The hexanucleotide repeat expansion GGGGCCn (also known as G4C2n) localizes in the first intron of the C9ORF72 gene and is the most common genetic cause of ALS and FTD (C9ALS/FTD). The pathomechanisms proposed for C9ALS/FTD suggest that from sense (G4C2)n- and anti-sense (C4G2)n-containing transcripts originate two different mechanisms of toxicity: i) by the alteration of RNA processing due to binding and sequestration of RNA-binding proteins, thereby leading to impairment of RNA metabolism; and ii) by their unconventional Repeat-associated non AUG (RAN) translation into five different dipeptide-repeats (DPRs). In addition, pathological expansion of (G4C2)n reduces the C9orf72 transcription causing loss of function of the C9ORF72 protein. The toxicity of some of these DPRs has been showed in several cell lines, in iPSC-derived neurons, in Drosophila and in mouse models. An impairment of the ubiquitin-proteasome system (UPS) due to aggregation of toxic proteins is largely demonstrated in neurodegenerative disorders and among the mechanisms of DPR-related toxicity. RAN translation of (G4C2)n-RNAs has been recently shown to require a near-cognate start codon upstream of the repeat in frame +1 and to be triggered by stress conditions in a cap-dependent or cap-independent way. However, the mechanism regulating RAN translation is still largely unknown. Importantly, no small molecules are known to selectively modulate RAN translation, even if antisense oligonucleotides (ASOs) and small molecules binding the r(GGGGCC)n have been proposed as therapeutics for C9ALS/FTD. In addition, no effective pharmacological approach to reduce the pathological load of DPRs is currently available. Here, I developed a high-throughput drug-screening assay to identify small molecules and relative molecular targets that can modulate the DPR level. Among the identified hits, two hits reduced DPRs expression levels triggering the protein clearance system in vitro. Moreover, the screening identified compounds having the same target that increased DPRs expression levels indicating the targeted pathway as a crucial modulator of the translation process of the C9orf72 repeat-containing mRNAs. Conversely, I showed that pharmacological inhibition of the pathway reduced DPRs expression levels in vitro, while in vivo it rescued climbing ability and increased life span of Drosophila flies carrying G4C2X36 repeats. Moreover, genetic ablation of the target reduced DPRs expression levels by decreasing their translation efficiency in vitro and rescued the pathological phenotype in vivo. Together, the results show the identification of new pathways as new drug targets for C9ALS/FTD.

More than 40 neurological diseases are known to be caused by large expansions oftandem repeat sequences scattered throughout the human genome in introns, exons and untranslated regions. The GGGGCC (G4C2) repeat expansion located in the first intron of the C9ORF72 gene is the most common genetic cause of amyotrophic lateral sclerosis and frontotemporal dementia (ALS/FTD). In C9 FTD/ALS, expanded transcripts are known to aggregate and accumulate in the cell nucleus, sequestering RNA binding proteins. Other expanded RNA species are exported to the cytoplasm to undergo a non-canonical form of translation termed ‘repeat-associated non-AUG (RAN) translation’. RAN translation leads to the production of toxic polydipeptide repeat proteins in the absence of a canonical AUG start codon. This dissertation will highlight new mechanistic features of translation across the G4C2 repeat expansion, identify a potential therapeutic for C9 FTD/ALS using RNAi and develop a cellular system to explore the G4C2 repeat RNA lifecycle. First, we demonstrate that increasing G4C2 repeat expansion size results in suppression of translation from both canonical and non-canonical start codons, suggesting that large polydipeptide repeats are rarely fully translated. We further find that initiation does not occur from within the repeat expansion, relying on upstream sequence for initiation. However, some reading frames are prone to substantial frameshifting, such as poly-GA. We also show that a bias in ii codon usage efficiency contributes to previously observed variations in the levels of each polydipeptide. Our results support and extend previous studies by identifying two new mechanisms that bias production of poly-dipeptides toward poly-GA in C9 FTD/ALS. Further, we generated central mismatch-containing short hairpin RNAs (shRNAs) targeting the G4C2 repeat expansion to reduce aggregation or block translation of repeatcontaining transcripts. Iterative design was able to improve shRNA processing efficiency and cellular abundance, yet they were unable to reduce nuclear RNA foci in patient-derived cells. Despite this, we show preliminary data suggesting that these shRNAs are able to target cytoplasmic repeat-containing transcripts and resulting in a reduced translation of poly-GP. Finally, we optimized the previously published RNA-protein interaction detection (RaPID) technique, which uses proximity dependent labelling by a mutant biotin ligase and mass spectrometry for protein identification in living cells, to identify proteins interacting with the G4C2 repeat expansion. We embedded the box B RNA hairpin between G4C2 repeats and tested the ability for λN fused to a biotin ligase mutant, BASU, to specifically bind the box B hairpin in vitro. We show that 6 repeats each side of the hairpin combined with an extended hairpin stem promotes specific binding of the λN-BASU fusion protein and is likely to be successful in cells. C9 FTD/ALS is a currently incurable neurodegenerative disorder largely due to the limited understanding of disease mechanism. This dissertation demonstrates new mechanisms of translation across the G4C2 repeat expansion that results in toxic DPR production while also developing a nucleic acid therapeutic for long-term treatment of C9 FTD/ALS and further developing systems to explore RNA-mediated toxicity in cells.

[ES] El equilibrio de la homeostasis de proteínas es esencial para asegurar la funcionalidad celular. La expresión de proteínas propensas a plegarse mal induce la formación de agregados tóxicos que alteran el correcto funcionamiento de estos sistemas de control, lo que conduce a un desequilibrio de la homeostasis de proteínas, y por consiguiente a una afectación patológica. Varias enfermedades neurodegenerativas, como la enfermedad de Huntington (EH), Parkinson, Alzheimer, entre otras, tienen en común esta marca patológica molecular. Especialmente, la EH pertenece a un grupo de patologías producidas por proteínas que contienen expansiones de poliQs (varias ataxias espinocerebelosas, la atrofia muscular bulbar y espinal y la atrofia dentatorubro-pálidoluisiana), que hacen que estos péptidos sean propensos a la agregación, y causen los problemas que hemos descrito. A pesar de que estas enfermedades son genéticas, y se conoce su causa molecular, se cree que la presencia de variantes alélicas en otros genes puede exacerbar o ralentizar la agregación de proteínas con poliQs. Por tanto, la identificación de estos genes permitirá profundizar en los mecanismos moduladores de la dinámica de agregación de poliQs e identificar dianas terapéuticas frente a la toxicidad de poliQs. También es ampliamente conocido que el ARN que porta tripletes CAG tiene carácter patogénico. En este trabajo hemos desarrollado modelos, empleando C. elegans, que muestran signos indirectos de que están expresando transcritos CAG patogénicos, puesto que los tejidos diana están alterados. Usamos uno de estos modelos, que perturba la función de las neuronas GABAérgicas del gusano, para realizar un cribado de 85 compuestos farmacológicos, que nos llevó a identificar cuatro compuestos que reducían los defectos motores en estos animales. Además de poliQs y transcritos CAG, también se producen péptidos derivados de una traducción no canónica, conocida como traducción RAN. En relación a esto, hemos profundizado en la identificación y modelización de estos péptidos en C. elegans mediante la expresión de expansiones CAG fusionadas a proteínas fluorescentes para su detección in vivo. Además hemos empleado otros modelos ya existentes, para caracterizar potenciales dianas terapéuticas, como AMPK, la cual puede ser activada por diferentes sustancias. Sin embargo, algunas sustancias, como la metformina o el salicilato, son pleiotrópicas. Por tanto, hemos caracterizado la activación sinérgica de AMPK, mediante metformina y salicilato, para reducir el estrés por agregados de poliQs, con lo que podríamos evitar que otras dianas resulten activadas. Por último, hemos demostrado que este tratamiento sinérgico reduce la toxicidad inducida por la α -sinucleína implicada en la enfermedad de Parkinson. Por otro lado, hemos caracterizado en C. elegans un nuevo alelo que potencia la la agregación de poliQs, vlt10, en el gen unc-1. Nuestros resultados sugieren que la mutación unc-1(vlt10) perturba la sinapsis eléctrica entre las neuronas sensoriales IL2 y ASJ, induciendo un exceso de señalización hormonal que requiere la función de la sulfotransferasa SSU-1. También hemos demostrado que la diana de esta señal es un receptor nuclear llamado NHR-1. En este mismo capítulo, hemos identificado otra ruta de señalización hormonal, mediada por otro receptor nuclear (DAF-12), que tiene un papel protector. Se desconoce qué hormona modula la actividad de NHR-1. Sin embargo, hemos identificado que algunos de los genes regulados por NHR-1 están relacionados con el metabolismo lipídico. Además, hemos observado que la disrupción de unc-1 induce la acumulación de lípidos en los gusanos, pero a la vez estos animales contienen menos ácidos grasos totales. Esto sugiere que las grasas juegan un papel fundamental en la modulación de la agregación de poliQs, y quizás señala posibles dianas terapéuticas contra enfermedades causadas / [CA] L'equilibri de l'homeòstasi de proteïnes és essencial per a assegurar la funcionalitat cel·lular. L'expressió de proteïnes propenses a plegar-se malament indueix la formació d'agregats tòxics i altera el correcte funcionament dels sistemes de control, cosa que condueix a un desequilibri de l'homeòstasi de proteïnes, i per consegüent a una afectació patològica. Diverses malalties neurodegeneratives, com la malaltia de Huntington (MH), Parkinson i Alzheimer, entre altres, tenen en comú aquesta signatura patològica. Especialment, la MH pertany a un grup de patologies produïdes per proteïnes que contenen expansions de poliQs (s'inclouen diverses atàxies espinocerebel·loses 1, 2, 3, 6, 7 i 17, l'atròfia muscular bulbar i espinal, i l'atròfia dentatorúbrica-pàl·lidaluisiana), que fan que aquests pèptids siguen propensos a l'agregació, i causen els problemes que hem descrit. Malgrat que aquestes malalties són genètiques i es coneix la seva causa molecular, es creu que la presència de variants al·lèliques en gens pot incrementar o alentir l'agregació de proteïnes amb poliQs. Per tant, la identificació de gens modificadors permet aprofundir en els mecanismes moduladors de la dinàmica d'agregació de poliQs ens permet trobar dianes terapèutiques enfront de la toxicitat de poliQs. També és àmpliament conegut que l'ARN que contenen expansions CAG té caràcter patogènic. Per tant, hem desenvolupat models, utilitzant C. elegans, en els quals es mostren signes indirectes que expressen transcrits patogènics, ja que els teixits diana revelen una funcionalitat alterada. Utilitzant aquests models, que alteren la funció de les neurones GABAèrgiques del cuc, hem realitzat un cribratge de 85 compostos farmacològics, que ens va portar a identificar quatre compostos que reduïen els defectes motors en aquests animals. A més de poliQs i l'ARN que conté expansions de CAG, es produeixen pèptids derivats d'una traducció no canònica, coneguda com a traducció RAN. En relació amb això, hem aprofundit en la identificació i modelització d'aquests pèptids en C. elegans mitjançant l'expressió d'expansions CAG fusionades a proteïnes fluorescents per a la seva detecció in vivo. A més hem emprat models ja generats, per a caracteritzar potencials dianes terapèutiques, com AMPK puga ser activat per diversos fàrmacs. No obstant això, alguns activadors, com la metformina o el salicilat, són substàncies pleiotròpiques. Per tant, hem caracteritzat l'activació sinèrgic de AMPK, mitjançant metformina i salicilat, per a reduir l'estrés induït per agregats de poliQs i s'evita l'activació de dianes no desitjades. I finalment, hem demostrat que aquest tractament sinèrgic podria ser utilitzat per a reduir proteïnes tòxiques com la α-sinucleína, causant de la malaltia de Parkinson. D'altra banda, hem caracteritzat un nou modulador de l'agregació de poliQs, vlt10, en el gen unc-1, que produeix un augment d'agregació de poliQs. Els nostres resultats suggereixen que la mutació unc-1(vlt10) pertorba la sinapsi elèctrica entre les neurones sensorials IL2 i ASJ, induint un excés de senyalització hormonal que requereix la funció de la sulfotransferasa SSU-1. També hem demostrat que la diana d'aquest senyal és un receptor nuclear anomenat NHR-1. En el mateix capítol, hem identificat una altra ruta de senyalització hormonal, mitjançada per un altre receptor nuclear (DAF-12), que té un paper protector. Es desconeix l'hormona que modula l'activitat de NHR-1. No obstant això, hem identificat que alguns del genes regulats per NHR-1 estan relacionats amb el metabolisme lipídic. els resultats han sigut confirmats. També hem observat que la disrupció de unc-1 indueix l'acumulació de lípids en els cucs, però simultàniament aquests animals contenen menys àcids grassos totals. Això suggereix que els greixos juguen un paper fonamental en la modulació de l'agregació de poliQs, i potser assenyala / [EN] The balance of protein homeostasis is essential to ensure cellular functionality. The expression of proteins that are prone to misfolding induces the formation of toxic aggregates, which leads to an imbalance in protein homeostasis and pathological consequences. Several neurodegenerative diseases, such as Huntington disease (HD), Parkinson, Alzheimer, among others, have this molecular pathological mark in common. HD belongs to a group of pathologies produced by proteins that contain expansions of polyQs (several spinocerebellar ataxias 1, 2, 3, 6, 7 and 17, bulbar and spinal muscular atrophy and the dentatorubral-pallidoluysian atrophy), which make these peptides prone to aggregation, and cause the problems described above. Although these diseases are genetic, and their molecular cause is known, it is believed that the presence of allelic variants in other genes can exacerbate or slow the polyQ aggregation. Therefore, the identification of these genes will allow delving into the modulating mechanisms of the polyQ aggregation dynamics and find therapeutic targets against the polyQ toxicity. In addition, RNA that contains CAG triplets is pathogenic. In this work we have developed models using C. elegans that show indirect signs of pathogenic transcript expression since altered functionality was observed in target tissues. We use a model, which disturbs the function of the worm's GABAergic neurons, to screen for 85 pharmacological compounds, which led us to identify four compounds that reduced motor defects in these animals. In addition to polyQs and CAG transcripts, also are produced peptides derived from a non-canonical translation, known as RAN translation. In this regard, we have delved into the identification and modelling of these peptides in C. elegans through the expression of CAG expansions fused to fluorescent proteins to investigate them in vivo. Furthermore, we have used models previously generated to characterize potential therapeutic targets, such as AMPK. This enzyme can be activated using different compounds. However, some activators, such as metformin or salicylate, are pleiotropic substances. Therefore, in the second chapter of this thesis, we have characterised the synergistic activation of AMPK, using metformin and salicylate, to reduce the stress induced by polyQ aggregates and prevent possible unwanted targets from being activated. Finally, we have shown that this synergistic treatment could be used to reduce α-synuclein toxicity, which is involved in Parkinson disease. On the other hand, we have characterised a new allele that enhances polyQ aggregation, vlt10, in the unc-1 gene. Our results suggest that the unc-1(vlt10) mutation disturbs the electrical synapse between sensory neurons IL2 and ASJ, inducing an excess of hormonal signalling that requires the function of the sulfotransferase SSU-1. We have also shown that the target of this signal is the nuclear receptor NHR-1. In the same chapter, we have identified another hormonal signalling pathway, mediated by another nuclear receptor (DAF-12), which has a protective role. It is unknown which hormone modulates the activity of NHR-1. However, we have identified several genes that regulate lipid metabolism and whose expression could be modulated by NHR-1. In addition, we have observed that the disruption of unc-1 induces the accumulation of lipids in worms, but at the same time these animals contain less total fatty acids. Thus, our results suggest that the metabolism of fats play a key role in modulating polyQs aggregation, highlighting potential therapeutic targets against diseases caused by aggregation-prone proteins. / Gómez Escribano, AP. (2021). Modelos de toxicidad inducidos por microsatélites CAG y caracterización de dianas terapéuticas en C. elegans [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/166783