Description
The abstract identifies abnormalities in IGF signaling in AD patients and models but explicitly states the underlying molecular mechanisms remain unclear. Understanding these mechanisms is critical for developing targeted IGF-based therapeutics.
Gap type: open_question Source paper: Insulin-Like Growth Factor Signaling in Alzheimer’s Disease: Pathophysiology and Therapeutic Strategies. (2025, Molecular neurobiology, PMID:39240280)
Resolution criteria
Resolution requires: (1) IGF receptor signaling array (RTK phosphorylation profiling) in AD patient brains vs age-matched controls (n>=20), mapping which IGF pathway branches (IRS-1, PI3K/AKT, MAPK/ERK) are specifically dysregulated; (2) iPSC-derived neurons from AD patients with IGF signaling mutations or variants, testing whether restoring IGF signaling (IGF-1, IGF-2, or IGFBP modulators) reduces tau/A-beta pathology by >=40%; (3) human CSF or plasma IGF biomarker levels correlated with longitudinal cognitive decline (n>=100, >=2-year follow-up), establishing biomarker validity for patient stratification. Descriptive signaling abnormality without mechanistic dissection in patient-derived models is insufficient.