Cyclase-associated protein 2 gene delivery: A potential multi-target approach for preventing synaptic failure in Alzheimer's disease

Mol Ther. 2026 Mar 4;34(3):1684-1706. doi: 10.1016/j.ymthe.2025.12.023. Epub 2025 Dec 11.

Abstract

Alzheimer's disease (AD) is marked by synaptic failure, with actin cytoskeleton alterations playing a key role in its pathogenesis. Cofilin, a regulator of actin dynamics in dendritic spines, forms cofilin-actin rods upon exposure to amyloid-β (Aβ) oligomers, contributing to synaptic loss. Cyclase-associated protein 2 (CAP2) is crucial for regulating cofilin activity. During long-term potentiation, CAP2 dimerization is relevant for cofilin translocation to spines required for spine remodeling. In AD, CAP2 is downregulated, thus disrupting synaptic CAP2/cofilin complexes. To investigate the neuroprotective potential of CAP2 overexpression in preventing Aβ-induced synaptic dysfunction, we used adeno-associated virus serotype 9 (AAV) gene delivery to elevate CAP2 levels in APP/PS1 mice-a model of amyloid pathology-starting from the asymptomatic stage. APP/PS1 animals received bilateral stereotaxic injection of either AAV expressing CAP2 or a control AAV. This approach preserved synaptic CAP2/cofilin interaction, maintained synaptic plasticity pathways, and sustained cognitive function. CAP2 overexpression reduced cofilin-actin rod formation and mitigated tau abnormalities. Notably, CAP2 is present in cofilin-actin rods, and its dimerization is required to prevent Aβ-driven synaptic loss but not to protect neurons from rod formation. These findings highlight CAP2 upregulation as a promising strategy to enhance neuronal resilience and counteract Aβ synaptic toxicity in AD.

Keywords: Alzheimer disease; CAP2; actin; actin rods; amyloid; cofilin; glutamatergic synapse; hippocampus; synaptic resilience; tau.

MeSH terms

  • Actin Depolymerizing Factors / metabolism
  • Alzheimer Disease* / genetics
  • Alzheimer Disease* / metabolism
  • Alzheimer Disease* / pathology
  • Alzheimer Disease* / therapy
  • Amyloid beta-Peptides / metabolism
  • Animals
  • Cytoskeletal Proteins* / genetics
  • Cytoskeletal Proteins* / metabolism
  • Dendritic Spines / metabolism
  • Dependovirus / genetics
  • Disease Models, Animal
  • Gene Transfer Techniques
  • Genetic Therapy / methods
  • Genetic Vectors / administration & dosage
  • Genetic Vectors / genetics
  • Humans
  • Mice
  • Mice, Transgenic
  • Neuronal Plasticity
  • Synapses* / metabolism
  • Synapses* / pathology

Substances

  • Amyloid beta-Peptides
  • Cytoskeletal Proteins
  • Actin Depolymerizing Factors