Differential roles of Aβ processing in hypoxia-induced axonal damage

• Hypoxia induces loss of structural integrity and transport capacity in RGC axons.
• Aβ mediates hypoxia-induced structural compromise of RGC axons.
• Aβ blockade does not restore active axonal transport capacity during hypoxia.
• Hypoxia-induced compromise of axonal structure but not transport depends on Aβ.
• Aβ inhibition could provide clinical benefit for aspects of axonal degeneration.

Axonopathy is a common and early phase in neurodegenerative and traumatic CNS diseases. Recent work suggests that amyloid β (Aβ) produced from amyloid precursor protein (APP) may be a critical downstream mediator of CNS axonopathy in CNS diseases, particularly those associated with hypoxia. We critically tested this hypothesis in an adult retinal explant system that preserves the three-dimensional organization of the retina while permitting direct imaging of two cardinal features of early-stage axonopathy: axonal structural integrity and axonal transport capacity. Using this system, we found via pharmacological inhibition and genetic deletion of APP that production of Aβ is a necessary step in structural compromise of retinal ganglion cell (RGC) axons induced by the disease-relevant stressor hypoxia. However, identical blockade of Aβ production was not sufficient to protect axons from associated hypoxia-induced reduction in axonal transport. Thus, Aβ mediates distinct facets of hypoxia-induced axonopathy and may represent a functionally selective pharmacological target for therapies directed against early-stage axonopathy in CNS diseases.