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Structures of filaments from Pick’s disease reveal a novel tau protein fold

Naturevolume 561pages137140 (2018) | Download Citation


The ordered assembly of tau protein into abnormal filamentous inclusions underlies many human neurodegenerative diseases1. Tau assemblies seem to spread through specific neural networks in each disease2, with short filaments having the greatest seeding activity3. The abundance of tau inclusions strongly correlates with disease symptoms4. Six tau isoforms are expressed in the normal adult human brain—three isoforms with four microtubule-binding repeats each (4R tau) and three isoforms that lack the second repeat (3R tau)1. In various diseases, tau filaments can be composed of either 3R or 4R tau, or of both. Tau filaments have distinct cellular and neuroanatomical distributions5, with morphological and biochemical differences suggesting that they may be able to adopt disease-specific molecular conformations6,7. Such conformers may give rise to different neuropathological phenotypes8,9, reminiscent of prion strains10. However, the underlying structures are not known. Using electron cryo-microscopy, we recently reported the structures of tau filaments from patients with Alzheimer’s disease, which contain both 3R and 4R tau11. Here we determine the structures of tau filaments from patients with Pick’s disease, a neurodegenerative disorder characterized by frontotemporal dementia. The filaments consist of residues Lys254–Phe378 of 3R tau, which are folded differently from the tau filaments in Alzheimer’s disease, establishing the existence of conformers of assembled tau. The observed tau fold in the filaments of patients with Pick’s disease explains the selective incorporation of 3R tau in Pick bodies, and the differences in phosphorylation relative to the tau filaments of Alzheimer’s disease. Our findings show how tau can adopt distinct folds in the human brain in different diseases, an essential step for understanding the formation and propagation of molecular conformers.

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We thank the patients’ families for donating brain tissue; M. R. Farlow for clinical evaluation; F. Epperson, R. M. Richardson and U. Kuederli for human brain collection and analysis; P. Davies, P. Seubert and M. Hasegawa for antibodies MC1, 12E8 and TauC4, respectively; S. Chen, C. Savva and G. Cannone for support with electron microscopy; T. Darling and J. Grimmett for help with computing; W. W. Seeley and M. G. Spillantini for discussions. M.G. is an Honorary Professor in the Department of Clinical Neurosciences of the University of Cambridge. This work was supported by the UK Medical Research Council (MC_UP_A025_1012 to G.M., MC_UP_A025_1013 to S.H.W.S. and MC_U105184291 to M.G.), the European Union (Joint Programme-Neurodegeneration Research REfrAME to M.G. and B.F. and the Innovative Medicines Initiative 2 IMPRiND, project number 115881, to M.G.), the US National Institutes of Health (grant P30-AG010133 to B.G.), the Department of Pathology and Laboratory Medicine, Indiana University School of Medicine (to B.G.) and an Alzheimer’s Association Zenith Award (to R.V.).

Reviewer information

Nature thanks E. H. Egelman, B. T. Hyman and the other anonymous reviewer(s) for their contribution to the peer review of this work.

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Author notes

  1. These authors jointly supervised this work: Sjors H. W. Scheres, Michel Goedert


  1. MRC Laboratory of Molecular Biology, Cambridge, UK

    • Benjamin Falcon
    • , Wenjuan Zhang
    • , Alexey G. Murzin
    • , Garib Murshudov
    • , R. Anthony Crowther
    • , Sjors H. W. Scheres
    •  & Michel Goedert
  2. Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA

    • Holly J. Garringer
    • , Ruben Vidal
    •  & Bernardino Ghetti


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B.G. performed neuropathology; H.J.G. and R.V. carried out genetic analysis; B.F. extracted tau filaments; B.F. and W.Z. conducted immunolabelling; B.F. and W.Z. purified recombinant tau proteins; B.F. carried out seeded aggregation; B.F. and W.Z. performed cryo-EM; B.F., W.Z. and S.H.W.S. analysed the cryo-EM data; B.F., W.Z., G.M. and A.G.M. built the atomic model; R.A.C. contributed to the inception of the study; M.G. and S.H.W.S. supervised the project; all authors contributed to writing the manuscript.

Competing interests

: The authors declare no competing interests.

Corresponding authors

Correspondence to Sjors H. W. Scheres or Michel Goedert.

Extended data figures and tables

  1. Extended Data Fig. 1 Further characterization of the filamentous tau pathology of Pick’s disease.

    a, Staining of Pick bodies in the frontotemporal cortex of patient 4 by Bodian silver and antibody AT8 (pS202 and pT205 tau), but not by Gallyas–Braak silver. Nuclei are counterstained blue in the AT8 panel. Scale bars, 20 µm. b, c, Immunolabelling of the tau filaments extracted from the frontotemporal cortex of patient 4. b, Immunoblots with antibodies BR133 (tau N terminus), BR134 (tau C terminus), RD3 (3R tau), anti-4R (4R tau), AT8 (pS202 and pT205 tau) and 12E8 (pS262 tau and/or pS356 tau). c, Immunogold negative-stain electron micrographs with antibodies BR133, BR134, 12E8 and MC1 of NPFs and WPFs with and without pronase treatment. Scale bar, 500 Å.

  2. Extended Data Fig. 2 NPF structure.

    a, Fourier shell correlation curves between two independently refined half-maps (black line) and between the cryo-EM reconstruction and refined atomic model (red line). b, Local resolution estimates for the NPF reconstruction. c, Helical axis views of the NPF reconstruction. d, Close-up views of the cryo-EM map with the atomic model overlaid. The top row shows the three Pro-Gly-Gly-Gly (PGGG) motifs; the bottom row shows several amino acids with large side chains.

  3. Extended Data Fig. 3 WPF structure.

    a, Fourier shell correlation curves between two independently refined half-maps. b, Local resolution estimates for the WPF reconstruction. c, WPF density at high (light grey) and low (dark grey) threshold with densities for two NPFs overlaid (yellow and blue). The atomic models fitted to the NPF densities in the region of the protofilament interface are shown in the boxed out area. d, Cryo-EM images showing WPFs from patient 4 (false coloured red), in which segments from one of the protofilaments have been lost. Scale bar, 500 Å. e, Negative-stain EM images of WPFs from patient 4 after incubation in 100 mM dithiothreitol for 20 h. Scale bar, 500 Å.

  4. Extended Data Fig. 4 Incompatibility of the Pick tau filament fold with 4R tau.

    Atomic model of the Pick fold with the 4R tau sequence overlaid. The region formed by Lys254–Lys274 from R1 is replaced by the Ser285–Val300 region from R2 in 4R tau. Residues that differ between these regions of R1 and R2 are coloured orange. The major discrepancies of lysine at position 294 in R2, instead of threonine at position 263 in R1, and valine at position 300 in R2, instead of glutamine at position 269 in R1, are highlighted with dashed red outlines. The minor discrepancy of weaker interactions of Cys291 of R2 with Leu357 and Ile360 compared with those formed by Ile260 of R1 is highlighted with a dashed yellow outline.

  5. Extended Data Fig. 5 Seeded aggregation of full-length 3R, but not 4R, tau by the sarkosyl-insoluble fraction from the brain of patient 4 with Pick’s disease.

    a, Coomassie-stained SDS–PAGE of the 0N3R and 0N4R recombinant tau preparations used for seeded aggregation. Two additional recombinant tau preparations were performed with similar results. b, Thioflavin T fluorescence measurements of 0N3R (red) and 0N4R (blue) recombinant tau after incubation with (triangles) or without (circles) the sarkosyl-insoluble fraction from the frontotemporal cortex of patient 4. The results are from three independent experiments using separate recombinant protein preparations. The sarkosyl-insoluble fraction from Pick’s disease brain efficiently seeded the aggregation of 3R, but not 4R, tau. RFU, relative fluorescent units.

  6. Extended Data Fig. 6 Immunoblot analysis of additional Pick’s disease cases.

    a, Diagram of 2N4R tau showing the N-terminal inserts (N1 and N2), the repeats (R1–R4) and the epitopes of antibodies BR133 (N terminus), BR136 (R1), anti-4R (R2), BR135 (R3), TauC4 (R4) and BR134 (C terminus). b, Immunoblots of epitope-deletion recombinant tau constructs with the antibodies shown in a. Identical results were obtained in two independent repeats. c, Immunoblots using the antibodies BR136, anti-4R, BR135 and TauC4 of tau filaments extracted from the frontotemporal cortex of 9 patients with Pick’s disease (patient 4 was used for cryo-EM). See Extended Data Table 1 for details of the patients with Pick’s disease.

  7. Extended Data Fig. 7 Immunogold negative-stain EM analysis of additional Pick’s disease cases.

    a, Representative immunogold negative-stain electron microscopy with antibodies BR133 (tau N terminus), BR136 (tau R1), anti-4R (tau R2), BR135 (tau R3), TauC4 (tau R4) and BR134 (tau C terminus) of NPFs and WPFs extracted from the frontotemporal cortex of patient 4. Scale bars, 100 nm. Similar results were obtained with tau filaments extracted from the frontotemporal cortices of eight additional patients with Pick’s disease. b, Table summarizing results from a. Results for patient 4 (shown in a and used for cryo-EM) are highlighted in yellow. See Extended Data Table 1 for details of the patients with Pick’s disease. Tick marks indicate antibody decoration of filaments, and crosses indicate that the antibodies did not decorate filaments. NPFs and WPFs were decorated by the antibodies against the N and C termini of tau, but not by the tau repeat-specific antibodies.

  8. Extended Data Table 1 Summary of the patients with Pick’s disease
  9. Extended Data Table 2 Anti-tau antibodies
  10. Extended Data Table 3 Cryo-EM data collection, refinement and validation statistics

Supplementary information

  1. Supplementary Figures

    This file contains Supplementary Figures: Source images for Western blots.

  2. Reporting Summary

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