A Farnesyltransferase Inhibitor Activates Lysosomes and Reduces
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SCIENCE TRANSLATIONAL MEDICINE | RESEARCH ARTICLE NEURODEGENERATIVE DISEASE Copyright © 2019 The Authors, some rights reserved; A farnesyltransferase inhibitor activates lysosomes and exclusive licensee American Association reduces tau pathology in mice with tauopathy for the Advancement Israel Hernandez1*, Gabriel Luna1*, Jennifer N. Rauch1, Surya A. Reis2, Michel Giroux1, of Science. No claim 3 1 1 4 4 to original U.S. Celeste M. Karch , Daniel Boctor , Youssef E. Sibih , Nadia J. Storm , Antonio Diaz , Government Works Susmita Kaushik4, Cezary Zekanowski5, Alexander A. Kang1, Cassidy R. Hinman1, Vesna Cerovac1, Elmer Guzman1, Honjun Zhou1, Stephen J. Haggarty2, Alison M. Goate6, Steven K. Fisher1,7, Ana M. Cuervo4, Kenneth S. Kosik1,7† Tau inclusions are a shared feature of many neurodegenerative diseases, among them frontotemporal dementia caused by tau mutations. Treatment approaches for these conditions include targeting posttranslational modifi- cations of tau proteins, maintaining a steady-state amount of tau, and preventing its tendency to aggregate. We discovered a new regulatory pathway for tau degradation that operates through the farnesylated protein, Rhes, a GTPase in the Ras family. Here, we show that treatment with the farnesyltransferase inhibitor lonafarnib reduced Rhes and decreased brain atrophy, tau inclusions, tau sumoylation, and tau ubiquitination in the rTg4510 mouse model of tauopathy. In addition, lonafarnib treatment attenuated behavioral abnormalities in rTg4510 mice and reduced microgliosis in mouse brain. Direct reduction of Rhes in the rTg4510 mouse by siRNA reproduced the results observed with lonafarnib treatment. The mechanism of lonafarnib action mediated by Rhes to reduce tau pathology was shown to operate through activation of lysosomes. We finally showed in mouse brain and in hu- man induced pluripotent stem cell–derived neurons a normal developmental increase in Rhes that was initially suppressed by tau mutations. The known safety of lonafarnib revealed in human clinical trials for cancer suggests that this drug could be repurposed for treating tauopathies. INTRODUCTION Ras superfamily (14). RASD2 became of interest in HD because it The tauopathies constitute a broad range of neurodegenerative dis- was thought to be expressed mainly in the striatum (15). However, eases, all of which share the hallmark feature of tau inclusions. Al- in humans, Rhes expression is clearly evident in the cerebral cortex though tau-related diseases including Alzheimer’s disease and chronic (16). Rhes activates autophagy independently of mammalian target of traumatic encephalopathy are serious public health problems (1), no rapamycin (mTOR) via interaction with beclin 1 (17). Furthermore, disease-modifying treatment currently exists for these conditions. Rhes has been shown to modulate the aggregation state of mutant Generally, approaches to treatment have directly targeted the tau pro- Huntingtin (mHtt), the protein mutated in HD, by promoting its tein and include tau antibodies (2), antisense oligonucleotides (3), sumoylation and reducing cell survival (18). This toxicity involves caspase cleavage products (4), and anti-aggregation agents (5). How- binding of Rhes to mHtt and requires the Rhes CXXX farnesylated ever, few pharmacologic interventions directed toward tau pathways membrane attachment site (18). We inferred that the induction of have reached clinical trials. Interventions in upstream pathways such autophagy is a pharmacological class effect of farnesyltransferase inhi- as inhibitors of tau phosphorylation (6) or acetylation (7) have shown bition (19) and could be relevant for tauopathies. Therefore, we studied some efficacy in animal models, but none of these approaches has farnesyltransferase as a therapeutic target for the treatment of tauopathies. had success in human clinical trials to date. Rapidly growing inter- We used the farnesyltransferase inhibitor lonafarnib, a drug for which est in autophagy as a downstream pathway that mediates tau clear- there is extensive clinical experience (20–22), and tested it in the rTg4510 ance (8–10) as well as the implication of autophagy and lysosomes mouse model of tauopathy. in other neurodegenerative conditions (11–13) suggest therapeutic opportunities. In Huntington’s disease (HD), a pathway linked to autophagy is mediated by the RASD2 gene, which encodes the Rhes RESULTS protein, a small guanosine triphosphatase (GTPase) member of the Farnesylation inhibition attenuates tau pathology in the rTg4510 mouse model of tauopathy 1 Lonafarnib is a potent farnesyltransferase inhibitor with a Ki (inhibi- Neuroscience Research Institute, University of California, Santa Barbara, Santa Barbara, tion constant) in the nanomolar range (23), which crosses the blood- CA 93106, USA. 2Department of Neurology, Massachusetts General Hospital, Chem- ical Neurobiology Lab, and Center for Genomic Medicine, Harvard Medical School, brain barrier and has only a few minor side effects in humans (21). Boston, MA 02114, USA. 3Department of Psychiatry, Washington University School We sought to determine the effects of lonafarnib administration in 4 of Medicine in St. Louis, St. Louis, MO 63110, USA. Department of Developmental the rTg4510 mouse, a widely used model of frontotemporal dementia and Molecular Biology and Institute for Aging Studies, Albert Einstein College of Medicine, New York, NY 10461, USA. 5Laboratory of Neurogenetics, Mossakowski (24). These mice develop tau tangles in the cerebral cortex by 4 months Medical Research Centre, Polish Academy of Sciences, 5 Pawinskiego St., 02-106 of age and in the hippocampus by 5.5 months of age along with the Warsaw, Poland. 6Department of Neuroscience, Icahn School of Medicine at Mount 7 loss of about 60% of their hippocampal CA1 neurons (24). Spatial Sinai, New York, NY 10029, USA. Department of Molecular, Cellular, and Developmen- memory deficits become apparent by 2.5 to 4 months of age, and tal Biology, University of California, Santa Barbara, Santa Barbara, CA 93106, USA. *These authors contributed equally to this work. electrophysiological properties of cortical neurons are affected before †Corresponding author. Email: [email protected] the accumulation of tau pathology (25, 26). To precisely determine Hernandez et al., Sci. Transl. Med. 11, eaat3005 (2019) 27 March 2019 1 of 17 SCIENCE TRANSLATIONAL MEDICINE | RESEARCH ARTICLE the effects of lonafarnib, we first replicated the time course for the red), which became apparent from ~12 weeks of age and preceded onset of tau pathology in rTg4510 mice (Fig. 1, A to K, and fig. S1). the appearance of MC1-positive neurons (fig. S1). As transgenic mice Similar to the reported data, immunoreactivity for the conforma- aged, anti-GFAP immunoreactivity increased in the cortex but not tional tau antibody MC1, corresponding to neurofibrillary tangles in the hippocampus (Fig. 1, I to K). Lonafarnib treatment decreased throughout the hippocampus, amygdala, entorhinal cortex, and ce- cortical astrocyte immunostaining when compared to vehicle-treated rebral cortex (Fig. 1A, green), was first detected at ~16 weeks of age mice (P = 0.041; Fig. 2, N to R) but displayed no effect on the hippo- (fig. S1D). Immunoreactivity progressed by 20 weeks of age to a mean campus (P = 0.236, ANOVA). of 93.0 ± 13.6 MC1-positive cells/mm2 in the cerebral cortex and 67.6 ± 13.1 MC1-positive cells/mm2 in the hippocampus (Fig. 1, Attenuation of behavioral abnormalities in rTg4510 mice by D and E). Wild-type (WT) mice showed no detectable MC1-positive farnesyltransferase inhibition neurons (Fig. 1C). As rTg4510 transgenic mice age, they display progressive behavioral Lonafarnib treatment was initiated at 10 weeks of age. Lonafarnib impairments. Marble burial and nest shredding behaviors (28, 29) was resuspended in 20% 2-hydroxypropyl-b-cyclodextrin as vehicle, are affected early, and by 30 weeks of age, transgenic animals have and rTg4510 mice were gavaged on an intermittent schedule, with progressed to hyperexcitability and obsessive circling. Using the same 5 days on and 5 days off at 80 mg/kg per day (27). Mice were evalu- lonafarnib treatment protocol (27, 30), beginning at 10 weeks of age, ated at 20 weeks of age (Fig. 2, A to H) and showed that drug treat- we sought to reduce or prevent the behavioral deficits induced by tau ment reduced MC1 immunoreactivity. The MC1 immunoreactivity pathology. Nest building was assessed at 20 weeks. WT littermates in the lonafarnib-treated mouse cortex (88.8 ± 8.1 MC1-positive produced well-rounded nests (Fig. 3A); however, untreated rTg4510 cells/mm2) and hippocampus (27.4 ± 5.2 MC1-positive cells/mm2) mice displayed poor nest shredding and, in some instances, left bed- was significantly reduced compared to either vehicle-treated mice ding material completely undisturbed (Fig. 3B). Lonafarnib treat- (183.3 ± 10.4 MC1-positive cells/mm2 in the cortex and 82.2 ± 6.8 ment rescued nest building (Fig. 3C). At 5 weeks of age, littermate MC1-positive cells/mm2 in the hippocampus; cortex: P = 0.006, controls and transgenic mice produced nests with similar scores hippocampus: P = 0.001; Fig. 2H) or untreated age-matched trans- (control mice, 3.58 ± 0.13; transgenic mice, 3.23 ± 0.12; P = 1.00). genic mice (cortex: P = 0.049, hippocampus: P = 9.6 × 10−6). Compa- Whereas control mice nesting scores did not significantly change with rable results were obtained by immunostaining mouse brain sections time (P = 1.00), transgenic mice nesting scores declined (P =