Alzheimer disease (AD) is the most common cause of dementia and one of the leading sources of morbidity and mortality in the aging population. Despite enormous social and economic costs associated with AD, current drugs are directed towards symptomatic relief and none are curative. In this project titled ?An integrated reverse engineering approach toward rapid drug repositioning for Alzheimer?s disease,? we propose to develop an innovative integrated drug repositioning strategy that combines computation-based drug prediction, computation-based human brain-blood-barrier (BBB) permeability prediction, retrospective large-scale clinical corroboration, and prospective experimental testing to rapidly identify anti-AD drug candidates. First, we will develop novel computational approaches to identify repositioning anti-AD candidates from all (>2,600) FDA-approved drugs. Second, we will develop novel multifaceted biology-based computational methods to predict which repositioned drug candidates can cross BBB in humans. Third, we will perform large-scale retrospective case-control studies to corroborate the clinical efficacy of repositioned drug candidates using patient electronic health record (EHR) data of >50 million patients. Finally, we will evaluate the therapeutic potential of promising repositioned candidates in experimental models. Our study will generate a large amount of data/knowledge/hypotheses that could serve as a starting point for us and others to conduct hypothesis-driven drug repositioning studies in other animal models of AD and in AD patients. We will build a comprehensive Alzheimer Drug Repositioning Knowledge Base (ADRKB) and develop interactive web applications to make ADRKB publicly available. The unique and powerful strength of our project is our ability to seamlessly combine novel computational predictions, retrospective clinical corroboration using patient EHRs, and experimental testing in animal models of AD to rapidly identify innovative drug candidates that may work in real-world AD patients. The repositioned drug candidates will have interpretable mechanisms of action, are highly likely to cross BBB in humans, have clinical effectiveness evidence gathered from ?real-world? AD patients, and have demonstrated efficacy in mouse models of AD. We anticipate that these findings can be expeditiously translated into clinical trials and benefit 5.4 million AD patients in United States and 47 million AD patients worldwide.

Public Health Relevance

! Alzheimer?s disease (AD) is a chronic and progressive neurodegenerative disorder that causes enormous personal and societal burdens. Currently there exist no cures for AD. In this project titled ?An integrated reverse engineering approach toward rapid drug repositioning for Alzheimer?s disease,? we propose to develop an innovative integrated drug repositioning strategy that combines novel computational drug prediction, novel computational brain-blood-barrier (BBB) permeability prediction, retrospective large-scale clinical corroboration, and prospective experimental testing to rapidly identify repositioned anti-AD drug candidates. The output of our project will be a list of ranked repositioned drug candidates with interpretable mechanisms of action, high BBB permeability in humans, supporting clinical efficacy evidence gathered from ?real-world? AD patients, and demonstrated efficacy in mouse models of AD. We anticipate that these findings can be expeditiously translated into clinical trials and benefit AD patients. Our study will generate a large amount of data/knowledge/hypotheses that could serve as a starting point for others to conduct hypothesis- driven biomedical and clinical drug repositioning studies in different animal models of AD and in patients.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG057557-02
Application #
9566845
Study Section
Special Emphasis Panel (ZAG1)
Program Officer
Petanceska, Suzana
Project Start
2017-09-15
Project End
2022-05-31
Budget Start
2018-07-15
Budget End
2019-05-31
Support Year
2
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Case Western Reserve University
Department
Genetics
Type
Schools of Medicine
DUNS #
077758407
City
Cleveland
State
OH
Country
United States
Zip Code
44106
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