TDP-43 misfolding and aggregation occurs as primary pathology in ALS/FTD (~95% and ~50% respectively) and as secondary pathology in AD (LATE-ND, 20-50%) and PD (10-15%). The investable thesis is NOT pan-NDD unification but precision stratification: TDP-43-positive ALS/FTD and LATE-ND subgroups. ASOs, aggregation blockers, and nuclear localization stabilizers are viable approaches. The tofersen precedent (accelerated approval for SOD1-ALS based on NfL reduction) demonstrates biomarker-driven development is feasible.
Auto-built from this analysis's top knowledge-graph edges.
graph TD
GBA1_mutations["GBA1 mutations"] -->|increases risk| PD["PD"]
TREM2_R47H_variant["TREM2 R47H variant"] -->|increases risk| Ad["Ad"]
alpha_synuclein_fibrils["alpha-synuclein fibrils"] -->|activates| NLRP3_Inflammasome["NLRP3 Inflammasome"]
TFEB_overexpression["TFEB overexpression"] -.->|inhibits| tau_A__pathology["tau/Aβ pathology"]
TARDBP_MUTATIONS["TARDBP MUTATIONS"] -->|causes| ALS_FTD["ALS/FTD"]
TDP_43_INCLUSIONS["TDP-43 INCLUSIONS"] -->|associated with| ALS_FTD_1["ALS/FTD"]
NfL_reduction["NfL reduction"] -->|biomarker for| als["als"]
TARDBP["TARDBP"] -->|cross disease mech| ALS["ALS"]
TARDBP_2["TARDBP"] -->|cross disease mech| FTD["FTD"]
TARDBP_3["TARDBP"] -->|cross disease mech| AD_LATE["AD/LATE"]
h_cross_synth_tdp43_rna_p["h-cross-synth-tdp43-rna-proteostasis"] -->|proposes shared me| TARDBP_4["TARDBP"]
SNCA["SNCA"] -->|cross disease mech| PD_5["PD"]
style GBA1_mutations fill:#ce93d8,stroke:#333,color:#000
style PD fill:#ef5350,stroke:#333,color:#000
style TREM2_R47H_variant fill:#ce93d8,stroke:#333,color:#000
style Ad fill:#ef5350,stroke:#333,color:#000
style alpha_synuclein_fibrils fill:#4fc3f7,stroke:#333,color:#000
style NLRP3_Inflammasome fill:#ce93d8,stroke:#333,color:#000
style TFEB_overexpression fill:#4fc3f7,stroke:#333,color:#000
style tau_A__pathology fill:#4fc3f7,stroke:#333,color:#000
style TARDBP_MUTATIONS fill:#ce93d8,stroke:#333,color:#000
style ALS_FTD fill:#ef5350,stroke:#333,color:#000
style TDP_43_INCLUSIONS fill:#4fc3f7,stroke:#333,color:#000
style ALS_FTD_1 fill:#ef5350,stroke:#333,color:#000
style NfL_reduction fill:#ce93d8,stroke:#333,color:#000
style als fill:#ef5350,stroke:#333,color:#000
style TARDBP fill:#4fc3f7,stroke:#333,color:#000
style ALS fill:#ef5350,stroke:#333,color:#000
style TARDBP_2 fill:#4fc3f7,stroke:#333,color:#000
style FTD fill:#ef5350,stroke:#333,color:#000
style TARDBP_3 fill:#4fc3f7,stroke:#333,color:#000
style AD_LATE fill:#ef5350,stroke:#333,color:#000
style h_cross_synth_tdp43_rna_p fill:#4fc3f7,stroke:#333,color:#000
style TARDBP_4 fill:#4fc3f7,stroke:#333,color:#000
style SNCA fill:#4fc3f7,stroke:#333,color:#000
style PD_5 fill:#ef5350,stroke:#333,color:#000No linked papers recorded for this hypothesis yet.
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 TARDBP, TIA1, UBQLN2, CHCHD10.
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 patients with LATE neuropathological change (LATE-NC) are stratified using CSF pTDP-43 levels (upper tertile, >75th percentile) and plasma NfL (>150 pg/mL) as dual inclusion criteria and treated wi | ≥30% reduction in annualized hippocampal atrophy rate; ≥0.5 point improvement or stabilization in CDR-SB at 18 months | — no observation — | pending | 0.35 |
| IF an antisense oligonucleotide targeting TARDBP mRNA (designed to reduce TDP-43 protein expression by >50%) is administered monthly for 12 months to patients with TDP-43-positive ALS (CSF pTDP-43 >2 | ≥40% relative reduction in plasma NfL at 12 months; ≥25% slowing in ALSFRS-R progression rate | — no observation — | pending | 0.45 |