Formaldehyde induces and promotes Alzheimer's disease pathologies in a 3D human neural cell culture model.

Formaldehyde, a reactive aldehyde widely present in the environment and associated with occupational exposure, has been linked to cognitive impairment and Alzheimer's disease (AD) in multiple epidemiological and animal studies. However, its contribution to AD-like pathology in human neural models remains poorly understood. We utilized a 3D culture system of human neural progenitor cells (ReNcell VM) differentiated into neurons and glial cells to model chronic formaldehyde exposure. Additionally, we established a 3D human AD model by transducing ReN cells with APP and PSEN1 mutations to assess the effects of formaldehyde in an AD genetic background. Long-term formaldehyde exposure (up to 12 weeks) induced a dose-dependent increase in Aβ40, Aβ42, APP, and phosphorylated tau levels in both wild-type and AD-mutant 3D cultures. These changes mimic hallmark features of AD neuropathology, suggesting that formaldehyde acts as a pathological driver in both sporadic and familial contexts. Our study provides direct evidence that chronic formaldehyde exposure may initiate and accelerate amyloid and tau pathologies in 3D human neural cell models. These findings support growing concerns about formaldehyde as a modifiable risk factor in neurodegeneration.