- Taubes, Alice;
- Nova, Phil;
- Zalocusky, Kelly A;
- Kosti, Idit;
- Bicak, Mesude;
- Zilberter, Misha Y;
- Hao, Yanxia;
- Yoon, Seo Yeon;
- Oskotsky, Tomiko;
- Pineda, Silvia;
- Chen, Bin;
- Jones, Emily A Aery;
- Choudhary, Krishna;
- Grone, Brian;
- Balestra, Maureen E;
- Chaudhry, Fayzan;
- Paranjpe, Ishan;
- De Freitas, Jessica;
- Koutsodendris, Nicole;
- Chen, Nuo;
- Wang, Celine;
- Chang, William;
- An, Alice;
- Glicksberg, Benjamin S;
- Sirota, Marina;
- Huang, Yadong
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.