# Developing splicing-targeted therapeutic strategies for neurological diseases

> **NIH NIH R01** · MASSACHUSETTS GENERAL HOSPITAL · 2022 · $420,000

## Abstract

Abstract
Alternative splicing of messenger RNA (mRNA) is a regulatory mechanism that controls transcript localization,
translation, and stability, and enables the expression of multiple protein isoforms from a single gene. In neurons,
splicing is finely controlled and is critical for regulation of neurogenesis, neuronal migration and structure,
synaptogenesis, and synaptic function. Growing evidence highlights a role for splicing alterations in neurological
diseases, emphasizing the need to better understand the mechanisms of RNA processing in order to develop
splicing-targeted therapies. Recent studies have shown that neurons can control gene expression during critical
developmental stages by coupling alternative splicing with nonsense mediated decay (NMD). This mechanism
relies on inclusion of cassette exons, known as poison exons, to create in-frame premature termination codons
that trigger transcript NMD and reduce protein expression. Importantly, genetic variants promoting constitutive
inclusion of poison exons have been associated with neurodevelopmental and, more recently,
neurodegenerative diseases. However, the field lacks rigorous methods to identify and annotate poison exons
and variants affecting their splicing. A well-established example in which increased exon inclusion can lead to
neurological diseases is the aberrant splicing of the microtubule associated protein tau (MAPT). Pathogenic
splicing mutations that promote MAPT exon 10 inclusion lead to increased 4R-tau isoform expression and
aberrant tau accumulation, whereas missense and deletion gain-of-function mutations in exon 10 are associated
with mutant 4R-tau pathology. In both contexts, an approach that promotes MAPT exon 10 exclusion would be
therapeutically beneficial. Given the increase relevance of misplicing in disease, the goal of the proposed work
is to advance the understanding of the role of splicing alterations in neurological diseases with the objective of
developing splicing-targeted therapeutics. In Aim 1, we will develop a transcriptomic approach to map poison
exons relevant for neuronal development and survival, and by intersecting the identified poison exons with
ClinVar pathogenic variants, we will catalog mutations that are likely to affect their splicing and contribute to
disease. Then, generation of CRISPR/Cas9-engineered human induced pluripotent stem cell (iPSC)-derived
neuronal models for a selective number of these mutations will allow us to evaluate the impact of aberrant poison
exon inclusion on neuronal phenotypes. In Aim 2, we will use a mRNA-targeted strategy that promotes MAPT
exon 10 skipping as proof-of-principle for the therapeutic potential of splicing modulator compounds, by showing
rescue of neuronal disease phenotypes in patient-derived neuronal models of frontotemporal dementia (FTD).
The development of novel mRNA-targeted therapies that specifically correct the molecular defects leading to
disease will be a major advance for the treatmen...

## Key facts

- **NIH application ID:** 10495534
- **Project number:** 1R01NS124561-01A1
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Elisabetta Morini
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $420,000
- **Award type:** 1
- **Project period:** 2022-08-01 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10495534

## Citation

> US National Institutes of Health, RePORTER application 10495534, Developing splicing-targeted therapeutic strategies for neurological diseases (1R01NS124561-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10495534. Licensed CC0.

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