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AWARD NUMBER: W81XWH-15-1-0112 TITLE: Molecular Mechanisms Underlying the Epileptogenesis and Seizure Progression in Tuberous Sclerosis Complex 1 Deficient Mouse Models PRINCIPAL INVESTIGATOR: James E. Goldman CONTRACTING ORGANIZATION: Columbia University New York, NY 10032 REPORT DATE: October 2016 TYPE OF REPORT: Annual PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 DISTRIBUTION STATEMENT: Approved for Public Release; Distribution Unlimited The views, opinions and/or findings contained in this report are those of the author(s) and should not be construed as an official Department of the Army position, policy or decision unless so designated by other documentation.

REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing this collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE October 2016 2. REPORT TYPE 3. DATES COVERED 9/15/15 9/14/16 Annual 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Molecular Mechanisms Underlying the Epileptogenesis and Seizure 5b. GRANT NUMBER Progression in Tuberous Sclerosis Complex 1 Deficient Mouse Models W81XWH-15-1-0112 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) James E. Goldman 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER E-Mail: jeg5@cumc.columbia.edu 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER Columbia University New York, NY 10032 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR S ACRONYM(S) U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 11. SPONSOR/MONITOR S REPORT NUMBER(S) 12. DISTRIBUTION / AVAILABILITY STATEMENT Approved for Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT We seek to understand four basic questions related to epileptogenesis: 1) What is the role of mtor dysregulation in epileptogenesis in the developing brain? 2) What are the molecular mechanisms downstream of mtor hyperactivation that trigger epileptogenesis in developing brains? 3) What are the long-term pharmacological treatments to prevent the development or progression of seizures? 4) What are biomarkers for epileptogenesis and the prognostic biomarkers for disease progression? We have established a neuroglial tuberous sclerosis complex 1(TSC1)-deficient mouse model in which spontaneous seizures begin at 2.5 months of the age and progress into 7-8months. This time course allows the analysis of molecular changes before and after the onset of spontaneous electrographic and behavioral seizures and provide reliable biomarkers for epileptogenesis and the progression of epilepsy. We have also developed a neuronal-specific mouse model, deleting Tsc1 by driving cre from the CAMK2 promoter. We propose gene expression profiling, electrophysiological, biochemical, immunohistochemical and behavioral studies. 15. SUBJECT TERMS Nothing listed 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT a. REPORT b. ABSTRACT c. THIS PAGE 18. NUMBER OF PAGES 7 19a. NAME OF RESPONSIBLE PERSON USAMRMC 19b. TELEPHONE NUMBER (include area code) Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std. Z39.18

Table of Contents Page 1. Introduction.1 2. Key Research Accomplishments...1 3. Impact.......4 4. Changes/Problems......4 5. Participants.....4

INTRODUCTION Tuberous Sclerosis Complex (TSC) is a multisystem genetic disorder caused by germline mutations in the TSC1 or TSC2 genes, which form a regulatory complex responsible for limiting the activity of an important intracellular regulator of cell growth and metabolism known as mammalian target of rapamycin complex 1 (mtorc1). The pathological hallmark of TSC brains are cortical tubers, characterized by disorganized cortical lamination, aberrant dendritic arbors and axonal projections, astrocyte gliosis and abnormal cell morphology (ie, dysplastic and heterotopic neurons and giant cells). mtor hyperactivity contributes to developmental brain malformations associated with seizures and cognitive and psychiatric deficits. In our studies, we want to understand the molecular changes that occur in neurons and astrocytes as a result of a deletion of TSC1, using a mouse model. These findings will help us understand molecular mechanisms underlying cellular changes in TSC and underlying epilepsy. Hopefully, a knowledge of these mechanisms will aid in a rational development of therapies. KEYWORDS Tuberous Sclerosis, Epilepsy, Neurons, Astrocytes, EEG, mtor, mrna translation, ACCOMPLISHMENTS The major goals of the project: Specific Aim 1: To Determine the effects of TSC1 deletion in the Tsc1 CamkII-Cre CKO and Tsc1 mgfap-cre CKO mice mice on epileptogenesis and progress of seizures. Inactivation of the Tsc1 or Tsc2 gene in different subtypes of brain cells, including neurons, glia or progenitor cells, all cause spontaneous seizures in animal models, suggesting that both neuronal and astroglial cells are active elements in the epileptic brain. In this aim, we hypothesize that TSC1 deletion in astrocytes and a subset of late-onset forebrain pyramidal neurons underlie the changes in preclinical epileptic EEG activities which progress into clinical behavioral seizures. To test this hypothesis, we will monitor spontaneous electrographic and behavioral seizures by continuous video/eeg recording in free-moving mice. We will perform Video-EEG tracking of epilepsy and epileptogenesis in both neuronal specific Tsc1 CamkII-Cre CKO and neuroglia Tsc1 mgfap-cre CKO mouse models. Specific Aim 2. To analyze the molecular changes downstream of TSC deficiency in astrocytes and neurons that are related to the initiation and progression of seizures. The initiation of the first seizure and the progression of the disease after the onset of seizures are two distinct processes. The identification of molecular changes for these two processes may provide biomarkers for epilepsy prevention and disease modification. We hypothesize that mtor controls the translation of a specific repertoire of neuronal and astrocytic genes, which cooperatively regulate the initiation and progression of epilepsy. Translational ribosomal profiling will be used to investigate gene expression in the both Tsc1 CamkII-Cre CKO and Tsc1 mgfap- Cre CKO mice, before and after the occurrence of spontaneous seizures. The gene expression signatures in these mice will be compared with previous report of transcriptional changes in response to chemical induced epilepsies and find common developmental changes in pathways responsible for epileptogenesis and for the progression of epilepsy. Specific Aim 3. Determine the effects of mtor inhibitor on the initiation and progression of seizures and on the molecular changes that accompany the initiation and progression of seizures. Preclinical studies demonstrate that mtor inhibitors can effectively treat seizures in mice with established epilepsy related to mtor pathway hyperactivation. However, the downstream mechanisms responsible for these effects have not been proven. In this aim, we will test the efficacy of potential treatments with mtorc1 inhibitors and identify molecule players that respond to or do not respond to mtorc1 inhibitors. We will examine the effects of rapamycin on the molecular changes associated with the EEG/seizure activity, focusing on those genes and pathways we have found to be significantly altered in studies of Specific Aim 2. 1

What we have accomplished: 1. We have developed, verified, and reproduced the critical molecular assays required for this work. New Technology for Highly-Sensitive Ribosome Profiling in Tissue In addition to conducting initial ribosome profiling and RNA-Seq experiments in our TSC mouse model, we have also worked to significantly improve the ribosome profiling technique itself during the first funding period. Specifically, we have developed a new ribosome profiling technique called ligation-free ribosome profiling that exhibits reduced bias and ~100-fold higher sensitivity than the originally reported method (Fig. 1). We recently reported this new technique and its application to cell type-specific translational profiling in the brain in Genome Biology (Hornstein et al, 2016). Ligation-free ribosome profiling is particularly useful for tissue-based studies and cell type-specific profiling experiments where material is limiting, and we have already deployed this new method for the ongoing studies described here. Fig. 1. Comparison of Ligation-Free Ribosome Profiling to Conventional Methods. A) Schematic of the steps involved in conventional ribosome profiling and ligation-free ribosome profiling. B) The power spectrum of 5 mapping positions from CDS reads resulting from ligation-free ribosome profiling method shows clear three-base periodicity that is characteristic of ribosome profiling libraries and reflects the single-codon translocation of the ribosome. C) Gene body distribution of mapped reads from ligation-free ribosome profiling show strong preference for coding-sequence, an additional property inherent to ribosome profiling libraries. D) Comparison of the number of uniquely mapped reads per gene in libraries generated with footprints from mouseforebrains prepared with conventional ribosome profiling strategy and the ligation-free method; the Pearson correlation r = 0.97 indicates a concordance between the two methods. E) Saturation analysis showing the number of unique genes detected following downsampling of ligation-free ribosome profiling and conventional ribosome profiling. F) Saturation analysis showing the number of unique footprints detected following downsampling of ligation-free ribosome profiling and conventional ribosome profiling. Ligation-Free Ribosome Profiling in CamK2a-Cre Tsc1 fl/fl Mice following Rapamycin Treatment One of the major goals of the proposed studies is to assess the alterations in protein synthesis regulation that occur in TSC in response to rapamycin treatment. We reasoned that the phenotypic effects of mutations in Tsc1 and the response to rapamycin treatment would be most significant in neurons. Therefore, we crossed Tsc1 fl/fl mice with CamK2a-Cre mice to generate offspring with Tsc1 deleted in CamK2a-expressing, excitatory neurons. We then conducted ribosome profiling and RNA-Seq on brain tissue isolated from animals both with and without rapamycin treatment. 2

In analyzing the results, we first sought to validate our approach and the efficacy of our rapamycin treatment. It is well-established that specific inhibition of mtorc1 results in sharp translational downregulation of a set of ribosomal proteins and translation factors through the 4EBP-EIF4E signaling axis. This interaction is facilitated by 5 -terminal oligopyrimidine (5 -TOP) tracts, which are CT-rich motifs common to the 5 -UTRs of target mrnas. We recently reported that translational control of these genes in the murine brain using ribosome profiling and a potent, competitive mtor inhibitor (Hornstein et al, 2016). However, rapamycin is significantly less potent and allosteric. We computed genome-wide translation efficiencies for the treated and untreated animals and ranked all genes based on their translation efficiency fold-change. Using gene set enrichment analysis (GSEA), we found that genes containing the TOP-motif are significantly enriched (p adj < 0.00001) among the genes that are translationally downregulated by rapamycin treatment (Fig. 2A). Hence, we concluded that the rapamycin treatment and our measurements were successful. We next sought to determine whether there are cell typespecific alterations in translation efficiency in response to rapamycin treatment. Our initial hypothesis is that these would be largely restricted to neurons, since the Tsc1 deletion occurs only in Camk2A-expressing cells. Figs. 2B-C show GSEA for translation efficiency fold-change for neuron-specific and oligodendrocyte-specific genes, respectively. Surprisingly, while there are some neuronspecific genes that are translationally downregulated by rapamycin, the effects are much more global and dramatic among genes specific to myelinating oligodendrocytes (p adj < 0.00001). These results are quite exciting and interesting, but further studies will be required to a) confirm this outcome by the addition of more replicates and b) determine whether there is an actual non-cell autonomous effect on oligodendrocyte phenotype. Fig. 2. Gene set enrichment analysis against genes ranked by rapamycin-induced translation efficiency fold-change in CamK2a-cre Tsc1fl/fl mice for A) TOP-motif containing genes (known mtor targets), B) neuron-specific genes, and C) myelinating oligodendrocyte-specific genes. 3

2. We have bred many of the mice required for the molecular studies and frozen brains for molecular analysis. These mice have had the TSC1 gene deleted from excitatory neurons in the cortex. They include appropriate controls as well as mice treated with rapamycin, an mtor inhibitor that allows the mice to survive without seizures. Sample ID Genotype Treatment Mouse ID Age at collection TGS-001 GT78.1_R1 TGS-002 Untreated GT78.1_R2 TGS-003 Control GT78.1_NA TGS-004 TSC1CKO;Rpl22flox/flox GT76_R3 (Knockout) TGS-005 GT75_R1 TGS-006 Rapamycin GT77.2_R2 TGS-007 treated GT78.1_R3 TGS-008 GT78_R3- TGS-009 #19_R1 TGS-010 Untreated #20_R4 TGS-011 Control #22_R5 TGS-012 GT77_L4 TGS-013 Rpl22flox/flox:CamKCre+ GT75_R2 TGS-014 (Control) GT75_L2 TGS-015 Rapamycin GT77.1_R5 treated TGS-016 GT77_R5 During the next reporting period we will begin to analyze the molecular changes in these brains, as described in the grant application. IMPACT Nothing to report CHANGES/PROBLEMS Nothing to report PRODUCTS Nothing to report PARTICIPANTS Individuals who have worked on the project: No change. Change in other support: Nothing to report. Other organizations: Nothing to report 4