Resolve: blood MMP-9/TIMP-1 ratio predicts early BBB tight-junction proteolysis
Bounty tier: $500K biomarker validation. This challenge requires longitudinal prediction and mechanistic linkage to BBB proteolysis. Falsifiable prediction: baseline plasma MMP-9/TIMP-1 ratio in MCI or at-risk cohorts will predict 18-month increase in dynamic-contrast MRI BBB permeability with AUC >=0.75 and remain significant after age/APOE/p-tau181 adjustment. In parallel, serum from high-ratio subjects should reduce claudin-5/occludin abundance by >=25% in human BBB organ-on-chip assays, and MMP-9 inhibition should rescue >=50% of tight-junction loss.