AbstractBackgroundMidlife obesity and diabetes are dramatically increasing in prevalence and are significant risk factors for dementia, but the mechanism linking these diseases is largely unknown. We believe that targeting this shared mechanism may represent an untapped therapeutic strategy to slow neurodegenerationMethodTo test this hypothesis, we are utilising a mouse model of prion disease (RML scrapie) that faithfully recapitulates many aspects of the neurodegenerative process common to multiple forms of dementia, including endoplasmic reticulum stress, synaptic loss, and cell death but without disease‐specific overexpression or introducing familial mutations. In these mice, worsening behavioural and motor signs can be quantified using machine learning based pose‐estimation and memory phenotyping. This also forms the basis of a new automated pipeline for screening potential neuroprotective compounds from the pool of previously approved drugs. We aim to understand the potential for repurposing anti‐diabetic and other compounds for dementia risk reduction.ResultIn preliminary experiments, treatment with the commonly used anti‐diabetic drug Metformin reduced the severity of motor disruption in prion‐inoculated mice fed either a control or a high‐fat diet, with evidence of prolonged survival. Furthermore, an unbiased query of the Connectivity Map database predicted numerous related drugs classes, used to treat metabolic disease, that reverse transcriptional signatures observed in the brains of prion‐inoculated mice.ConclusionTogether these suggest a possible mechanistic convergence of anti‐diabetic compounds on a neuroprotective mechanism. To gain insight into the molecular mechanisms that might be shared in the brain between metabolic and neurodegenerative disease, we are now using multi‐omics approaches to characterise the signatures of drugs that delay prion signs. We aim to improve the prediction and validation of compounds for repurposing in dementia and identify the patient groups most likely to benefit from early intervention.
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