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Amyloid-beta 42 (Aβ42) is a 42-amino acid peptide derived from the proteolytic cleavage of the amyloid precursor protein (APP) by β-secretase and γ-secretase (UniProt P05067). In its misfolded monomeric state, Aβ42 is highly prone to self-aggregation due to its hydrophobic C-terminus, leading to the formation of neurotoxic oligomers and insoluble amyloid plaques (PubMed: 28913148). This process is a hallmark of Alzheimer's disease pathogenesis, as described by the amyloid cascade hypothesis (PubMed: 30635407). Therapeutic interventions targeting misfolded Aβ42 monomers, such as the monoclonal antibody solanezumab, aim to sequester these species and prevent their assembly into larger, more toxic aggregates (PubMed: 29361447). While some drugs target the monomeric form to enhance clearance, others focus on the transition from monomer to oligomer to mitigate synaptic dysfunction and neurodegeneration (PubMed: 31034602). Monitoring the Aβ42/Aβ40 ratio in cerebrospinal fluid and plasma serves as a critical biomarker for early diagnosis and therapeutic efficacy (PubMed: 30670666). Despite the focus on pathological forms, physiological Aβ may play roles in synaptic modulation and antimicrobial defense, raising concerns about total depletion (PubMed: 27225120). Overall, Aβ42 monomers represent a key upstream target in the complex landscape of neurodegenerative proteinopathies.
Therapeutic agents target misfolded Aβ42 monomers through 'peripheral sink' mechanisms or direct conformational stabilization to prevent the nucleation and elongation of toxic amyloid fibrils (PubMed: 29361447, PubMed: 31034602).
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