Donanemab-mediated amyloid plaque clearance reduces microglial activation and neuronal injury, which diminishes the pathological drive for GSK3β and CDK5 kinase activity. As these kinases become less active, tau phosphorylation at threonine 217 decreases, leading to CSF p-tau217 normalization that reflects disease modification. However, the mechanistic specificity of this pathway is uncertain since GSK3β/CDK5 are constitutive kinases with ubiquitous functions regulated by insulin signaling, Wnt pathways, and PI3K/Akt—not primarily by amyloid burden.
Curated pathway from expert analysis
flowchart TD
A["Amyloid Plaque<br/>Clearance"]
B["Tau Kinase Activity<br/>Normalization"]
C["GSK3B<br/>Inhibition"]
D["CDK5<br/>Inhibition"]
E["CSF p-tau217<br/>Reduction"]
F["CSF p-tau217<br/>Normalization"]
A --> B
B --> C
B --> D
C --> E
D --> E
E --> F
style A fill:#1b5e20,stroke:#a5d6a7,color:#a5d6a7
style F fill:#1b5e20,stroke:#a5d6a7,color:#a5d6a7No linked papers recorded for this hypothesis yet.
No curated PDB or AlphaFold mapping for GSK3B yet. Search RCSB →
Median TPM across 13 brain regions for GSK3B, CDK5 from GTEx v10.
No clinical trials data linked to this hypothesis yet.
No curated ClinVar variants loaded for this hypothesis.
Run scripts/backfill_clinvar_variants.py to fetch P/LP/VUS variants.
No DepMap CRISPR Chronos data found for GSK3B, CDK5.
Run python3 scripts/backfill_hypothesis_depmap.py to populate.
No resource usage or linked notebooks recorded for this hypothesis yet.
| Prediction | Predicted | Observed | Status | Conf |
|---|---|---|---|---|
| IF early Alzheimer's disease participants receiving Donanemab achieve ≥70% reduction in cortical amyloid PET signal (Centiloid <20) after 18 months of treatment, THEN cerebrospinal fluid (CSF) biomark | CSF phospho-GSK3β Ser9 or CDK5p25/p35 ratio reduced by ≥30% at month 18 | — no observation — | pending | 0.55 |
| IF Donanemab-mediated amyloid clearance (≥70% PET reduction, Centiloid <20) is achieved by month 18, THEN CSF p-tau217 concentration will decrease by ≥40% from baseline in the same cohort, independent | CSF p-tau217 reduced by ≥40% at month 18 | — no observation — | pending | 0.72 |