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Alzheimer’s disease (AD) drug research has traditionally focused on removing toxic amyloid-β (Aβ) and Tau aggregates, leading to FDA-approved anti-Aβ antibodies. However, the real-world effectiveness of these drugs is still uncertain due to the multifactorial nature of AD. There is a need to shift from single target approaches to combinatorial strategies that address multiple targets. Mitochondria play a crucial role in resilience mechanisms that maintain cellular homeostasis and impede disease progression across molecular, cellular, and brain-wide levels. A functional mitochondrial network is essential for preserving protein homeostasis, sustaining energy status, and maintaining synaptic firing rates. The MIND-AD CRE aims to coordinate interdisciplinary research to understand AD holistically and justify combinatorial treatments.

A. Molecular Scale

The Molecular Scale Program aims to explore whether targeting specific regulators can simultaneously enhance mitochondrial function and suppress Tau aggregation. It adopts a proteomic approach to map the differential vulnerability of the neuronal proteome to misfolding and aggregation following energy stress or the expression of proteins with familial Alzheimer’s mutations. Additionally, the program seeks to provide the first description of the role of wild-type and pathological Tau in controlling NMDR trafficking in synaptic plasticity, offering a mechanistic basis for Tau-based therapeutic development. By applying machine-learning approaches to Alzheimer’s patient-derived neurons, the program aims to determine the mitochondrial components that drive Alzheimer’s pathogenesis. Furthermore, it will pre-clinically test combination therapies targeting signalling pathways involved in protein aggregation in Alzheimer’s.

B. Cellular Scale

The Cellular Scale Program aims to employ advanced machine learning-based protein design to create high-affinity binding probes that identify and target key regulators of mitophagy in Alzheimer’s. It also seeks to develop iPSC-generated models to understand the interplay between the cytoskeleton, mitochondria, and energy in Alzheimer’s. Additionally, the program supports a biotech start-up’s vision to address autophagy-driven degradation and correct mitophagy in Alzheimer’s. By exploring the novel role of ICL-tribute in the onset or spread of Alzheimer’s hallmarks, the program aims to gain new insights. Furthermore, it will investigate whether aging and deprivation of glucose and oxygen in mice replicate the mitochondrial dysfunction observed in Alzheimer’s.

C. Brain-Wide Scale

The Brain-Wide Scale Program aims to investigate brain-wide pathways to clear Aβ aggregates in vivo. It seeks to develop a suite of tests with superior sensitivity compared to current industry-standard tests for detecting neuropsychological changes. Additionally, the program focuses on creating novel MRI applications for differential diagnosis, including quantitative cortical thickness maps for individual patients, and translating earlier work with diffusion imaging and quantitative susceptibility mapping. The program emphasizes CRE-wide harmonization of data collection for brain-wide assessments (memory and motor) in transgenic mouse models, mapped against molecular and cellular scale analyses, and validated in Alzheimer’s tissue. Furthermore, it aims to navigate the path from bench to bedside through clinical trials utilizing low-intensity ultrasound to treat Alzheimer’s.

D. Drug Targeting and Delivery Across Scales

The Drug Targeting and Delivery Across Scales Program aims to deliver antibody therapeutics across the blood-brain barrier using adeno-associated virus to target Aβ and Tau pathology. It seeks to develop mRNA therapeutics for various intracellular targets, including Tau. Additionally, the program pioneers the world’s first intravenous targeted non-viral CRISPR therapy by utilising scanning ultrasound for genome editing in the brain. Furthermore, it focuses on delivering novel anti-Tau antibodies, with and without ultrasound, to enhance functional outcomes.

E. Multiscale Mathematical Models

Quantitative systems pharmacology (QSP) approaches integrate mathematical modelling and experimental data to examine the mechanistic links between molecular mechanisms of drugs, disease biology, and clinical outcomes. Introduced in 2011, the QSP discipline has significantly impacted pharmaceutical development, particularly in oncology and inflammation. QSP models have supported >150 FDA submissions in the last decade. However, QSP’s application in neurodegenerative diseases is still in its infancy and has been identified as a priority area (a recent survey conducted across 50 major pharmaceutical industries).

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