Therapeutics against Alzheimer’s disease (AD) have been developed mostly based on “amyloid hypothesis”. However, even though reduction of amyloid beta burden in the brain was successful in a number of human clinical trials, the effect on clinical symptoms has not been confirmed. Therefore, many pharmaceutical companies are currently trying to identify alternative target molecules other than amyloid beta whose direct role in the upstream of Alzheimer’s disease pathology is now challenged.
We have been analyzing AD pathology using the non-biased approach such as comprehensive phosphoproteome analysis, and identified multiple molecules like MARCKS and SRRM2 whose phosphorylation states are changed before extracellular amyloid aggregation appear in the brain of four types of AD mouse model. Their phosphorylation changes are also confirmed in postmortem brains of human AD patients, suggesting such changes may reflect human AD pathology.
Phosphorylation of SRRM2 at Ser1068 that occurs at the early stage of AD, loses binding affinity to a chaperone protein TCP1alpha when it is phosphorylated, suppresses transfer of SRRM2 to the nucleus, and inhibits the function of SRRM2 as a scaffold molecule stabilizing RNA-related proteins. Moreover, we identify PQBP1, a causative gene for human intellectual disability (ID), as the molecule that is stabilized by SRRM2 in the nucleus. PQBP1 is involved in post-transcriptional expression of multiple molecules essential for neuronal synapse function, and the decrease leads to abnormal brain function. Actually, AD model mice show similar synapse phenotypes to that of PQBP1-linked ID model mice. Gene therapy of AD model mice with AAV-PQBP1 recovers such synapse phenotypes and resultant cognitive impairment.
Collectively, we have confirmed existence of several pathological changes that precede extracellular amyloid aggregation, which should be called as “ultra-early stage pathology of AD”, and developed an unexpected strategy of gene therapy using an ID-causative gene to improve synapse function of AD that targets key molecules at the ultra-early stage of AD.
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