PEPTIDIC INHIBITORS OF AMYLOID SELF- AND CROSS-ASSEMBLY

20250161408 · 2025-05-22

    Inventors

    Cpc classification

    International classification

    Abstract

    The present invention relates to a peptide, and to a pharmaceutical composition and a heterocomplex comprising the peptide. Furthermore, the present invention relates to the peptide, the pharmaceutical composition, or the heterocomplex for use in a method of preventing or treating Alzheimer's disease and/or for use in a method of preventing or treating type 2 diabetes. The present invention further relates to the peptide, the pharmaceutical composition, or the heterocomplex for use in a method of diagnosing Alzheimer's disease and/or for use in a method of diagnosing type 2 diabetes. The present invention also relates to a kit for the in vitro or in vivo detection of amyloid fibrils or aggregates, or for the diagnosis of Alzheimer's disease and/or type 2 diabetes in a patient. Moreover, the present invention relates to the use of the peptide or of the heterocomplex in an in vitro assay for the detection of monomeric islet amyloid polypeptide (LAPP), monomeric A.sub.40 (.sub.42), amyloid fibrils, or amyloid aggregates.

    Claims

    1. A peptide having an amino acid sequence according to formula 1 TABLE-US-00013 (formula1) (X.sub.1).sub.m(X.sub.2).sub.n(X.sub.3).sub.p(X.sub.4).sub.qF.sub.aF.sub.bAEX.sub.5-X.sub.6X.sub.7X.sub.8-NKGAIIX.sub.9X.sub.10X.sub.11VG (G).sub.r(V).sub.s(V).sub.t wherein, m, n, p, q, r, s, and t are, independently at each occurrence, selected from 0 and 1; X.sub.1 is selected from glutamine, asparagine, alanine, glutamic acid, and aspartic acid; X.sub.2 is selected from lysine, modified lysine, alanine, modified alanine, ornithine, modified ornithine, diaminobutyric acid, diaminopropionic acid, arginine, and modified arginine; X.sub.3 is selected from leucine, N-methyl-leucine, alanine, N-methyl-alanine, isoleucine, N-methyl-isoleucine, valine, N-methyl-valine, glycine, N-methyl-glycine, norleucine, N-methyl-norleucine, phenylalanine, N-methyl-phenylalanine, tyrosine, and N-methyl-tyrosine; X.sub.4 is selected from leucine, N-methyl-leucine, alanine, N-methyl-alanine, isoleucine, N-methyl-isoleucine, valine, N-methyl-valine, glycine, N-methyl-glycine, norleucine, N-methyl-norleucine, phenylalanine, N-methyl-phenylalanine, tyrosine, and N-methyl-tyrosine; F.sub.a and F.sub.b are, independently at each occurrence, selected from phenylalanine, N-methyl-phenylalanine, halogenated phenylalanine, tyrosine, and N-methyl-tyrosine; A is, independently at each occurrence, selected from alanine, N-methyl-alanine, leucine, N-methyl-leucine, valine, N-methyl-valine, glycine, and N-methyl-glycine; E is selected from glutamic acid, N-methyl-glutamic acid, aspartic acid, N-methyl-aspartic acid, glutamine, N-methyl-glutamine, asparagine, N-methyl-asparagine, alanine, N-methyl-alanine, glycine, and N-methyl-glycine; X.sub.5 is selected from aspartic acid, glutamic acid, asparagine, aspartic acid, alanine, and glycine; X.sub.6, X.sub.7, and X.sub.8 are, independently at each occurrence, selected from norleucine, leucine, phenylalanine, methionine, tryptophan, tyrosine, threonine, alanine, isoleucine, valine, and modified forms thereof; N is selected from asparagine, glutamine and alanine; K is selected from lysine, modified lysine, alanine, norleucine, ornithine, modified ornithine, diaminobutyric acid, diaminopropionic acid, arginine, and modified arginine; G is, independently at each occurrence, selected from glycine and alanine; I is, independently at each occurrence, selected from isoleucine, leucine, norleucine, and valine; X.sub.9 is selected from glycine, alanine, and serine; X.sub.10 is selected from leucine, alanine, isoleucine, threonine, norleucine, and valine; X.sub.11 is selected from norleucine, leucine, phenylalanine, methionine, tryptophan, tyrosine, threonine, alanine, isoleucine, and valine; and V is, independently at each occurrence, valine; and pharmaceutically acceptable salts, esters, solvates, polymorphs and modified forms thereof.

    2. The peptide according to claim 1, having an amino acid sequence according to formula 2 TABLE-US-00014 (formula2) (X.sub.1).sub.m(X.sub.2).sub.n(L.sub.a).sub.p(V.sub.a).sub.qF.sub.aF.sub.bAEX.sub.5-X.sub.6X.sub.7X.sub.8-NKGAIIX.sub.9X.sub.10X.sub.11VG (G).sub.r(V).sub.s(V).sub.t wherein, m, n, p, q, r, s, and t are, independently at each occurrence, selected from 0 and 1; X.sub.1 is selected from glutamine, asparagine, alanine, glutamic acid, and aspartic acid; X.sub.2 is selected from lysine, modified lysine alanine, modified alanine, ornithine, modified ornithine, diaminobutyric acid, diaminopropionic acid, arginine, and modified arginine; L.sub.a is leucine or N-methyl-leucine; V.sub.a is valine or N-methyl-valine; F.sub.a and F.sub.b are, independently at each occurrence, selected from phenylalanine, N-methyl-phenylalanine, halogenated phenylalanine, tyrosine, and N-methyl-tyrosine; A is, independently at each occurrence, selected from alanine, N-methyl-alanine, leucine, N-methyl-leucine, valine, N-methyl-valine, glycine, and N-methyl-glycine; E is selected from glutamic acid, N-methyl-glutamic acid, aspartic acid, N-methyl-aspartic acid, glutamine, N-methyl-glutamine, asparagine, N-methyl-asparagine, alanine, N-methyl-alanine, glycine, and N-methyl-glycine ; X.sub.5 is selected from aspartic acid, glutamic acid, asparagine, aspartic acid, alanine, and glycine; X.sub.6, X.sub.7, and X.sub.8 are, independently at each occurrence, selected from norleucine, leucine, phenylalanine, methionine, tryptophan, tyrosine, threonine, alanine, isoleucine, valine, and modified forms thereof ; N is selected from asparagine, glutamine and alanine; K is selected from lysine, modified lysine , alanine, norleucine, ornithine, modified ornithine , diaminobutyric acid, diaminopropionic acid, arginine, and modified arginine ; G is, independently at each occurrence, selected from glycine and alanine ; I is, independently at each occurrence, selected from isoleucine, leucine, norleucine, and valine; X.sub.9 is selected from glycine, alanine, and serine ; X.sub.10 is selected from leucine, alanine, isoleucine, threonine, norleucine, and valine ; and X.sub.11 is selected from norleucine, leucine, phenylalanine, methionine, tryptophan, tyrosine, threonine, alanine, isoleucine, and valine ; V is, independently at each occurrence, valine; wherein at least one of L.sub.a, V.sub.a, F.sub.a, and F.sub.b is an N-methylated amino acid; and pharmaceutically acceptable salts, esters, solvates, polymorphs and modified forms thereof.

    3. The peptide according to claim 1, having an amino acid sequence according to any one of formulae 3-5 TABLE-US-00015 (formula3) QKL.sub.aV.sub.aF.sub.aF.sub.bAED-X.sub.6X.sub.7X.sub.8-NKGAIIGLNleVGGVV (formula4) F.sub.aF.sub.bAED-X.sub.6X.sub.7X.sub.8-NKGAIIGLNleVGGVV (formula5) QKL.sub.aV.sub.aF.sub.aF.sub.bAED-X.sub.6X.sub.7X.sub.8-NKGAIIGLNleVG wherein, Q is glutamine; K is, independently at each occurrence, lysine; L.sub.a is leucine or N-methyl-leucine; V.sub.a is valine or N-methyl-valine; F.sub.a and F.sub.b are, independently at each occurrence, phenylalanine or N-methyl-phenylalanine; A is, independently at each occurrence, alanine; E is glutamic acid; D is aspartic acid; X.sub.6, X.sub.7, and X.sub.8 are, independently at each occurrence, selected from norleucine, leucine, phenylalanine, methionine, tryptophan, tyrosine, threonine, alanine, isoleucine, and valine; N is asparagine; G is, independently at each occurrence, glycine; I is, independently at each occurrence, isoleucine; L is leucine; Nle is norleucine; V is, independently at each occurrence, valine; wherein at least one of L.sub.a, V.sub.a, F.sub.a, and F.sub.b is an N-methylated amino acid; and pharmaceutically acceptable salts, esters, solvates, polymorphs and modified forms thereof.

    4. The peptide according to claim 1, wherein X.sub.6, X.sub.7, and X.sub.8 are the same amino acid selected from norleucine, leucine, phenylalanine, methionine, tryptophan, tyrosine, threonine, alanine, isoleucine, and valine.

    5. The peptide according to claim 1, having an amino acid sequence according to any one of formulae 6-8, TABLE-US-00016 (formula6) QKL.sub.aV.sub.aF.sub.aF.sub.bAEDNleNleNleNKGAIIGLNleVGGVV, (formula7) QKL.sub.aV.sub.aF.sub.aF.sub.bAEDLLLNKGAIIGLNleVGGVV, (formula8) QKL.sub.aV.sub.aF.sub.aF.sub.bAEDFFFNKGAIIGLNleVGGVV, wherein, Q is glutamine; K is, independently at each occurrence, lysine; L.sub.a is leucine or N-methyl-leucine; V.sub.a is valine or N-methyl-valine; F.sub.a and F.sub.b are, independently at each occurrence, phenylalanine or N-methyl-phenylalanine; A is, independently at each occurrence, alanine; E is glutamic acid; D is aspartic acid; Ne is norleucine; N is asparagine; G is, independently at each occurrence, glycine; I is, independently at each occurrence, isoleucine; L is, independently at each occurrence, leucine; V is, independently at each occurrence, valine; F is, independently at each occurrence, phenylalanine; wherein at least one of L.sub.a, V.sub.a, F.sub.a, and F.sub.b is an N-methylated amino acid; and pharmaceutically acceptable salts, esters, solvates, polymorphs and modified forms thereof.

    6. The peptide according to claim 2, wherein two or more of L.sub.a, V.sub.a, F.sub.a, and F.sub.b are an N-methylated amino acid.

    7. The peptide according to claim 1, wherein said peptide has an amino acid sequence according to any one of formulae 9-17, TABLE-US-00017 (formula9) QK(N-methyl-L)V(N-methyl-F)FAEDNleNleNleNKGAII GLNleVGGVV, (formula10) QKL(N-methyl-V)F(N-methyl-F)AEDNleNleNleNKGAII GLNleVGGVV, (formula11) QK(N-methyl-L)V(N-methyl-F)FAEDLLLNKGAIIGLNleV GGVV, (formula12) QKL(N-methyl-V)F(N-methyl-F)AEDLLLNKGAIIGLNleV GGVV, (formula13) QK(N-methyl-L)V(N-methyl-F)FAEDFFFNKGAIIGLNleV GGVV, (formula14) QKL(N-methyl-V)F(N-methyl-F)AEDFFFNKGAIIGLNleV GGVV, (formula15) QK(N-methyl-L)(N-methyl-V)(N-methyl-F) (N-methyl-F)AEDFFFNKGAIIGLNleVGGVV, (formula16) QK(N-methyl-L)(N-methyl-V)(N-methyl-F) (N-methyl-F)AEDLLLNKGAIIGLNleVGGVV, (formula17) QK(N-methyl-L)(N-methyl-V)(N-methyl-F) (N-methyl-F)AEDNleNleNleNKGAIIGLNleVGGVV, wherein, Q is glutamine; K is, independently at each occurrence, lysine; L is, independently at each occurrence, leucine; V is, independently at each occurrence, valine; F is, independently at each occurrence, phenylalanine; A is, independently at each occurrence, alanine; E is glutamic acid; D is aspartic acid; Ne is, independently at each occurrence, norleucine; N is asparagine; G is, independently at each occurrence, glycine; I is, independently at each occurrence, isoleucine; and pharmaceutically acceptable salts, esters, solvates, polymorphs and modified forms thereof.

    8. The peptide according to claim 1, wherein said peptide consists of a sequence according to any one of formulae 1-17.

    9. A pharmaceutical composition comprising a peptide according to claim 1 and a pharmaceutically acceptable excipient.

    10. A heterocomplex comprising a peptide according to claim 1, and amyloid- peptide and/or islet amyloid polypeptide.

    11. A method selected from: A) a method of preventing or treating Alzheimer's disease and/or for preventing or treating type 2 diabetes, wherein said method comprises administering, to a subject in need of such prevention or treatment, the peptide according to claim 1, or a heterocomplex comprising a peptide according to claim 1 and amyloid- peptide and/or islet amyloid polypeptide; and B) a method of diagnosing Alzheimer's disease and/or diagnosing type 2 diabetes, wherein said method comprises administering, to a subject to be tested for Alzheimer's disease and/or type 2 diabetes an effective amount of the peptide according to claim 1, or a heterocomplex comprising a peptide according to claim 1 and amyloid- peptide and/or islet amyloid polypeptide.

    12. (canceled)

    13. The method according to claim 11, wherein said peptide is linked to, or administered together with, a suitable reporter molecule that allows detection of A40(42), islet amyloid polypeptide (IAPP), and/or amyloid aggregates or co-aggregates thereof by a suitable detection methodology and wherein said subject, after administration of said peptide, is subjected to said suitable detection methodology.

    14. A kit for the in vitro or in vivo detection of amyloid fibrils or aggregates, or for the diagnosis of Alzheimer's disease and/or type 2 diabetes in a subject, said kit comprising the peptide according to claim 1, a pharmaceutical composition comprising the peptide according to claim 1, or a heterocomplex comprising a peptide according to claim 1 and amyloid- peptide and/or islet amyloid polypeptide , in a freeze-dried form in a suitable container, and a buffered solvent in a separate container for reconstitution of said peptide in solution.

    15. A method for detecting monomeric islet amyloid polypeptide (IAPP), monomeric A40(42), amyloid fibrils, amyloid aggregates, and/or amyloid co-aggregates wherein said method comprises the use, in an in vitro assay, of the peptide according to claim 1, or of a heterocomplex comprising a peptide according to claim 1 and amyloid- peptide and/or islet amyloid polypeptide , in an in vitro assay.

    16. The peptide according to claim 3, wherein X.sub.6, X.sub.7, and X.sub.8 are independently at each occurrence, selected from norleucine, leucine, and phenylalanine.

    17. The peptide according to claim 4, wherein X.sub.6, X.sub.7, and X.sub.8 are the same amino acid selected from norleucine, leucine, and phenylalanine

    18. The peptide according to claim 6, wherein L.sub.a and V.sub.a; L.sub.a and F.sub.a; L.sub.a and F.sub.b; V.sub.a and F.sub.a; V.sub.a and F.sub.b; F.sub.a and F.sub.b; L.sub.a, V.sub.a, and F.sub.a; L.sub.a, V.sub.a, and F.sub.b; L.sub.a, F.sub.a, and F.sub.b; V.sub.a, F.sub.a, and F.sub.b; or L.sub.a, V.sub.a, F.sub.a, and F.sub.b are N-methylated amino acids.

    19. The peptide according to claim 18, wherein at least L.sub.a and F.sub.a, or at least V.sub.a and F.sub.b, are an N-methylated amino acid.

    20. The method according to claim 13, wherein the suitable detection methodology is selected from positron emission tomography (PET), nuclear magnetic resonance (NMR), magnetic resonance imaging (MRI), and PET-MRI.

    21. The method according to claim 15, wherein said in vitro assay is selected from an enzyme linked immunosorbent assay (ELISA), a radioimmuno assay (RIA), and a Dot/Slot blot assay.

    Description

    BRIEF DESCRIPTION OF THE FIGURES

    [0177] The present invention is now further described by reference to the following figures.

    [0178] All methods mentioned in the figure descriptions below were carried out as described in detail in the examples.

    [0179] FIG. 1 shows the ACM design concept, their effects on IAPP amyloid self-assembly and cytotoxicity, and ACM secondary structures. a Sequences of IAPP and A40(42), proposed models of fIAPP and fA40 folds, and hypothetical IAPP/A340 hetero-amyloids (b-strands, pink & underlined; hot segments of self-/cross-interactions, bold; loop residues, italics). b ACM inhibitor design strategy. Template A(15-40) in a b-strand-loop-b-strand fold proposed for fA40 is modified via (a)N-methylations in A(17-20), (b) substitution of A(24-26) by hydrophobic tripeptides, and (c) Met35 substitution by Nle. c Sequences of the six ACMs and negative controls VGS-VF and VGS-LF (Table 3). Each sequence corresponds to two different ACMs which contain the same LTS but a different couple of N-methylated residues (dashed boxes). Color code as in a; green or violet for peptide names and corresponding N-methylated residues. d Nle3-VF, L3-VF, and F3-VF block IAPP amyloid self-assembly. Fibrillogenesis of IAPP (16.5 M) alone or with ACMs or VGS-VF assessed via ThT binding (IAPP/peptide 1/2) (meansSD, 3 assays). e Nle3-VF, L3-VF, and F3-VF suppress formation of toxic IAPP assemblies. Solutions of d (7 day-aged (VFS-VF 24 h)) added to RIN5fm cells; cell viability determined via MTT reduction (meansSD, 3 assays, n=3 each). f Nle3-LF, L3-LF, and F3-LF block IAPP amyloid self-assembly. Assay as in d (IAPP/peptide 1/2 except L3-LF (1/2.5)) (meansSD, 3 assays). g Nle3-LF, L3-LF, and F3-LF suppress formation of toxic IAPP assemblies. Solutions of f (7 day-aged (VGS-LF 24 h)) added to RIN5fm cells; cell viability determined via MTT reduction (meansSD, 3 assays, n=3 each). h & i Secondary structure of ACMs. Far-UV CD spectra of ACMs of d and f versus non-inhibitors (5 M, pH 7.4). j ACMs inhibit seeding of IAPP by preformed fIAPP. Fibrillogenesis of IAPP (12 M) w/o or with fIAPP seeds (10%) and seeded IAPP/ACM mixtures assessed via ThT binding (IAPP/ACM 1/2) (meansSD, 3-9 assays). k ACMs inhibit fA42-mediated cross-seeding of IAPP. Fibrillogenesis of IAPP with and w/o fA42 seeds (10%) versus IAPP/ACM mixtures (IAPP 12 M, IAPP/ACM 1/2) (meansSD, 3-6 assays).

    [0180] FIG. 2 shows nanomolar affinity IAPP/ACM interactions yield amyloid-like but ThT-invisible nanofibers. a Nanomolar affinity IAPP/ACM interactions as determined by fluorescence spectroscopy. Fluorescence spectra of Fluos-IAPP (5 nM) and its mixtures with Nle3-VF (pH 7.4) at indicated molar ratios (data from one representative binding assay (n=3)). Inset, binding curve; data are meansSD from 3 assays. b IAPP/ACM interactions result in hetero-dimers and medium-to-high MW hetero-assemblies. Characterization of IAPP/Nle3-VF hetero-complexes via cross-linking at different time points and NuPAGE and Western blot using anti-IAPP (left) or anti-AP (right) antibodies. IAPP/Nle3-VF mixtures (1/2; IAPP, 30 M) were cross-linked with glutaraldehyde; orange box indicates medium-to-high MW hetero-assemblies (major species); arrows indicate hetero-di-/-tri-/tetramers. c Characterization of IAPP/Nle3-VF hetero-assemblies via size exclusion chromatography (SEC). Chromatograms of IAPP alone (16.5 M) or its mixtures with Nle3-VF (1/2) at 0 h and at 96 h. Black arrow indicates IAPP monomers and Nle3-VF dimers; blue arrows indicate IAPP/Nle3-VF hetero-dimers and medium-to-high MW hetero-assemblies. d IAPP/Nle3-VF co-assemblies are more disordered than b-sheet-rich IAPP assemblies. Far-UV CD spectra of 7 day-aged IAPP (16.5 M; pH 7.4) and its mixtures (1/2) with the Nle3-VF or VGS-VF (non-inhibitor) are shown; for comparison, the spectrum of freshly dissolved IAPP (o h) is also shown. e IAPP/Nle3-VF co-assembly blocks surface-exposure of hydrophobic clusters occurring at early steps of IAPP amyloid self-assembly as determined by anilinonaphthalene 8-sulfonate (ANS) binding. Fluorescence emission spectra of ANS alone/with IAPP (2 M) (left) and of ANS alone/with IAPP/ACM (1/2) mixtures (right) (pH 7.4) were measured at various time points of self- or co-assembly as indicated. f IAPP/ACM interactions results into ThT-invisible fibrils of indistinguishable appearance to fIAPP by TEM. TEM images of 7 day-aged IAPP (16.5 M) and its mixtures (1/2) with ACMs or VGS-VF (non-inhibitor) (solutions from FIG. 1d,f). Scale bars: 100 nm. g fIAPP and fibrils in IAPP/Nle3-VF mixture exhibit the amyloid cross-b structure signature. X-ray fiber diffraction patterns of fIAPP and fibrils present in aged IAPP/Nle3-VF mixture (1/2) showed major meridional and equatorial reflections at 4.7 and 10 .

    [0181] FIG. 3 shows evidence for supramolecular IAPP/ACM nanofiber co-assembly. a Immunogold TEM images of aged IAPP/Nle3-VF (1/2; IAPP, 16.5 M) reveals fibrils which bind to both anti-fIAPP and anti-AP antibodies (IAPP, 5 nm gold; Nle3-VF, 10 nm gold). Scale bars: 100 nm. b Heteromeric nature of ThT-invisible fibrils in aged Biotin-IAPP/Nle3-VF (1/2; Biotin-IAPP, 16.5 M) as assessed by a biotin pull-down assay. Components were revealed by WB with anti-AP (upper part) and anti-IAPP (lower part) antibodies; lane Nle3-VF (control), Nle3-VF directly loaded onto the gel (w/o beads). c STED images of supramolecular heteromeric nanofiber bundles in aged IAPP/Nle3-VF (1/2; IAPP(total), 16.5 M) containing TAMRA-IAPP and Atto647-Nle3-VF (10%). Scale bars: 5 m. d 2-Photon microscopy (2 M) images of nanofiber bundles in aged IAPP containing TAMRA-IAPP (10%) (left), aged IAPP/Nle3-VF containing TAMRA-IAPP and Fluos-Nle3-VF (10%) (middle), and aged IAPP/Nle3-VF containing TAMRA-IAPP and Atto647N-Nle3-VF (10%) (right) (1/2; IAPP(total), 16.5 M). Scale bars: 10 m. e-h 2 M images of heteromeric fibrous superstructures in aged TAMRA-IAPP/Fluos-Nle3-VF (1/2) (TAMRA-IAPP 16.5 mM). Short colored arrows indicate nanofiber bundles parallel or intertwined (red, TAMRA-IAPP; green, Fluos-Nle3-VF) or overlaying (yellow); long white arrows indicate twists or wrapping. Scale bars: panel (e) 5 m, (f) upper part, 5 mm & lower parts, 1 mm, (g) 50 mm, (h) 50 mm (insets 5 mm). i 2 M image of a huge nanotube-like co-assembly found in aged TAMRA-IAPP/Fluos-Nle3-VF (1/2; TAMRA-IAPP, 16.5 M) (upper panel) and 3D-reconstruction of z-stacks (lower panel). Scale bars: 100 m (inset 10 m).j FLIM-FRET analysis of TAMRA-IAPP/Fluos-Nle3-VF co-assembly of (g) indicates a very close (<5.5 nm) donor-acceptor proximity. Left panel, fluorescence decay curves (top) and lifetimes (bottom) of donor (Fluos-Nle3-VF) without or with acceptor (TAMRA-IAPP); a strong shift of donor lifetime in the presence of acceptor is observed. Middle panel/left side, FLIM image showing donor life time; life time range 0 ns (dark blue) to 3.5 ns (red); scale bar, 50 m. Middle panel/right side, FLIM-FRET efficiency (%); efficiency range 30% (dark blue) to 95% (red); scale bar, 50 m. Right panel, donor lifetime (<1 ns) and FLIM-FRET efficiency distributions (>80%).

    [0182] FIG. 4 shows mechanism of formation and properties of IAPP/ACM nanofiber co-assemblies. a Evolution of hf-IAPP/ACM from amorphous co-aggregates. TEM images of IAPP (16.5 M) and IAPP/Nle3-VF mixtures (1/2) between 0 and 7 days of incubation. Scale bars: 100 nm. b TEM images of 7 day-aged IAPPGI/Nle3-VF or rat APP/Nle3-VF (1/2) shows amorphous aggregates. Scale bars: 100 nm. c IAPP monomers/prefibrillar species template nanofiber co-assembly. 2 M images of Fluos-Nle3-VF (33 M) cross-seeded with freshly made TAMRA-IAPP (5%). Scale bars: 10 m; inset, 1 m. d FLIM-FRET of nanofiber co-assembly of c at 48 h reveals identical FLIM-FRET properties to hf-TAMRA-IAPP/Fluos-Nle3-VF (1/2; 7 day-aged) from FIG. 3j. Left panel, fluorescence decay curves (top) and lifetimes (bottom) of Fluos-Nle3-VF without or with TAMRA-IAPP shows a strong shift of donor lifetime in the presence of acceptor. Middle panel/upper part, FLIM image showing donor life time; range as indicated; scale bar, 5 m. Middle panel/lower part, FLIM-FRET efficiency (%); range as indicated; scale bar, 5 m. Right panel, distributions donor lifetime (<1 ns) and FLIM-FRET efficiency (>80%). e hf-IAPP/ACM are seeding incompetent. IAPP (12 M) fibrillogenesis alone or with 10% hf-IAPP/ACM, fIAPP, or IAPP/VGS-VF was followed by ThT binding (meansSD, 3-4 assays). f Thermostability of hf-IAPP/ACM versus fIAPP. Left panel, ThT binding of fIAPP and hf-IAPP/Nle3-VF before/after boiling (5 min); means t SD, 3 assays. Right panel, TEM images after boiling; scale bars: 100 nm. g Degradation of hf-IAPP/ACM versus fIAPP by proteinase K (PK) followed by dot blot. fIAPP or hf-IAPP/Nle3-VF were subjected to PK digestion (37 C.); quantification by anti-fIAPP and anti-AP antibodies. Representative membranes from 3-6 assays. h Phagocytosis of hf-IAPP/ACMs versus fIAPP by primary murine BMDMs and cultured murine BV2 microglia. Left panel, representative microscopic images of cells following incubation (6 h, 37 C.) with TAMRA-fIAPP (3.3 M) or hf-TAMRA-IAPP/Nle3-VF (3.3 M); red dots, TAMRA-IAPP; scale bars, 100 m. Mid and right panels, amounts of phagocytic cells (% of total). Data meansSD from 15-18 peptide preparations analyzed in 5 cell assays with each assay well analyzed in 3 fields of view; *** P<0.001 (unpaired t-test).

    [0183] FIG. 5 shows proposed mechanism and hypothetical models of IAPP/ACM nanofiber co-assembly versus IAPP amyloid self-assembly. Lower part, IAPP self-assembly into toxic oligomers and amyloid fibrils. Upper part, in the presence of ACMs, IAPP monomers/prefibrillar species are redirected into initially amorphous and non-toxic hetero-assemblies which convert into amyloid-like but ThT-invisible and non-toxic heteromeric nanofibers and their fibrous superstructures. Shown are hypothetical models of heteromeric nanofibers (a-c) and supramolecular co-assemblies thereof (d) generated by lateral (a,b,d) or axial (c) co-assembly of the ACM with two of the previously suggested fIAPP folds or variants thereof (indicated by *). The ACM is shown in A amyloid core-mimicking strand-loop-strand folds; blue dots indicate N-methyl rests.

    [0184] FIG. 6 shows inhibition of A42 amyloid self-assembly via ThT-invisible and non-toxic A42/ACM nanofiber co-assembly. a ACMs inhibit A42 amyloid self-assembly. Fibrillogenesis of A42 (5 FM) and A42/ACM (1/1) followed by ThT binding (meansSD, 3 assays). b ACMs suppress A42 cytotoxicity. Aged A42 (5 M) or A42/ACM (1/1) (6 days) (w/o ThT) were added to PC12 cells; cell damage determined via MTT reduction (meansSD, 3 assays, n=3 each). c ACMs suppressed seeding of A42 by fA42. Fibrillogenesis of A42 (5 M) without or with fA42 seeds (10%) and of fA42-seeded A42/ACM (1/1) followed by ThT binding (meansSD, 3 assays). d Aged A42/ACM consists of ThT-invisible fibrils (hf-A42/ACMs). TEM images of A42 (fA42) and A42/ACM mixtures (1/1) (from b; 6 day-aged) are shown; scale bars, 100 nm. Bottom right, bar diagram showing fibril lengths; **P<0.001 (one-way ANOVA & Bonferroni; n=15-23). e 2 M images of fA42 and hf-A42/ACMs. Fibrillar co-assemblies in aged A42 containing TAMRA-A42 (50%) (2 h; fibrillogenesis plateau), aged A42/Fluos-Nle3-VF containing TAMRA-A42/Fluos-Nle3-VF (50%) (4 days), and aged A42/Fluos-L3-VF containing TAMRA-A42/Fluos-L3-VF (50%) (6 days). White arrowheads indicate ribbon- or nanotube-like co-assemblies (yellow); white arrows indicate large node-like parts (yellow); colored arrows indicate TAMRA-A42 (red) and Fluos-L3-VF (green) building units; scale bars, 10 m. f FLIM-FRET of hf-TAMRA-A42/Fluos-Nle3-VF of e indicates regions of high proximity (<5.5 nm) of the two polypeptides. Left panel/left side, FLIM image showing Fluos-Nle3-VF life times in the two regions of interest (ROIs); life time range, 0 ns (dark blue) to 3 ns (red); scale bar, 10 m. White arrows indicate ROI-1 (node-like) while dotted lines indicate ROI-2 (cable-like). Left panel/right side, diagrams showing lifetimes of donor without or with acceptor in ROI-1 or ROI-2; a pronounced reduction of donor fluorescence lifetime in the presence of acceptor is observed; the shift is stronger in ROI-1. Right panel/left side, distribution of FLIM-FRET efficiency (%); efficiency range 0% (dark blue) to 95% (red); scale bar, 10 m. Right panel/right side, bar diagrams showing FLIM-FRET efficiency (%) distribution in ROI-1 (>80%) and ROI-2 (60-100%).

    [0185] FIG. 7 shows properties and functions of A42/ACM co-assemblies. a A42/ACM co-assembly ameliorates A42-mediated LTP impairment in murine hippocampal slices ex vivo.

    [0186] Left, time course of synaptic transmission; meansSEM (n=7-8 for A42/ACM (1/10), n=8 for A42 (50 nM) and buffer controls, and n=36 for ACMs alone (500 nM)). Right, LTP values: averages from the last 10 min of recording; data, meansSEM (n, see above); ***P<0.001 versus A42 (one-way ANOVA & Bonferroni). b hf-A42/ACM are seeding incompetent. A42 (5 M) fibrillogenesis alone or seeded with fA42, hf-A342/Nle3-VF, or hf-A42-L3-VF (10%) determined by ThT binding (meansSD, 3 assays). c Degradation of hf-A42/Nle3-VF and fA42 by PK (37 C.) followed by dot blot; A42 quantification by A(1-17)-specific antibody. Representative membranes from 3 assays. d Thermolability of hf-A42/ACM versus fA42. TEM images of boiled fA42 (15 min) versus hf-A42/Nle3-VF (5 min); scale bars: 100 nm. e Phagocytosis of hf-A342/ACM versus fA42 by cultured murine BV2 microglia. Left and mid panels, representative microscopic images of cells after incubation (6 h, 37 C.) with TAMRA-fA42, hf-TAMRA-A42/Nle3-VF, and hf-TAMRA-A42/L3-VF (1 M); red dots indicated TAMRA-A42; scale bars, 100 m. Right panel, amounts of phagocytic cells (% of total). Data meansSD from 8-10 peptide preparations analyzed in 2 cell assays, each assay well analyzed in 3 fields of view; *P<0.05 (unpaired t-test). f Effects of ACMs on fIAPP-mediated cross-seeding of A42 fibrillogenesis (left panel) or cytotoxicity (right panel). Left panel, fibrillogenesis of A42 (10 M) or A42/ACM (1/2) mixtures following cross-seeding with fIAPP (20%) and of A42 w/o fIAPP seeds (10 M) determined by ThT binding (meansSD, n=4-8). Right panel, solutions (made as for left panel w/o ThT; 1.5 h aged) were added to PC12 cells; cell damage determined via MTT reduction (meansSD, 3 assays, n=3 each). g-j 2 M characterization of supramolecular co-assemblies in A42 solutions after cross-seeding with fIAPP (20%) in the absence (g,h) or presence of ACM (ij). g & h 2 M images of TAMRA-fIAPP-cross-seeded A42 containing HiLyte647-A42 (50%) (1.5 h; incubations as in f) show clusters of A42 assemblies bound to/branching out of fIAPP surfaces; yellow arrow, A42-fIAPP contact site; scale bars: 10 m (g) and 100 mm (h). i 2 M images of fibrillar co-assemblies in TAMRA-fIAPP-cross-seeded A42/Nle3-VF mixtures containing HiLyte647-A42/Fluos-Nle3-VF (50%) (1.5 h; incubations as in f); scale bars: 10 m. Upper panel, fIAPP covered by A42, Nle3-VF, and A42/Nle3-VF (co-)assemblies and surrounded by amorphous or round/elliptical co-assemblies (see also j). Lower panel, huge ternary nanofiber co-assembly. j 3D reconstruction of z-stacks/still images of fibrous co-assemblies shown in i/upper panel. White arrow and dashed line in image on the top indicate view of the section shown below; yellow arrows, round/elliptical co-assemblies; red arrow, fIAPP; blue & green arrows, A42 & Nle3-VF bound to fIAPP; encircled area indicates A42/Nle3-VF co-assembly bound to fIAPP. Scale bars, 10 m (top), 1 m (bottom).

    [0187] FIG. 8 shows schematic overview of identified co-assemblies and proposed mechanisms of ACM-mediated suppression of A42 amyloid self-assembly (a) and its cross-seeding by fIAPP (b,c). a Lower row, A42 self-assembles into toxic oligomers and fA42. Upper row, non-toxic ACMs bind with low nanomolar affinity A42 and redirect it into heteromeric nanofiber co-assemblies (hf-A42/ACM) which are non-toxic, seeding incompetent, and thermolabile and become easier degraded and more effectively phagocytosed than fA42. hf-A42/ACM which may form by lateral or axial co-assembly are shown. b Cross-seeding of A42 by fIAPP yields via 2ndary nucleation fA42/fIAPP co-assemblies, fA42, and toxic A42 oligomers. c ACM-mediated inhibition of cross-seeding of A42 by fIAPP. Non-toxic ACMs and ACM/A42 co-assemblies (both fibrillar and amorph) bind to fIAPP yielding non-toxic and cross-seeding-incompetent fibrous co-assemblies.

    [0188] FIG. 9 shows an identification of best-suited LTS for inhibitor design. a Sequences of A(15-40) (abbreviated VGS) and designed analogs thereof (red: LTS; blue: hot segments; purple: Met35Nle substitution). b Effects of VGS and analogs on IAPP fibril formation: fibrillogenesis of IAPP (16.5 M) with or without the peptides determined by the ThT binding assay (IAPP/peptide 1/2) (meansSD, 3 assays). c Far-UV CD spectra of VGS and its analogs (5 M, pH 7.4).

    [0189] FIG. 10 shows an identification of best-suited sequence positions for N-methylations (a-e) and effects of partial segments of Nle3-VF on IAPP amyloid self-assembly (f-g). a Sequences of the four designed N-methylated Nle3 analogs (red: (Nle)3; blue: hot segments; purple: Met35Nle substitution); numbers indicate positions of N-methylated residues (for numbering the residues of all analogs, their numbers in the A40 sequence were used). b Effects of the Nle3 analogs on IAPP fibrillogenesis. Fibrillogenesis of IAPP alone (16.5 M) or its mixtures with the different analogs was studied via the ThT binding assay (IAPP/peptide 1/2). Dashed boxes indicate incubation time points at which parts of the solutions were used for the MTT reduction assay shown in c. Of note, data of Nle3-VF and Nle3-LF are also shown in FIG. 1d,f. Data are means * SD from 3 assays. c Effects of Nle3 analogs on formation of cytotoxic IAPP assemblies. Solutions of b (24 h or 7 days aged as indicated) were added to RIN5fm cells; cell damage was determined via MTT reduction (meansSD, 3 assays, n=3 each). Of note, data of Nle3-VF and Nle3-LF is also shown in FIG. 1e,g. d Effects of Val18Phe20(VF) or Leu17Phe19(LF)N-methylated analogs of the non-inhibitors VGS, R3, and G3 on IAPP fibrillogenesis as compared to inhibitor Nle3-VF. Fibrillogenesis of IAPP alone (16.5 M) or its mixtures with the analogs was studied via ThT binding (IAPP/peptide 1/2). Dashed boxes indicate incubation time points at which parts of the solutions were used for the MTT reduction assay shown in e. Of note, data of Nle3-VF are also shown in FIG. 1d. Data are meansSD from 3 assays. e Effects of peptides studied under d on IAPP cytotoxicity. Solutions of d were added to RIN5fm cells; cell damage determined via MTT reduction (meansSD, 3 assays, n=3 each). Of note, data of Nle3-VF are also shown in FIG. 1e. f Sequences and abbreviations of synthesized and tested partial segments of Nle3-VF (see g,h) (color code: same as in a). g Effects of the partial segments of Nle3-VF shown in f on IAPP fibrillogenesis as compared to Nle3-VF. Fibrillogenesis of IAPP alone (16.5 M) or its mixtures with each of the segments was studied via ThT binding (IAPP/segment 1/2). Data are meansSD from 3 assays. h Effects of peptides studied under g on IAPP cytotoxicity. Solutions of g (at 24 h) were added to RIN5fm cells; cell damage determined via MTT reduction (meansSD, 3 assays, n=3 each).

    [0190] FIG. 11 shows concentration-dependence of inhibitory effects of ACMs on IAPP amyloid self-assembly. Fibrillogenesis of IAPP (16.5 M) alone or in presence of Nle3-VF (a), Nle3-LF (b), L3-VF (c), L3-LF (d), F3-VF (e), and F3-LF (f) at the indicated IAPP/ACM ratios was followed by the ThT binding assay. Data are meansSD from 3-8 assays.

    [0191] FIG. 12 shows a determination of IC.sub.50 values of inhibitory effects of ACMs on formation of cell-damaging IAPP assemblies. Aged solutions (24 h) of IAPP alone (100 nM) or its mixtures with different amounts of ACMs were added to RIN5fm cells. Cell damage was determined by the MTT reduction assay for mixtures of IAPP with Nle3-VF (a), Nle3-LF (b), L3-VF (c), L3-LF (d), F3-VF (e) and F3-LF (f) as indicated; cytotoxicity of IAPP alone is included in each graph for comparison (red symbol). Data and determined IC.sub.50 values are meansSD from three assays (n=3 each).

    [0192] FIG. 13 shows that ACMs self-assemble into soluble, non-fibrillar, p-sheet rich, and non-toxic aggregates. a TEM examination of aged solutions of the six ACMs (100 M; 4 days) reveals amorphous aggregates as main species; scale bars: 100 nm. b ACM aggregates do not bind ThT. ThT binding properties of the aged solutions of ACMs used in a and the non-inhibitor VGS-VF are shown (100 M; 4 days). The ThT binding properties of an aged A040 solution (100 M; 4 days) is shown for comparison. Data are meansSD from 3 assays. c ACM aggregates are not cytotoxic. Effects of aged solutions of ACMs and VGS-VF (4 days aged solutions from a; at 20 M) on PC12 cell viability as determined via the MTT reduction assay.

    [0193] For comparison, effects of an aged fibrillar A40 (solution from b; at 20 M) are shown. Data are meansSD from 3 assays, n=3 each. d Nle3-VF oligomerization studied by far-UV CD spectroscopy. CD spectra at different peptide concentrations as indicated (aq. solution, pH 7.4) are shown. Loss of signal was indicative of oligomerization; however, no turbidity or precipitation was observed. e Self-assembly of Nle3-VF studied by fluorescence spectroscopic titrations. Emission spectra of Fluos-Nle3-VF (5 nM) alone and with various Nle3-VF amounts as indicated (Fluos-Nle3-VF/Nle3-VF) (pH 7.4); spectra are from one representative assay out of three. Inset, binding curve (data meansSD from 3 binding curves); determined app. K.sub.D=51.9 * 4.5 nM (mean * SD from 3 binding curves).

    [0194] FIG. 14 shows the determination of binding affinities of IAPP/ACM interactions by fluorescence spectroscopic titrations. Fluorescence emission spectra of Fluos-IAPP (5 nM) alone or in the presence of different molar ratios of ACMs as indicated (Fluos-IAPP/ACM) (pH 7.4) are shown on the left side of each figure panel; spectra are from one assay out of three. Data on the interactions of Fluos-IAPP with (a) Nle3-VF, (b) Nle3-LF, (c) L3-VF, (d) L3-LF, (e) F3-VF, and (f) F3-LF are shown as indicated. On the right side of each figure panel, the corresponding binding curves are shown; data are meansSD from 3 binding curves. Determined app. K.sub.Ds (meansSD from 3 binding curves) are in Table 1.

    [0195] FIG. 15 shows that IAPP/ACM interactions yield hetero-di-/-tri-/-tetramers and large amounts of poorly resolved medium-to-high MW hetero-assemblies. Characterization of hetero-complexes in aged mixtures of IAPP with 5 ACMs (IAPP/peptide, 1/2; IAPP, 30 M; pH 7.4; 7 days) via cross-linking, NuPAGE, and Western blot with anti-IAPP antibody. For comparison, assemblies present in aged IAPP (30 M; pH 7.4; 7 days) and its mixtures with non-inhibitors VGS-VF and VGS-LF (IAPP/peptide, 1/2; IAPP, 30 M; pH 7.4; 7 days) are also shown.

    [0196] FIG. 16 shows the evidence that ThT invisible fibrils found in IAPP/ACM mixture are neither fIAPP rests which were not detected by ThT nor fIAPP with non-specifically bound ACM. a Dot blot analysis shows that same amounts of IAPP were present in aliquots of IAPP alone or IAPP/Nle3-VF mixtures used for ThT binding, MTT reduction assays, and TEM. These results excluded the possibility that the lack of ThT binding of the fibrils found in aged IAPP/Nle3-VF mixtures might be due to the presence of less amounts of fIAPP in the aliquots of the mixtures than in the aged IAPP alone solutions, e.g. caused by fIAPP sticking to microtube walls in the presence of Nle3-VF. Aliquots (equal volumes) from freshly made (o h) or 7 days aged solutions of IAPP (fIAPP; 16.5 M) or IAPP/Nle3-VF (1/2) mixtures were spotted onto nitrocellulose membrane. IAPP (1.3 g) in freshly made (o h) solutions was quantified with an anti-IAPP antibody whereas in 7 days aged solutions (consisting mostly of fibrils) by a fibril-specific anti-fIAPP antibody4. b The applied ThT assay had a high fIAPP detection sensitivity. Aged IAPP (16.5 M; 7 days) consisting mostly of fIAPP (based on TEM and ThT binding (FIG. 1d & 2f) was serially diluted as indicated and fibrils were quantified by the ThT binding assay. ThT signals that differed significantly from the buffer were found for fIAPP concentrations >3.3 M corresponding to 20% of total fIAPP amount. Data are meansSD (n=3); ***P<0.01, *P<0.05 (1-way ANOVA & Bonferroni). c Lack of ThT reactivity of fibrils in IAPP/Nle3-VF mixtures is not due to competition between ThT and Nle3-VF for binding to fIAPP. ThT binding of fIAPP (16.5 M; 96 h aged) and an IAPP/Nle3-VF (1/2) mixture (96 h aged) was determined using 20 and 200 M ThT and no differences were observed (data are meansSD from 3 assays; buffer values were subtracted). d fIAPP does not lose its ThT binding potential after co-incubation (coating) with ACMs. fIAPP (IAPP 16.5 M, 9 days aged) before and 1 day after co-incubation with Nle3-VF or F3-VF (33 M). Data are meansSD from 3 assays; see also related assay in FIG. 19b.

    [0197] FIG. 17 shows additional TEM, CLSM, and STED evidence for IAPP/ACM co-assembly into nanofibers and supramolecular nanofiber bundles. a Immunogold TEM image of fibrils in aged IAPP/Nle3-VF mixture (IAPP, 16.5 M; 1/2, 7 days aging) reveals fibrils which bind both the anti-fIAPP (IAPP fibril specific; 5 nm gold) and the anti-A3 antibody (Nle3-VF; 10 nm gold). Highlighted areas depict fibrils which bind to both antibodies. Scale bars, 100 nm. b Confocal laser-scanning microscopy (CLSM) images of nanofiber co-assemblies in aged IAPP/Nle3-VF (1/2) mixture containing TAMRA-IAPP and Atto647N-Nle3-VF (10%) (IAPP(total) 16.5 mM, 7 day-aging). Scale bars, 5 m. c STED images of nanofiber co-assemblies in aged IAPP or IAPP/Nle3-VF (1/2) mixture as indicated containing TAMRA-IAPP and Atto647N-Nle3-VF (10%) (IAPP(total) 16.5 mM, 7 days aging). Scale bars, 1 m. d 3D reconstructions of z-stacks/still images of TAMRA-IAPP/Atto647N-Nle3-VF nanofiber co-assemblies shown in FIG. 3d. Arrows and dashed lines in the left panel indicate view of the sections shown in the right panel. Scale bars, 1 m. e 3D reconstructions of z-stacks/still images of TAMRA-IAPP/Fluos-Nle3-VF nanofiber co-assemblies found in the 2 M studies of FIG. 3d. Arrows and dashed lines in the left panel indicate view of the sections shown in the right panel. Scale bars, 5 m. f Example of the estimation of the width of a TAMRA-IAPP/Atto647N-Nle3-VF heteromeric nanofiber bundle (prepared as in c) determined with the full-width-at half-maximum values of an intensity based line-profile plot. Top panel, STED image; green line indicates region of interest (ROI) chosen for measurement; scale bar, 5 m. Bottom panel, intensity plots of Atto647N and TAMRA channels; Dx, heteromeric nanofiber bundle width measured at half-maximum of the peak height.

    [0198] FIG. 18 shows additional 2 M evidence for supramolecular IAPP/ACM nanofiber co-assemblies. a 2 M image of a huge loop-like co-assembly (shown in FIG. 3g) found in aged TAMRA-IAPP/Fluos-Nle3-VF (1/2) mixtures (TAMRA-IAPP 16.5 M; aging 6 days). In the insets, magnified image parts show m-sized bicolored rods (widths 1.7 m, lengths 5 m) (short white arrows) as potential building blocks of braided parts of the co-assembly. Scale bars: 50 m (insets 5 m). b 2 M images of fibrous superstructures including tape-like heteromeric nanofiber bundles (right panel) found in aged TAMRA-IAPP/Fluos-L3-VF mixtures (TAMRA-IAPP 16.5 M, 1/2, 7 day-aging). Colored arrows in the insets indicate fibrillar stacks of the two peptides arranged in parallel (red arrows, TAMRA-IAPP; green arrows, Fluos-L3-VF); or overlaying (yellow arrows). Scale bars: 50 m in the image of the left panel and 5 m for the magnified areas 1 and 2 and all images of the right panel. c 2 M images of heteromeric fibrous nanofiber bundles found in aged TAMRA-IAPP/Fluos-F3-VF mixtures (TAMRA-IAPP 16.5 M, 1/2, 7 day-aging); color code for arrows as in a; scale bars, 5 m. d 2 M images of fibrillar assemblies found in aged TAMRA-IAPP (16.5 M, 7 day-aged) (left) and its aged mixture with the non-inhibitor Fluos-VGS-VF (1/2, 7 days aged) (right). These latter mixtures consisted mostly of fIAPP bundles. Scale bars, 5 jm.

    [0199] FIG. 19 shows that ACM-coated fIAPP are distinct from ThT-invisible and non-toxic hf-IAPP/ACM and their formation is not a major reason for ACM inhibitory activity on IAPP amyloid self-assembly. a Dot blot analysis reveals that both ACMs and the non-inhibitor VGS-VF bind fIAPP. Membranes containing spotted fIAPP (40 mg) were probed with N-terminal fluorescein-labeled peptides (Fluos-ACMs and Fluos-VGS-VF, 0.2 M). Representative results from 2-3 assays are shown. b Addition of Nle3-VF to already nucleated IAPP fibrillogenesis does not affect the amount of ThT-reactive fibrils. ThT binding was measured in IAPP (16.5 M) alone or its mixtures with Nle3-VF (33 mM) at the indicated time points before and after Nle3-VF addition. Data are meansSD from 3 assays. c Addition of ACMs to preformed fIAPP does not affect fIAPP cytotoxicity. ACMs (Nle3-VF and F3-VF; 33 M) were added to preformed fIAPP (16.5 M, 7 days aged). Following co-incubation for 1 day, fIAPP alone, its mixtures with the ACMs, and ACMs alone were added to RIN5fm cells (fIAPP, 500 nM). Cell damage was determined via MTT reduction. Data of fIAPP and its mixtures are meansSD of 6 wells from 2 assays (n=3 each). Data of ACMs alone are from 1 assay (n=3); additional data on the lack of cytotoxic effects of the ACMs are in FIG. 13c. d Immunogold TEM reveals significant differences between the antibody binding ability of fibrils in aged IAPP/Nle3-VF mixtures (hf-IAPP/Nle3-VF) and the fibrils in Nle3-VF-coated fIAPP solutions. Shown are immunogold TEM images of fIAPP solutions (24 h or 5 day-aged), IAPP/Nle3-VF mixtures (1/2; IAPP 16.5 M, 5 day-aged), and Nle3-VF-coated fIAPP as indicated. Nle3-VF-coated fIAPP was made by adding Nle3-VF (33 M) to preformed fIAPP (IAPP (16.5 M) aged for 24 h) and co-incubating for 5 days. fIAPP was detected by anti-fIAPP specific antibody (5 nm gold nanoparticles; white arrowheads) and Nle3-VF by anti-AP antibody (10 nm gold nanoparticles; orange arrowheads) exhibiting a 10-20% NSB to fIAPP (see antibody binding quantification graph; right side). Scale bars: 100 nm. On the right side, the quantification of antibody binding of the four different incubations expressed as antibody reactivity (% of total bound) is presented (d, days). Nle3-VF-coated fIAPP bound significantly more anti-AP antibody than fibrils in IAPP/Nle3-VF mixtures; ***P<0.001, **P<0.01, *P<0.05 by one-way ANOVA & Bonferroni. e 2PM examination of Nle3-VF-coated fIAPP reveal a distinct morphology that is different from hf-IAPP/Nle3-VF. In contrast to hf-IAPP/Nle3-VF, Nle3-VF-coated fIAPP consisted of fIAPP bundles randomly covered by large amorphous Fluos-Nle3-VF aggregates. 3D reconstructions of z-stacks/still images are shown. Arrows and dashed lines in the left panel indicate view of the sections shown in right panel. Scale bars, 20 m for the image in the left panel and 5 m for image sections 1 and 2.

    [0200] FIG. 20 shows that early IAPP/ACM co-assemblies are amorphous and non-cytotoxic. a Early IAPP/ACM co-assemblies consist mostly of amorphous aggregates. TEM analysis of 24 h aged incubations of IAPP (16.5 M) and its mixtures with ACMs (33 M). Scale bars: 100 nm. b Early non-fibrillar IAPP/ACM co-assemblies are non-cytotoxic. Incubations of IAPP (16.5 M) and its mixtures with ACMs (1/2; 24 h-aged) were added to RIN5fm cells and cell damage was determined via MTT reduction (meansSD, 3 assays, n=3 each).

    [0201] FIG. 21 shows that FLIM-FRET analysis of fibrillar co-assemblies found in Fluos-Nle3-VF (33 M) following addition of preformed TAMRA-fIAPP (10%) reveal no significant FLIM-FRET events. a Fluorescence lifetime of donor (Fluos-Nle3-VF) without or with acceptor (TAMRA-fIAPP) reveals no changes in donor lifetime in the presence of acceptor. b Upper part, FLIM image of the fibrillar co-assembly showing donor life time; life time as indicated; scale bar, 10 m. Lower part, donor fluorescence lifetime distributions (2 ns) in the fibrillar co-assembly. c Upper part, FLIM-FRET efficiency (%) observed in the fibrillar co-assembly; efficiency distribution as indicated; scale bar, 10 m. Lower part, FLIM-FRET efficiency distribution in the fibrillar co-assembly (<40%).

    [0202] FIG. 22 shows that IAPP/L3-VF-nanofibers are much more efficiently phagocytosed than fIAPP by primary murine BMDMs and cultured murine BV2 microglia. Left panel, representative microscopic images of BMDMs or BV2 cells as indicated following incubation (6 h, 37 C.) with TAMRA-fIAPP (3.3 M) (left side) or hf-TAMRA-IAPP/L3-VF (3.3 M) (right side) as indicated (compare with FIG. 4h); red dots indicate TAMRA-IAPP; scale bars, 100 m. Right panel, amounts of BMDM (mid) or BV2 (right) cells (% of total) that phagocytosed fIAPP and hf-IAPP/L3-VF. Data are meansSD from 5 independent peptide preparations studied in one cell assay with each well analyzed in 3 fields of view; *** P<0.001, ** P<0.01 (unpaired t-test).

    [0203] FIG. 23 shows the determination of IC.sub.50 values of inhibitory effects of ACMs on formation of cell-damaging A42 assemblies. PC12 cells were incubated with 6-day aged A42 alone (1 M) or its mixtures with different molar ratios of ACMs and cell damage was determined by the MTT reduction assay for mixtures of A42 with Nle3-VF (a), L.sub.3-VF (b), F3-VF (c) and F3-LF (d); red symbols show effects of A42 alone. Data and IC.sub.50 values are meansSD from 3 assays (n=3 each).

    [0204] FIG. 24 shows that the formation of long fibrils in A42/ACM mixtures is linked to ACM inhibitory effect on A42 fibrillogenesis. a TEM images of two 6 day-aged sets of mixtures, i.e. the A42/ACM 1/1 mixtures (set (A); full inhibition of A42 fibrillogenesis according to ThT binding (FIG. 6a)) and the A342/ACM 1/0.001 mixtures (set (B); no inhibition of fA042 fibrillogenesis according to ThT binding (shown in b) as compared to 6 day-aged A42 alone (A42, 5 M). All four ThT-negative mixtures of set (A) consisted of 2-4-fold longer fibrils than A42 aged under the same conditions, which consisted of ThT-positive fA42 (FIG. 6d). By contrast, all four ThT-positive mixtures of set (B) consisted of fibrils of identical appearance and widths to fA42. Scale bars: 100 nm. b A42 amyloid self-assembly is not affected when an A42/ACM molar ratio of 1/0.001 is used. A42 fibrillogenesis (5 VtM) alone or with each of the ACMs (5 nM) assessed by ThT binding (meansSD, 3 assays). Of note, TEM images in a are from 6 day-aged solutions made as in b but w/o ThT.

    [0205] FIG. 25 shows 2 M images of diverse fibrous A42/ACM superstructures. a Supramolecular A42/Nle3-VF nanofiber co-assembly containing 50% TAMRA-A42/Fluos-Nle3-VF (merged image presented in FIG. 6e) is shown here with each channel (CH1 (TAMRA) and CH2 (Fluos)) separately and merged. Scale bars, 10 m. b Huge A42/L3-VF ribbon-/nanotube-like nanofiber co-assembly (TAMRA-A42/Fluos-L3-VF (50%); A42(total), 5 mM; 1/2, 6 days). Scale bars, 100 m and 10 m in magnified areas 1 and 2. c, d A42/F3-VF and A42/F3-LF ribbon-like nanofiber co-assemblies (TAMRA-A42/Fluos-ACM (50%); A42(total) 5 M, 1/2, 6 days) as indicated. Scale bars, 10 m.

    [0206] FIG. 26 shows a characterization of A342/ACM interactions and hetero-complexes by fluorescence spectroscopy, size-exclusion chromatography (SEC), cross-linking, and far-UV CD spectroscopy. a Nle3-VF binds A42 with low nanomolar affinity as determined by fluorescence spectroscopic titrations. Fluorescence spectra of FITC-A42 (5 nM) and its mixtures with Nle3-VF (pH 7.4) at indicated molar ratios (data from one representative binding assay (n=3)). Inset, binding curve; data meansSD from 3 assays; app. K.sub.D, 14.5 8.0 (Table 2). b Characterization of hf-A42/Nle3-VF via SEC. Chromatograms of aged (6 days) A42 (5 M), Nle3-VF (5 M), and their 1/1 mixture (5 M each) consisting mostly of ThT-invisible fibrils (FIG. 6d) are shown. Arrow indicates high MW hetero-assemblies; arrowheads indicate A42 and Nle3-VF monomers. c Kinetics of A42/Nle3-VF co-assembly as followed by cross-linking with glutaraldehyde. This was performed in solutions of A42, A42/Nle3-VF (1/2), and Nle3-VF at different incubation time points in combination with NuPAGE and WB with anti-A(1-17) antibody (6E10) which recognizes A42 but not the ACM. Orange box marks smear of unresolved bands corresponding of medium-to-high MW hetero-assemblies; arrow indicates hetero-dimers. d hf-A42/Nle3-VF have less -sheet structure than fA342. Far-UV CD spectra of aged (6 days) A42 (5 M), Nle3-VF (5 M) and their 1/1 mixture (5 M each) are shown. Under these experimental conditions A42 and A42/Nle3-VF mixtures consisted mostly of fibrils (FIG. 6d).

    [0207] FIG. 27 shows that binding of ACMs to preformed fA42 does not convert fA42 into ThT-invisible heteromeric nanofibers. a Dot blot analysis shows that ACMs bind to fA42. Membranes containing spotted fA42 or A42 monomers (10 mg each) were probed with various Fluos-ACMs (2 M); results are representative from 2 assays. b Addition of Nle3-VF to already nucleated fA42 fibrillogenesis does not affect amounts of already formed ThT-positive fibrils. ThT binding was measured in fA42 (5 M) alone or its mixtures with Nle3-VF (5 mM) at the indicated time points before and after Nle3-VF addition. Data means * SD (3 assays except for the 24 h time point of A42 (aged 120 min)+Nle3-VF (1 assay)).

    [0208] FIG. 28 shows data on the inhibitory activity of N-terminal truncated analogs of Nle3-VF on IAPP amyloid self-assembly. Analogs 20-40 and 21-40 cannot inhibit whereas all other analogs inhibit as full length Nle3-VF. The results indicate that N-terminal segment QKLV are not crucial for inhibitory activity. Effects of N-terminal truncated Nle3-VF analogs on IAPP amyloid self-assembly are shown. ThT binding assay of IAPP/peptide mixtures. Incubations were prepared in ThT buffer with 0.5% HFIP containing 16.5 M IAPP alone or its mixture with peptides (1:2); mixtures of IAPP with the corresponding analog are indicated by the + sign. Data are meansSD from 3 assays.

    [0209] Applied abbreviations of the analogs as follows: [0210] Abbreviation 17-40: stands for Nle3-VF analog w/o N-terminal segment QK [0211] Abbreviation 18-40: stands for Nle3-VF analog w/o N-terminal segment QKL [0212] Abbreviation 19-40: stands for Nle3-VF analog w/o N-terminal segment QKLV [0213] Abbreviation 20-40: stands for Nle3-VF analog w/o N-terminal segment QKLVF [0214] Abbreviation 21-40: stands for Nle3-VF analog w/o N-terminal segment QKLVFF

    [0215] FIG. 29 shows data on the inhibitory activity of C-terminal truncated analogs of Nle3-VF on IAPP amyloid self-assembly. C-terminal truncated analogs 15-36 does not inhibit whereas analogs 15-37 and 15-38 inhibit as full length Nle3-VF. The results indicate that C-terminal segment GVV are not crucial for inhibitory activity. Effects of C-terminal truncated Nle3-VF analogs on IAPP amyloid self-assembly are shown. ThT binding assay of IAPP/peptide mixtures. Incubations were prepared in ThT buffer with 0.5% HFIP containing 16.5 M IAPP alone or its mixture with peptides (1:2); mixtures of IAPP with the corresponding analogs are indicated by the + sign. Data are meansSD from 3 assays.

    [0216] Applied abbreviations of the analogs as follows: [0217] Abbreviation 15-38: stands for Nle3-VF analog w/o C-terminal segment VV [0218] Abbreviation 15-37: stands for Nle3-VF analog w/o C-terminal segment GVV [0219] Abbreviation 15-36: stands for Nle3-VF analog w/o C-terminal segment GGVV

    [0220] FIG. 30 shows data on the inhibitory activity of a 4-fold N-methylated Nle3-VF analog termed Nle3-LVFF on IAPP amyloid self-assembly. The data show that Nle3-LVFF inhibits similar to the 2-fold N-methylated analogs Nle3-VF and Nle3-LF. The results indicate that N-methylation of all four residues of segment LVFF are compatible with inhibitor function.

    [0221] Effects of 4-fold N-methylated Nle3-VF analog termed Nle3-LVFF on IAPP amyloid self-assembly are shown. ThT binding assay of IAPP/peptide mixtures. Incubations were prepared in ThT buffer with 0.5% HFIP containing 16.5 M IAPP alone or its mixture with peptides (1:2) as indicated. Data are meansSD from 3 assays.

    [0222] FIG. 31 shows that L3-VF and F3-LF suppress LTP impairment mediated by preformed A42 oligomers in murine hippocampal slices ex vivo. Left, time course of synaptic transmission; meansSD (n=12 for A42 oligomers and n=6 for A42 oligomers/ACM mixtures (1/10); (A42 oligomers (50 nM), 24 h aged, 30 C.). Right, LTP values: averages from the last 10 min of recording; data, meansSD (n, see above); ***P<0.001 (P=0.0003) and *P<0.05 (P=0.0152) versus Ab42 oligomers as indicated (Kruskal-Wallis test with Dunn's multiple comparisons test). This data shows that, advantageously, the inhibitors are able to suppress the synaptotoxic effect of A42 aggregates in an ex-vivo mouse model of AD-related synaptic damage; the data supports the physiological significance of the in vitro results and the suggestion that the inhibitory peptides are promising candidates for anti-amyloid drugs in the treatment of diseases such as AD.

    [0223] FIG. 32 shows that an addition of ACMs to preformed toxic A42 oligomers (oA42) results in a suppression of fibrillogenesis and cytotoxicity and an increase of A42 phagocytosis by BV2 microglia. a Addition of Nle3-VF to preformed toxic oA42 oligomers (2 h-aged A42 (5 mM); presence and cytotoxicity of oligomers confirmed by Dot blot analysis with A11 antibody and the MTT reduction assay, see b,c) results in a delay of fibrillogenesis as determined by the ThT binding assay (meansSD, 3 independent assays). ThT binding measured in A42 (5 M) alone or its mixtures (1/1) with Nle3-VF before and after Nle3-VF addition at the indicated time points. Grey arrows indicate time points of addition of aliquots of solutions running in parallel to the above solutions to PC12 cells for the MTT reduction assay shown in b. b Addition of Nle3-VF to preformed cytotoxic oA42 (2 h-aged A42 (5 mM); see a) suppresses formation of more toxic species as determined by the MTT reduction assay (meansSD, 3 independent assays, n=3 technical replicates each). Aliquots of solutions (made as in a but without ThT) were added (1 mM) to PC12 cells and cellular MTT reduction was measured at the indicated incubation time points (o, 2, and 4 h; grey arrows in a). c Dot blot analysis of A42 (top) and TAMRA-A42 (bottom) (5 M; made as above but without ThT) at different time points of incubation using anti-oligomer A11 antibody indicates the presence of significant amounts of (TAMRA-)A42 oligomers in 2-6 h aged solutions. Results are representative from 2 (A42) or 3 (TAMRA-A42) independent assays. As the 4 and 6 h-aged solutions contained large amounts of fibrils as well according to the ThT assay shown in a, the 2 h-aged (TAMRA-)A42 solutions were used to study whether direct addition of ACMs to preformed oligomers ((TAMRA-)oA42) might affect their cytotoxicity and phagocytosis (see d and e). d oA42 and TAMRA-oA42 exhibit similar cell-damaging properties and Nle3-VF (i/1) suppresses their cytotoxicity. Left panel, addition of Nle3-VF to preformed TAMRA-oA42 suppresses cytotoxicity as determined by the MTT reduction assay (meansSD from 4 (TAMRA-oA42 and TAMRA-oA42 (2 h)) or 3 ((TAMRA-oA42+Nle3-VF) (2 h)) independent assays, n=3 technical replicates each); *P<0.05 (P=0.02001) for (TAMRA-oA42+Nle3-VF) (2 h) versus TAMRA-oA42 (2 h) as indicated (one-way ANOVA & Bonferroni). Aliquots of TAMRA-oA42 alone (2 h-aged TAMRA-A42), TAMRA-oA42 aged for additional 2 h (TAMRA-oA42 (2 h)), and TAMRA-oA42 following addition of Nle3-VF (1/1) and incubation for 2 h ((TAMRA-oA42+Nle3-VF) (2 h)) were added (1 mM) to PC12 cells. Right panel, the corresponding oA42 data are shown for comparison. Addition of Nle3-VF to preformed oA42 suppresses cytotoxicity as determined by the MTT reduction assay. Aliquots of oA42 alone (2 h-aged A42), oA42 aged for additional 2 h (oA42 (2 h)), and oA42 following addition of Nle3-VF (1/1) and incubation for 2 h ((oA42+Nle3-VF) (2 h)) were added (1 mM) to PC12 cells. Results are meansSD from 6 (oAI42 and oA42 (2 h)) or 3 ((oA42+Nle3-VF) (2 h)) independent assays, n=3 technical replicates each); *P<0.05 (P=0.0129) for oA42 (2 h) versus oA42 and **P<0.01 (P=0.00477) for (oA42+Nle3-VF) (2 h) versus oA42 (2 h) as indicated (one-way ANOVA & Bonferroni). e Addition of Nle3-VF or L3-VF to TAMRA-oA42 results in increased A42 phagocytosis by cultured murine BV2 microglia. Phagocytosis of TAMRA-oA42 alone after incubation for 2 h (TAMRA-oA42 (2 h)) versus TAMRA-oA42 after addition of Nle3-VF or L3-VF and co-incubation for 2 h ((TAMRA-oA42+Nle3-VF(or L3-VF)) (2 h)) was determined. Left panel, representative microscopic images of cells after incubation (6 h, 37 C.) with the peptide solutions (prepared as in d) as indicated; red dots indicate TAMRA-A42; scale bars, 100 m. Right panel, amounts of phagocytic cells (% of total). Data are meansSD from 20 (TAMRA-oA42 (2 h)), 12 ((TAMRA-oA42+Nle3-VF) (2 h)), and 8 ((TAMRA-oA42+L3-VF)) (2 h)) biologically independent samples analyzed in 3 independent cell assays, each assay well analyzed in 3 fields of view; **P<0.01(P=0.0098) for (TAMRA-oA42+L3-VF) (2 h) versus TAMRA-oA42 and ****P<0.0001 for (TAMRA-oA42+Nle3-VF) (2 h) versus TAMRA-oA42 as indicated (one-way ANOVA & Bonferroni). This data show that, advantageously, the inhibitors are able to suppress the cytotoxicity of already formed cytotoxic Abeta42 oligomers resulting into increased phagoocytosis by cultured murine BV2 microglia (in comparison to non-inhibitor-treated toxic Abeta42 aggregates). These findings support the suggestion that the peptides of the invention are promising candidates for anti-amyloid drugs for the treatment of diseases such as AD.

    [0224] FIG. 33 shows that Nle3-LVFF blocks amyloid self-assembly of A42. Inhibition of A42 fibril formation by Nle3-LVFF assessed by the ThT binding assay. A42 (5 M) or its mixtures with peptides (1:1) were incubated in 45 mM ammonium acetate, pH 8.5, containing 10 M of ThT (37 C.). Inhibitors alone (5 M) were incubated in parallel as controls. Error bars: means +SD (n=3). Data on the inhibitory effect of a peptide of the invention containing four N-methylations. The data shows that, advantageously, Nle3-LVFF is a potent inhibitor of A42 amyloid self-assembly. Furthermore, the double N-methylated peptides are potent inhibitors of A42 amyloid self-assembly as well. These findings support that the peptides of the invention, such as the 4-N-methylated peptides of the invention, are promising candidates for anti-amyloid drugs for the treatment of diseases such as AD.

    [0225] In the following, reference is made to the examples, which are given to illustrate, not to limit the present invention.

    EXAMPLES

    Example 1: Methods

    Peptides and Peptide Synthesis

    [0226] IAPP, IAPP-GI, rat IAPP, and their N.sup.a-terminal fluorescein- or biotin-labeled analogs were synthesized by Fmoc-based solid phase synthesis (SPPS), subjected to air-oxidation, and purified by RP-HPLC. Their stock solutions were prepared in 1,1,3,3,3,3-hexafluoro-2-isopropanol (HFIP) (4 C.), filtered over 0.2 m filters (Millipore), and concentrations were determined by UV spectroscopy. TAMRA-IAPP was synthesized by overnight coupling of 5,6-carboxytetramethylrhodamine (TAMRA) (Novabiochem/Merck) to RINK-resin-bound IAPP using a 3-fold molar excess of 2-(1H-Benzotriazol-1-yl)-1,1,3,3-tetramethyluronium-hexafluorophosphate (H BTU) and a 4.5 molar excess of N,N-diisopropylethylamine (DIEA) in N,N-dimethylformamide (DMF). TAMRA-IAPP cleavage from the resin and RP-HPLC purification were performed as for the other labeled IAPP analogs; stocks were made in HFIP (4 C.). A42 was synthesized on Tentagel R PHB resin (0.18 mmol/g; Rapp Polymere) by Fmoc-SPPS. Seed-free aqueous A42 stock solutions (10-20 M) were obtained by SEC performed. Briefly, HPLC-purified A42 was dissolved (1 mg/ml) in a solution of 5 M GdnHCl in 10 mM TRIS/HCl pH 6.0 and loaded onto a Superdex 75 10/300 GL column (eluent: 50 mM ammonium acetate pH 8.5, 0.5 ml/min). The monomeric A42 elution peak was collected on ice, stored at 4 C. and used within 1 week; peptide concentration was determined by UV spectroscopy. Fluorescein-isothiocyanate-p-Ala-labeled A42 (FITC-A42) and TAMRA-labeled A42 (TAMRA-A42) were from Bachem and HiLyte647-A42 from AnaSpec; their stocks were prepared in HFIP (4 C.).

    [0227] All A(15-40) analogs comprising ACMs, non-inhibitors, and partial segments thereof (Tables 3 and 6) were synthesized using previously described standard Fmoc-SPPS protocols and in most cases WANG-resin (0.3-0.5 mmol/g; Iris Biotech); Tentagel R PHB resin was used for Nle3, R3, and G3-VF (0.16 mmol/g; Rapp Polymere). Briefly, double couplings were usually performed using 3-fold molar excess protected amino acid and HBTU and 4.5-fold molar excess of DIEA in DMF. For difficult couplings, we applied either 2-(7-aza-1H-benzotriazole-1-yl)-1,1,3,3-tetramethyluronium-hexafluorophosphate (HATU), or 4-6-fold molar excess of protected amino acids, and/or triple couplings. N-terminal fluorescein-labeled A(15-40) analogs were synthesized by coupling peptide-resins with 5,6-carboxyfluorescein (Sigma-Aldrich) using 3-fold molar excess protected amino acid and HATU and 4.5-fold molar excess of DIEA (double couplings). N-terminal Atto647N-labeled Nle3-VF was synthesized by coupling peptide-resin with Atto647N (carboxy-derivative) (ATTO-TEC) using HATU. Peptide cleavage from the resin was performed with 95% TFA/H.sub.2O. All peptides were purified by RP-HPLC on Nucleosil 100 C18 (Grace) or Reprosil Gold 200 C18 columns (Dr. Maisch). Stock solutions were made in HFIP (4 C.); peptide concentrations were determined by peptide weight or by UV spectroscopy (fluorescently labeled analogs).

    [0228] All synthetic peptides were characterized by matrix-assisted laser desorption ionization (MALDI-MS) or electrospray ionization (ESI-MS) mass spectrometry (Table 6).

    Thioflavin T (ThT) Binding Assays

    [0229] IAPP fibrillogenesis-related studies. Effects of the different peptides on IAPP fibrillogenesis including self- and cross-seeded fibrillogenesis were studied in combination with TEM and MTT reduction assays according to previously established ThT binding assay systems. At the indicated time points, aliquots of peptide incubations (made as described below) were gently mixed with the ThT solution (20 mM ThT in 0.05 M glycine/NaOH, pH 8.5, if not stated otherwise) in a 96-well black MTP (FluoroNune/Thermo Fisher Scientific). ThT binding was determined immediately by measuring fluorescence emission at 486 nm following excitation at 450 nm using a 2030 Multilabel Reader VictorX3 instrument (PerkinElmer Life Sciences). ThT binding of seeds/buffer were subtracted from the data in all assays related to seeding events; in all other cases raw or normalized data are shown if not stated otherwise. All IAPP-related incubations were performed at 20 C. except for the (cross-)seeded ones (RT). Preformed fAAPP were generally prepared by incubating IAPP (12 or 16.5 M) in ThT buffer for 3-9 days (20 C.), quantified by ThT binding, and verified by TEM.

    [0230] Peptide incubations were performed as follows: for studying effects on IAPP fibrillogenesis, freshly made IAPP (16.5 M) and IAPP/peptide mixtures were incubated in 50 mM sodium phosphate buffer, pH 7.4, with 100 mM NaCl containing 0.5% HFIP (abbreviated ThT buffer) for up to 7 days. For studying effects on fIAPP-mediated seeding of IAPP fibrillogenesis, preformed fIAPP (10%) were added to freshly made IAPP (12 M) or IAPP/peptide-mixtures (1/2) in ThT buffer; solutions were incubated for several days as indicated. To determine the detection limit of the IAPP-related ThT binding assay, fIAPP were first made by incubating IAPP (16.5 M) in ThT buffer (7 days). Following fIAPP quantification by ThT binding and verification by TEM (FIG. 1d and FIG. 2f), serial fIAPP dilutions were made and ThT binding was measured as described in the first paragraph. Significance of differences between ThT binding of the various fIAPP amounts versus buffer alone was analyzed by one-way ANOVA and Bonferroni's Multiple Comparison test. To investigate whether ACM binding to fIAPP surfaces might compete with ThT binding, ThT binding of preformed fIAPP (16.5 M, ThT buffer, 4 day-aged) and hf-IAPP/Nle3-VF (16.5 mM, ThT buffer, 4 day-aged) was determined using ThT solutions containing 20 or 200 M ThT. To investigate whether binding of ACMs to fIAPP surfaces (ACM coating of fIAPP) might block ThT binding of fIAPP, ACM (2-fold) was added to preformed fIAPP (16.5 mM); ThT binding of ACM/fIAPP mixtures and non-treated fIAPP was determined before and following co-incubation of ACM with fIAPP (1 day) as above. To investigate effects of Nle3-VF on already nucleated IAPP fibrillogenesis, aliquots of an IAPP incubation (16.5 M in ThT buffer) were added to the ACM at different time points of fibrillogenesis. To investigate whether hf-IAPP/ACM co-assemblies might seed IAPP fibrillogenesis, seed amounts (10%) of hf-IAPP/ACM (made by incubating IAPP (16.5 M) with ACM (2-fold) for 7 days in ThT buffer) were added to freshly made IAPP (12 M in ThT buffer); incubations were performed for 48 h. Seeding effects of preformed fIAPP (10%) made under the same conditions as hf-IAPP/ACM were studied in parallel. Dot blot analysis (FIG. 16a) confirmed that similar amounts of fIAPP and hf-IAPP/ACM were used for seeding or other assays. To determine the effects of ACMs on fA42-mediated cross-seeding of IAPP fibrillogenesis, seed amounts (10%) of fA42 (made by incubating A42 (88 M) in ThT buffer containing 1% HFIP for 19 days at 37 C.; fibril formation confirmed by ThT binding and TEM) were added to freshly made IAPP (12 M in ThT buffer) or IAPP/peptide mixtures (1/2); incubations were performed for 48 h.

    [0231] ACM fibrillogenesis-related studies. To study the fibrillogenic potential of ACMs, peptides and A40 (positive control) (100 M) were incubated in 10 mM aqueous sodium phosphate buffer, pH 7.4 (1% HFIP) for 4 days. ThT fluorescence was measured at 0 h and 4 days by mixing an aliquot with a ThT containing solution (121 M ThT, 0.05 M glycine/NaOH, pH 8.5); buffer values were subtracted from the data shown in FIG. 13b. The absence of fibrils and cytotoxic aggregates from these solutions was confirmed by TEM (FIG. 13a) and MTT reduction assays (FIG. 13c).

    [0232] A42 fibrillogenesis-related studies. To study effects of the different peptides on A42 fibrillogenesis, synthetic A42 isolated from SEC (see Peptides & peptide synthesis) was used. Peptide incubations were performed in the presence of ThT in 96-well black MTPs (FluoroNunc, Thermo Fisher Scientific). Incubation conditions for all assays were (if not stated otherwise): A42 (5 M) alone or its mixture with the peptide (at the indicated molar ratios) in 45 mM ammonium acetate, pH 8.5, containing 10 M ThT (37 C.); MTPs were shaken (500 rpm; orbital shaker (CAT S20)) for the first 5 h of the fibrillogenesis. ThT fluorescence was measured with a 2030 Multilabel Reader VictorX3 instrument at the indicated time points as under IAPP-related assays. Values of seeds or buffer alone were subtracted from the data in self-/cross-seeding assays; all other data shown are raw data except for data in FIG. 27b which were normalized).

    [0233] For studying effects of ACMs on fA42-mediated seeding of A42, preformed fA42 (made by incubating A42 (5 M) as above but w/o ThT for 6 days (TEM, FIG. 6d)) were added to freshly made A42 (5 M) or A42/ACM mixtures (5 M each; made on ice) just before the addition of ThT (10 M). fA42 seed concentration was 0.5 M (10%) and incubations (37 C.) were performed as above. Of note, fA42 were quantified/verified by ThT binding, dot blots, and TEM. For studying whether hf-A42/ACM might seed A42 fibrillogenesis, A42 (5 M) and A42/ACM mixtures (5 M each) were first incubated for 6 days w/o ThT as described in the top section to obtain fA42 and hf-A42/ACM; fibrils were quantified/verified by ThT binding (fA42), TEM (fA42 and hf-A42/ACM), and dot blots. Seed amounts of fA42 or hf-A42/ACM (10%, 0.5 mM) were then mixed (on ice) with freshly made A42 (5 M) in 45 mM ammonium acetate, pH 8.5, and following addition of ThT (10 M) incubations (37 C.) were performed as described above. To study effects of ACMs added at post-nucleation time points of A42 fibrillogenesis, A42 (5 M) was incubated in the presence of ThT as described in the top section and mixed with the ACM (1/1) at the indicated time points of fibrillogenesis. Effects of ACMs on fIAPP-mediated cross-seeding of A42 were studied as follows: A42 (10 M) alone and A42/ACM mixtures (1/2) were prepared as above on ice. Preformed fIAPP (2 M) (made by incubating IAPP (128 M) in ThT buffer for 9-12 days; fIAPP quantified/verified by ThT and TEM) were added to the above solutions just prior to the addition of ThT (10 mM). Final composition of the assay buffer was: 45 mM ammonium acetate, pH 8.5, containing 10 M ThT and <2% of ThT buffer resulting from the fIAPP seed or the buffer alone solution (in the A42 w/o seed (control) solution). Incubations (37 C.) and determination of ThT fluorescence were performed as for all other A42-related studies.

    Assessment of Cell Damage Via the MTT Reduction Assay

    [0234] Studied on the effects of peptides on formation of cell damaging IAPP assemblies were performed in cultured RIN5fm cells in combination with the ThT binding assay and TEM. Briefly, cells were cultivated and platted in 96-well plates. Aliquots of solutions used for the ThT binding assays (see ThT binding assays) were diluted with cell medium at the indicated incubation time points (24 h or 7 days) and added to the cells at the indicated final concentrations. Following incubation with the cells for 20 h (37 C., humidified atmosphere, 5% CO.sub.2) cell damage was assessed by measuring cellular MTI reduction. IC.sub.50 values were determined. Briefly, IAPP (16.5 mM) was incubated with different molar ratios of the ACMs in ThT buffer (see under ThT binding assay) for 24 h and solutions added to the cells (IAPP, 100 nM); cell viability was assessed as above. To determine cell damaging effects of ACM-coated fIAPP, preformed fIAPP (16.5 M) was co-incubated with the ACM (33 mM) for 1 day as under ThT-binding assays. Solutions of ACM-coated fIAPP versus fIAPP alone were diluted with cell medium and incubated with the cells (fIAPP, 500 nM) as described above.

    [0235] The studies on effects of ACMs on formation of cell-damaging A42 assemblies were performed in combination with the ThT binding assay and TEM using PC12 cells cultured and plated. Incubations of A42 alone and its mixtures were made in MTPs as described for the ThT binding assays (parallel to the incubations made for the ThT binding assay) but w/o ThT; 6 day-aged solutions (37 C.) were diluted with cell medium and added to the PC12 cells at the indicated final concentrations. Following incubation with the cells for 20 h (37 C., humidified atmosphere, 5% CO.sub.2), cell damage was assessed by measuring cellular MTT reduction. To determine IC.sub.50 values of the effects of ACMs, incubations of A42 (5 M) or its mixtures with various amounts of the ACMs were performed as for the ThT binding assay (37 C.) but w/o ThT in MTPs. 6 day-aged incubations were diluted with medium and added to the PC12 cells (A42, 1 mM) and cell damage was assessed following 20 h incubation with the cells as above. On note, anomalous concentration-dependence profiles were found for mixtures of A42 with L3-LF and Nle3-LF most likely due to aggregation; therefore, IC.sub.50 values were not determined.

    [0236] To study effects of ACMs on fIAPP-mediating cross-seeding of formation of cell-damaging A42 assemblies, incubations were made as for the corresponding ThT binding assays but w/o ThT in MTPs. Solutions were aged for 1.5 h (37 C., shaking 500 rpm). Aliquots were diluted with cell medium, incubated with PC12 cells at the indicated final concentrations for 20 h and cellular MTT reduction was measured as above.

    [0237] Effects of ACMs on PC12 cell viability were studied using the 4 day-aged solutions applied in the ThT binding assays which were performed to determine their amyloidogenic potential (see under ThT binding assays). Following incubation with the cells (at 20 mM) for 20 h, cell damage was assessed by MTT reduction; data were corrected for buffer effects. For comparison, effects of aged A40 were also studied and cytotoxicity was as expected.

    Transmission Electron Microscopy (TEM)

    [0238] Aliquots of solutions used for ThT binding, MTT reduction, or other assays were applied on formvar/carbon-coated grids at the indicated incubation time points. Grids were washed with ddH.sub.2O and stained using aqueous 2% (w/v) uranyl acetate. Examination of the grids was done with a JEOL 1400 Plus electron microscope (120 kV). For A42-related studies, solutions made as for the ThT binding assay but w/o containing ThT were used for TEM and the MTT reduction assays. Kinetics of evolution of IAPP homo- and IAPP/Nle3-VF hetero-fibrils from amorphous aggregates was followed by TEM in solutions made in 10 mM sodium phosphate buffer, pH 7.4 (FIG. 4a) and also in solutions made in ThT buffer and very similar results were found.

    Immunogold-TEM

    [0239] Immunogold-TEM was performed. Briefly, peptide solutions made as described for the corresponding ThT binding assays were applied onto the grids at the indicated incubation time points. Grids were blocked with 0.1% BSA in 1PBS. fIAPP was detected with a fibril-specific mouse anti-fIAPP antibody (Synaptic Systems; Cl. 91E7). Nle3-VF was revealed by a rabbit anti-A40 polyclonal antibody (Sigma-Aldrich) exhibiting 10-20% NSB to IAPP. The two antibodies (in 0.1% BSA in 1PBS; dilution 1/10) were deposited simultaneously onto the grid and incubated for 20 min. Following washing with 1PBS, grids were incubated (20 min) with secondary antibodies goat anti-rabbit gold-conjugate (10 nm) and goat anti-mouse gold-conjugate (5 nm) (Sigma-Aldrich) (in 0.1% BSA in 1PBS, dilution 1/10) as above. Following 1PBS and ddH.sub.2O washings, uranyl acetate staining and grid examination were performed as described under TEM. To quantify IAPP and Nle3-VF contents of fibrils, 5 and 10 nm gold particles were counted; antibody reactivity is expressed as % of total number of gold particles bound. Significance was analyzed by one-way ANOVA and Bonferroni's Multiple Comparison test.

    Far-UV CD Spectroscopy

    [0240] CD spectra were recorded using a Jasco 715 spectropolarimeter. CD spectra (average of 3 spectra) were measured between 195-250 nm, at 0.1 nm intervals, a response time of 1 see, and at RT. The spectrum of the buffer was always subtracted from the spectra of the peptide solutions. Peptide incubations related to ACM alone or ACM/IAPP interactions were performed. Briefly, to study peptide conformations and oligomerization propensities, CD spectra of freshly made solutions in 10 mM sodium phosphate buffer, pH 7.4, containing 1% HFIP were measured at 5 mM or at the indicated concentrations in concentration-dependence studies. For studying hf-IAPP/ACM, IAPP (16.5 M) was incubated with Nle3-VF or VGS-VF (33 M) in ThT buffer as for the ThT binding assay for 7 days and spectra were measured at the indicated time points. For comparison, spectra of IAPP, Nle3-VF and VGS-VF alone were also measured. For studying the structure of hf-A42/Nle3-VF, incubations were performed as for the ThT binding assays but in the absence of ThT. Briefly, A42 alone (5 M), Nle3-VF alone (5 M), and their mixtures (5 M each) in 45 mM ammonium acetate (pH 8.5) were incubated for 6 days at 37 C. and CD spectra were measured.

    Fluorescence Spectroscopic Titration Assays

    [0241] Fluorescence spectroscopic studies were performed with a Jasco FP-6500 fluorescence spectrophotometer. Briefly, excitation was at 492 nm and spectra were measured between 500 and 600 nm. All titrations were performed in freshly made solutions of synthetic N-terminal fluorescently labeled peptide (5 nM) and various amounts of unlabeled peptide in 10 mM sodium phosphate buffer, pH 7.4 (1% HFIP) within 2-5 min following solution preparation. Under these experimental conditions, freshly made solutions of Fluos-IAPP and FITC-A42 (5 nM) consist mostly of monomers and the same was found for Fluos-ACMs (5 nM) (FIG. 13e and data not shown). Apparent binding affinities (app. K.sub.Ds) were estimated by using 1/1 binding models. However, due to the high self-assembly propensities of involved peptides more complex models might also apply. Determined app. K.sub.Ds are means (SD) from three binding curves derived from three independent titration assays.

    Cross-Linking, NuPAGE, and Western Blot (WB)

    [0242] Hetero-complex cross-linking studies in combination with NuPAGE and WB were performed with a previously developed assay system used for the characterization of AP and IAPP homo- and hetero-assemblies. Briefly, for characterizing IAPP homo-/hetero-assemblies, IAPP (30 M), IAPP/ACM mixtures (1/2) and ACMs alone (60 M) were incubated in 10 mM sodium phosphate buffer (pH 7.4) for up to 7 days (20 C.). In the case of A42 homo-/hetero-assemblies, A42 (30 M) and A42/ACM mixtures (1/2) were incubated in 10 mM sodium phosphate buffer (pH 7.4) for up to 6 days. At the indicated time points (o h, 24 h, and 7 days (IAPP studies) or 0 h, 3 h, 24 h, and 6 days (A42 studies)) aliquots were cross-linked (2 min) with 25% aqueous glutaraldehyde (Sigma-Aldrich) and treated with a 2 M NaBH.sub.4 solution (in 0.1 M NaOH, 20 min). Following precipitation with trichloroacetic acid (10%) (4-C) and centrifugation (10 min, 12000 g), pellets were dissolved in reducing NuPAGE sample buffer, boiled (5 min, 95 C.) and subjected to NuPAGE gel electrophoresis as described using 4-12% Bis-Tris gels and MES running buffer (Thermo Fisher Scientific). Equal amounts of IAPP or A42 were loaded in all lanes. Peptides were transferred onto nitrocellulose membranes (XCell II Blot Module, Thermo Fisher Scientific). Membranes were blocked overnight (10 C.) with 5% milk in TBS-T (20 mM Tris/HCl, 150 mM NaCl and 0.05% Tween-20). To reveal homo-/hetero-assemblies, membranes were incubated (2 h) with one of the following primary antibodies (in 5% milk in TBS-T): rabbit polyclonal anti-IAPP (Peninsula; 1:1000) for IAPP-containing assemblies, rabbit polyclonal anti-A40 (Sigma-Aldrich; 1:2000) for ACM-containing assemblies, or mouse monoclonal anti-A(1-17) (6E10, BIOZOL; 1:2000) for A42-containing assemblies (no cross-reactivity with ACMs). Primary antibodies were combined with suitable peroxidase (POD)-coupled secondary antibodies (donkey anti-rabbit-POD (1:5000) or goat anti-mouse-POD (1:1000)) and homo-/hetero-assemblies were revealed with SuperSignal West Dura Extended Duration Substrate (Thermo Fisher Scientific). Membranes were stripped by incubating in stripping buffer (2% SDS, 100 mM b-mercaptoethanol, 50 mM TRIS, pH 6.8) for 20 min at 60 C. and at RT for 45 min. Prestained protein size markers ranging from 3.5 to 260 kDa (Invitrogen) were electrophoresed in the same gels.

    Size Exclusion Chromatography (SEC)

    [0243] SEC was performed with a Superdex 7510/300 GL column (GE Healthcare); flow rate was 0.5 ml/min and detection was at 214 nm. For IAPP-related studies, elution buffer was 50 mM sodium phosphate buffer, pH 7.4, containing 100 mM NaCl. IAPP (16.5 M) or IAPP/ACM (or IAPP/VGS-VF) mixtures (1/2) were incubated in ThT buffer as for the ThT binding assays and at the indicated incubation time points centrifuged (1 min, 20000 g) and loaded onto the column. For A42-related studies, elution buffer was 50 mM ammonium acetate, pH 8.5. A42 (5 M) or A42/ACM (1/1) mixtures were incubated under ThT binding assay conditions (w/o ThT) and loaded onto the column at indicated time points. The column was calibrated with proteins/peptides of known molecular weights.

    ANS Binding Fluorescence Spectroscopy

    [0244] ANS binding studies were performed with a Jasco FP-6500 fluorescence spectrophotometer. Briefly, excitation was at 355 nm and fluorescence emission spectra were recorded between 355 and 650 nm. Solutions of ANS alone (8 M) and its mixtures with IAPP (2 M) or IAPP/Nle3-VF (1/2) mixtures were freshly made in 10 mM sodium phosphate buffer, pH 7.4, containing 1% HFIP and spectra were recorded at the indicated time points.

    Hetero-Complex Pull-Down Assays

    [0245] Pull-down assays were performed using streptavidin-coupled magnetic beads (Dynabeads M-280 Streptavidin, Dynal). Briefly, solutions of Biotin-IAPP (16.5 M), Biotin-IAPP/Nle3-VF-mixtures (1/2), and Nle3-VF (33 M; control for non-specific binding (NSB) to beads) in 10 mM sodium phosphate buffer, pH 7.4 were aged for 7 days (20 C.) and subsequently incubated with the beads for 4 h at RT. Bead-bound complexes were isolated by magnetic affinity. Following washing, beads were boiled with reducing NuPAGE sample buffer (5 min, 95 C.) and supernatants subjected to NuPAGE electrophoresis and WB as described under Cross-linking, NuPAGE and WB. Equal amounts were loaded in all lanes; lane Nle3-VF (control), freshly dissolved Nle3-VF without incubation with the beads.

    Confocal Laser Scanning Microscopy (CLSM) and 3D Stimulated Emission Depletion (STED) Imaging

    [0246] IAPP or IAPP/ACM mixtures (1/2) containing 10% N-terminal fluorescently-labeled analogs TAMRA-IAPP and Atto647N-ACM (IAPP(total), 16.5 M; ACM(total), 33 mM) were incubated in 10 mM sodium phosphate buffer, pH 7.4 for 7 days (20 C.). Aliquots (30-40 l) were pipetted onto SuperFrost Plus adhesion slides (Thermo Fisher Scientific), air-dried, covered with a high precision covershlip (#1.5; Ibidi), and embedded using Prolong Diamond Antifade Mountant (Thermo Fisher Scientific). CLSM and STED were performed using a Leica SP8 STED 3 microscope (HC PL APO 93x/1.30 GLYC CORR STED objective) with a tunable white light laser source to excite fluorophores. Depletion power (660 nm (TAMRA), 775 nm (Atto647N)) and time-gated detection of excited light were chosen to minimize sample damage while optimizing xyz-resolutions. Images were collected in a sequential scanning mode (hybrid-diode detectors) to maximize signal collection while minimizing channel cross-talk (TAMRA: excitation 552 nm/emission 557-645 nm; Atto647N: excitation 646 nm/emission 651-700 nm). 3D reconstructions/fibril measurements were performed using Leica's LAS-X software package (v1.2). Datasets were deconvoluted using Leica's Lightning application.

    Two-Photon Microscopy (2 M) and FLIM-FRET Studies

    [0247] Solutions analyzed by 2 M or FLIM-FRET consisted of either N-terminal fluorescently-labeled peptides (100%) or mixtures of labeled with non-labeled peptides (when indicated) and were prepared as follows: for most IAPP-related studies, hf-IAPP/ACM were made by incubating TAMRA-IAPP (16.5 M) with synthetic N-terminal fluorescein- or Atto647N-labeled ACMs (33 M) in 10 mM sodium phosphate buffer, pH 7.4 (abbreviated 1 b) for 6-7 days (20 C.). For comparison, aged TAMRA-IAPP (16.5 M) was also examined and consisted mostly of fibrillar assemblies (TAMRA-fIAPP; FIG. 18d). In some cases (i.e. samples examined by both STED and 2 M), IAPP/ACM mixtures (6-7 days aged, 1 b (20 C.)) consisting of 16.5 mM IAPP(total) and 33 mM ACM(total) with each of them containing 10% of labeled peptide were used as indicated.

    [0248] For 2 M and FLIM-FRET studies related to ACM-coated fIAPP, first fIAPP were made by incubating an IAPP/TAMRA-IAPP mixture (16.5 M IAPP(total) containing 10% TAMRA-IAPP) in 1 b for 48 h. fIAPP were then co-incubated with a mixture of Nle3-VF/Atto647-Nle3-VF (33 M Nle3-VF(total) for 1 day (20 C.)) to yield ACM-coated fIAPP. For 2 M and FLIM-FRET studies regarding the role of monomeric/prefibrillar IAPP on formation of IAPP/Nle3-VF nanofiber co-assemblies, aliquots from a freshly made mixture of Fluos-Nle3-VF (33 mM) with TAMRA-IAPP (1.65 mM) in 1 b (20 C.) were examined at the indicated incubation time points. For the corresponding studies on the role of fIAPP, preformed TAMRA-fIAPP seeds (3.3 mM); TAMRA-fIAPP was made by incubating TAMRA-IAPP (16.5 mM) in 1 b for 5 days (20 C.). For all A42-related studies, solutions consisted of 1/1 mixtures of unlabeled/labeled peptides (as indicated) and were prepared as for the ThT binding assays (w/o ThT) (45 mM ammonium acetate, pH 8.5, 37 C.; aging as indicated) as follows: for the studies on fA42 versus hf-A42/ACM, A42 solutions (A42(total) 5 M) consisted of 50% TAMRA-A42 and 50% A42 (6 day-aging); A42/ACM mixtures (1/2) contained, in addition to A42/TAMRA-A42 (1/1; A342(total), 5 M), ACM/Fluos-ACM (1/1; ACM(total), 10 M) (4-6 day-aging).

    [0249] For studies on fIAPP-mediated cross-seeding of A42, the A42 alone solution (A42(total), 10 M) contained HiLyte647-A42 (50%); the A42/ACM (1/2) mixtures consisted of A42/HiLyte647-A42 (1/1) (A42(total), 10 M) and Nle3-VF/Fluos-Nle3-VF (1/1) (Nle3-VF(total), 20 M); solutions were aged for 1.5 h. TAMRA-fIAPP seeds were made by incubating TAMRA-IAPP (128 M) in ThT buffer for 6 days (20 C.)); their concentration in the cross-seeded solution was 2 M. Aliquots from the above solutions were applied onto SuperFrost Plus adhesion slides, air-dried, washed (A42-related studies) and embedded with Prolong Diamond Antifade Mountant as for CLSM and STED.

    [0250] Samples were imaged on a two(multi)-photon Leica TCSPC SP8 DIVE FALCON LIGHTNING microscope (Leica) equipped with extended IR spectrum tunable laser (680-1300 nm) (New InSight X3, Spectra-Physics) and fixed IR laser (1045 nm), advanced Vario Beam Expander (VBE), ultra-high-speed resonance scanner (8 kHz), HC PL IRAPO 25/1.0 WATER objective, and FLIM-FRET modality. Images were collected in sequential scanning mode (hybrid-diode detectors; TAMRA: excitation 1100 nm/emission 560-630 nm; fluorescein (Fluos): excitation 920 nm/emission 480-550 nm; HiLyte647: excitation 1280 nm/emission 635-715 nm) and handled using Leica's LAS-X software package. Deconvolutions were performed using Huygens Professional or Leica's Lightning application.

    [0251] For fluorescence lifetime imaging (FLIM), up to 1000 photons/pixel were captured (time-correlated single-photon counting (TCSPC) mode). Samples were prepared as described above. Fluorescence decays were fit using Leica's FALCON software applying multi-exponential models. Quality of fits was assessed by randomly distributed residuals/low Chi-square values. The number of components (n) used for fittings was manually fixed to values (n=2-4) that minimized Chi-square statistic. In control experiments, fluorescence lifetime of the donor fluorescent molecule (Fluos-Nle3-VF) (33 M, 1 b, aging 6 days) in absence of acceptor was acquired similarly (a multi-exponential model was applied). Amplitude-weighted average lifetime was calculated as =(.sub.i.sub.i)/.sub.i (.sub.i: amplitude of each lifetime .sub.i). FLIM-FRET efficiency was calculated by FRET eff=1(.sub.DA/.sub.D); (.sub.DA=lifetime donor in presence of acceptor; .sub.D=lifetime donor alone).

    Dot Blot Assays to Assess Binding of ACMs to IAPP and A42Fibrils and Monomers

    [0252] IAPP (128 M) and A42 (11 M) incubations were made as for ThT binding assays (A42 w/o ThT) and deposited onto nitrocellulose membranes (IAPP: 40 g, A42: 10 g) either directly following their preparation (for monomers) or after 2 days of aging (for fibrils; confirmed by ThT binding and TEM). After blocking (5% milk in TBS-T, 2 h, RT) and several washing steps (with TBS-T and ThT buffer), membranes were incubated with N-terminal fluorescein-labeled ACMs (Fluos-ACMs) at 0.2 M for IAPP-related membranes or 2 M for A42-related membranes; incubation was overnight (10 C.) in ThT buffer (containing 1% HFIP). To control for fibril autofluorescence, similar membranes were incubated in parallel with buffer only. Bound peptides were visualized using a LAS-400 mini instrument (Fujifilm) equipped with a suitable fluorescence filter.

    Dot Blot Analysis for Quantification of Fibrils

    [0253] Dot blot analysis was used to verify the presence of equal amounts of homo- and heteromeric fibrillar assemblies in the aliquots of solutions examined by the various different assays, e.g. the ThT binding assay, the MTT reduction assay, or the PK digestion assay. For example, in the case of the solutions used for ThT binding and MTT reduction assays, 7 day-aged IAPP (16.5 M) or IAPP/ACM (1/2) mixtures were prepared as described under ThT binding assays; TEM showed that fibrils were major species in both kinds of solutions (FIG. 2f). Aliquots (1.3 g IAPP) were spotted onto 0.2 m-nitrocellulose membranes. For comparison, freshly made solutions (containing no fIAPP or hf-IAPP/ACM according to ThT binding (IAPP) and TEM) were made as above and spotted immediately. IAPP present in 0 h aged solutions of IAPP alone and solutions containing non-fibrillar IAPP/ACM co-assemblies (TEM data FIG. 4a) was revealed using a rabbit polyclonal anti-IAPP antibody (Peninsula; 1:1000) whereas for fIAPP present in 7 day-aged solutions the fIAPP-specific mouse anti-fIAPP antibody (Synaptic Systems; Cl. 91E7, 1:500) was used. Incubations with antibodies and membrane development were done as under PK digestion assays.

    Assessment of Fibril Thermostability by TEM and ThT Binding

    [0254] Solutions consisting mainly of fIAPP, hf-IAPP/Nle3-VF, fA42 or hf-A42/Nle3-VF were prepared as described under ThT binding assays (fIAPP 16.5 M, 7 day-aged; hf-IAPP/Nle3-VF, IAPP 16.5 mM, Nle3-VF 33 M, 7 day-aged; fA42 5 M, 6 day-aged; hf-A42/Nle3-VF, 5 M each, 6 day-aged; A42 incubations w/o ThT) and boiled (95 C.) for 5 min except for fA42 which was boiled for 15 min. TEM grids were loaded, stained, and analyzed as under TEM. ThT binding of fIAPP and hf-IAPP/Nle3-VF solutions was assessed by mixing aliquots before or after boiling with a ThT solution as described under ThT binding assays; buffer values were subtracted from the data.

    Proteinase K (PK)Fibril Digestion Assay in Combination with Dot Blot

    [0255] The PK digestion assay was performed based on protocols by Ladiwala et al. and Cho et al. Briefly, PK stocks (100 g/ml) were prepared in 50 mM TRIS/HCl pH 8.0 containing 10 mM CaCl.sub.2; the final PK concentration in the assay was 0.5 g/ml. fIAPP (16.5 M) or hf-IAPP/ACM (1/2) were prepared by incubating the peptides in 10 mM sodium phosphate buffer, pH 7.4 for 7 days (20 C.); fibril formation was confirmed by ThT binding (fIAPP) and TEM. fA42 (5 M) and hf-A42/ACM (1/i) were made as described under ThT binding assays (w/o ThT; 7 day-aging). For IAPP-related assays, solutions were made by mixing 60 l of the fIAPP or hf-IAPP/ACM solutions with 0.3 l of the PK stock solution. For A42-related assays, solutions were made by mixing 200 l of fA42 or hf-A42/ACM solutions with 1 l PK stock. Solutions made as above but w/o PK were used as controls for 100% undigested fibrils. Solutions were incubated at 37 C. and at indicated time points aliquots were dotted onto nitrocellulose membranes and spots were quickly dried by air. Membranes were washed (TBS-T) and blocked (5% milk in TBS-T, overnight (10 C.)). The following primary antibodies were used for membrane development (2 h, in 5% milk in TBS-T (RT)): mouse anti-fIAPP (Synaptic Systems, Cl. 91E7; 1:500) for fIAPP; mouse anti-A(1-17) (6E10, BIOZOL; 1:2000) for A42); rabbit anti-A40 (Sigma-Aldrich; 1:2000) for ACMs. Primary antibodies were combined with goat anti-mouse-POD (1:1000) or donkey anti-rabbit-POD (1:5000); detection was as under Cross-linking, NuPAGE and WB.

    Phagocytosis Assay

    [0256] Phagocytosis of fIAPP and fA42 versus hf-IAPP/ACM and hf-A42/ACMs was studied in primary murine BMDMs and cultured murine BV2 microglia using TAMRA-IAPP and TAMRA-A42 and essentially following an established protocol. Briefly, BV2 cells were maintained in GlutaMAX-supplemented RPMI1640 medium containing 10% FBS and 1% penicillin/streptomycin on poly-L-ornithine-coated flasks. For the phagocytosis assay, BV2 cells were seeded into 24-well plates containing coverslips in serum-free RPMI1640-GlutaMAX and further incubated for 24 h (5% CO.sub.2, 37 C.) to reach 10000 cells/well. Primary BMDMs were obtained from bone-marrow monocytes isolated from wildtype C57BL/6 mice, plated in 24-well plates at a density of 10000cells/well, and differentiated with L929 cell-conditioned medium (RPMI1640, 10% FBS, 1% penicillin/streptomycin) for 7 days. Thereafter, cells were incubated with aged peptide solutions at 37 C. for 6 h. Peptide solutions were prepared as follows: for IAPP-related studies, TAMRA-fIAPP (16.5 M) and hf-TAMRA-IAPP/ACM (16.5 mM) were made by incubating peptides/peptide mixtures (1/2) in ThT buffer for 7 days as for the ThT binding assay. Solutions were diluted with cell medium and added to the cells at a final homo-/hetero-nanofiber (IAPP) concentration of 3.3 M. For A42-related cell uptake studies, TAMRA-fA42 (5 M) and hf-TAMRA-A42/ACM (5 M) were prepared by incubating the peptides/peptide mixtures (1/1) under ThT assay conditions (w/o ThT) for 6 days. Following centrifugation (20 min, 20000 g), pellets were resuspended in cell medium and incubated with the cells for 6 h at a final homo-/hetero-fibril concentration of 1 M. Of note, dot blot analysis and BCA showed that the main peptide fraction was present in the pellet.

    [0257] To address the question whether addition of Nle3-VF or L3-VF to preformed A42 oligomers may affect their phagocytosis, preformed TAMRA-A42 oligomers (TAMRA-oA342) were prepared as for MTT reduction assays by incubating TAMRA-A42 (5 M) for 2 h under ThT binding assay conditions. For studying the effect of the ACMs, TAMRA-oA42 was mixed with Nle3-VF or L3-VF (1/1) and, following co-incubation for 2 h (under ThT binding assay conditions), mixtures were diluted with cell medium (TAMRA-A42, 1 M) and incubated with the BV2 cells for 6 h as described above. TAMRA-oA42 alone was incubated for 2 h as well and treated thereafter as its mixtures with the ACMs.

    [0258] Following incubation of the cells with the peptides, supernatants were removed and cells on the coverslips were washed 5 times with ice-cold 1PBS, fixed with 4% paraformaldehyde, washed with 1PBS, permeabilized with 0.2% Triton-X 100, and rinsed three times with cold 1PBS. Coverslips were mounted with Vectashield Antifade mounting medium containing DAPI (Vector Laboratories). Images were acquired using a Leica DMi8 fluorescence microscope. The percentage of cells that had taken up peptides was calculated by dividing the number of BV2 cells or BMDMs that phagocytosed TAMRA-labeled peptide by the total cell count, multiplied by 100. Significance was analyzed by unpaired student's t-test.

    Hippocampal Long-Term Potentiation (LTP) Measurements

    [0259] LTP measurements were performed. Briefly, sagittal hippocampal slices (350 m) were obtained from C57BL/6N male mice (6-8 weeks) in ice-cold Ringer solution bubbled with a mixture of 95% O.sub.2 and 5% CO.sub.2 and according to protocols approved by the ethical committee on animal care and use of the government of Bavaria Germany. Extracellular recordings were performed using artificial cerebrospinal fluid (ACSF)-filled glass microelectrodes (2-3 MW) at RT. ACSF consisted of 125 mM NaCl, 2.5 mM KCl, 25 mM NaHCO, 2 mM CaCl.sub.2, 1 mM MgCl.sub.2, 25 mM D-glucose, and 1.25 mM NaH.sub.2PO.sub.4 (pH 7.3) and was bubbled with 95% O.sub.2 and 5% CO.sub.2. Field excitatory postsynaptic potentials (fEPSPs) were evoked in the hippocampal CA1 dendritic region via two independent inputs by stimulating the Schaffer collateral commissural pathway (Scep). For LTP induction, high-frequency stimulation (HFS; 100 Hz/100 pulses) conditioning pulses were delivered to the same Seep inputs. Both stimulating electrodes were used to utilize the input specificity of LTP, thus allowing for the measurement of an internal control within the same slice. A42 (50 nM), A42/ACM mixtures (1/10) or ACMs alone (500 nM) were freshly dissolved in ACSF and applied 60-90 min before HFS. Responses were measured for 60 min after HFS. To study effects of ACMs on the LTP impairment mediated by pre-oligomerized A42, A42 (50 nM) was pre-incubated in ACSF for 24 h (30 C.) and then mixed with L3-VF or F3-LF (1/10) (in ACSF); pre-oligomerized A42 alone and A42/ACM mixtures were applied to the slices 90 min before HFS. fEPSP slope measurements (20-80% of peak amplitude) are presented as % fEPSP slope of baseline (the 20 min control period before tetanic stimulation was set to 100%). Data analysis by 1-way ANOVA and Bonferroni's multiple comparison test.

    X-Ray Fiber Diffraction

    [0260] fIAPP and hf-IAPP/Nle3-VF were made by aging IAPP (1024 M) or a mixture of IAPP (1024 M) and Nle3-VF (2048 M) in ddH.sub.2O for 3 days. A droplet of each solution was placed between glass rods supported by plasticine balls and allowed to dry (humidified atmosphere, 2-4 days, RT). X-ray diffraction data were collected at the facility Single-Crystal X-Ray Diffractometry of the TUM Catalysis Research Center (CRC) using a Bruker D8 Venture diffractometer equipped with a CPAD detector (Bruker Photon II), an IMS micro source with CuK radiation (=1.54178 ) and a Helios optic using the APEX3 software package (Version 2019-1.0, Bruker AXS Inc., Madison, Wisconsin, USA, 2019).

    Example 2: Inhibitor Design and Concept Evaluation

    [0261] For inhibitor design, A(15-40) was used as a template in the context of the fA40 fold; this features a -strand-loop--strand motif with A(12-22) and AR(30-40) forming the P-strands and A(23-29) the loop (FIG. 1a,b). A minimum number of chemical modifications was made aiming at (a) distorting the loop, (b) stabilizing -sheet structure, and (c) suppressing intrinsic amyloidogenicity of A(15-40) while maintaining its pronounced self-/cross-assembly propensity in analogy to the ISM concept (FIG. 1b). The modifications were: (a) substitution of loop tripeptide A(24-26) (Val-Gly-Ser) by -sheet propagating tripeptides consisting of identical large hydrophobic residues, to strengthen -sheet interaction surfaces while being incompatible with localization in turns/3-arcs and (b) selective amide bond N-methylation of two alternate residues within one of the two A -strand segments, to suppress intrinsic amyloidogenicity of ACMs and their co-assemblies (FIG. 1b). Positions of N-methylations were based on fA40 models and previous SAR studies. Finally, Met35 was replaced by Nle to avoid Met(O)-related side effects.

    [0262] To evaluate the concept, 13 A(15-40) analogs containing various different loop tripeptide segments (LTS), comprising (Nle)3, (Leu)3, (Phe)3, (Arg)3, (Gly)3, or Val-Gly-Ser (control LTS) and one pair of two N-methylated residues were designed, synthesized and studied (FIG. 1c, Table 3). In addition, to identify best suited LTS, various non-N-methylated analogs were synthesized and screened in initial studies (Table 3): First, the effect of unmodified A(15-40) (abbreviated VGS) on IAPP fibrillogenesis was studied by using the amyloid-specific thioflavin T binding assay and was found unable to inhibit (FIG. 9a,b). However, non-N-methylated analogs Nle3 and L3 containing LTS (Nle)3 or (Leu)3 instead of A(24-26) led to some delay of fibrillogenesis (FIG. 9a,b). By contrast, analogs R3 and G3 containing LTS (Arg)3 and (Gly)3, respectively, did not inhibit and far-UV CD spectroscopy indicated less b-sheet structure than in Nle3 and L3 (FIG. 9a-c). These findings suggested that Nle3 or L3 might be suitable candidates for further modifications.

    [0263] Peptide Nle3 was then used as a template to identify best-suited positions for N-methylations. The four Nle3 analogs Nle3-LF, Nle3-VF, Nle3-GI, and Nle3-GG were synthesized, each of them containing two N-methylations placed at specific residues either within the N-terminal region corresponding to A(15-23) (analogs Nle3-VF and Nle3-LF) or within the C-terminal region corresponding to A(27-40) (analogs Nle3-GI & Nle3-GG) (FIG. 10a, Table 3). Peptides Nle3-VF and Nle3-LF (FIG. 1c) carrying N-methylations at Val18/Phe20 and at Leu17/Phe19, respectively, fully suppressed IAPP fibrillogenesis and cytotoxicity as determined by ThT binding in combination with the 3-[4,5 dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) reduction assay in cultured rat insulinoma (RIN5fm) cells (FIG. 1d-g, FIG. 10b,c and FIG. 11a,b). By contrast, Nle3-GI and Nle3-GG, carrying N-methylations at Gly29/Ile31 and at Gly29/Ile33, respectively, did not inhibit (FIG. 10b,c). Titrations of cytotoxic IAPP with Nle3-VF or Nle3-LF revealed nanomolar IC.sub.5 values consistent with highly potent inhibitory activities (Table 1, FIG. 12a,b). Of note, introduction of the N-methylations of Nle3-VF and Nle3-LF into the non-inhibitory peptides VGS, G3 or R3 did not convert them into inhibitors (FIG. 10d,e). Also, partial Nle3-VF segments Nle3-VF(15-23), Nle3-VF(27-40), and Nle3-VF(21-40) did not inhibit (FIG. 10f-h). These results showed that both the loop tripeptide (Nle)3 and one of the two N-methylation patterns within A(17-20) Val18Phe20 and Leu17Phe19 are optimal to convert A(15-40) into a nanomolar inhibitor of IAPP.

    [0264] To further evaluate the concept, we next synthesized and tested the four peptides L3-VF, L3-LF, F3-VF, and F3-LF containing loop tripeptides (Leu)3 or (Phe)3 and each of the two identified N-methylation patterns (FIG. 1c, Table 3). All of them fully suppressed IAPP fibrillogenesis and related cytotoxicity (FIG. 1d-g, FIG. 11c-f) and nanomolar IC.sub.50 values were obtained (Table 1, FIG. 12c-f).

    [0265] Far-UV CD spectroscopy revealed significant amounts of b-sheet structure in all six inhibitory ACMs whereas non-inhibitors VGS-VF and VGS-LF were less structured (FIG. 1h,i). In addition, ACMs exhibited strong self-assembly propensities; however, they were soluble, non-amyloidogenic and non-cytotoxic up to at least 500-fold higher concentrations than their IC.sub.5, values (FIG. 13). Importantly, in the presence of ACMs both self- and cross-seeding of IAPP amyloid formation by preformed fIAPP or fA42 were strongly suppressed as found by the ThT binding assay (FIG. 1j,k).

    [0266] Together, the studies identified the six ACMs Nle3-VF, Nle3-LF, L3-VF, L3-LF, F3-VF, and F3-LF (FIG. 1c, Table 3) as highly potent inhibitors of self-/cross-seeded IAPP amyloid self-assembly.

    Example 3: ACMs Co-Assemble with IAPP into Amyloid-Like but Non-Toxic Nanofibers and their Diverse Highly Ordered Superstructures

    [0267] To obtain insight into the inhibition mechanism, the inventors next studied ACM interactions and co-assemblies. First, fluorescence spectroscopic titrations of N-terminal fluorescein-labeled IAPP (Fluos-IAPP) (5 nM) with ACMs revealed high affinity interactions. In fact, most app. K.sub.Ds were <100 nM and in very good agreement with the determined IC.sub.50 values (FIG. 2a, FIG. 14, Table 1). As freshly made solutions of Fluos-IAPP at 5 nM consist mainly of monomers, these results suggested that ACMs bind IAPP monomers/prefibrillar species with high affinity. IAPP/ACM hetero-assemblies were then cross-linked at various incubation time points with glutaraldehyde, separated by NuPAGE, and visualized by Western blot (WB) (FIG. 2b & FIG. 15). IAPP alone contained monomers, clearly resolved low MW oligomers (2-6-mers), and fibrils which did not enter the gel (FIG. 2b). By contrast, a strong smear between 15 kDa and the upper end of the gel was observed in IAPP/ACM mixtures already at 0 h indicative of large amounts of medium-to-high MW co-assemblies (FIG. 2b, FIG. 15). In addition, bands corresponding to hetero-dimers and hetero-tri-/-tetramers or IAPP mono-/dimers were also present in the IAPP/ACM mixtures, whereas the pattern of IAPP/non-inhibitor mixtures was as for IAPP alone (FIG. 2b, FIG. 15). Formation of hetero-dimers and large MW aggregates was further confirmed by size exclusion chromatography (SEC) (FIG. 2c).

    [0268] Far UV-CD spectroscopy revealed that IAPP/Nle3-VF co-assemblies exhibited a mixture of disordered and b-sheet structure (FIG. 2d). By contrast, the CD spectra of aged IAPP and IAPP/non-inhibitor (VGS-VF) mixtures were typical for -sheet-rich aggregates (FIG. 2d).

    [0269] Furthermore, anilino-naphthalene 8-sulfonate (ANS) binding studies indicated that IAPP/Nle3-VF co-assembly fully suppressed surface-exposure of hydrophobic clusters which occurs at early steps of IAPP amyloid self-assembly and is likely related to cytotoxic oligomer formation (FIG. 2e).

    [0270] To characterize the morphology of the IAPP/ACM co-assemblies, solutions used for ThT binding and MTT reduction assays were examined with transmission electron microscopy (TEM). As expected, fibrillar assemblies were major species in aged IAPP and its mixtures with the non-inhibitor VGS-VF (FIG. 2f). However, surprisingly, the aged mixtures of IAPP with all six ACMs exclusively consisted of fibrillar assemblies as well; these fibrils were indistinguishable from fIAPP fibrils by TEM (6-10 nm widths and 100-200 nm lengths) (FIG. 2f, Table 4). Notably, in contrast to aged IAPP and IAPP/non-inhibitor mixtures, no turbidity, gelation, or precipitation, was observed in the above IAPP/ACM mixtures. X-ray fiber diffraction revealed then that fibrils in IAPP/Nle3-VF mixtures exhibited the cross- pattern, which is typical for amyloid fibrils (FIG. 2g). Because fIAPP strongly binds ThT and ACMs were non-amyloidogenic up to 100 mM at least (FIG. 1d, FIG. 13a,b), it seemed reasonable to speculate that the fibrils in the IAPP/ACM mixtures could be: (a) fIAPP which escaped detection by the ThT binding assay or (b) fIAPP which was covered with non-specifically bound ACMs; competition of ACMs and ThT for the same fIAPP binding sites might have blocked ThT binding to fIAPP. However, these possibilities were excluded by a series of experiments (FIG. 16).

    [0271] The ThT-invisible and non-cytotoxic fibrils found in the IAPP/ACM incubations (termed hf-IAPP/ACM) might thus be heteromeric. To obtain more evidence for this hypothesis, the inventors first applied immunogold TEM. In fact, aged IAPP/ACM mixtures contained fibrils which bound both the anti-IAPP and the anti-AP (anti-ACM) antibody (FIG. 3a, FIG. 17a).

    [0272] Additional support was obtained by hetero-complex pull-down assays. Here, ThT-invisible fibrils present in aged mixtures of N-terminal biotin-labeled IAPP (Biotin-IAPP) with Nle3-VF were captured by streptavidin-coated magnetic beads and their components revealed by WB (FIG. 3b).

    [0273] High-resolution advanced laser-scanning microscopy provided further unequivocal evidence for diverse supramolecular IAPP/ACM nanofiber co-assemblies (FIG. 3c-i, FIG. 17b-f, FIG. 18).

    [0274] Confocal laser scanning (CLSM), stimulated emission depletion (STED), and two-photon microscopy (2 M) visualization of aged IAPP/Nle3-VF mixtures containing N-terminal TAMRA-labeled IAPP (TAMRA-IAPP) and N-terminal Atto647-labeled Nle3-VF (Atto647N-Nle3-VF) or N-terminal fluorescein-labeled Nle3-VF (Fluos-Nle3-VF) revealed large amounts of mm-long heteromeric nanofiber bundles (FIG. 3c,d, FIG. 17b-e). Their widths were 23276 nm (n=33) whereas fIAPP homomeric nanofiber assemblies formed under identical conditions were less broad (12423 nm (n=19), p<0.001) as estimated by the more accurate STED nanoscopy (FIG. 3c, FIG. 17f). 3D reconstructions of z-stacks of 2 M pictures suggested that heteromeric nanofiber bundles consist of laterally co-assembled, parallel arranged/in part intertwined stacks of IAPP and ACM molecules (FIG. 17d,e). Additional 2 M studies revealed diverse highly ordered fibrous superstructures including huge macromolecular loops (500 m long) (FIG. 3g,h, FIG. 18a) and ribbon- or nanotube-like co-assemblies (widths 5-20 mm, lengths >50 mm) (FIG. 3h,i). Interestingly, parts of the ribbon-like co-assemblies were reminiscent of giant DNA double helixes (FIG. 3h,i). Here, IAPP assemblies seemed to wrap and link two parallel-running heteromeric nanofiber bundles and similar observations were made in the nanotube-like co-assemblies. Twisted heteromeric nanofiber bundles were also observed (FIG. 3h). Notably, IAPP mixtures with other ACMs but not with the non-inhibitor VGS-VF contained similar heteromeric nanofiber superstructures as the IAPP/Nle3-VF mixtures (FIG. 18b-d).

    [0275] At this stage, detailed studies on the interaction of ACMs with fAPP were performed. Dot blots showed that ACMs and the non-inhibitor VGS-VF bind fIAPP. However, ACM/fIAPP co-assemblies (termed ACM-coated fIAPP) consisted of fIAPP bundles which were randomly covered by amorphous Nle3-VF aggregates and maintained the ThT binding and cytotoxic properties of fIAPP (FIG. 19; see also FIG. 16). These results further supported the notion that hf-IAPP/ACM were distinct from ACM-coated fIAPP.

    [0276] To learn more about the molecular architecture of the IAPP/ACM nanofibers, we used fluorescence lifetime imaging/Frster resonance energy transfer (FLIM-FRET). Pronounced FLIM-FRET events were observed in TAMRA-IAPP/Fluos-Nle3-VF nanofiber co-assemblies (FIG. 3j). The faster donor (Fluos-Nle3-VF) fluorescence decay, its strongly reduced lifetime (0.8 ns) in presence of the acceptor (TAMRA-IAPP), and the appreciable FLIM-FRET efficiency (85%) were consistent with a very close donor-acceptor proximity i.e. <5.5 nm corresponding to the Frster radius of the TAMRA/Fluos pair (FIG. 3i). The FLIM-FRET data supported the notion that IAPP and the ACM might be part of the same fibril.

    [0277] Together, these results suggested that the potent inhibitory effect of ACMs is mediated by nanomolar affinity co-assembly with IAPP monomers/prefibrillar species into amyloid-like but ThT-invisible and non-cytotoxic nanofibers and their diverse highly ordered superstructures.

    Example 4: ACM/IAPP Nanofibers Evolve from Amorphous Co-Assemblies and IAPP May Act as a Template

    [0278] The inventors next asked at which stage of the co-assembly process the fibrillar co-assemblies form. The cross-linking and SEC studies indicated that large hetero-assemblies were present already at the begin of the co-incubation (FIG. 2b,c). TEM only detected amorphous aggregates between 0 and 48 h whereas fibrils were the most abundant species at later time points (7 days) (FIG. 4a, FIG. 20a). Notably, early amorphous aggregates in the IAPP/ACM mixtures were non-cytotoxic as also found for the fibrils (FIG. 2ob). Thus, non-toxic hf-IAPP/ACM likely evolve via structural rearrangements of non-toxic amorphous co-aggregates.

    [0279] Because ACMs were non-amyloidogenic in isolation but co-assembled with IAPP into amyloid-like nanofibers, the inventors hypothesized that the amyloidogenic character of IAPP could play a role. In fact, TEM showed that no fibrils formed in mixtures of Nle3-VF with the natively occurring (human) IAPP analog rat IAPP or the earlier designed double N-methylated IAPP analog IAPP-GI, which have high sequence identity to IAPP but are weakly or non-amyloidogenic (FIG. 4b). Moreover, cross-nucleation studies using 2 M and FLIM-FRET suggested a templating role for IAPP monomers/prefibrillar species (FIG. 4c,d). Addition of seed amounts (5%) of TAMRA-IAPP monomers to Fluos-Nle3-VF yielded within 48 h nanofiber co-assemblies of similar appearance and identical FLIM-FRET properties to the nanofiber co-assemblies present in the 7 day-aged TAMRA-IAPP/Fluos-Nle3-VF (1/2) mixtures (FIG. 4c, 4d, FIG. 3f,j). Notably, no appreciable FLIM-FRET events were detected when TAMRA-fIAPP seeds were used (FIG. 21).

    Example 5: Additional Properties of Hf-IAPP/ACM

    [0280] The inventors next studied whether the non-toxic hf-IAPP/ACM may differ from fIAPP regarding other properties as well. First, the inventors asked whether hf-IAPP/ACM can seed IAPP fibrillogenesis. However in contrast to fIAPP or fibrils present in IAPP/non-inhibitor mixtures, seed amounts of hf-IAPP/ACM were unable to accelerate IAPP fibrillogenesis as assessed by ThT binding (FIG. 4e).

    [0281] Pathogenic amyloid fibrils are usually characterized by an extraordinary high stability. Therefore, the inventors compared the thermostabilities of IAPP/ACM nanofibers and fIAPP by using ThT binding and TEM. In contrast to fIAPP, hf-IAPP/Nle3-VF were fully converted into amorphous aggregates after heating to 95 C. for 5 min (FIG. 4f). Furthermore, most pathogenic amyloids are resistant toward proteolytic degradation including PK degradation. fIAPP and hf-IAPP/ACM were therefore incubated with PK and degradation kinetics followed by dot blot analysis using anti-fIAPP and anti-Ap (anti-ACM) antibodies (FIG. 4g). Remarkably and in contrast to fIAPP, which was stable to PK digestion for at least 30 h, hf-IAPP/ACM were fully degraded in <6 h with their ACM component being degraded within few minutes. Finally, the inventors studied the cellular uptake efficiency of hf-IAPP/ACM in direct comparison to fIAPP. In fact, the uptake of amyloid assemblies by macrophages and microglia is a major mechanism of amyloid clearance in both AD or T2D. Uptake of fIAPP versus hf-IAPP/ACM was studied in primary murine bone marrow-derived macrophages (BMDMs) and the well-established murine microglial cell line BV2 by fluorescence microscopy using TAMRA-IAPP as tracer. The inventors found that 3- to 10-fold higher amounts of hf-TAMRA-IAPP/ACM were phagocytosed by both cell types as compared to TAMRA-fIAPP (FIG. 4h, FIG. 22). Together, the results revealed several potentially beneficial properties of non-toxic hf-IAPP/ACM, i.e. seeding incompetence, thermolability, high PK sensitivity, and an efficient cellular clearance profile, which clearly distinguished them from pathogenic fIAPP.

    Example 6: Proposed Hypothetical Models of IAPP/ACM Nanofiber Co-Assembly

    [0282] The structure of A/IAPP hetero-amyloids has not been yet elucidated. Based on suggested structures of fIAPP and fA40(42) and the polymorphic nature of self-/cross-amyloid assembly, various different interfaces could be involved in hf-IAPP/ACM formation (FIG. 5). The inventors data suggested that single IAPP/ACM nanofibers and basic units of their superstructures may form by lateral co-assembly of two or more protofilament-like stacks of IAPP and ACM molecules (FIG. 5). Thereby, b-sheet-prone segments of the ACM part corresponding to A(21-40) would become incorporated into the b-sheet H-bond network of the ACM protofilament yielding diverse cross-interaction surfaces with both IAPP and ACM stacks (FIG. 5a,b). The proposed arrangement of A(21-40) is also supported by the finding that A(15-40) analogs with N-methylations within AB(21-40) did not inhibit (FIG. 10a-c). IAPP protofilament cross-interactions with the ACM could be mediated via previously suggested IAPP segments and fIAPP folds or yet unknown variants thereof. The lack of a 2.sup.nd IAPP protofilament and a non-ideal IAPP/AP(ACM) side chain interdigitation in the hetero-nanofiber as compared to fIAPP and/or intrinsic instability of involved IAPP and/or ACM folds could account for hetero-nanofiber lability. Notably, axial IAPP/ACM protofilament co-assembly could also occur (FIG. 5e). However, the STED and 2 M data, the expected higher instability of such a protofilament due to the N-methylations, and the observed lack of inhibitory effects of partial ACM segments (FIG. 10f-h) make this scenario less likely.

    Example 7: ACMs Inhibit A42 Amyloid Self-Assembly Via Co-Assembly into ThT-Invisible and Non-Toxic Nanofibers and their Diverse Superstructures

    [0283] In analogy to other A-derived A inhibitors, ACMs also interfere with A amyloid self-assembly. In fact, ThT binding and MTT reduction assays in PC12 cells showed that all six ACMs (A42/ACM 1/i) effectively suppressed formation of A42 fibrils and cytotoxic assemblies (FIG. 6a,b). Titrations of cytotoxic A42 with ACMs yielded mostly nanomolar IC.sub.50 values consistent with potent inhibitory activity (Table 2, FIG. 23). Furthermore, ACMs strongly suppressed seeding of A42 fibrillogenesis by preformed fA42 (FIG. 6c).

    [0284] Remarkably, TEM examination of the aged ThT-negative and non-cytotoxic A42/ACM mixtures revealed that they exclusively consisted of fibrils (FIG. 6d). These fibrils were 2-4 times longer than fA42 while their widths were identical to the widths of fA42 (7-8 nm) (FIG. 6d, Table 5). Additional TEM and ThT studies suggested that formation of long fibrils was linked to inhibitory activity (FIG. 24a,b). Because the fibrils in the A42/ACM mixtures were significantly longer than fA42, non-toxic, and could not solely consist of fA42, which strongly binds ThT, or the non-amyloidogenic ACMs, we assumed that they might be heteromeric (termed hf-A42/ACM).

    [0285] 2PM examination of aged A42/ACM mixtures containing N-terminal TAMRA-labeled A42 (TAMRA-A42) and Fluos-ACMs revealed diverse heteromeric fibrous superstructures. These comprised several m-long heteromeric nanofiber bundles with widths between 0.5-2 mm and related heterogeneous superstructures, i.e. ribbons, tapes, or nanotube-like ones with widths between 3-14 m (FIG. 6e and FIG. 25). The 2 M images and 3D reconstructions of z-stacks indicated that both axial and lateral co-assembly might underlie their formation, likely enabled by the high degree of sequence identity between ACMs and AR(15-40). In hf-A42/Nle3-VF, we observed thick nodes periodically arranged along a long cable-like part (FIG. 6e). Pronounced FLIM-FRET events were detected which were consistent with close distances between the two peptides, i.e. <5.5 nm (FIG. 6f). Notably, a stronger reduction of Fluos-Nle3-VF lifetime in the presence of TAMRA-A42, i.e. from 2.1 to 0.8 ns, and a higher FLIM-FRET efficiency (>80%) were observed in the node regions of interest (ROI-1) than in the cable-like ones (ROI-2) (FIG. 6f). A closer donor-acceptor distance or more donor molecules in nodes might account for this finding.

    [0286] ACM/A42 interactions and hetero-complexes were then studied by fluorescence spectroscopy, SEC, cross-linking in combination with NuPAGE and WB, and far-UV CD spectroscopy (FIG. 26). Fluorescence spectroscopic titrations of N-terminal FITC-labeled A42 (FITC-A42,5 nM) with ACMs yielded nanomolar app. K.sub.Ds (Table 2, FIG. 26a). SEC and cross-linking studies revealed large MW hetero-assemblies in A42/Nle3-VF mixtures consistent with the TEM and 2 M findings (FIG. 26b,c). Cross-linking also identified A42/Nle3-VF hetero-dimers; their formation might underlie hetero-nanofiber co-assembly. Far-UV CD spectroscopy indicated less b-sheet structure in hf-A42/Nle3-VF as compared to fA42 (FIG. 26d).

    [0287] Together, the results suggested that the potent inhibitory effect of ACMs on A42 amyloid self-assembly is mediated by nanomolar affinity interactions of ACMs with A42 monomers/prefibrillar species which redirect them into long ThT-invisible and non-toxic hetero-nanofibers and their diverse mm-scaled superstructures. Further studies suggested that binding of ACMs to preformed fA42 does not result in this kind of co-assemblies (FIG. 27).

    Example 8: Additional Properties of A42/ACM Co-Assembly

    [0288] Hippocampal synaptic plasticity is regarded as a key mediator of learning and memory processes; its damage by toxic A42 aggregates is a major responsible factor in AD pathogenesis. The inventors ex vivo electrophysiological studies in mouse brains revealed that in the presence of various different ACMs A42-mediated inhibition of hippocampal long-term potentiation (LTP) was fully ameliorated (FIG. 7a). As inhibition of LTP by A42 is linked to loss of memory and cognitive functions in AD, this data supported the potential physiological relevance of the in vitro determined inhibitory effects.

    [0289] We then investigated whether hf-A42/ACM might differ from fA42 with respect to their seeding competence. In fact, the ThT binding assay showed that, in contrast to fA42, hf-A42/Nle3-VF and hf-Ap42/L3-VF were seeding-incompetent (FIG. 7b). Furthermore, we asked whether hf-A42/ACM might exhibit similar proteolytic degradation, thermolability, and cellular clearance features as hf-IAPP/ACM. Kinetics of PK-mediated degradation of fA42 versus hf-A42/Nle3-VF were studied by dot blot analysis and the 6E10 antibody which specifically recognizes A42 (A(1-17)) but not the ACMs. hf-A42/Nle3-VF were degraded within 30 min whereas degradation of fA42 took 2 h, i.e. was 4 times slower (FIG. 7c). Thermostability studies using TEM then showed that hf-A42/Nle3-VF were fully converted into amorphous aggregates after 5 min at 95 C.; by contrast, fA42 were stable at 95 C. for at least 15 min (FIG. 7d). Finally, phagocytosis of TAMRA-fA42 and hf-TAMRA-A42/Nle3-VF(L3-VF) by cultured BV2 microglia cells was quantified by applying fluorescence microscopy. Significantly higher amounts of hf-TAMRA-A42/ACM became phagocytosed as compared to TAMRA-fA42 (FIG. 7e).

    [0290] Together, these findings revealed that ThT-invisible and non-toxic hf-A42/ACM were seeding-incompetent and less thermostable than fA42 and that they became more efficiently degraded by PK and phagocytosed by BV2 microglia than fA42.

    Example 9: Inhibition of fIAPP-Mediated Cross-Seeding of A42 Amyloid Self-Assembly by ACMs

    [0291] Cross-seeding of A42 amyloid self-assembly by fIAPP accelerates A42 amyloid self-assembly and could link onset and pathogenesis of T2D with AD. In a simplified mechanistic scenario, fIAPP seeds will template formation of IAPP/A42 hetero-amyloids which will template further cytotoxic A42 self-/cross-assembly events. Thereby, polymorphic cross-interactions between amyloid core regions may play an important role.

    [0292] Because ACMs contain the A amyloid core, bind with high affinity both IAPP and A42, incl. fIAPP and fA42, and inhibit their amyloid self-assembly, the inventors assumed that they might also interfere with cross-seeding of A42 by fIAPP. In fact, ACMs effectively suppressed fIAPP-mediated cross-seeding of A42 fibrillogenesis and cytotoxicity (FIG. 7f). Involved supramolecular (co-)assemblies were then studied by 2 M (FIG. 7g-j). First, preformed TAMRA-fIAPP seeds were added to A42 containing N-terminal HiLyte647-labeled A42 (HiLyte647-A42). 2 M at the fibrillogenesis plateau revealed large A42 clusters, consisting of apparently amorphous aggregates or fibrils, bound to/branching out from fIAPP surfaces (FIG. 7g,h). This data was consistent with secondary (cross-)nucleation. However, a completely different picture was obtained when TAMRA-fIAPP seeds were added to a mixture of A42 with Nle3-VF containing HiLyte647-A42 and Fluos-Nle3-VF (FIG. 7i,j). Major species were: (a) large fibrous A42/Nle3-VF/IAPP co-assemblies (many m long; widths 1-5 m) and (b) diverse roundish/elliptical A42/Nle3-VF/IAPP or A42/Nle3-VF co-assemblies (up to 10 m) (FIG. 7h-j). Analysis of 2 M images and 3D-reconstructions suggested that fibrous co-assemblies consisted of A342, Nle3-VF, and A42/Nle3-VF bound to fIAPP bundles (FIG. 7i,j). Thus, suppression of A42 cross-seeding likely occurs via a dual mechanism (FIG. 8): (1) sequestration of A42 into non-toxic ACM/A42 co-assemblies (both fibrillar and amorphous ones) and (2) binding of non-toxic ACM and ACM/A42 co-assemblies to fIAPP yielding cross-seeding-incompetent and non-toxic ternary nanofiber co-assemblies.

    Example 10: Tables

    TABLE-US-00007 TABLE 1 IC.sub.50 values of inhibitory effects of ACMs on IAPP-mediated cell damage.sup.[a] and app. K.sub.Ds of ACM/IAPP interactions.sup.[b][c]. IC.sub.50 (SD) app. K.sub.D (SD) ACM (nM).sup.[a] (nM).sup.[b][c] Nle3-VF 65.0 (5.2) 69.5 (1.4) Nle3-LF 82.1 (10.2) 55.4 (5.9) L3-VF 112.5 (8.1) 77.3 (2.9) L3-LF 133.2 (29.0) 143.2 (5.0) F3-VF 78.5 (13.6) 15.0 (1.9) F3-LF 41.7 (4.1) 37.6 (2.9) .sup.[a]IC.sub.50 values, means (SD) from 3 titration assays (n = 3 each) .sup.[b]Determined by titrations of N-terminal fluorescein-labeled IAPP (5 nM; pH 7.4) with ACMs .sup.[c]App. K.sub.Ds are means (SD) from 3 binding curves

    TABLE-US-00008 TABLE 2 IC.sub.50 values of inhibitory effects of ACMs on A42-mediated cell damage.sup.[a] and app. K.sub.Ds of ACM/A42 interactions.sup.[b][c]. IC.sub.50 (SD) app. K.sub.D (SD) ACM (nM).sup.[a] (nM).sup.[b][c] Nle3-VF 367 (79) 14.5 (8.0) Nle3-LF n.d. 11.1 (6.0) L3-VF 261 (140) 38.0 (2.0) L3-LF n.d. 2.6 (1.4) F3-VF 1032 (297) 160.8 (12.9) F3-LF 262 (115) 430.6 (7.1) .sup.[a]IC.sub.50 values, means (SD) from 3 titration assays (n = 3 each); n.d.: not determined .sup.[b]Determined by titrations of N-terminal FITC-labelled A42 (5 nM; pH 7.4) with ACMs .sup.[c]App. K.sub.Ds, means (SD) from three binding curves

    TABLE-US-00009 TABLE3 AminoacidsequencesandabbreviationsoftemplatesegmentA(15-40)(firstrow) andsynthesizedandtestedpeptidesi.e.the6amyloidinhibitors (ACMs;greybackground)andthenon-inhibitors.Thesequenceofsegment A(24-26)(highlighted)andappliedlooptripeptidesegments(LTS) areshownbythethree-lettercode;differentcolorsareusedforthe differentLTS;peptidesarearrangedingroupsaccordingtotheirLTS. N-methylatedaminoacidsareshowninbold.AllpeptideshaveafreeN-terminal aminogroup(NH.sub.2-)andareC-terminalcarboxylicacids(-COOH).Nle3-VF, Nle3-LF,L3-VF,L3-LF,F3-VF,andF3-LFarestronginhibitors. PeptideSequence Abbreviation QKLVFFAED-Val-Gly-Ser-NKGAIIGLMVGGVV A(15-40) QKLVFFAED-Nle-Nle-Nle-NKGAIIGLNleVGGVV Nle3 QKL(N-Me)VF(N-Me)FAED-Nle-Nle-Nle-NKGAIIGLNleVGGVV Nle3-VF QK(N-Me)LV(N-Me)FFAED-Nle-Nle-Nle-NKGAIIGLNleVGGVV Nle3-LF QKLVFFAED-Nle-Nle-Nle-NK(N-Me)GA(N-Me)IIGLNleVGGVV Nle3-GI QKLVFFAED-Nle-Nle-Nle-NK(N-Me)GAII(N-Me)GLNleVGGVV Nle3-GG QKLVFFAED-Leu-Leu-Leu-NKGAIIGLNleVGGVV L3 QKL(N-Me)VF(N-Me)FAED-Leu-Leu-Leu-NKGAIIGLNleVGGVV L3-VF QK(N-Me)LV(N-Me)FFAED-Leu-Leu-Leu-NKGAIIGLNleVGGVV L3-LF QKL(N-Me)VF(N-Me)FAED-Phe-Phe-Phe-NKGAIIGLNleVGGVV F3-VF QK(N-Me)LV(N-Me)FFAED-Phe-Phe-Phe-NKGAIIGLNleVGGVV F3-LF QKLVFFAED-Val-Gly-Ser-NKGAIIGLNleVGGVV VGS(A(15-40)) QKL(N-Me)VF(N-Me)FAED-Val-Gly-Ser-NKGAIIGLNleVGGVV VGS-VF QK(N-Me)LV(N-Me)FFAED-Val-Gly-Ser-NKGAIIGLNleVGGVV VGS-LF QKLVFFAED-Arg-ArgArg-NKGAIIGLNleVGGVV R3 QKL(N-Me)VF(N-Me)FAED-Arg-Arg-Arg-NKGAIIGLNleVGGVV R3-VF QK(N-Me)LV(N-Me)FFAED-Arg-Arg-Arg-NKGAIIGLNleVGGVV R3-LF QKLVFFAED-Gly-Gly-Gly-NKGAIIGLNleVGGVV G3 QKL(N-Me)VF(N-Me)FAED-Gly-Gly-Gly-NKGAIIGLNleVGGVV G3-VF

    TABLE-US-00010 TABLE 4 Widths of fIAPP and fibrils found in aged IAPP, IAPP/ACM and IAPP/VGS-VF mixtures as determined by TEM. Peptide or Fibril width peptide mixture (nm).sup.[a] IAPP 9.7 (2.3) IAPP + Nle3-VF 8.3 (1.9) IAPP + L3-VF 7.7 (1.5) IAPP + F3-VF 8.7 (1.8) IAPP + Nle3-LF 6.1 (1.1) IAPP + L3-LF 7.9 (1.8) IAPP + F3-LF 6.6 (1.2) IAPP + VGS-VF 8.5 (2.0) .sup.[a]Measured in 7 days aged IAPP and IAPP/peptide mixtures (from FIG. 1d, f; TEM images FIG. 2f). Data are means (SD) from 21-47 fibrils

    TABLE-US-00011 TABLE 5 Lengths and widths of fA42 and fibrils found in A42/ACM mixtures as determined by TEM. Peptide or Fibril length Fibril width peptide mixture (nm).sup.[a] (nm).sup.[a] A42 154 (58) 7.8 (1.6) A42 + Nle3-VF 472 (138) 7.3 (1.7) A42 + Nle3-LF 590 (268) 7.5 (1.1) A42 + L3-VF 458 (106) 6.9 (1.4) A42 + L3-LF 347 (72) 7.0 (2.2) A42 + F3-VF 354 (117) 6.9 (1.3) A42 + F3-LF 358 (118) 7.3 (1.5) .sup.[a]Measured in 6 days aged solutions of A42 and its mixtures (1/1) with ACMs (from FIG. 6b; TEM images FIG. 6d). Data are means (SD) from 15-23 (lengths) or 21-23 (widths) fibrils (see also bar diagram in FIG. 6d)

    TABLE-US-00012 TABLE 6 Molecular weights (M) of synthesized peptides which were used in this study as determined by MALDI-TOF-MS or ESI-MS (*). [M + H].sup.+ [M + H].sup.+[a] or ([M + Na].sup.+) [M + Na].sup.+[b] Peptide calculated (g/mol) found (g/mol) Nle3 2726.61 (2748.59) 2748.71.sup.[b] Nle3-VF 2754.67 (2776.65) 2776.89.sup.[b] Nle3-LF 2754.67 (2776.65) 2776.83.sup.[b] Nle3-GI 2754.67 (2776.65) 2776.50.sup.[b] Nle3-GG 2754.67 (2776.65) 2777.13.sup.[b] L3 2726.61 (2748.59) 2727.00.sup.[a]* L3-VF 2754.67 (2776.65) 2776.99.sup.[b] L3-LF 2754.67 (2776.65) 2757.00.sup.[a]* F3-VF 2856.63 (2878.61) 2878.92.sup.[b] F3-LF 2856.63 (2878.61) 2878.73.sup.[b] VGS 2630.48 (2652.46) 2652.35.sup.[b] VGS-VF 2658.54 (2680.52) 2681.37.sup.[b] VGS-LF 2658.54 (2680.52) 2680.47.sup.[b] R3 2855.67 (2877.65) 2855.97.sup.[a] R3-VF 2883.73 (2905.71) 2884.80.sup.[a]* R3-LF 2883.73 (2905.71) 2883.99.sup.[a] G3 2558.43 (2580.41) 2580.42.sup.[b] G3-VF 2586.49 (2608.47) 2609.00.sup.[b] Nle3-VF(15-23).sup.[c] 1124.62 (1146.60) 1146.62.sup.[b] Nle3-VF(27-40).sup.[c] 1309.81 (1331.79) 1331.93.sup.[b] Nle3-VF(21-40).sup.[c] 1964.17 (1986.15) 1986.21.sup.[b] Fluos-Nle3-VF 3112.97 (3134.95) 3134.93.sup.[b] Fluos-Nle3-LF 3112.97 (3134.95) 3135.16.sup.[b] Fluos-L3-VF 3112.97 (3134.95) 3134.94.sup.[b] Fluos-L3-LF 3112.97 (3134.95) 3134.75.sup.[b] Fluos-F3-VF 3214.93 (3236.91) 3237.05.sup.[b] Fluos-F3-LF 3214.93 (3236.91) 3236.59.sup.[b] Fluos-VGS-VF 3016.84 (3038.82) 3038.84.sup.[b] A42 4512.28 (4534.26) 4512.83.sup.[a]* rat IAPP 3918.96 (3940.94) 3923.54.sup.[a] IAPP-GI 3929.92 (3951.90) 3930.47.sup.[a] IAPP 3901.86 (3923.84) 3902.41.sup.[a] Biotin-IAPP 4240.19 (4262.17) 4241.13.sup.[a] TAMRA-IAPP 4314.29 (4336.27) 4313.95.sup.[a] Fluos-IAPP 4260.16 (4282.14) 4260.48.sup.[a] Atto647N-Nle3-VF 3382.57 (3404.55) 3381.85.sup.[a] M, monoisotopic mass; .sup.[a][M + H].sup.+; .sup.[b][M + Na].sup.+; .sup.[c]numbering of residues/segments of partial A(15-40) or ACM analogs according to their sequence numbers in A40.

    Example 11: Discussion

    [0293] The inventors exploited A/IAPP cross-interactions to design A amyloid core mimics (ACMs) as inhibitors of amyloid self-assembly of both IAPP and A42. Collectively, the inventors identified six 26-residue peptides as effective amyloid inhibitors of both IAPP and A42. All six ACMs bound IAPP with nanomolar affinity and blocked its cytotoxic amyloid self-assembly with nanomolar IC.sub.50 values. In addition, all six ACMs bound A42 with nanomolar affinity and blocked its cytotoxic self-assembly, three of them with nanomolar IC.sub.50 values. Moreover, ex vivo electrophysiology in murine brains showed a full amelioration of A42-mediated damage of synaptic plasticity by ACMs. Importantly, ACMs also inhibited reciprocal cross-seeding of IAPP and A42 amyloid self-assembly. ACMs thus belong to the most effective inhibitors of in vitro amyloid self-assembly of IAPP, A42, or both polypeptides.

    [0294] The inventors most remarkable finding was that ACMs, which were non-amyloidogenic in isolation, exerted their potent amyloid inhibitor function via a novel mechanism, i.e. by co-assembling with IAPP or A42 into amyloid-like but ThT-invisible and non-toxic nanofibers and their diverse highly ordered fibrous superstructures. The latter ones comprised large heteromeric nanofiber bundles and several mm-sized loops, ribbons, and nanotube-like superstructures. Furthermore, non-toxic ternary fibrous co-assemblies consisting of fIAPP, A42, and ACM formed when A42 cross-seeding by fIAPP was performed in the presence of ACMs.

    [0295] Unexpectedly, IAPP(A42)/ACM nanofiber co-assembly was efficiently inhibited by the peptides of the invention. In fact, ACMs contained all three A hot segments for high affinity interactions with IAPP, A42, and themselves, and combined inbuilt -sheet extension blocking (N-methylations) with -sheet stabilization/extension enabling (LTS and A(21-40)) elements.

    [0296] The identified IAPP/ACM nanofibers were indistinguishable from fIAPP by TEM and had the cross- amyloid core signature by XRD, but were less ordered than fIAPP according to CD spectroscopy. Our TEM, STED, 2 M, and FLIM-FRET studies suggested that nanofibers and basic parts of their fibrous superstructures consisted of laterally co-assembled, parallel arranged or intertwined/twisted, protofilament-like IAPP and ACM stacks. In addition, the inventors' studies showed that hf-IAPP/ACM evolve from large amorphous co-assemblies and suggested that IAPP monomers/prefibrillar species might template this process likely via hetero-dimers. Although the mechanistic steps are yet unclear, IAPP/ACM nanofiber co-assembly could proceed in analogy to proposed mechanisms of self- and co-assembly of IAPP and A.

    [0297] The identified A42/ACM nanofibers had similar widths but 2-4 times greater lengths than fA42. The inventors' imaging results were consistent with both axial and lateral co-assembly, the former likely underlying hetero-nanofiber elongation.

    [0298] Another notable finding of the inventors' study relates to the potentially beneficial properties of IAPP/ACM and A42/ACM nanofibers. These clearly distinguished them from pathogenic fIAPP and fA42 and, in addition to their non-toxic nature and seeding incompetence, comprised thermolability, proteolytic degradability, and a more efficient phagocytosis than fIAPP and fA42. Such features are reminiscent of labile/reversible functional amyloids, in which they may serve to control their formation/storage/disassembly related to their diverse biological functions. Examples are amyloids from certain secreted peptide hormones or from proteins forming reversible subcellular condensates. By contrast, most pathological amyloids are linked to cell damage and characterized by high stability and resistance to proteolysis. Furthermore, increasing evidence suggests that amyloid fold polymorphism underlies amyloid pathogenicity and functional diversity. The inventors' results suggest that, in addition to pathogenic IAPP/AP hetero-amyloids generated by fibril-mediated cross-seeding, potentially beneficial IAPP/AP hetero-amyloids, such as those mimicked by IAPP/ACM nanofibers, might also exist and this could be also the case for other cross-interacting amyloids. The structural characterization of IAPP/ACM nanofibers should help in identifying molecular factors that may diverge cytotoxic amyloid self-assembly into non-toxic and labile hetero-amyloids and enable the exploitation of amyloid fold versatility to designing effective anti-amyloid molecules.

    [0299] In conclusion, the present invention offers a novel class of designed peptides as highly potent inhibitors of amyloid self-assembly and reciprocal cross-seeding of IAPP and A42, and as highly promising leads for effective anti-amyloid drugs in both T2D and AD. In addition, the identified nanofiber co-assemblies should guide the design of novel functional (hetero-)amyloid-based supramolecular nanomaterials for biomedical and biotechnological applications.

    REFERENCES

    [0300] [1] Yan, L. M. et al. Selectively N-Methylated Soluble IAPP Mimics as Potent IAPP Receptor Agonists and Nanomolar Inhibitors of Cytotoxic Self-Assembly of Both IAPP and Abeta40. Angew Chem Int Ed Engl 52 10378-10383, doi:10.1002/anie.201302840 (2013).

    [0301] The features of the present invention disclosed in the specification, the claims, and/or in the accompanying figures may, both separately and in any combination thereof, be material for realizing the invention in various forms thereof.