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The accumulation of abnormal protein aggregates is a major characteristic of many neurodegenerative disorders, including Parkinson’s disease (PD). The intracytoplasmic deposition of a-synuclein aggregates and Lewy bodies, often found in PD and other a-synucleinopathies, is thought to be linked to inefficient cellular clearance mechanisms, such as the proteasome and autophagy/lysosome pathways. The accumulation of a-synuclein aggregates in neuronal cytoplasm causes numerous autonomous changes in neurons. However, it can also affect the neighboring cells through transcellular transmission of the aggregates. Indeed, a progressive spreading of Lewy pathology among brain regions has been hypothesized from autopsy studies. We tested whether inhibition of the autophagy/lysosome pathway in a-synuclein-expressing cells would increase the secretion of a-synuclein, subsequently affecting the a-synuclein deposition in and viability of neighboring cells. Our results demonstrated that autophagic inhibition, via both pharmacological and genetic methods, led to increased exocytosis of a-synuclein. In a mixed culture of a-synuclein-expressing donor cells with recipient cells, autophagic inhibition resulted in elevated transcellular a-synuclein transmission. This increase in protein transmission coincided with elevated apoptotic cell death in the recipient cells. These results suggest that the inefficient clearance of a-synuclein aggregates, which can be caused by reduced autophagic activity, leads to elevated a-synuclein exocytosis, thereby promoting a-synuclein deposition and cell death in neighboring neurons. This finding provides a potential link between autophagic dysfunction and the progressive spread of Lewy pathology.

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