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Down syndrome (DS), or trisomy 21, is the most common chromosomal abnormality and the leading cause of intellectual disability (ID)1. Impaired neurogenesis during DS fetal development is one of the causes of intellectual disability in DS2. Human DS fetal studies show a reduction in brain weight and volume, reduced neurons, increased astrocytes3,4, and abnormal distribution of neurons in layers II and IV5,6. Additionally, the second phase of cortical development, i.e., the emergence of lamination, is both delayed and disorganized in DS7.
Neurodevelopment defects in DS have been studied mostly using mice models of DS such as Ts65Dn, Ts1Rhr, and Ts1cje8. However, these mice models were not able to fully recapitulate various phenotypes observed in DS studies due to physiological and developmental differences between mice and humans9, which led to failed clinical trials10. The invention of induced pluripotent stem cells11,12 provided an opportunity to model Down syndrome neurological impairment using cells derived directly from individuals with DS. However, earlier attempts to model DS neurodevelopmental defects using human iPSCs met with inconsistent results and could not fully explain neurodevelopmental defects observed in DS fetal brain sections13,14,15,16. For instance, a report published by Shi et al. found DS-related Alzheimer's phenotypes but reported no difference in DS neurogenesis compared to euploid controls15. Similarly, Weick et al. reported reduced synaptic activity but normal neurogenesis in DS compared to euploid controls16. However, normal neurogenesis in DS reported in these publications was not consistent with observation from DS fetal brain sections. Later, a report by Hibaoui et al. reported reduced neurogenesis in DS, which was consistent with the observation from the DS fetal brain section14. However, this report and another recent report described the reduced proliferation of DS NPCs as the cause of reduced neurogenesis in DS14,17. However, only reduced proliferation of DS NPCs could not explain increased astroglial cells and delayed emergence of lamination during DS fetal brain development.
In recently published work, a human iPSC-based DS-impaired neurogenesis model showing reduced neurogenesis was developed. This model found that impaired neurogenesis in DS is due to biphasic cell cycle defects during the neurogenic stage (the stage during which neural progenitor cells are generated from pluripotent stem cells). During the first phase in the neurogenic stage, DS NPCs exhibit reduced proliferation compared to isogenic euploid neural cells, followed by increased proliferation of DS NPCs compared to isogenic euploid cells in the late phase of the neurogenic stage18.
In this manuscript, a step-by-step detailed protocol for the differentiation of Down syndrome hiPSCs and its isogenic euploid hiPSCs into cortical neurons has been described. The overall goal of this method is to provide a detailed, step-by-step protocol for differentiating a pair of DS hiPSCs and its isogenic euploid hiPSCs into cortical neurons with a focus on modeling the neurogenesis defects associated with DS. This protocol is designed to offer a robust and reproducible system for investigating the cellular and molecular mechanisms underlying abnormalities causing DS-impaired neurogenesis.
The rationale behind the development of this protocol is to allow the differentiation of pluripotent stem cells into cortical neurons by utilizing principles of developmental neurobiology, thereby allowing the identification of phenotypes that arise due to disease/disorder. It aimed to take a minimalistic approach to neural differentiation of iPSCs by avoiding compounds like cAMP or DAPT, which may mask disease phenotypes arising due to defects in the Ca++ channel or NOTCH pathway, respectively. Similarly, the use of Ascorbic acid, BDNF, and GDNF was also avoided, which may mask other neurological disease-related phenotypes by potentiating neurogenesis.
The advantages of this technique over alternative methods lie in providing robust recapitulation of neurological phenotypes observed in DS fetal brain sections. Of note, compared to mouse models, the human iPSC-based system eliminates cross-species differences, providing a more relevant model for studying human-specific neurodevelopmental processes9 but until now has failed to recapitulate DS impaired neurogenesis observed in DS fetal stages onwards. Further, the use of isogenic pairs of hiPSCs reduces variability and enhances the reliability of observed phenotypic differences. This protocol will be of particular interest to researchers studying neurodevelopmental disorders and human neurogenesis. It is especially relevant for those seeking to model human-specific aspects of DS or those interested in developing therapeutic interventions targeting the neurogenesis defects associated with trisomy 21.