pT231-tau protein exists in the two completely distinct cis and trans conformations, as depicted in cartoons of the primary backbone structures. Cis, but not trans, pT231-tau loses normal function and also gains toxic function. Pin1 prevents the accumulation of the pathogenic cis pT231-tau conformation in AD by converts it to the non-pathogenic trans.
Conformation-specific antibodies and/or vaccines against the pathogenic cis pT231-tau might be developed for the diagnosis and treatment of AD, especially at early stages.