PROJECT SUMMARY
Prion disease is a uniquely rapid, universally fatal progressive neurodegenerative disease of humans and other
mammals. It arises from a single protein, the native prion protein (PrP), which is capable of post-translationally
misfolding into a self-templating and deadly “prion.” Genetic and pharmacological proofs of concept
increasingly identify PrP dosage as the key to understanding, and ultimately intercepting this pathogenic
cascade. In mice with genetically altered PrP levels, lower PrP levels lead to longer survival following prion
infection, while excess PrP hastens disease. PrP-lowering antisense oligonucleotides (ASOs) now show
promise as a potential therapeutic strategy. However, effective implementation will hinge on a deeper
understanding of how PrP level controls the rates of prion nucleation, replication and neurotoxicity, and how
this control translates across disease timepoints, species and strains. Though almost all human prion disease
originates in the brain, PrP-lowering interventions have not yet been tested in spontaneous, rather than
inoculated, prion models. Meanwhile, the magnitude of protection conveyed by 50% genetic PrP reduction can
vary between model systems; the relative contributions of slowed prion replication and slowed neurotoxicity to
observed survival benefit in different species and prion strains remain to be disentangled. Finally, PrP lowering
must be studied in the context of patient-derived human prions, to assess how above learnings extrapolate to
strains of public health interest. We will fill these gaps by assessing the following. 1) Kinetics of spontaneous
prion formation. Using a new mouse model of spontaneous prion disease, we will track the spontaneously
disease process through serial molecular measurements of neuronal damage and prion seeding activity.
Through PrP-lowering tool compounds administered at different timepoints, we will disentangle how PrP
dosage modulates prion formation, amplification, neurotoxicity and symptomatic progression. 2) Rapid and
slow prion subtypes as a function of PrP dosage. Using newly engineered PrP knockout hamster and rat
models, we will characterize the kinetics of pathological biomarker rise relative to disease onset and terminal
illness as a function of PrP expression level in both canonically rapid (hamster) and more slowly progressive
(rat) prion disease systems. 3) Impact of PrP lowering on human prions. Using a series of novel
“humanized” mouse lines expressing human PrP at six different dosage levels, that have been shown
susceptible to multiple clinically relevant human prion strains, we will characterize time to pathology, symptom
onset, and terminal illness. PrP level will be varied on a lifelong basis through genetically manipulation, as well
as through postnatal, precisely timed intervention with PrP-lowering tool compounds. Taken together, these
studies will illuminate PrP’s control of disease kinetics across a spectrum of prion disease paradigms, while
building a scientific foundation to guide future development of PrP-lowering therapeutics.