Integrative Genomic and Functional Analyses Reveal NINL as a Modulator of Tau Aggregation.

Introduction: Proteostasis dysfunction is a hallmark of frontotemporal dementia (FTD) and Alzheimer's disease (AD), yet the genetic and molecular pathways that disrupt protein homeostasis remain poorly understood. Methods: We integrated human genetics, transcriptomics, and functional studies to identify proteostasis network components involved in tauopathy. Results: We identified 18 proteostasis network genes harboring 75 rare, damaging variants enriched in FTD and/or AD. These genes, spanning multiple proteostasis pathways, were differentially expressed in MAPT mutant neurons and dysregulated in FTD and AD brains. NINL, which encodes Nlp, emerged as the only gene consistently upregulated across all datasets. NINL overexpression reduced tau seeding and enhanced lysosomal proteolytic activity, whereas two FTD-enriched NINL frameshift variants impaired Nlp expression and abolished these protective effects. Discussion: Our findings identify a set of proteostasis genes with genetic and transcriptional links to neurodegeneration and reveal NINL as a novel regulator of tau aggregation, potentially upregulated as an adaptive response to proteotoxic stress.