A repeat expansion mutation in the C9orf72 gene is the most common known genetic cause of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). In this study, using multiple cell-based assay systems, we reveal both increased dipeptide repeat protein (DRP) toxicity in primary neurons and in differentiated neuronal cell lines. Using flow cytometry and confocal laser scanning microscopy of cells treated with fluorescein isothiocyanate (FITC)-labeled DRPs, we confirm that poly-glycine-arginine (GR) and poly-proline-arginine (PR) DRPs entered cells more readily than poly-glycine-proline (GP) and poly-proline-alanine (PA) DRPs. Our findings suggest that the toxicity of C9-DRPs may be influenced by properties associated with differentiated and aging motor neurons. Further, our findings provide sensitive cell-based assay systems to test phenotypic rescue ability of potential interventions. Int. J. Mol. Sci. 2019, 20, 6238 2 of 20 suggest that it may act as a guanine nucleotide exchange factor for small GTPases, as it has been shown to regulate endosomal trafficking and autophagy in neurons [13]. Another hypothesis suggests RNA gain-of-function neurotoxicity, resulting from RNA binding protein-sequestering RNA foci accumulating in neurons following expression of repeat expanded, intronic, C9orf72 transcripts [14][15][16][17][18].A third suggests that dipeptide repeat proteins (DRPs) derived from RAN translation of C9HRE RNA transcripts constitute a toxic gain-of-function mutation. These DRPs: poly-glycine-arginine (GR), poly-proline-arginine (PR), poly-glycine-proline (GP), poly-proline-alanine (PA), and poly-glycine-alanine (GA) have been shown to cause toxicity as well as interfere with vital cellular processes, including RNA biogenesis, endoplasmic reticulum function, the Notch signaling pathway, and nucleocytoplasmic transport [15,[19][20][21][22][23][24][25][26]. Testing of post-mortem tissues from ALS/FTD patients has not shown a correlation between the amount or localization of C9-DRPs and neurodegenerative phenotype, which contributes to skepticism that C9-DRPs are the major contributor to C9-ALS/FTD pathogenesis [27]. However, polyGP has been detected in cerebral spinal fluid of people carrying C9HRE mutations both before and during ALS or FTD disease progression and is being explored as a biomarker of therapeutic effects in people carrying this mutation [28]. Uncovering the mechanisms of action of C9-DRPs and developing assay systems to test possible anti-DRP therapeutics remains imperative to understanding, and perhaps treating, C9ALS/FTD. Recently, multiple groups have conducted studies exploring the effects of cell-line incubation in the presence of synthesized C9-DRPs, typically between 10 and 20 repeats, and revealed signs of cytotoxicity and implicated various impaired cellular processes driving cell death [29][30][31][32][33].In this study, we developed multiple cell-based assay systems to assess changes in cellular function and health caused by exogenous treatment with C9-DRPs. Usin...