Experimental and real-world evidence supporting the computational repurposing of bumetanide for APOE4-related Alzheimer's disease

Nat Aging. 2021 Oct;1(10):932-947. doi: 10.1038/s43587-021-00122-7. Epub 2021 Oct 11.

Abstract

The evident genetic, pathological, and clinical heterogeneity of Alzheimer's disease (AD) poses challenges for traditional drug development. We conducted a computational drug repurposing screen for drugs to treat apolipoprotein (apo) E4-related AD. We first established apoE-genotype-dependent transcriptomic signatures of AD by analyzing publicly-available human brain database. We then queried these signatures against the Connectivity Map database containing transcriptomic perturbations of >1300 drugs to identify those that best reverse apoE-genotype-specific AD signatures. Bumetanide was identified as a top drug for apoE4 AD. Bumetanide treatment of apoE4 mice without or with Aβ accumulation rescued electrophysiological, pathological, or cognitive deficits. Single-nucleus RNA-sequencing revealed transcriptomic reversal of AD signatures in specific cell types in these mice, a finding confirmed in apoE4-iPSC-derived neurons. In humans, bumetanide exposure was associated with a significantly lower AD prevalence in individuals over the age of 65 in two electronic health record databases, suggesting effectiveness of bumetanide in preventing AD.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Alzheimer Disease* / drug therapy
  • Amyloid beta-Peptides / metabolism
  • Animals
  • Apolipoprotein E4 / genetics
  • Apolipoproteins E / genetics
  • Bumetanide / pharmacology
  • Drug Repositioning
  • Humans
  • Mice
  • Mice, Transgenic

Substances

  • Apolipoprotein E4
  • Bumetanide
  • Amyloid beta-Peptides
  • Apolipoproteins E