Tauopathies are age-associated neurodegenerative diseases whose mechanistic underpinnings remain elusive, partially due to lack of appropriate human models. Current human induced pluripotent stem cell (hiPSC)-derived neurons express very low levels of 4-repeat (4R)-tau isoforms that are normally expressed in adult brain. Here, we engineered new iPSC lines to express 4R-tau and 4R-tau carrying the P301S MAPT mutation when differentiated into neurons. 4R-P301S neurons display progressive Tau inclusions upon seeding with Tau fibrils and recapitulate features of tauopathy phenotypes, including shared transcriptomic signatures, autophagic body accumulation, and impaired neuronal activity. A CRISPRi screen of genes associated with Tau pathobiology identified over 500 genetic modifiers of Tau-seeding-induced Tau propagation, including retromer VPS29 and the UFMylation cascade as top modifiers. In AD brains, the UFMylation cascade is altered in neurofibrillary-tangle-bearing neurons. Inhibiting the UFMylation cascade suppressed seeding-induced Tau propagation. This model provides a powerful platform to identify novel therapeutic strategies for 4R tauopathy.

The accumulation of tau aggregates is associated with neurodegenerative diseases collectively known as tauopathies. Tau aggregates (fibrils) isolated from different tauopathies such as Alzheimer's Disease, corticobasal degeneration and progressive supranuclear palsy have distinct Cryo-EM structures with respect to their packed fibril cores. To understand the mechanisms by which tau can be sensitized to form distinct aggregate conformations, we created a panel of tau variants encoding for individual disease-associated missense mutations in full-length 0N4R tau (WT and 36 mutants). We developed a high-throughput protein purification platform for direct comparison of tau variants in biochemical assays. Structural analysis of the protease-resistant core of tau aggregates formed in vitro reveals that mutations can promote aggregate core packing distinct from that produced by WT tau. Comparing aggregate structure changes with aggregation kinetic parameters for tau mutants revealed no clear linkage between these two aggregation properties. We also found that tau mutation-dependent alterations of tau aggregate structure are not readily explained by current tau fibril structure data. This is the first study to show the broad potential of tau mutations to alter the packed core structures contained within aggregated tau and sheds new insights into the molecular mechanisms underlying the formation of tau aggregate structures that may drive their associated pathology in disease.