Genetic insights into drug targets for sporadic Creutzfeldt-Jakob disease: Integrative multi-omics analysis

Objective: Sporadic Creutzfeldt-Jakob disease (sCJD) is a fatal rapidly progressive neurodegenerative disorder with no effective therapeutic interventions. We aimed to identify potential genetically-supported drug targets for sCJD by integrating multi-omics data. Methods: Multi-omics-wide association studies, Mendelian randomization, and colocalization analyses were employed to explore potential therapeutic targets using expression, single-cell expression, DNA methylation, and protein quantitative trait locus data from blood and brain tissues. Outcome data was from a case-control genomewide association study, which included 4110 sCJD patients and 13,569 controls. Further investigations encompassed druggability, potential side effects, and associated biological pathways of the identified targets. Results: Integrative multi-omics analysis identified 23 potential therapeutic targets for sCJD, with five targets ( STX6, XYLT2, PDIA4, FUCA2, KIAA1614 ) having higher levels of evidence. One target ( XYLT2 ) shows promise for repurposing, two targets ( XYLT2 , PDIA4 ) are druggable, and three ( STX6 , KIAA1614 , and FUCA2 ) targets represent potential future breakthrough points. The expression level of STX6 and XYLT2 in neurons and oligodendrocytes was closely associated with an increased risk of sCJD. Brain regions with high expression of STX6 or causal links to sCJD were often those areas commonly affected by sCJD. Conclusions: Our study identified five potential therapeutic targets for sCJD. Further investigations are warranted to elucidate the mechanisms underlying the new targets for developing disease therapies or initiate clinical trials.