Composite
43%
Novelty
55%
Feasibility
40%
Impact
55%
Mechanistic
55%
Druggability
50%
Safety
40%
Confidence
48%

Mechanistic description

Cathepsin D Replacement to Overcome Lysosomal Protease Deficiency

Evidence for (5)

  • Cathepsin D deficiency causes severe neurodegeneration with lysosomal storage accumulation

  • Cathepsin D expression and activity are reduced in aged brain and AD temporal lobe

  • Lysosomal pH becomes less acidic in aging neurons, impairing cathepsin activation

  • Cystamine/cysteamine increases cathepsin D activity and reduces aggregation in NCL models

  • Cathepsin D is major aspartic protease responsible for degrading protein aggregates in lysosomes

Evidence against (6)

  • Cathepsin D knockout mice paradoxically have enhanced Aβ deposition due to compensatory protease upregulation

  • Cathepsin D is required for α-synuclein fibril formation

  • Cathepsin D release from lysosomes triggers apoptosis

  • Cathepsin D processes neurotrophins (BDNF, NGF) - disruption may impair signaling

  • AAV delivery to aged neurons inefficient due to impaired trafficking - defeats strategy

  • No CNS enzyme replacement therapy exists for any lysosomal protease