Career
At the start of his career in 1980, Tanzi worked as a research technologist for James Gusella at Massachusetts General Hospital. There, he assisted in localizing the Huntington's disease gene; their findings were published in Nature in 1983. This was the first study to localize a disease gene purely based on genetic linkage with genomic variants.
In 1987, based on his doctoral studies at Harvard Medical School, he was the lead author of seven papers published in Science and Nature between 1987 and 1988, describing the initial cloning, mapping, and characterization of the gene encoding the amyloid beta-protein precursor (APP), the first reported Alzheimer’s disease gene. Two other groups reported the cloning of APP at that time. In 1991-1992, Tanzi and Wilma Wasco, discovered the two APP family members, APLP1 and APLP2.
In 1995, Tanzi collaborated with Drs. Peter Hyslop and Jerry Schellenberg to discover the two other EO-FAD genes, presenilin 1 and 2 (PSEN1 and PSEN2). He has published many key studies characterizing the role of the EO-FAD genes in health and disease. All three genes remain among the most highly studied drug targets in the field of AD aimed at reducing beta-amyloid deposition.
In 1993, Tanzi first discovered the gene for the neurodegenerative disease, Wilson's disease; his findings were published in Nature Genetics. In that same year, he contributed to the discovery of the first familial amyotrophic lateral sclerosis (ALS) gene, SOD1, by providing the key genetic and physical mapping data for chromosome 21 used to find the gene defect.
As the leader of the Cure Alzheimer's Fund's Alzheimer's Genome Project, Tanzi several other AD genes, most notably, CD33, reported in 2008 with Lars Bertram, in the American Journal of Human Genetics. In that study, Tanzi reported the first family-based genome-wide association study of AD, which most notably to the identification of the first innate immune microglial AD gene, CD33, which encodes a cell-surface receptor on monocytes and microglia. In 2013, Tanzi and Dr. Ana Griciuc first reported in Neuron that increased expression of CD33 in microglial cells in AD brain and showed that a protective CD33 gene variant was associated with reductions in CD33 expression and Abeta levels in AD brain. Importantly, they showed CD33 inhibits microglial phagocytosis and clearance of Abeta and induces pro-inflammatory cytokine release leading to neuroinflammation. They also elucidated the molecular mechanism by which sialic acid binds to CD33 to induce neuroinflammation.
In a follow-up study published in Neuron in 2019, Tanzi and Griciuc compared the neuroinflammatory effects of the CD33 gene to another AD-associated innate immune gene, TREM2. Knockout of CD33 in AD mice attenuated amyloid-beta pathology and improved cognition while knockout of TREM2 led to opposite effects. They then showed that TREM2 functions downstream of CD33 and that crosstalk between CD33 and TREM2 involves the neuroinflammation-related IL-1beta/IL-1RN axis cluster. CD33 has now emerged as the primary target for novel drug discovery programs aimed at curbing neuroinflammation, at over a dozen pharmaceutical and biotech companies. Other AD genes Tanzi has discovered include ADAM10, UBQLN1, IDE, A2M, ITGB3, and ATXN1. In 2020, he used multiple whole genome sequencing datasets for the first time to identify sex-specific genetic risk factors for AD (ZBTB7C, GRID1, RIOK3, MCPH1) as well as several novel Alzheimer's disease-associated rare variants in loci related to synaptic function and neuronal development (FNBP1L, SEL1L, LINC00298, PRKCH, C15ORF41, C2CD3, KIF2A, APC, LHX9, NALCN, CTNNA2, SYTL3, CLSTN2, DTNB, DLG2). In 2022, Tanzi and colleagues whole-genome sequencing to discover two new genes associated with Alzheimer's disease: DTNB and DLG2.
Over the past three decades, Tanzi has also contributed to the development of novel therapeutics for AD. In 2000, Tanzi and the late Dr. Steven Wagner discovered a class of Alzheimer’s drugs that they termed "gamma secretase modulators (GSM)". GSM's reverse the Abeta42:Abeta40 ratio and thereby prevent amyloid plaques. Notably, they do not inhibit gamma-secretase. Tanzi and Wagner have published several papers on these compounds. Their GSM is now slated for AD clinical trials in 2026 with Acta Pharmaceuticals.
In 2014, Tanzi, and his ex-trainees, Doo Yeon Kim and Se Hoon Choi, were the first to use human stem cells to create three-dimensional cell culture organoids of AD, dubbed by The New York Times as “Alzheimer's-in-a-Dish”. This model was the first to recapitulate all three key AD pathological hallmarks in vitro, and, most importantly, resolved a decades-long debate as to whether Abeta pathology causes the formation of neurofibrillary tangles. Using this system, they were the first to definitively show that amyloid plaques directly cause neurofibrillary tangles, something that could not be shown in mouse models of early-onset familial AD gene mutations in APP and the presenilins (owing to differences in mouse and human isoforms of the Tau protein, the principal component of neurofibrillary tangles). This 3-D cell culture model/human brain organoid system of AD has also made drug screening considerably faster and more cost-effective. Most recently, using a modified 3-D human stem cell-derived neural-glial cell AD model, Tanzi has helped develop therapies targeted against neuroinflammation in AD.
In another set of groundbreaking studies, Tanzi, working with the late Dr. Robert Moir, investigated whether amyloid beta (Abeta) may play a normal role in the brain. They demonstrated Abeta to be a potent antimicrobial peptide (AMP) in the brain's innate immune system. In 2018, they showed Herpes viruses trigger plaque pathology in AD. Tanzi and Moir refer to this as the “antimicrobial protection hypothesis” of AD. In 2025, Tanzi and Will Eimer reported in Nature Neuroscience that Alzheimer’s-related tau-tangles protect against herpes virus infection in the brain. Based on this, Tanzi has proposed that Alzheimer’s pathology - amyloid plaques, tau-tangles, and neuroinflammation - evolved as an orchestrated host defense system for the brain
In other studies, Tanzi and his trainee, Zhongcong Xie, published several seminal papers providing the first evidence that the widely used general inhalant anesthetic, isoflurane, induces Abeta generation, apoptosis, and neurodegeneration in the mouse brain and post-operative CSF of patients. This has gradually led to a dramatic reduction in the clinical use of isoflurane in the operating room, especially in elderly patients and Alzheimer's patients.
Music
In musical pursuits, Tanzi has served as a studio keyboard player for Joe Perry and Aerosmith. He also co-wrote the tribute song to Alzheimer's patients called "Remember Me", performed by singer Chris Mann. He plays keyboards on the albums: Aerosmith: Music from Another Dimension by Aerosmith and Joe Perry's Switzerland Manifesto and Switzerland Manifesto MKII He has also performed with the legendary opera star, Renee Fleming.
