bioRxiv · 10.1101/2025.08.28.672784
GSDME unlocks astrocyte-driven neurotoxicity in Alzheimer's Disease
Abstract
Astrocytic calcium dysregulation and reactivity precede A{beta} deposition in amyloid-{beta} deposition in Alzheimers disease (AD) but the neurotoxic mechanisms remain unclear. We show that GSDME acts as a switch, linking MAM-mediated calcium release to astrocyte-driven neurotoxicity. Specifically, A{beta}-activated microglial signals activate astrocytic GSDME, releasing its N-terminal fragment, which targets MAMs and triggers ER calcium efflux. This induces biphasic CaMKII phosphorylation, initially boosting NRF2 defenses, then activating NF-{kappa}B-driven inflammation, shifting astrocytes from protective to toxic states. GSDME activation also drives astrocyte-derived exosomes (ADEs) to carry neurotoxic tau, proinflammatory miRNAs, and toxic lipids, propagating toxicity. GSDME deletion in AD mice reduces A{beta} burden, restores NF-{kappa}B/NRF2 balance, reprograms astrocytes and ADEs to protective states, and rescues cognition. Multi-omics profiling of serum ADEs from AD patients reveals a disease-specific signature with central neurotoxicity and peripheral immune regulation. These findings position GSDME as a promising dual diagnostic and therapeutic target for early AD invention.
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Xie, X., Ji, C., Xu, J., Lu, X., Guo, G., Liu, W., Wu, X., Chen, Y., Zhang, Y., Wang, J., Li, J., Hu, X., Chen, S., Wang, G., Liu, Q.. 2025-09-02. GSDME unlocks astrocyte-driven neurotoxicity in Alzheimer's Disease. https://doi.org/10.1101/2025.08.28.672784
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