Frontotemporal dementia as a consequence of GRN mutations: From disease cause to models to therapies

Frontotemporal dementia (FTD) encompasses a broad, clinically and neuropathologically diverse group of neurodegenerative disorders associated with changes in personality, behaviour, and/or language due to the progressive degeneration of the frontal and temporal lobes of the brain. Mutations in several genes, including the progranulin (PGRN) encoding gene (GRN), have been found to cause FTD. PGRN is a pleiotropic factor with an important role in controlling lysosomal homeostasis, inflammatory processes, and neural function and differentiation under normal and pathological conditions. Heterozygosity for disease-causing, loss-of-function mutations in GRN reduces circulating PGRN levels, suggesting that familial FTD is related to PGRN haploinsufficiency. Since the original identification of FTD-causative mutations in the GRN gene in 2006, significant progress in both preclinical and clinical research has resulted in improved disease understanding of GRN-FTD, which have facilitated the development of several promising therapeutic approaches currently in preclinical testing and early and late stage clinical trials.