Ribavirin mitigates Alzheimer's disease model phenotypes by enhancing lysosomal function and suppressing ISR

Alzheimer's disease (AD) is a debilitating neurodegenerative disorder for which effective therapies remain an urgent unmet need. This study investigated the therapeutic potential of the synthetic nucleoside analogue ribavirin in transgenic Caenorhabditis elegans (C. elegans) models of AD. We demonstrate that ribavirin specifically reduced the paralysis rate and improved short-term non-associative learning capacity of the Aβ AD models. These functional benefits were supported by a marked reduction in Aβ aggregation in vivo and a direct inhibition of Aβ structural transition from α-helix to β-sheet in vitro. Moreover, ribavirin could stably bind to the Aβ1-42 pentamer, disrupt the existing β-sheet networks, and increase the solvent exposure of hydrophobic residues. Mechanistically, ribavirin exerted its neuroprotective effects by enhancing lysosomal activity, attenuating Aβ-induced activation of the integrated stress response (ISR) in C. elegans models. Genetic studies further revealed that the efficacy of ribavirin was functionally dependent upon AMPK signalling, suggesting critical role of AMPK pathway. Crucially, ribavirin acted selectively, as it did not broadly activate other canonical stress responses. These findings establish a strong mechanistic rationale for repurposing ribavirin as a potential neuroprotective agent targeting AD.