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Microtubule-associated protein tau (pathological form) (tau (pathological), p-tau (for phosphorylated tau))

Target
tau (pathological), p-tau (for phosphorylated tau)
Molecular classification
Microtubule-associated protein, Intrinsically disordered protein, Aggregation-prone protein, Prion-like protein (in the context of propagation), Other
01

Overview

Pathological tau protein refers to abnormally modified forms of the microtubule-associated protein tau, mainly through hyperphosphorylation, truncation, acetylation, or other post-translational modifications, which result in loss of normal microtubule binding and gain of toxic aggregation properties[1][5][9]. In its pathological state, tau misfolds and aggregates into insoluble fibrillar structures (such as neurofibrillary tangles), disrupting cytoskeletal integrity, axonal transport, synaptic function, and contributing to the death of neurons[1][3][5]. Pathological tau is a central molecular driver of Alzheimer’s disease and other tauopathies, with different diseases associated with different isoforms and structural "folds" of tau filaments[2][4][5][6]. Targeting pathological tau is a major therapeutic strategy in neurodegenerative research, although no tau-directed therapies are yet approved for disease modification in humans.

Other names
Pathological tauPathological tau proteinHyperphosphorylated tauAggregated tauTauopathy-associated tauNeurofibrillary tangle protein
02

Mechanism of action

Inhibition of tau aggregation, Promotion of tau clearance (immunotherapy), Reduction of tau phosphorylation (kinase inhibition), Destabilization or degradation of pathological tau conformers, Modulation of tau splicing to alter isoform balance

03

Biological functions

Microtubule stabilization (normal physiology)Axonal transport (normal physiology)Protein aggregation (pathological)Promotes neurofibrillary tangle formation (pathological)Alters synaptic and nuclear function (pathological)Other
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Disease associations

Neurodegenerative diseaseAlzheimer’s diseaseFrontotemporal dementia (including Pick’s disease, corticobasal degeneration, progressive supranuclear palsy)Parkinsonism (tauopathies)Chronic traumatic encephalopathyOther
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Safety considerations

Lack of specificity: normal tau has critical neuronal rolesOff-target CNS effects (immunotherapy)Potential for worsening other pathologies (e.g., amyloid-β interaction)Blood-brain barrier penetration challengesPro-inflammatory or neurotoxic immune responses
06

Interacting drugs

Anti-tau antibodies (e.g., gosuranemab, semorinemab, tilavonemab, zagotenemab)

4 more in the full profile.

07

Biomarkers

CSF phosphorylated tau (p-tau)CSF total tauPlasma phosphorylated tauPositron emission tomography (PET) ligands targeting aggregated tauNeurofibrillary tangle detection in neuropathology

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