Alzheimer's disease (AD) is common, devastating, and creates enormous social and financial burdens. At present, no effective disease-modifying AD treatment is available or imminent, in part because we lack a complete understanding of the cellular mechanisms and pathways that fail in human neurons and glial cells during disease, and in part because we don't adequately understand how common genetic variants alter human neuronal and glial phenotypes. Here we propose to test whether APP and PS mutations generated in common genetic backgrounds in human induced pluripotent stem cells (hIPSC) generate the same early neuronal phenotypes and then to investigate the extent to which a candidate set of genes identified by GWAS studies generate comparable phenotypes when reduced, increased, or altered by naturally occurring variants. To tackle both problems, we propose unique applications of hIPSC technology to 1) dissect how FAD mutations alter key pathways and then 2) to test how individual genetic background and identified risk factors predispose to SAD biochemical phenotypes in human neurons and astrocytes. Where possible, we will link the in vitro information to clinical data on individual patients and to post-mortem pathology from the UCSD ADRC. The analysis of hIPSC lines from SAD patients will be crucial to probe how common genetic risk factors act in neurons and astrocytes and will also give an initial estimate of the frequency of genomes in SAD patients and controls that cause relevant SAD phenotypes in neural cells differentiated in vitro. This frequency estimate will help address the important long-term question of whether hIPSC lines can be used to predict the likelihood that a given individual will develop SAD, i.e., to generate a predictive genomic/hIPSC diagnostic for SAD. This proposal capitalizes upon previous work from us and others that analyzed hIPSC lines from patients carrying an APP duplication (APPDp) or trisomy 21. Both situations appear to cause FAD by increasing APP expression by 50% in an otherwise euploid genome. Neurons made from these hIPSC lines exhibit typical AD biochemical alterations including elevated A?, elevated activation of GSK3, and elevated phosphorylation of tau at a proposed pathological site. We also found that APPV717F but not PS1dE9 mutations cause elevated p-tau levels. Thus, early neuronal phenotypes of APP and presenilin mutations might be different raising the possibility that there may be multiple early pathogenic pathways that can be studied using hIPSC technology. We also found that hIPSC studies can elucidate how one common genetic risk factor, SORL1, acts in human neurons. We thus propose three specific aims: 1) Test the hypothesis that APP, PS1, and ?-secretase mutations trigger the same early events in human neurons and astrocytes leading to downstream biochemical pathology typical of AD. 2) Test the hypothesis that genes identified as risk factors in GWAS studies generate AD phenotypes and altered endocytosis, trafficking, or transport when over or underexpressed. 3) Test the hypothesis that common genetic variants identified in GWAS studies act by altering gene expression in neurons or astrocytes.
Alzheimer's disease (AD) is common, devastating, and creates enormous social and financial burdens. At present, no effective disease-modifying AD treatment is available or imminent, in part because we lack a complete understanding of the cellular mechanisms and pathways that fail in human neurons and glial cells during disease, and in part because we don't adequately understand how common genetic variants alter human neuronal and glial phenotypes. Here we propose to use new types of stem cell technology to better understand these issues and to inform better therapy development.
