Cited by 127Alzheimer's disease research and treatmentsDown syndrome and intellectual disability researchDementia and Cognitive Impairment Research

Patient-specific Alzheimer-like pathology in trisomy 21 cerebral organoids reveals BACE2 as a gene dose-sensitive AD suppressor in human brain

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Alić, Ivan, Goh, Pollyanna A., Murray, Aoife, Portelius, Erik, Gkanatsiou, Eleni, Gough, Gillian, Mok, Kin Y., Koschut, David +42 more·2021·Molecular Psychiatry

Published version of a preprint

Abstract

A population of more than six million people worldwide at high risk of Alzheimer’s disease (AD) are those with Down Syndrome (DS, caused by trisomy 21 (T21)), 70% of whom develop dementia during lifetime, caused by an extra copy of β-amyloid-(Aβ)-precursor-protein gene. We report AD-like pathology in cerebral organoids grown in vitro from non-invasively sampled strands of hair from 71% of DS donors. The pathology consisted of extracellular diffuse and fibrillar Aβ deposits, hyperphosphorylated/pathologically conformed Tau, and premature neuronal loss. Presence/absence of AD-like pathology was donor-specific (reproducible between individual organoids/iPSC lines/experiments). Pathology could be triggered in pathology-negative T21 organoids by CRISPR/Cas9-mediated elimination of the third copy of chromosome 21 gene BACE2 , but prevented by combined chemical β and γ-secretase inhibition. We found that T21 organoids secrete increased proportions of Aβ-preventing (Aβ1–19) and Aβ-degradation products (Aβ1–20 and Aβ1–34). We show these profiles mirror in cerebrospinal fluid of people with DS. We demonstrate that this protective mechanism is mediated by BACE2 -trisomy and cross-inhibited by clinically trialled BACE1 inhibitors. Combined, our data prove the physiological role of BACE2 as a dose-sensitive AD-suppressor gene, potentially explaining the dementia delay in ~30% of people with DS. We also show that DS cerebral organoids could be explored as pre-morbid AD-risk population detector and a system for hypothesis-free drug screens as well as identification of natural suppressor genes for neurodegenerative diseases.

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  • Evidence in preclinical models demonstrates that genes other than APP being in three copies modify aspects of DSAD, such as cognition and amyloid-β load.

    “Evidence in preclinical models demonstrates that genes other than APP being in three copies modify aspects of DSAD, such as cognition and amyloid-β load [1, 50, 70]”

    From Apolipoprotein E abundance is elevated in the brains of individuals with Down syndrome–Alzheimer’s disease (2025) · cites this paper as [1]

    The Results section (‘Trisomy of BACE2 skews non-amyloidogenic Aβ peptide ratios and suppresses AD-like pathology in organoids’; page unavailable) reports that removing the third BACE2 copy led to amyloid deposits in trisomy 21 cerebral organoids. This supports the claim about a gene other than APP modifying amyloid pathology in a preclinical model, but the paper does not demonstrate an effect on cognition. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

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Authors
Alić, I., Goh, P. A., Murray, A., Portelius, E., Gkanatsiou, E., Gough, G., Mok, K. Y., Koschut, D., Brunmeir, R., Yeap, Y. J., O’Brien, N. L., Groet, J., Shao, X., Havlicek, S., Dunn, N. R., Kvartsberg, H., Brinkmalm, G., Hithersay, R., Startin, C., Hamburg, S., Phillips, M., Pervushin, K., Turmaine, M., Wallon, D., Rovelet-Lecrux, A., Soininen, H., Volpi, E., Martin, J. E., Foo, J. N., Becker, D. L., Rostagno, A., Ghiso, J., Krsnik, Ž., Šimić, G., Kostović, I., Mitrečić, D., LonDownS Consortium, Strydom, A., Fisher, E., Wiseman, F., Nizetic, D., Hardy, J., Tybulewicz, V., Karmiloff-Smith, A., Francis, P. T., Blennow, K., Strydom, A., Hardy, J., Zetterberg, H., & Nižetić, D.
Affiliations
  • Queen Mary University of London (GB)
  • Nanyang Technological University (SG)
  • University of Gothenburg (SE)
  • UCL Queen Square Institute of Neurology (GB)
  • Agency for Science, Technology and Research (SG)
  • King's College London (GB)
  • University College London (GB)
  • Inserm (FR)
  • University of Eastern Finland (FI)
  • University of Westminster (GB)
  • New York University (US)
  • University of Zagreb (HR)
  • The Francis Crick Institute (GB)
Venue
Molecular Psychiatry
Published
2020-07-10
Volume
26
Issue
10
Pages
5766-5788
ISSN
  • 1359-4184 (ISSN-L)
  • 1476-5578
OpenAlex
W3041871366
Cited by
123
References
64
Citations by year
2026: 9 · 2025: 22 · 2024: 16 · 2023: 21 · 2022: 20 · 2021: 24 · 2020: 9 · 2019: 2
FWCI
11.73
Type
journal article
Language
en
Open access
Locations
  • Molecular Psychiatry (publishedVersion, cc-by)
  • bioRxiv (Cold Spring Harbor Laboratory) (acceptedVersion)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • DR-NTU (Nanyang Technological University) (submittedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
  • Research Portal (King's College London) (submittedVersion, cc-by)
  • Queen Mary Research Online (Queen Mary University of London) (submittedVersion, cc-by)
  • WestminsterResearch (University of Westminster) (submittedVersion, cc-by)
  • The Francis Crick Institute (cc-by)
Funders
  • BrightFocus Foundation (A2015275S)
  • Wellcome Trust (FP7/2007–2013, 098330, 608765, 098330/Z/12/Z, 217199, 217199/Z/19/Z, 098327/Z/12/Z)
  • Francis Crick Institute (10194)
  • EU Joint Programme – Neurodegenerative Disease Research
  • Alzheimer's Society
  • Zaklade Adris
  • Parkinson's UK (G-0907)
  • European Commission (608765, GA KK 01 1 1 01 0007, 2007–2013, FP7 2007-2013, FP7/2007, IP-2019-04-3584)
  • Rosetrees Trust
  • National Research Foundation (NRF-NRFF2016-03)
  • National Research Foundation Singapore (NRFF2016, NRF-NRFF2016-03)
  • Agence Nationale de la Recherche (ANR-17-JPCD-0003)
  • Royal Swedish Academy of Sciences (2017-00915)
  • Fondation pour la Recherche Médicale
  • Hjärnfonden (FO2017‑0243, FO2017, ALFGBG-715986)
  • Vetenskapsrådet (FP7/2007-2013, 2017-00915, (#ALFGBG-715986, ALFGBG-720931, FO2017-0243)
  • Hrvatska Zaklada za Znanost (IP-2019-04, IP-2016-06-9451, PZS-2019-02-4277, IP-2019-04-3584, GA KK01.1.1.01.0007, KK01.1.1.01.0007, 2019‐04‐3584)
  • UK Dementia Research Institute (#2017-00915, ALFGBG-715986, FO2017-0243, -0243, -715986)
  • National Institutes of Health (IP-2019-04-3584, FP7/2007-2013, 1rf1ag059695-01a1, KK.01.1.1.01.0007, GA KK01.1.1.01.0007)
  • Medical Research Council (FP7/20072013, MR/L501542/1, MR/S011277/1, MR/R024901/1, MR/N026004/1, 608765, MR/T002581/1)
  • National Medical Research Council (NMRC/CIRG/1438/ 2015)
  • European Regional Development Fund (GA KK01.1.1.01.0007, FP7/2007‐2013, 2007 – 2013, KK.01.1.1.01.0007, IP-2019-04-3584)
  • National Institute on Aging (RF1 AG059695)
Topics
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Keywords
Down syndrome, Alzheimer's disease, BACE2, brain organoids, amyloid-beta, tau hyperphosphorylation, BACE1 inhibitors, gene dosage, beta-secretase inhibition, gamma-secretase inhibition, cerebrospinal fluid biomarkers, neurodegeneration, drug screening
MeSH terms
Alzheimer Disease, Brain, Down Syndrome, Humans, Organoids, Trisomy, Genes, Suppressor, Amyloid beta-Peptides, Aspartic Acid Endopeptidases, Amyloid Precursor Protein Secretases

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