Synaptopathy and Pathogenesis in Frontotemporal Dementia: Role of CYLD - Frontotemporal dementia (FTD) is the leading cause of dementia before the age of 60 and the second most
common form of dementia overall after Alzheimer’s disease (AD), and there is no cure. FTD is caused by
focal but progressive atrophy of frontal and/or anterior temporal cortices that leads to changes in personality,
apathy, loss of empathy, disinhibition, and language disability at early-mid stages, and general memory and
cognitive deteriorations requiring a full-time care at later stages. Consistently, it is thought that early
prodromal synaptic and circuit dysfunctions underlying behavior impairments may precede massive late-
onset neuronal cell loss and disability. However, molecular mechanisms underlying FTD-associated
synaptopathies that contribute to disease initiation and progression are not well understood. FTD is linked
clinically, pathologically, genetically, and mechanistically to amyotrophic lateral sclerosis (ALS). Up to 50% of
FTD are familial and associated with mutations of at least 15 genes of diverse functions. Remarkably, at least
10 of these genes are involved in autophagy, which has emerged as a central mechanism in FTD/ALS.
However, it remains enigmatic how autophagy is dysregulated in FTD/ALS and how exactly autophagy
dysfunctions cause the diseases, presenting a major hurdle and knowledge gap in development of
autophagy-based therapeutic strategies. Recently, a gain of function mutation in the CYLD gene is identified
in FTD/ALS patients, placing CYLD as the newest member of the FTD/ALS-causing gene family. CYLD
encodes a Lys63-specific deubiquitinating enzyme and interacts with several FTD gene products, including
p62/SQSTM1, Optineurin, and TBK1, suggesting a potential role for CYLD in autophagy related to FTD.
CYLD is best known as a tumor suppressor linked to familial cylindromatosis and immune signaling, but its
roles in neurons and synapses are poorly understood. Our published and ongoing studies indicate that CYLD
is an abundant Lys63-specific synaptic deubiquitinase that has a major role in synapse maintenance,
function, and plasticity through regulation of neuronal autophagy. The goals of this R01 application are to
define the molecular details and functional consequences of CYLD-dependent autophagy in synapse
remodeling (Aim 1), to characterize a newly generated inducible and reversable transgenic mouse model
carrying the FTD-causing mutation CYLDM719V in FTD pathogenesis (Aim 2), and to investigate the
pathogenic role of CYLDM719V in FTD and explore therapeutic strategies in human induced pluripotent stem
cell (iPSC)-derived cortical neurons (Aim 3). Our study represents the first attempt to investigate the role of a
new disease gene in FTD pathogenesis. The proposed studies are fundamentally important and highly
significant because they have the potential to uncover novel pathogenic mechanisms and treatment
strategies for FTD and related neurodegenerative diseases.