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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.
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
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