PROJECT SUMMARY/ABSTRACT Alzheimer’s Disease (AD) has predominantly been characterized by amyloid plaques and neurofibrillary tau tangles, and soluble oligomers of these peptides are thought to be toxic; hence, targeting these histopathological hallmarks has led to a long series of clinical trials, but to date they have all failed. Intriguingly, aberrant palmitoylation of multiple proteins has been reported in AD. Accordingly, we seek here to simultaneously modulate the location and activity of multiple AD-associated proteins (neurotransmitter receptor NMDAR, amyloid plaque-associated BACE1 and APP, and neurofibrillary tangle-associated Fyn kinase) by altering their shared post-translational modification, palmitoylation. To this effort, we will transfer learnings from a drug development program of a small molecule that removes palmitate from proteins, N-(tert-butyl)-hydroxylamine (NtBuHA, called CIRC825) in the well-defined neurodegenerative disease that is associated with over- palmitoylation, CLN1 Batten (CLN1). Of great importance to this AD-related grant, extrasynaptic (e)NMDARs containing predominantly GluN2B subunits have been implicated to be overactivated in the pathogenesis of AD. In a feasibility study demonstrating our approach will work in the context of human AD, our preliminary findings have recently shown that CIRC825 treatment virtually eliminates the aberrant hyperexcitable phenotype in human AD hiPSC cerebrocortical neurons compared to WT. Additionally as feasibility data, we investigated CIRC825 in CHOAPP cells (which overexpress APP), and found it lowered palmitoylation of APP, and it decreased Aβ42 generation (the pathogenic form) without decreasing soluble Aβ40. The aims of this Phase 1 work are focused on expanding our understanding the pathomolecular importance of the palmitoylation of APP, BACE1, Fyn, and NMDAR in both Cln1-/- mouse neurons and in human (h)iPSC-derived 2D cortical neuronal cultures and 3D cerebral organoids that have familial AD mutations. Human iPSCs to be used include wPSEN1 M146V/WT and APPswe/WT hiPSC lines as well as the PSEN1 ΔE9/WT hiPSC line (with WT isogenic controls). We will modulate palmitoylation in these models by treating them with CIRC825. Finally, in a Cln1-/- mouse model, we will compare physiologic benefits of CIRC825 to those of memantine. Specifically, in aim 1 we will evaluate CIRC825 in cultured CLN1-/- neurons and (h)iPSC-derived AD neurons for 1) effects on decreasing palmitoylation of APP, BACE1, Fyn, and NMDAR; 2) suppression of extra-synaptic dendritic Ca2+ influxes by calcium imaging, and 3) mitigation of glutamate-induced cell death in an excitotoxicity assay. In aim 2 we will test concentration-dependent physiologic effects of CIRC825 on (h)iPSC-derived 3D cerebral organoids (with familial AD mutations and WT controls), using multiple assays including patch-clamp electrophysiology, calcium imaging, multi-electrode array experiments, and immunohistochemistry. In aim 3 we will investigate the dose- dependent response of CIRC825 and memantine in CLN1-/- mice, assessing for motor deficits by a rotarod analysis, cognitive deficits by a water-maze and Y-maze assessment, and control of seizures by EEG. On completion of this work, we aim to demonstrate with greater confidence that palmitoylation is a druggable target in AD, which, to our knowledge, is a novel pharmacologic approach in AD. Further, as CIRC825 is being investigated in IND-enabling studies, we aim to develop a data package on CIRC825 that justifies more rigorous investigations of its efficacy in AD models, with the ultimate goal of clinical translation of CIRC825 (or other hydroxylamine derivatives) in AD. Results of this work will guide a Phase II program that is focused on a more targeted dose range assesment in Cln1-/- sheep and investigations in a broader set of AD models, including in hAPP-J20 and 5XfAD transgenic mice.

PROJECT NARRATIVE Alzheimer’s Disease (AD) has recently been reported to have too much of a fat, called palmitate, on proteins that are associated with the progression of the disease. Palmitate can control the location and activity of these disease-associated proteins within brain cells. We will use a new drug, called CIRC825, that can change the amount of palmitate on proteins, and we will explore how our drug can provide benefit to multiple models of AD, including a mouse model that is associated with too much palmitate on proteins, called CLN1.