CUTS RNA Biosensor for the Real-Time Detection of TDP-43 Loss-of-Function

Reviewer #1 (Public review):

Summary:
The authors create an elegant sensor for TDP -43 loss of function based on cryptic splicing of CFTR and UNC13A. The usefulness of this sensor primarily lies in its use in eventual high throughput screening and eventual in vivo models. The TDP-43 loss of function sensor was also used to express TDP-43 upon reduction of its levels.

Strengths:
The validation is convincing, the sensor was tested in models of TDP-43 loss of function, knockdown and models of TDP-43 mislocalization and aggregation. The sensor is susceptible to a minimal decrease of TDP-43 and can be used at the protein level unlike most of the tests currently employed,

Weaknesses:
Although the LOF sensor described in this study may be a primary readout for high-throughput screens, ALS/TDP-43 models typically employ primary readouts such as protein aggregation or mislocalization. The information in the two following points would assist users in making informed choices. 1. Testing the sensor in other cell lines 2. Establishing a correlation between the sensor's readout and the loss of function (LOF) in the physiological genes would be useful given that the LOF sensor is a hybrid structure and doesn't represent any physiological gene. It would be beneficial to determine if a minor decrease (e.g., 2%) in TDP-43 levels is physiologically significant for a subset of exons whose splicing is controlled by TDP-43.

Considering that most TDP-LOF pathologically occurs due to aggregation and or mislocalization, and in most cases the endogenous TDP-43 gene is functional but the protein becomes non-functional, the use of the loss of function sensor as a switch to produce TDP-43 and its eventual use as gene therapy would have to contend with the fact that the protein produced may also become nonfunctional. This would eventually be easy to test in one of the aggregation modes that were used to test the sensor.. However, as the authors suggest, this is a very interesting system to deliver other genetic modifiers of TDP-43 proteinopathy in a regulated fashion and timely fashion.

Reviewer #2 (Public review):

Summary:
The authors goal is to develop a more accurate system that reports TDP-43 activity as a splicing regulator. Prior to this, most methods employed western blotting or QPCR-based assays to determine whether targets of TDP-43 were up or down-regulated. The problem with that is the sensitivity. This approach uses an ectopic delivered construct containing splicing elements from CFTR and UNC13A (two known splicing targets) fused to a GFP reporter. Not only does it report TDP-43 function well, but it operates at extremely sensitive TDP-43 levels, requiring only picomolar TDP-43 knockdown for detection. This reporter should supersede the use of current TDP-43 activity assays, it's cost-effective, rapid and reliable.

Strengths:
In general, the experiments are convincing and well designed. The rigor, number of samples and statistics, and gradient of TDP-43 knockdown were all viewed as strengths. In addition, the use of multiple assays to confirm the splicing changes were viewed as complimentary (ie PCR and GFP-fluorescence) adding additional rigor. The final major strength I'll add is the very clever approach to tether TDP-43 to the loss of function cassette such that when TDP-43 is inactive it would autoregulate and induce wild-type TDP-43. This has many implications for the use of other genes, not just TDP-43, but also other protective factors that may need to be re-established upon TDP-43 loss of function.

Weaknesses:
Admittedly, one needs to initially characterize the sensor and the use of cell lines is an obvious advantage, but it begs the question of whether this will work in neurons. Additional future experiments in primary neurons will be needed. The bulk analysis of GFP-positive cells is a bit crude. As mentioned in the manuscript, flow sorting would be an easy and obvious approach to get more accurate homogenous data. This is especially relevant since the GFP signal is quite heterogeneous in the image panels, for example, Figure 1C, meaning the siRNA is not fully penetrant. Therefore, stating that 1% TDP-43 knockdown achieves the desired sensor regulation might be misleading. Flow sorting would provide a much more accurate quantification of how subtle changes in TDP-43 protein levels track with GFP fluorescence.

Some panels in the manuscript would benefit from additional clarity to make the data easier to visualize. For example, Figure 2D and 2G could be presented in a more clear manner, possibly split into additional graphs since there are too many outputs. Sup Figure 2A image panels would benefit from being labeled, its difficult to tell what antibodies or fluorophores were used. Same with Figure 4B.

Figure 3 is an important addition to this manuscript and in general is convincing showing that TDP-43 loss of function mutants can alter the sensor. However, there is still wild-type endogenous TDP-43 in these cells, and it's unclear whether the 5FL mutant is acting as a dominant negative to deplete the total TDP-43 pool, which is what the data would suggest. This could have been clarified. Additional treatment with stressors that inactivate TDP-43 could be tested in future studies.

Overall, the authors definitely achieved their goals by developing a very sensitive readout for TDP-43 function. The results are convincing, rigorous, and support their main conclusions. There are some minor weaknesses listed above, chief of which is the use of flow sorting to improve the data analysis. But regardless, this study will have an immediate impact for those who need a rapid, reliable, and sensitive assessment of TDP-43 activity, and it will be particularly impactful once this reporter can be used in isolated primary cells (ie neurons) and in vivo in animal models. Since TDP-43 loss of function is thought to be a dominant pathological mechanism in ALS/FTD and likely many other disorders, having these types of sensors is a major boost to the field and will change our ability to see sub-threshold changes in TDP-43 function that might otherwise not be possible with current approaches.

Reviewer #3 (Public review):

The DNA and RNA binding protein TDP-43 has been pathologically implicated in a number of neurodegenerative diseases including ALS, FTD, and AD. Normally residing in the nucleus, in TDP-43 proteinopathies, TDP-43 mislocalizes to the cytoplasm where it is found in cytoplasmic aggregates. It is thought that both loss of nuclear function and cytoplasmic gain of toxic function are contributors to disease pathogenesis in TDP-43 proteinopathies. Recent studies have demonstrated that depletion of nuclear TDP-43 leads to loss of its nuclear function characterized by changes in gene expression and splicing of target mRNAs. However, to date, most readouts of TDP-43 loss of function events are dependent upon PCR-based assays for single mRNA targets. Thus, reliable and robust assays for detection of global changes in TDP-43 splicing events are lacking. In this manuscript, Xie, Merjane, Bergmann and colleagues describe a biosensor that reports on TDP-43 splicing function in real time. Overall, this is a well described unique resource that would be of high interest and utility to a number of researchers. Nonetheless, a couple of points should be addressed by the authors to enhance the overall utility and applicability of this biosensor.

Author response:

Public Reviews:

Reviewer #1 (Public review):

Summary:

The authors create an elegant sensor for TDP -43 loss of function based on cryptic splicing of CFTR and UNC13A. The usefulness of this sensor primarily lies in its use in eventual high throughput screening and eventual in vivo models. The TDP-43 loss of function sensor was also used to express TDP-43 upon reduction of its levels.

Strengths:

The validation is convincing, the sensor was tested in models of TDP-43 loss of function, knockdown and models of TDP-43 mislocalization and aggregation. The sensor is susceptible to a minimal decrease of TDP-43 and can be used at the protein level unlike most of the tests currently employed.

Weaknesses:

Although the LOF sensor described in this study may be a primary readout for high-throughput screens, ALS/TDP-43 models typically employ primary readouts such as protein aggregation or mislocalization. The information in the two following points would assist users in making informed choices. 1. Testing the sensor in other cell lines 2. Establishing a correlation between the sensor's readout and the loss of function (LOF) in the physiological genes would be useful given that the LOF sensor is a hybrid structure and doesn't represent any physiological gene. It would be beneficial to determine if a minor decrease (e.g., 2%) in TDP-43 levels is physiologically significant for a subset of exons whose splicing is controlled by TDP-43.

Considering that most TDP-LOF pathologically occurs due to aggregation and or mislocalization, and in most cases the endogenous TDP-43 gene is functional but the protein becomes non-functional, the use of the loss of function sensor as a switch to produce TDP-43 and its eventual use as gene therapy would have to contend with the fact that the protein produced may also become nonfunctional. This would eventually be easy to test in one of the aggregation modes that were used to test the sensor.. However, as the authors suggest, this is a very interesting system to deliver other genetic modifiers of TDP-43 proteinopathy in a regulated fashion and timely fashion.

We thank Reviewer #1 for their detailed feedback. In response, we will investigate the function of CUTS in neuronal cells and evaluate how a modest reduction in TDP-43 levels affects the splicing of physiologically relevant TDP-43-regulated cryptic exons within these cells (eg. STMN2, UNC13A, etc…).

Reviewer #2 (Public review):

Summary:

The authors goal is to develop a more accurate system that reports TDP-43 activity as a splicing regulator. Prior to this, most methods employed western blotting or QPCR-based assays to determine whether targets of TDP-43 were up or down-regulated. The problem with that is the sensitivity. This approach uses an ectopic delivered construct containing splicing elements from CFTR and UNC13A (two known splicing targets) fused to a GFP reporter. Not only does it report TDP-43 function well, but it operates at extremely sensitive TDP-43 levels, requiring only picomolar TDP-43 knockdown for detection. This reporter should supersede the use of current TDP-43 activity assays, it's cost-effective, rapid and reliable.

Strengths:

In general, the experiments are convincing and well designed. The rigor, number of samples and statistics, and gradient of TDP-43 knockdown were all viewed as strengths. In addition, the use of multiple assays to confirm the splicing changes were viewed as complimentary (ie PCR and GFP-fluorescence) adding additional rigor. The final major strength I'll add is the very clever approach to tether TDP-43 to the loss of function cassette such that when TDP-43 is inactive it would autoregulate and induce wild-type TDP-43. This has many implications for the use of other genes, not just TDP-43, but also other protective factors that may need to be re-established upon TDP-43 loss of function.

Weaknesses:

Admittedly, one needs to initially characterize the sensor and the use of cell lines is an obvious advantage, but it begs the question of whether this will work in neurons. Additional future experiments in primary neurons will be needed. The bulk analysis of GFP-positive cells is a bit crude. As mentioned in the manuscript, flow sorting would be an easy and obvious approach to get more accurate homogenous data. This is especially relevant since the GFP signal is quite heterogeneous in the image panels, for example, Figure 1C, meaning the siRNA is not fully penetrant. Therefore, stating that 1% TDP-43 knockdown achieves the desired sensor regulation might be misleading. Flow sorting would provide a much more accurate quantification of how subtle changes in TDP-43 protein levels track with GFP fluorescence.

Some panels in the manuscript would benefit from additional clarity to make the data easier to visualize. For example, Figure 2D and 2G could be presented in a more clear manner, possibly split into additional graphs since there are too many outputs. Sup Figure 2A image panels would benefit from being labeled, its difficult to tell what antibodies or fluorophores were used. Same with Figure 4B.

Figure 3 is an important addition to this manuscript and in general is convincing showing that TDP-43 loss of function mutants can alter the sensor. However, there is still wild-type endogenous TDP-43 in these cells, and it's unclear whether the 5FL mutant is acting as a dominant negative to deplete the total TDP-43 pool, which is what the data would suggest. This could have been clarified. Additional treatment with stressors that inactivate TDP-43 could be tested in future studies.

Overall, the authors definitely achieved their goals by developing a very sensitive readout for TDP-43 function. The results are convincing, rigorous, and support their main conclusions. There are some minor weaknesses listed above, chief of which is the use of flow sorting to improve the data analysis. But regardless, this study will have an immediate impact for those who need a rapid, reliable, and sensitive assessment of TDP-43 activity, and it will be particularly impactful once this reporter can be used in isolated primary cells (ie neurons) and in vivo in animal models. Since TDP-43 loss of function is thought to be a dominant pathological mechanism in ALS/FTD and likely many other disorders, having these types of sensors is a major boost to the field and will change our ability to see sub-threshold changes in TDP-43 function that might otherwise not be possible with current approaches.

We thank Reviewer #2 for their constructive evaluation of our study. In response, we will assess CUTS in human neuronal cells, as also recommended by Reviewer #1. Additionally, we will incorporate an analysis of CUTS using flow cytometry to provide quantitative measurements of GFP signal. We agree that investigating how CUTS responds to stressors affecting TDP-43 function would be a valuable addition (eg. MG132), and we will include this data in the revisions to the study.

We also appreciate the feedback on our figures and will work to enhance their clarity, incorporating the Reviewer’s suggestions. Specifically, we will split Figure 2D and 2G into multiple plots and ensure clearer labeling of the image panels in Figures 2A and 4B.

Regarding the comment on the 5FL data, we believe this occurrence can be explained by existing literature, and we will address this directly in the discussion section of the manuscript.

Reviewer #3 (Public review):

The DNA and RNA binding protein TDP-43 has been pathologically implicated in a number of neurodegenerative diseases including ALS, FTD, and AD. Normally residing in the nucleus, in TDP-43 proteinopathies, TDP-43 mislocalizes to the cytoplasm where it is found in cytoplasmic aggregates. It is thought that both loss of nuclear function and cytoplasmic gain of toxic function are contributors to disease pathogenesis in TDP-43 proteinopathies. Recent studies have demonstrated that depletion of nuclear TDP-43 leads to loss of its nuclear function characterized by changes in gene expression and splicing of target mRNAs. However, to date, most readouts of TDP-43 loss of function events are dependent upon PCR-based assays for single mRNA targets. Thus, reliable and robust assays for detection of global changes in TDP-43 splicing events are lacking. In this manuscript, Xie, Merjane, Bergmann and colleagues describe a biosensor that reports on TDP-43 splicing function in real time. Overall, this is a well described unique resource that would be of high interest and utility to a number of researchers. Nonetheless, a couple of points should be addressed by the authors to enhance the overall utility and applicability of this biosensor.

We thank Reviewer #3 for their time and thoughtful assessment of our manuscript. We will address all their recommendations, including expanding the discussion on the CE sequences utilized in the CUTS sensor and exploring the potential utility of the CUTS sensor in alternative disease-relevant systems.