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. 2020 Aug 19;9:33. doi: 10.1186/s40035-020-00209-y

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© The Author(s) 2020

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 1 — Schematic representation on possible changes of wild-type SOD1 in ALS. (Left) A natively folded SOD1 binds copper and zinc ions and forms an intramolecular disulfide bond. Pathological conditions might disrupt intracellular metal homeostasis and augment oxidative stress/ER stress, facilitating the formation of misfolded SOD1 even without any disease-causing mutations. Disulfide-crosslinked oligomers and insoluble aggregates of wild-type SOD1 have been detected in spinal cords of sporadic ALS. (Right) SOD1 has been known to constitutively secreted to extracellular fluid such as ISF and CSF, and recently, toxic wild-type SOD1 in abnormally misfolded conformations was detected in CSF of sporadic ALS. Misfolded SOD1 appears to be cleared by humoral immune response and/or glymphatic/intramural peri-arterial drainage systems, and their failure might contribute to the disease.