For three decades, Alzheimer's drug development has chased the wrong protein. Billions of dollars and hundreds of failed trials later, researchers at the University of New Mexico have identified OTULIN—an enzyme previously known only for regulating inflammation—as a master switch that controls whether tau protein is produced in the first place. When they disabled OTULIN in neurons, tau vanished entirely, and the cells remained healthy.
The discovery inverts conventional thinking. Rather than trying to clear tau tangles after they form, OTULIN inhibition could stop tau from being made at all. A small-molecule inhibitor called UC495 has already shown it can reduce pathological tau in Alzheimer's patient neurons without killing the cells. If the approach works in humans, it could address not just Alzheimer's but more than 20 related tauopathies—from frontotemporal dementia to chronic traumatic encephalopathy—that collectively affect over 55 million people worldwide.