Arnyloid-beta 42 (A beta 42) aggregates represent a prominent histopathological feature in Alzheimer's disease (AD); thus, immunotherapy against oligomeric A beta 42 aggregates is considered to be a potentially safe and specific therapeutic strategy. In this study, we identified an anti-oligomeric A beta 42 aggregate single-chain variable fragment (scFv) antibody, HT6, that is capable of efficiently binding to medium-sized A beta 42 aggregates (mainly 18-45 kDa) in vitro with an equilibrium dissociation constant (K-D) of 3.0 x 10(-6) M, whether they were derived from A beta 42 monomer, larger A beta 42 oligomers, or even fibrils. This ability allowed scFv HT6 to induce the gradual disassembly of large A beta 42 aggregates into small A beta 42 oligomers while simultaneously effectively inhibiting the further development of A beta 42aggregates. Moreover, the scFv HT6-targeted conformational region on A beta 42 aggregates was found to be more local and relatively close to the N-terminus of A beta 42; thus, scFv HT6 significantly delayed or even prevented the aggregation of A beta 42 protofibrils, while significantly reducing the cytotoxicity of A beta 42 oligomers. Overall, this study demonstrate that even though the decrease in the cytotoxicity of A beta 42 aggregates might be closely related to the reduction in A beta 42 aggregates and vice versa, the reduction in A beta 42 aggregates might not necessarily be accompanied by or followed by the reduction or even elimination of the cytotoxicity of A beta 42 aggregates. This insight enriches the diversity of anti-oligomeric A beta 42 antibodies, further providing a new understanding into the relationship between their binding pattern to A beta 42 aggregates and the efficacy against their formation, offering a therapeutic strategy to delay the progression of AD.