# Validation of r(G4C2)exp-binding small molecules in vivo and c9FTD/ALS biomarker development

> **NIH NIH P01** · SCRIPPS FLORIDA · 2021 · $259,424

## Abstract

PROJECT SUMMARY/ABSTRACT 
G4C2 repeat expansions in C9ORF72 are the most common genetic cause of frontotemporal dementia (FTD) 
and amyotrophic lateral sclerosis (ALS). Success in developing a treatment for “c9FTD/ALS” will require a 
better understanding of disease pathomechanisms, rigorous testing of r(G4C2)exp-binding compounds in pre- 
clinical models, and the development of pharmacodynamic and clinical biomarkers. Putative pathomechanisms 
of “c9FTD/ALS” involve RNA transcribed from the expansion [r(G4C2)exp]. We have shown these transcripts 
serve as templates for the synthesis of “c9RAN proteins” through repeat-associated non-ATG (RAN) 
translation. That neuronal inclusions of c9RAN proteins are a pathological hallmark of c9FTD/ALS implicates 
RAN translation as a mechanism of disease. Indeed, poly(GR) and poly(PR) c9RAN proteins cause 
nucleocytoplasmic transport defects in yeast, and our studies reveal nuclear pore protein pathology in 
poly(GA)-expressing mice. These findings are consistent with those demonstrating that C9ORF72 repeat 
expansions impair nucleocytoplasmic transport and provoke atypical gene expression in c9FTD/ALS patient- 
derived cell models. Of note, we found extensive transcriptome changes in the brains of c9ALS patients, 
including abnormal alternative splicing of genes involved in nucleocytoplasmic transport. Whether this RNA 
misregulation is caused by c9RAN proteins and/or other events associated with r(G4C2)exp, and whether these 
transcriptome defects underlie the development of TDP-43 pathology, a hallmark feature of c9FTD/ALS argued 
to be a primary cause of neurodegeneration, are questions of importance that we will investigate. In addition, 
we will evaluate the therapeutic benefit of neutralizing r(G4C2)exp; together with leaders of Projects 1 and 3, we 
have shown that small molecule binders of r(G4C2)exp mitigate c9FTD/ALS-associated defects in patient- 
derived cell models. Therefore, we will screen r(G4C2)exp probes emerging from Project 1 in c9FTD/ALS 
patient-derived lymphoblastoid cell lines, and those showing promise will be screened in c9FTD/ALS iPSN by 
Project 3. Ultimately, we will validate lead compounds in our (G4C2)66 mice, yet another crucial step in moving 
drugs towards clinical trials. Likewise, because testing potential therapies in clinical trials will demand reliable, 
efficient means to measure target engagement and patient responses to treatment, and because there is an 
urgent need for indicators of c9FTD/ALS prognosis and disease stage, we will evaluate whether poly(GP) 
c9RAN proteins can serve these purposes. Our exciting findings that poly(GP) proteins are detectable in 
cerebrospinal fluid (CSF) and peripheral blood lymphocytes from c9FTD/ALS patients, coupled with preliminary 
data suggesting that CSF poly(GP) levels associate with clinical features of disease, provide compelling 
support for the use of poly(GP) as a biomarker of c9FTD/ALS. Overall, through the pre-clinical v...

## Key facts

- **NIH application ID:** 10150906
- **Project number:** 5P01NS099114-05
- **Recipient organization:** SCRIPPS FLORIDA
- **Principal Investigator:** LEONARD PETRUCELLI
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $259,424
- **Award type:** 5
- **Project period:** 2017-06-15 → 2022-04-01

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10150906

## Citation

> US National Institutes of Health, RePORTER application 10150906, Validation of r(G4C2)exp-binding small molecules in vivo and c9FTD/ALS biomarker development (5P01NS099114-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10150906. Licensed CC0.

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