Fig. 1: Molecular mechanisms of secreted clusterin for preventing Alzheimer’s disease.

Secreted clusterin (sCLU; outlined in orange): A binds and prevents the aggregation of Aβ; B interacts with LRP2 to transport Aβ species across the blood-brain barrier into the periphery; C interacts with TREM2 to transport Aβ into glial cells for lysosomal degradation; D prevents assembly of the membrane attack complex and associated apoptosis; E interacts with VGLUT1 to stimulate excitatory neurotransmission; F interacts with APOER2 and VLDR to induce reelin signaling, which decreases tau phosphorylation by inhibiting GSK3β; and G prevents oxidative stress and associated CASP3-mediated apoptosis. Illustrations were created using Biorender.com.