PTI-125 is a novel compound demonstrating a promising new approach to treating
IntroductionAlzheimer's disease (AD) represents one of the greatest health care burdens, affecting 35 million persons worldwide and an estimated 115 million persons by 2050 (Wimo and Prince, 2010). AD is a devastating dementia that first presents as progressive memory loss and later can include neuropsychiatric symptoms. Diagnosis is confirmed at autopsy by amyloid deposits and neurofibrillary tangles (NFTs) containing the microtubuleassociated protein tau. This neuropathology is estimated to precede symptoms by 10 years (Trojanowski et al., 2010). Current AD treatment is limited to acetylcholinesterase inhibitors, with mild and short-lived cognitive enhancement, and memantine, an NMDAR antagonist that may delay some later stage symptoms.Amyloid- (A), in particular A 42 , is commonly recognized as the principal causative agent in AD, though its mechanism is debated. Cognitive impairment and the magnitude of synaptic deficit in the AD brain are more highly correlated with soluble A than with the abundance of amyloid plaques, suggesting that soluble A inflicts synaptic impairment (Naslund et al., 2000). Robust evidence demonstrates that soluble A elicits a toxic signaling cascade by the ␣7-nicotinic acetylcholine receptor (␣7nAChR), leading to impaired synaptic activities, intraneuronal A 42 aggregates, and cognitive deficits (Liu et al., 2001;Pettit et al., 2001;Chen et al., 2006;Dziewczapolski et al., 2009;Wang et al., 2009). This aberrant signaling activates the kinases ERK2 and JNK1, which phosphorylate tau, leading to the formation of NFTs .A 42 binds ␣7nAChR with femtomolar affinity (Wang et al., 2000a,b); therefore, to prevent A 42 -induced ␣7nAChR toxic signaling, anti-A therapies must either compete with this extremely high-affinity interaction or essentially eliminate all A 42 . After the initial femtomolar interaction, numerous A 42 molecules bind the receptor, eventually causing internalization and amyloid plaques. These additional A 42 molecules appear to bind at a lower (picomolar) affinity (Wang et al., 2009); hence, it is possible to remove sufficient amounts of A 42 to prevent plaque formation without any impact on the toxic signaling by the highaffinity A 42 -␣7nAChR interaction. Furthermore, pharmacotherapies aiming to prevent A 42 binding to ␣7nAChRs by directly targeting the receptor could, unfortunately, alter ␣7nAChR sensitivity or cell surface expression, especially if they surpass subpicomolar affinity. Alternative strategies to reduce A 42 signaling by ␣7nAChR are needed.We show here that A 42 toxic signaling requires the recruitment of the scaffolding protein filamin A (FLNA), which otherwise has very low levels of association with ␣7nAChR. Filamins are large cytoplasmic proteins best known for crosslinking actin but increasingly implicated in cell signaling (Stossel et al., 2001 A-induced FLNA recruitment to ␣7nAChRs and to reduce A 42 signaling. PTI-125 decreases A 42 affinity for ␣7nAC...