalamus&#44; brainstem&#44; and olfactory bulb in older mice&#44; but deposits were less numerous in these brain regions&#46; Astrogliosis and microgliosis were proportional to A&#946;<span class="elsevierStyleInf">1-42</span> levels and A&#946; deposition in 5xFAD brain and began at approximately the time when plaques initially appeared&#46; Intraneuronal A&#946;<span class="elsevierStyleInf">1-42</span> accumulated in 5xFAD brain starting at 1&#46;5 months of age&#44; just before the first appearance of A&#946; deposits at 2 months&#46; Synaptic loss started already at 4 months of age and was significant from 9 months in 5xFAD brain&#44; and large pyramidal neurons in cortical layer 5 and subiculum were visibly reduced in number at 9 months of age&#46;<a class="elsevierStyleCrossRef" href="#bib68">68</a> 5xFAD mice developed deficits in spatial memory tasks and also exhibited impairments in trace and contextual fear conditioning tests at 4-6 months of age&#46;<a class="elsevierStyleCrossRefs" href="#bib68">68&#44;75</a></p><p id="para200" class="elsevierStylePara elsevierViewall">Data on the characteristics of the main transgenic mouse models of AD are summarized in <a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl1"></elsevierMultimedia></span></span><span id="cesec70" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle80">3&#46; Insights into Alzheimer disease pathogenesis from studies in transgenic models</span><p id="para210" class="elsevierStylePara elsevierViewall">Although none of the AD transgenic models fully replicates the human disease&#44; they have suggested new insights into the pathophysiology of A&#946; toxicity&#44; particularly with respect to the effects of different A&#946; species and the possible pathogenic role of A&#946; oligomers&#46;<a class="elsevierStyleCrossRef" href="#bib11">11</a></p><p id="para220" class="elsevierStylePara elsevierViewall">In the 1980s it was debated whether A&#946; deposits&#44; and in particular CAA at the cerebral vessel walls&#44; had a central nervous system or a peripheral source&#46;<a class="elsevierStyleCrossRef" href="#bib11">11</a> Studies in APP23 mice&#44; which developed a similar degree of both A&#946; plaques and CAA&#44; provided the first evidence that a neuronal source of APP&#47;A&#946; is sufficient to induce cerebrovascular A&#946; and associated neurodegeneration&#46;<a class="elsevierStyleCrossRef" href="#bib51">51</a> Accordingly&#44; studies in transgenic mice with almost exclusive neuronal central nervous system expression of APP&#44; like APPDutch mice&#44; which develop almost only CAA&#44; strongly suggest that neuronal A&#946; produced in the brain generates cerebrovascular A&#946; neuropathology&#46; In addition&#44; although A&#946;<span class="elsevierStyleInf">1-42</span> may be needed as a seed for A&#946; deposition in either compartment &#40;parenchyma and vasculature&#41;&#44; studies in APPDutch and APPDutch&#47;PS1 mice suggest that A&#946;<span class="elsevierStyleInf">1-40</span> promotes vascular deposition&#44; whereas A&#946;<span class="elsevierStyleInf">1-42</span> shifts deposition toward parenchymal A&#946;&#46;<a class="elsevierStyleCrossRef" href="#bib55">55</a> Moreover&#44; studies in hAPP-Arc mice&#44; with APP-Arctic mutation &#40;E693G&#41; combined with APP-Swedish and APP-Indiana mutations&#44; suggest that some property of the APP E693G mutation&#44; besides its effect on the A&#946;<span class="elsevierStyleInf">1-40</span>&#47;A&#946;<span class="elsevierStyleInf">1-42</span> ratio&#44; may also influence parenchymal deposition versus vascular deposition&#46;<a class="elsevierStyleCrossRef" href="#bib56">56</a> Therefore&#44; the existing AD transgenic mouse models have shown considerable utility in deciphering the pathobiology of CAA&#46;</p><p id="para230" class="elsevierStylePara elsevierViewall">Analyses of the brain of APP transgenic mouse models in which large amounts of A&#946; have accumulated in plaques but no neurodegeneration has developed&#44; such as PDAPP&#44;<a class="elsevierStyleCrossRefs" href="#bib35">35&#44;36</a> Tg2576&#44;<a class="elsevierStyleCrossRefs" href="#bib40">40&#44;41</a> TgCRND8&#44;<a class="elsevierStyleCrossRef" href="#bib45">45</a> and APP23<a class="elsevierStyleCrossRef" href="#bib65">65</a> mice&#44; provide no or very sparse support for the well-established amyloid cascade hypothesis&#46; This hypothesis supports the idea that increased A&#946; production and extracellular accumulation in plaques leads to neurotoxicity&#44; resulting in widespread neuronal loss and dementia&#46;<a class="elsevierStyleCrossRef" href="#bib76">76</a> Some reasons for this have been discussed&#46; Perhaps the neurotoxicity is sparse in APP mouse models because murine neurons might be devoid of the downstream pathways necessary for A&#946; to induce toxicity&#44; such as the processes leading to Tau aggregation and neurofibrillary tangle formation in AD brain&#46;<a class="elsevierStyleCrossRef" href="#bib11">11</a> Interestingly&#44; subsequent to the original amyloid hypothesis&#44; it became clear that A&#946; plaque counts correlate relatively poorly with the level of cognitive decline in AD and that the number of neurofibrillary tangles correlates more strongly with the degree of dementia&#46;<a class="elsevierStyleCrossRef" href="#bib77">77</a> Perhaps only certain species of A&#946; &#40;A&#946;<span class="elsevierStyleInf">1-40</span>&#44; A&#946;<span class="elsevierStyleInf">1-42</span>&#44; or truncated A&#946;&#41; are neurotoxic&#44; and by using mutations linked to familial AD we poorly replicate the processes of A&#946; production and aggregation in sporadic AD brain&#46;<a class="elsevierStyleCrossRef" href="#bib11">11</a> Curiously&#44; truncated A&#946; peptides were demonstrated in AD brain more than 10 years ago&#44;<a class="elsevierStyleCrossRefs" href="#bib78">78&#44;79</a> but the observations were partially ignored&#46; Today it is well established that only a fraction of A&#946; in <span class="elsevierStyleItalic">postmortem</span> AD brain is full-length A&#946;<span class="elsevierStyleInf">1-40</span> or A&#946;<span class="elsevierStyleInf">1-42</span>&#59; N-terminally truncated variants of A&#946; &#40;A&#946;<span class="elsevierStyleInf">3-42</span> and A&#946;<span class="elsevierStyleInf">11-42</span>&#41; are prevalent in senile plaques of AD brain&#46;<a class="elsevierStyleCrossRefs" href="#bib80">80&#44;81</a> Unlike the classical amyloid cascade hypothesis&#44; it was subsequently shown that soluble oligomers of A&#946;<span class="elsevierStyleInf">1-42</span> and not plaque-associated A&#946; correlate best with cognitive dysfunction in AD&#46;<a class="elsevierStyleCrossRefs" href="#bib6">6&#44;82</a></p><p id="para240" class="elsevierStylePara elsevierViewall">There is now a great interest in identifying which A&#946; species &#40;A&#946;<span class="elsevierStyleInf">1-40</span>&#44; A&#946;<span class="elsevierStyleInf">1-42</span>&#44; or truncated A&#946;&#41; and form &#40;oligomers or deposits&#41; would be responsible for neurotoxicity&#44; and in understanding the relationship between A&#946; and Tau pathologies&#46;<a class="elsevierStyleCrossRef" href="#bib11">11</a> APP transgenic mice have provided strong evidence for the toxicity of soluble A&#946; oligomers <span class="elsevierStyleItalic">in vivo</span> by showing that many pathological and functional changes in mice occur before the appearance of A&#946; plaque pathology&#46; For example&#44; studies in PDAPP mice demonstrated that loss of volume in the hippocampus&#44; predominantly localized to the dentate gyrus&#44; was present in 100-day-old mice well before A&#946; deposition in plaques&#46;<a class="elsevierStyleCrossRef" href="#bib83">83</a> In addition&#44; loss in total dendritic length was evident in the dentate gyrus of 90-day-old PDAPP mice well before A&#946; accumulation occurs&#46;<a class="elsevierStyleCrossRef" href="#bib84">84</a> Tg2576 mice exhibited increased ratio of soluble A&#946;<span class="elsevierStyleInf">1-42</span>&#47;A&#946;<span class="elsevierStyleInf">1-40</span>&#44; deficits in synaptic plasticity in the hippocampal CA1 field and dentate gyrus&#44; loss of dendritic spines in the dentate gyrus&#44; and impaired spatial and contextual memory months before significant A&#946; deposition&#46;<a class="elsevierStyleCrossRefs" href="#bib42">42&#44;43</a> In APP23 mice&#44; spatial memory deficits preceded plaque formation and the increase in plaque-associated A&#946;<span class="elsevierStyleInf">1-42</span> peptides&#44; but correlated negatively with soluble A&#946; concentration&#46;<a class="elsevierStyleCrossRef" href="#bib50">50</a> Tg-ArcSwe mice exhibited robust deficits in spatial memory and contextual fear conditioning before the onset of A&#946; deposition&#44;<a class="elsevierStyleCrossRefs" href="#bib57">57-59</a> and the cognitive impairments correlated inversely with soluble A&#946; levels&#46;<a class="elsevierStyleCrossRef" href="#bib59">59</a> 3xTg-AD mice developed age-dependent synaptic plasticity deficits and spatial memory impairment before A&#946; plaque and neurofibrillary tangle pathologies but instead in correlation with soluble A&#946;<span class="elsevierStyleInf">1-42</span>&#46;<a class="elsevierStyleCrossRefs" href="#bib63">63&#44;64</a> Finally&#44; APP&#47;PS1 mice&#44; which exhibit large numbers of compact A&#946; plaques in the cerebral cortex and hippocampus&#44; showed a selective increase in A&#946;<span class="elsevierStyleInf">1-42</span> in their brains and reduced performance in a spatial memory task in the period preceding overt A&#946; deposition&#46;<a class="elsevierStyleCrossRef" href="#bib47">47</a> These studies are consistent with the more critical role of A&#946;<span class="elsevierStyleInf">1-42</span> in the pathogenesis of AD and suggest a neurotoxic effect of soluble forms of A&#946;&#46;</p><p id="para250" class="elsevierStylePara elsevierViewall">Since the discovery that truncated A&#946;<span class="elsevierStyleInf">3-42</span> represents a major species in senile plaques of AD brain&#44;<a class="elsevierStyleCrossRefs" href="#bib80">80&#44;81</a> this peptide has received considerable attention&#46; In comparison with A&#946;<span class="elsevierStyleInf">1-42</span>&#44; A&#946;<span class="elsevierStyleInf">3-42</span> has stronger aggregation propensity and increased toxicity <span class="elsevierStyleItalic">in vitro</span>&#46;<a class="elsevierStyleCrossRefs" href="#bib85">85-87</a> Recently&#44; a new transgenic mouse model &#40;TBA2&#41; was generated&#44;<a class="elsevierStyleCrossRef" href="#bib88">88</a> which expressed only truncated A&#946;<span class="elsevierStyleInf">3-42</span> in neurons without any of the other A&#946; peptides&#44; and it was demonstrated for the first time that this peptide is neurotoxic <span class="elsevierStyleItalic">in vivo</span>&#44; inducing neuronal loss and concomitant neurological deficits characterized by loss of motor coordination and ataxia&#46;</p><p id="para260" class="elsevierStylePara elsevierViewall">In the past&#44; A&#946; has been regarded as acting extracellularly&#44; whereas recent evidence points to toxic effects of A&#946; in intracellular compartments&#46; First reports showing that A&#946; is initially deposited in neurons before occurring in the extracellular space date back roughly 20 years&#46;<a class="elsevierStyleCrossRefs" href="#bib89">89&#44;90</a> More recently&#44; it has been shown that neurons in AD-vulnerable regions accumulate A&#946;<span class="elsevierStyleInf">1-42</span> and it has been further suggested that this accumulation precedes extracellular A&#946; deposition and neurofibrillary tangle formation&#46;<a class="elsevierStyleCrossRef" href="#bib91">91</a> Consecutively&#44; a variety of reports has been published demonstrating A&#946; in neurons of AD brain&#46;<a class="elsevierStyleCrossRefs" href="#bib92">92-95</a> Curiously&#44; soluble A&#946; oligomers&#44; which have been suggested as the most toxic species&#44; are formed&#44; preferentially&#44; intracellularly within neuronal processes and synapses rather than extracellularly&#46;<a class="elsevierStyleCrossRefs" href="#bib96">96&#44;97</a> In all transgenic mouse models in which marked neuronal loss has been so far reported&#44; this was preceded by considerable amounts of intraneuronal A&#946; peptides&#46;<a class="elsevierStyleCrossRef" href="#bib98">98</a> For example&#44; in APP&#47;PS1KI mice&#44; which developed severe learning deficits correlating with CA1 field neuronal loss and hippocampal atrophy&#44; increased intraneuronal A&#946;<span class="elsevierStyleInf">1-42</span> and not plaque-associated A&#946; coincided well with neuronal loss&#59; the intraneuronal N-truncated A&#946;<span class="elsevierStyleInf">3-42</span> species was also increased&#44; however&#44; the dominant species was A&#946;<span class="elsevierStyleInf">1-42</span> in the APP&#47;PS1KI model&#46;<a class="elsevierStyleCrossRefs" href="#bib67">67&#44;73</a> In agreement with this study&#44; investigations in TBA2 mice showed for the first time that intraneuronal A&#946;<span class="elsevierStyleInf">3-42</span> accumulation is sufficient for triggering neuronal death and inducing an associated neurological phenotype&#46; Although the TBA2 model lacks important AD-typical neuropathological features like tangles and hippocampal degeneration&#44; it clearly demonstrated that intraneuronal A&#946;<span class="elsevierStyleInf">3-42</span> is neurotoxic <span class="elsevierStyleItalic">in vivo</span>&#46;<a class="elsevierStyleCrossRef" href="#bib88">88</a> Intraneuronal A&#946;<span class="elsevierStyleInf">1-42</span> accumulation has also been reported in several transgenic mouse models with no overt neuronal loss&#44; including Tg2576&#44;<a class="elsevierStyleCrossRef" href="#bib44">44</a> 3xTg-AD&#44;<a class="elsevierStyleCrossRef" href="#bib63">63</a> and 5xFAD&#46;<a class="elsevierStyleCrossRef" href="#bib68">68</a> These studies indicate that intraneuronal soluble A&#946; is a pathological feature of AD that has long been neglected and is turning out to be the key factor leading to neuronal loss in the disease before the extracellular A&#946; deposition&#46;</p><p id="para270" class="elsevierStylePara elsevierViewall">Loss of neuronal synaptic density and synapse number represents another invariant feature of AD that appears to precede overt neuronal degeneration&#46;<a class="elsevierStyleCrossRefs" href="#bib99">99&#44;100</a> Notably&#44; it has been shown that the loss of synaptic terminals correlates better with cognitive decline than plaque and tangle load or neuronal loss&#44; leading to the concept that losing synapses is one of the key events leading to cognitive dysfunction in AD&#46;<a class="elsevierStyleCrossRefs" href="#bib37"><span class="elsevierStyleSup">37&#44;101&#8211;104</span></a> There is accumulating evidence from AD transgenic mice that intraneuronal A&#946;<span class="elsevierStyleInf">1-42</span> triggers not only early neuronal loss but also synaptic deficits&#46; For example&#44; Tg2576 mice showed increased intraneuronal A&#946;<span class="elsevierStyleInf">1-42</span> accumulation with aging&#44; and this accumulation was associated with abnormal synaptic morphology before A&#946; plaque pathology&#46;<a class="elsevierStyleCrossRef" href="#bib44">44</a> 3xTg-AD mice developed age-dependent synaptic plasticity deficits&#44; but before A&#946; plaque and neurofibrillary tangle pathologies&#59; synaptic dysfunction correlated with the accumulation of intraneuronal A&#946;<span class="elsevierStyleInf">1-42</span>&#46;<a class="elsevierStyleCrossRef" href="#bib63">63</a> Intraneuronal A&#946;<span class="elsevierStyleInf">1-42</span> accumulated in 5xFAD brain starting at 1&#46;5 months of age&#44; just before the first appearance of A&#946; deposits at 2 months&#46; Synaptic loss started already at 4 months of age and was significant from 9 months in 5xFAD brain&#44; whereas local neuronal loss first became apparent at 9 months of age&#46;<a class="elsevierStyleCrossRef" href="#bib68">68</a> The development of the APP<span class="elsevierStyleInf">SL</span>&#47;PS1 mice&#44; which exhibit intraneuronal A&#946;<span class="elsevierStyleInf">1-42</span> accumulation&#44; offered for the first time the possibility to address the question of whether alterations in synaptic integrity precede neuronal loss in a transgenic animal model of AD&#44; and the data indicated that loss of neurons was of limited impact on age-related synaptic loss and that at least part of synaptic loss seen in regions free of A&#946; deposits was due to elevated levels of soluble A&#946; oligomers&#46;<a class="elsevierStyleCrossRef" href="#bib69">69</a></p><p id="para280" class="elsevierStylePara elsevierViewall">Regarding the interaction between A&#946; and Tau pathologies&#44; although A&#946; plaque development is almost certainly driven by the APP and PS1 FAD mutations&#44; whereas the tangle-like pathology is driven by the Tau mutations&#44; it does appear that such mutations interact&#44; as suggested by studies in transgenic mouse models with Tau mutation&#46; For example&#44; bigenic TAPP mice &#40;expressing K670N&#47;M671L mutant APP and P301L mutant Tau&#41; have enhanced neurofibrillary pathology in limbic regions&#44; most notably the amygdala&#44; in comparison with transgenic JNPL3 animals &#40;expressing singly P301L mutant Tau&#41;&#44; suggesting that the formation of Tau inclusions might be influenced by increasing the level of APP or A&#946; peptides&#46;<a class="elsevierStyleCrossRef" href="#bib62">62</a> Additionally&#44; intracerebral injections of anti-A&#946; antibodies into the hippocampus of 3xTg-AD mice not only reduced A&#946; accumulation but also resulted in clearance of early-stage&#44; but not late-stage&#44; hyperphosphorylated Tau aggregates&#46; Whereas A&#946; deposits were cleared within 3 days&#44; the Tau lesions required a slightly longer time and were not reduced until 5 days after injection&#46; Thus&#44; A&#946; was cleared first&#44; followed by the clearance of Tau localized in the somatodendritic compartment&#46; Conversely&#44; by 30 days after injection&#44; A&#946; deposits reemerged&#44; although the Tau pathology was not apparent at this time point&#46;<a class="elsevierStyleCrossRef" href="#bib105">105</a> These studies thus show that modulating A&#946; affects Tau pathology and suggest that Tau pathology may be downstream of A&#946; generation&#46;</p></span></span><span id="cesec80" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle90">CONCLUSION</span><p id="para290" class="elsevierStylePara elsevierViewall">To study AD&#44; a variety of transgenic mouse models has been generated through the overexpression of the APP and&#47;or the presenilins harboring one or several mutations found in familial AD&#46;<a class="elsevierStyleCrossRefs" href="#bib34">34&#44;40&#44;45&#44;49&#44;53</a>&#44; Although none of the AD transgenic mice models reproduces the human condition exactly&#44; the ability to study similar pathological processes in living animals has provided valuable insights into disease mechanisms and opportunities to test therapeutic approaches&#46;<a class="elsevierStyleCrossRef" href="#bib11">11</a> The AD mouse models have been key to understanding the roles of soluble A&#946; oligomers in disease pathogenesis&#44; as well as of the relationship between A&#946; and Tau pathologies&#46; Data obtained from the comparison of different AD mouse lines indicate that the onset and the severity of the A&#946; deposits are directly linked to the level of soluble A&#946;<span class="elsevierStyleInf">1-42</span> peptide&#46;<a class="elsevierStyleCrossRefs" href="#bib42">42&#44;43&#44;47&#44;58&#44;59&#44;63&#44;64&#44;83&#44;84</a> There is accumulating evidence from AD transgenic mice that intraneuronal A&#946;<span class="elsevierStyleInf">1-42</span> triggers early neuronal loss as well as synaptic deficits&#46;<a class="elsevierStyleCrossRef" href="#bib63">63</a>&#44; Studies in a transgenic animal model of AD that exhibits marked neuronal and synaptic loss indicate that alterations in synaptic integrity precede neuronal loss&#44;<a class="elsevierStyleCrossRef" href="#bib69">69</a> which is in accordance with the hypothesis that synaptic loss is one of the earliest events in AD pathogenesis&#46;<a class="elsevierStyleCrossRefs" href="#bib37"><span class="elsevierStyleSup">37&#44;101&#8211;104</span></a> Furthermore&#44; evidence from AD transgenic mouse models supports the notion that A&#946; may directly or indirectly interact with Tau to accelerate neurofibrillary tangle formation&#46;<a class="elsevierStyleCrossRefs" href="#bib62">62&#44;105</a> Finally&#44; the AD transgenic models may allow to define and evaluate potential drug targets and to develop therapeutic strategies that might interfere or delay the onset of AD&#46;<a class="elsevierStyleCrossRef" href="#bib106">106</a></p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:4 [
        0 => array:2 [
          "identificador" => "xpalclavsec1581351"
          "titulo" => "KEYWORDS"
        ]
        1 => array:3 [
          "identificador" => "cesec10"
          "titulo" => "INTRODUCTION"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "cesec20"
              "titulo" => "1&#46; Genetics implicated in Alzheimer disease pathogenesis"
            ]
            1 => array:3 [
              "identificador" => "cesec30"
              "titulo" => "2&#46; Transgenic mouse models of Alzheimer disease"
              "secciones" => array:3 [
                0 => array:2 [
                  "identificador" => "cesec40"
                  "titulo" => "Mouse Models with APP Mutation"
                ]
                1 => array:2 [
                  "identificador" => "cesec50"
                  "titulo" => "Mouse Models with Tau Mutation"
                ]
                2 => array:2 [
                  "identificador" => "cesec60"
                  "titulo" => "Mouse Models with Presenilin Mutation"
                ]
              ]
            ]
            2 => array:2 [
              "identificador" => "cesec70"
              "titulo" => "3&#46; Insights into Alzheimer disease pathogenesis from studies in transgenic models"
            ]
          ]
        ]
        2 => array:2 [
          "identificador" => "cesec80"
          "titulo" => "CONCLUSION"
        ]
        3 => array:1 [
          "titulo" => "REFERENCES"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2011-03-15"
    "fechaAceptado" => "2011-03-16"
    "PalabrasClave" => array:1 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "KEYWORDS"
          "identificador" => "xpalclavsec1581351"
          "palabras" => array:5 [
            0 => "Neurodegenerative disorder"
            1 => "Senile plaques"
            2 => "Neurofibrillary tangles"
            3 => "Neuronal loss"
            4 => "Animal models"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:1 [
      "en" => array:1 [
        "resumen" => "<span id="ceabs10" class="elsevierStyleSection elsevierViewall"><p id="spara40" class="elsevierStyleSimplePara elsevierViewall">Alzheimer disease is the most common cause of dementia among the elderly&#44; accounting for &#8764;60-70&#37; of all cases of dementia&#46; The neuropathological hallmarks of Alzheimer disease are senile plaques &#40;mainly containing &#946;-amyloid peptide derived from amyloid precursor protein&#41; and neurofibrillary tangles &#40;containing hyperphosphorylated Tau protein&#41;&#44; along with neuronal loss&#46; At present there is no effective treatment for Alzheimer disease&#46; Given the prevalence and poor prognosis of the disease&#44; the development of animal models has been a research priority to understand pathogenic mechanisms and to test therapeutic strategies&#46; Most cases of Alzheimer disease occur sporadically in people over 65 years old&#44; and are not genetically inherited&#46; Roughly 5&#37; of patients with Alzheimer disease have familial Alzheimer disease&#8212;that is&#44; related to a genetic predisposition&#44; including mutations in the amyloid precursor protein&#44; presenilin 1&#44; and presenilin 2 genes&#46; The discovery of genes for familial Alzheimer disease has allowed transgenic models to be generated through the overexpression of the amyloid precursor protein and&#47;or presenilins harboring one or several mutations found in familial Alzheimer disease&#46; Although none of these models fully replicates the human disease&#44; they have provided valuable insights into disease mechanisms as well as opportunities to test therapeutic approaches&#46; This review describes the main transgenic mouse models of Alzheimer disease which have been adopted in Alzheimer disease research&#44; and discusses the insights into Alzheimer disease pathogenesis from studies in such models&#46; In summary&#44; the Alzheimer disease mouse models have been the key to understanding the roles of soluble &#946;-amyloid oligomers in disease pathogenesis&#44; as well as of the relationship between &#946;-amyloid and Tau pathologies&#46;</p></span>"
      ]
    ]
    "multimedia" => array:2 [
      0 => array:7 [
        "identificador" => "fig1"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 243
            "Ancho" => 425
            "Tamanyo" => 20358
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">Schematic diagram illustrating proteolytic cleavage of the amyloid precursor protein &#40;APP&#41;&#46; &#945;-Secretase &#40;non-amyloidogenic pathway&#41; cleaves APP within the A&#946; domain to liberate two peptides&#44; including the neuroprotective soluble APP&#945;&#44; whereas &#946;- and &#947;-secretases &#40;amyloidogenic pathway&#41; act sequentially to cleave APP in the N- and C-terminal portions of the A&#946; region&#44; respectively&#44; producing A&#946; peptide and initiating neurodegenerative activity&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl1"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spara30" class="elsevierStyleSimplePara elsevierViewall">CAA &#8200;&#61;&#8200; cerebral amyloid angiopathy&#59; Dash &#40;-&#41; &#8200;&#61;&#8200; not reported&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Mousemodel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Gene &#40;mutation&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Intraneuronal A&#946;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">ParenchymalA&#946; plaques&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">HyperphosphorylatedTau&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Neurofibrillarytangles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Neuronalloss&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Synapticloss&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">CAA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Primaryreference&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PDAPP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APP &#40;V717F&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Games et al&#46; 1995&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tg2576&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APP &#40;K670N&#47;M671L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hsiao et al&#46; 1996&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">TgCRND8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APP &#40;K670N&#47;M671L&#44; V717F&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Chishti et al&#46; 2001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APP&#47;PS1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APP &#40;K670N&#47;M671L&#41;&#44;PS1 &#40;M146L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Holcomb et al&#46; 1998&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APP23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APP &#40;K670N&#47;M671L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Little&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sturchler-Pierrat et al&#46; 1997&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tg-SwDI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APP &#40;E693Q&#44; D694N&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Davis et al&#46; 2004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APPDutch&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APP &#40;E693Q&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Little&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Herzig et al&#46; 2004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APPDutch&#47;PS1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APP &#40;E693Q&#41;&#44;PS1 &#40;G384A&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Little&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Herzig et al&#46; 2004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">hAPP-Arc&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APP &#40;E693G&#44; K670N&#47;M671L&#44; V717F&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Little&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cheng et al&#46; 2004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tg-ArcSwe&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APP &#40;E693G&#44; K670N&#47;M671L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lord et al&#46; 2006Knobloch et al&#46; 2007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APPArc&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APP &#40;E693G&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">R&#246;nnb&#228;ck et al&#46; 2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">TAPP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APP &#40;K670N&#47;M671L&#41;&#44;Tau &#40;P301L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lewis et al&#46; 2001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3xTg-AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APP &#40;K670N&#47;M671L&#41;&#44;Tau &#40;P301L&#41;&#44;PS1 &#40;M146V&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Oddo et al&#46; 2003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APP<span class="elsevierStyleInf">SL</span>&#47;PS1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APP &#40;K670N&#47;M671L&#44; V717I&#41;&#44;PS1 &#40;M146L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wirths et al&#46; 2002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APP&#47;PS1KI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APP &#40;K670N&#47;M671L&#44; V717I&#41;&#44;PS1 &#40;M233T&#47;L235P&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Casas et al&#46; 2004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">5xFAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">APP &#40;K670N&#47;M671L&#44; I716V&#44; V717I&#41;&#44;PS1 &#40;M146L&#47;L286V&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Oakley et al&#46; 2006&nbsp;\t\t\t\t\t\t\n
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