Overview

Cryo-electron microscopy (cryo-EM) has emerged as a transformative technique in structural biology, driving an exponential increase in the number of structures deposited in the Protein Data Bank. Current workflows now routinely achieve the near-atomic resolution essential for understanding the molecular pathology of neurodegenerative and metabolic disorders. This provides a comprehensive overview of the field, tracing the evolution from early structural studies to modern pipelines powered by deep-learning algorithms for helical reconstruction. We address the persistent bottleneck of sample preparation, detailing the physical challenges of fibril clumping and interfacial adsorption, alongside emerging solutions to these problems. Furthermore, we examine the complexities of structural polymorphism, discussing how environmental factors and seeding drive conformational diversity and how this heterogeneity impacts biochemical assays. Finally, we highlight the translational value of these high-resolution maps, demonstrating how they enable the rational, structure-based design of peptide inhibitors and small molecules capable of disaggregating pathogenic fibrils.

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David B. Teplow, Ph.D., is a Professor of Neurology, Emeritus, at UCLA and an internationally recognized leader in efforts to understand and treat Alzheimer's disease. Dr. Teplow's group has used a multi-disciplinary approach to determine how neurotoxic peptides, such as the amyloid β-protein (Alzheimer's disease) and α-synuclein (Parkinson’s disease), form neurotoxic structures that kill neurons and to develop the means to block these processes. Dr. Teplow received undergraduate training at UC Berkeley; a Ph.D. from the University of Washington; and was a postdoctoral scholar at Caltech. Before coming to UCLA, Dr. Teplow was a faculty member in the Department of Neurology, Harvard Medical School. Dr. Teplow has published >250 peer-reviewed articles, books and book chapters, and commentaries, in addition to serving on numerous national and international scientific advisory boards. Dr. Teplow was a founding editor of the Journal of Molecular Neuroscience and Current Chemical Biology, He is Editor-in-Chief of the Elsevier serial Progress in Molecular Biology and Translational Science and is Associate Editor-in-Chief of the American Journal of Neurodegenerative Disease.

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