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D'Acunzo P, Argyrousi EK, Ungania JM, Kim Y, DeRosa S, Pawlik M, Goulbourne CN, Arancio O, Levy E. Mitovesicles secreted into the extracellular space of brains with mitochondrial dysfunction impair synaptic plasticity. Mol Neurodegener 2024; 19:34. [PMID: 38616258 PMCID: PMC11017499 DOI: 10.1186/s13024-024-00721-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/18/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Hypometabolism tied to mitochondrial dysfunction occurs in the aging brain and in neurodegenerative disorders, including in Alzheimer's disease, in Down syndrome, and in mouse models of these conditions. We have previously shown that mitovesicles, small extracellular vesicles (EVs) of mitochondrial origin, are altered in content and abundance in multiple brain conditions characterized by mitochondrial dysfunction. However, given their recent discovery, it is yet to be explored what mitovesicles regulate and modify, both under physiological conditions and in the diseased brain. In this study, we investigated the effects of mitovesicles on synaptic function, and the molecular players involved. METHODS Hippocampal slices from wild-type mice were perfused with the three known types of EVs, mitovesicles, microvesicles, or exosomes, isolated from the brain of a mouse model of Down syndrome or of a diploid control and long-term potentiation (LTP) recorded. The role of the monoamine oxidases type B (MAO-B) and type A (MAO-A) in mitovesicle-driven LTP impairments was addressed by treatment of mitovesicles with the irreversible MAO inhibitors pargyline and clorgiline prior to perfusion of the hippocampal slices. RESULTS Mitovesicles from the brain of the Down syndrome model reduced LTP within minutes of mitovesicle addition. Mitovesicles isolated from control brains did not trigger electrophysiological effects, nor did other types of brain EVs (microvesicles and exosomes) from any genotype tested. Depleting mitovesicles of their MAO-B, but not MAO-A, activity eliminated their ability to alter LTP. CONCLUSIONS Mitovesicle impairment of LTP is a previously undescribed paracrine-like mechanism by which EVs modulate synaptic activity, demonstrating that mitovesicles are active participants in the propagation of cellular and functional homeostatic changes in the context of neurodegenerative disorders.
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Affiliation(s)
- Pasquale D'Acunzo
- Center for Dementia Research, Nathan S. Kline Institute for Psychiatric Research, 10962, Orangeburg, NY, USA
- Department of Psychiatry, New York University Grossman School of Medicine, 10016, New York, NY, USA
| | - Elentina K Argyrousi
- Department of Pathology and Cell Biology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, 10027, New York, NY, USA
- Department of Medicine, Columbia University, 10027, New York, NY, USA
| | - Jonathan M Ungania
- Center for Dementia Research, Nathan S. Kline Institute for Psychiatric Research, 10962, Orangeburg, NY, USA
| | - Yohan Kim
- Center for Dementia Research, Nathan S. Kline Institute for Psychiatric Research, 10962, Orangeburg, NY, USA
- Department of Psychiatry, New York University Grossman School of Medicine, 10016, New York, NY, USA
| | - Steven DeRosa
- Center for Dementia Research, Nathan S. Kline Institute for Psychiatric Research, 10962, Orangeburg, NY, USA
| | - Monika Pawlik
- Center for Dementia Research, Nathan S. Kline Institute for Psychiatric Research, 10962, Orangeburg, NY, USA
| | - Chris N Goulbourne
- Center for Dementia Research, Nathan S. Kline Institute for Psychiatric Research, 10962, Orangeburg, NY, USA
| | - Ottavio Arancio
- Department of Pathology and Cell Biology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, 10027, New York, NY, USA
- Department of Medicine, Columbia University, 10027, New York, NY, USA
| | - Efrat Levy
- Center for Dementia Research, Nathan S. Kline Institute for Psychiatric Research, 10962, Orangeburg, NY, USA.
- Department of Psychiatry, New York University Grossman School of Medicine, 10016, New York, NY, USA.
- Department of Biochemistry & Molecular Pharmacology, New York University Grossman School of Medicine, 10027, New York, NY, USA.
- NYU Neuroscience Institute, New York University Grossman School of Medicine, 10016, New York, NY, USA.
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Wu K, Xu C, Qiu G, Guo Q, Chen C, Liu W, Liu J, Liu K, Zhu F. Association of lower liver function with cognitive impairment in the Shenzhen ageing-related disorder cohort in China. Front Aging Neurosci 2022; 14:1012219. [PMID: 36313027 PMCID: PMC9609155 DOI: 10.3389/fnagi.2022.1012219] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background Accumulating evidence suggests that alterations in liver function may play an important role in the pathogenesis of Alzheimer's disease (AD). However, it remains unclear whether there is any relationship between lower liver function and cognitive impairment among the elderly. Methods From 2017 to 2018, we recruited 7,201 older people (over 60 years old) from 51 community health centers in the Luohu District of Shenzhen City. According to the Mini-Mental State Examination (MMSE) score and education level, participants were divided into a cognitive impairment group (n = 372) and a normal cognitive function group (n = 6,829). Nonparametric test, chi-square tests, and binary logistic regression were used to analyze the data. Results Cognitive impairment group exhibits older age, more female sex, lower education level, and lower levels of albumin and triglyceride. Additionally, the aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio was mainly distributed in the range of 1.17 to 1.3 in the cognitive impairment group, and 0.85 to 1.00 in the normal cognitive function group (χ2 = 10.02, p = 0.04). Binary logistic regression showed that cognitive impairment was significantly associated with age (OR = 0.934, 95%CI: 0.886-0.985, p = 0.017), female sex (OR = 2.255, 95%CI: 1.761-2.888, p < 0.001), lower education level (less than senior high school) (OR = 11.509, 95%CI: 9.064-14.613, p < 0.001), and lower albumin (OR = 1.023, 95%CI: 1.004-1.043, p = 0.011). Conclusion Except for age, female sex, and lower education level, lower level of albumin and elevated AST to ALT ratio correlate with cognitive impairment. Whether lower liver function plays a role in AD needs to be further studied.
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Affiliation(s)
- Kaiyu Wu
- Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin, China,Cognitive Impairment Ward of Neurology Department, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen, Guangdong, China
| | - Chunyan Xu
- Cognitive Impairment Ward of Neurology Department, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen, Guangdong, China
| | - Guozhen Qiu
- Cognitive Impairment Ward of Neurology Department, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen, Guangdong, China
| | - Qiwen Guo
- Cognitive Impairment Ward of Neurology Department, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen, Guangdong, China
| | - Chunchun Chen
- Cognitive Impairment Ward of Neurology Department, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen, Guangdong, China
| | - Wei Liu
- Key Laboratory of Modern Toxicology of Shenzhen, Shenzhen Medical Key Subject of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Jianjun Liu
- Key Laboratory of Modern Toxicology of Shenzhen, Shenzhen Medical Key Subject of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Kangding Liu
- Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Feiqi Zhu
- Cognitive Impairment Ward of Neurology Department, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen, Guangdong, China,*Correspondence: Feiqi Zhu,
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3
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Yang Y, Tapias V, Acosta D, Xu H, Chen H, Bhawal R, Anderson ET, Ivanova E, Lin H, Sagdullaev BT, Chen J, Klein WL, Viola KL, Gandy S, Haroutunian V, Beal MF, Eliezer D, Zhang S, Gibson GE. Altered succinylation of mitochondrial proteins, APP and tau in Alzheimer's disease. Nat Commun 2022; 13:159. [PMID: 35013160 PMCID: PMC8748865 DOI: 10.1038/s41467-021-27572-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 11/25/2021] [Indexed: 02/07/2023] Open
Abstract
Abnormalities in brain glucose metabolism and accumulation of abnormal protein deposits called plaques and tangles are neuropathological hallmarks of Alzheimer's disease (AD), but their relationship to disease pathogenesis and to each other remains unclear. Here we show that succinylation, a metabolism-associated post-translational protein modification (PTM), provides a potential link between abnormal metabolism and AD pathology. We quantified the lysine succinylomes and proteomes from brains of individuals with AD, and healthy controls. In AD, succinylation of multiple mitochondrial proteins declined, and succinylation of small number of cytosolic proteins increased. The largest increases occurred at critical sites of amyloid precursor protein (APP) and microtubule-associated tau. We show that in vitro, succinylation of APP disrupted its normal proteolytic processing thereby promoting Aβ accumulation and plaque formation and that succinylation of tau promoted its aggregation to tangles and impaired microtubule assembly. In transgenic mouse models of AD, elevated succinylation associated with soluble and insoluble APP derivatives and tau. These findings indicate that a metabolism-linked PTM may be associated with AD.
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Affiliation(s)
- Yun Yang
- Integrated Medicine Research Center for Neurological Rehabilitation, College of Medicine, Jiaxing University, 314001, Jiaxing, China
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, 10065, USA
- Burke Neurological Institute, White Plains, NY, 10605, USA
| | - Victor Tapias
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Diana Acosta
- Department of Biochemistry, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Hui Xu
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, 10065, USA
- Burke Neurological Institute, White Plains, NY, 10605, USA
| | - Huanlian Chen
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, 10065, USA
- Burke Neurological Institute, White Plains, NY, 10605, USA
| | - Ruchika Bhawal
- Proteomics and Metabolomics Facility, Institute of Biotechnology, Cornell University, Ithaca, NY, 14853, USA
| | - Elizabeth T Anderson
- Proteomics and Metabolomics Facility, Institute of Biotechnology, Cornell University, Ithaca, NY, 14853, USA
| | - Elena Ivanova
- Imaging Core, Burke Neurological Institute, White Plains, NY, 10605, USA
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, 10591, USA
| | - Hening Lin
- Department of Chemistry and Chemical Biology, Cornell University, Ithaca, NY, 14853, USA
- Howard Hughes Medical Institute, Department of Chemistry and Chemical Biology, Cornell University, Ithaca, NY, 14853, USA
| | - Botir T Sagdullaev
- Ophthalmology and Neuroscience, Weill Cornell Medicine, New York, NY, 10065, USA
- Laboratory for Visual Plasticity and Repair, Burke Neurological Institute, White Plains, NY, 10605, USA
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, 10591, USA
| | - Jianer Chen
- Integrated Medicine Research Center for Neurological Rehabilitation, College of Medicine, Jiaxing University, 314001, Jiaxing, China
| | - William L Klein
- Department of Neurobiology, Northwestern University, Evanston, IL, 60208, USA
| | - Kirsten L Viola
- Department of Neurobiology, Northwestern University, Evanston, IL, 60208, USA
| | - Sam Gandy
- Department of Neurology and Mount Sinai Center for Cognitive Health and NFL Neurological Center, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Research and Development Service and Division of Neurology, James J Peters VA Medical Center, 130 West Kingsbridge Rd, Bronx, NY, 10468, USA
- James J Peters Veterans Medical Center, Bronx, NY, 10468, USA
- Department of Psychiatry Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Vahram Haroutunian
- Department of Psychiatry Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- JJ Peters VA Medical Center MIRECC, Bronx, NY, 10468, USA
- Mount Sinai NIH Neurobiobank, New York, NY, 10029, USA
| | - M Flint Beal
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, 10065, USA
| | - David Eliezer
- Department of Biochemistry, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Sheng Zhang
- Proteomics and Metabolomics Facility, Institute of Biotechnology, Cornell University, Ithaca, NY, 14853, USA
| | - Gary E Gibson
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, 10065, USA.
- Burke Neurological Institute, White Plains, NY, 10605, USA.
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Anderson CC, Marentette JO, Prutton KM, Rauniyar AK, Reisz JA, D'Alessandro A, Maclean KN, Saba LM, Roede JR. Trisomy 21 results in modest impacts on mitochondrial function and central carbon metabolism. Free Radic Biol Med 2021; 172:201-212. [PMID: 34129926 PMCID: PMC8355208 DOI: 10.1016/j.freeradbiomed.2021.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 12/18/2022]
Abstract
Down syndrome (DS) is the most common genetic cause of intellectual disability. Mechanistically, oxidative stress and mitochondrial dysfunction are reported to be etiological factors for many of the DS-related comorbidities and have previously been reported in a number of in vitro and in vivo models of DS. The purpose of this study was to test for the presence of mitochondrial dysfunction in fibroblast cells obtained via skin biopsy from individuals with DS, and to assess the impact of trisomy 21 on central carbon metabolism. Using extracellular flux assays in matched dermal fibroblasts from euploid and DS individuals, we found that basal mitochondrial dysfunction is quite mild. Stressing the cells with a cocktail of mitochondrial stressors revealed a significant mitochondrial deficit in DS cells compared to euploid controls. Evaluation of extracellular acidification rate did not reveal a baseline abnormality in glycolysis; however, metabolomic assessments utilizing isotopically labeled glucose and glutamine revealed altered central carbon metabolism in DS cells. Specifically, we observed greater glucose dependency, uptake and flux into the oxidative phase of the pentose phosphate pathway in DS fibroblasts. Furthermore, using induced pluripotent stem cells (iPSC) we found that mitochondrial function in DS iPSCs was similar to the previously published studies employing fetal cells. Together, these data indicate that aberrant central carbon metabolism is a candidate mechanism for stress-related mitochondrial dysfunction in DS.
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Affiliation(s)
- Colin C Anderson
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, USA
| | - John O Marentette
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, USA
| | - Kendra M Prutton
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, USA; Linda Crnic Institute for Down Syndrome, School of Medicine, University of Colorado, Aurora, CO, USA
| | - Abhishek K Rauniyar
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, USA
| | - Julie A Reisz
- Department of Biochemistry and Molecular Genetics, USA
| | | | - Kenneth N Maclean
- Department of Pediatrics, USA; Linda Crnic Institute for Down Syndrome, School of Medicine, University of Colorado, Aurora, CO, USA
| | - Laura M Saba
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, USA
| | - James R Roede
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, USA; Linda Crnic Institute for Down Syndrome, School of Medicine, University of Colorado, Aurora, CO, USA.
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5
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Petersen ME, Rafii MS, Zhang F, Hall J, Julovich D, Ances BM, Schupf N, Krinsky-McHale SJ, Mapstone M, Silverman W, Lott I, Klunk W, Head E, Christian B, Foroud T, Lai F, Rosas HD, Zaman S, Wang MC, Tycko B, Lee JH, Handen B, Hartley S, Fortea J, O’Bryant S. Plasma Total-Tau and Neurofilament Light Chain as Diagnostic Biomarkers of Alzheimer's Disease Dementia and Mild Cognitive Impairment in Adults with Down Syndrome. J Alzheimers Dis 2021; 79:671-681. [PMID: 33337378 PMCID: PMC8273927 DOI: 10.3233/jad-201167] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The need for diagnostic biomarkers of cognitive decline is particularly important among aging adults with Down syndrome (DS). Growing empirical support has identified the utility of plasma derived biomarkers among neurotypical adults with mild cognitive impairment (MCI) and Alzheimer's disease (AD); however, the application of such biomarkers has been limited among the DS population. OBJECTIVE This study aimed to investigate the cross-sectional diagnostic performance of plasma neurofilament light chain (Nf-L) and total-tau, individually and in combination among a cohort of DS adults. METHODS Plasma samples were analyzed from n = 305 (n = 225 cognitively stable (CS); n = 44 MCI-DS; n = 36 DS-AD) participants enrolled in the Alzheimer's Biomarker Consortium -Down Syndrome. RESULTS In distinguishing DS-AD participants from CS, Nf-L alone produced an AUC of 90%, total-tau alone reached 74%, and combined reached an AUC of 86%. When age and gender were included, AUC increased to 93%. Higher values of Nf-L, total-tau, and age were all shown to be associated with increased risk for DS-AD. When distinguishing MCI-DS participants from CS, Nf-L alone produced an AUC of 65%, while total-tau alone reached 56%. A combined model with Nf-L, total-tau, age, and gender produced an AUC of 87%. Both higher values in age and total-tau were found to increase risk for MCI-DS; Nf-L levels were not associated with increased risk for MCI-DS. CONCLUSION Advanced assay techniques make total-tau and particularly Nf-L useful biomarkers of both AD pathology and clinical status in DS and have the potential to serve as outcome measures in clinical trials for future disease-modifying drugs.
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Affiliation(s)
- Melissa E. Petersen
- University of North Texas Health Science Center, Department of Family Medicine and Institute for Translational Research, 3500 Camp Bowie Blvd, Fort Worth, Texas, 76107, USA
| | - Michael S. Rafii
- Alzheimer’s Therapeutic Research Institute (ATRI), Keck School of Medicine, University of Southern California, 9860 Mesa Rim Road, San Diego, California, 92121, USA
| | - Fan Zhang
- University of North Texas Health Science Center, Department of Family Medicine and Institute for Translational Research, 3500 Camp Bowie Blvd, Fort Worth, Texas, 76107, USA
| | - James Hall
- University of North Texas Health Science Center, Institute for Translational Research and Department of Pharmacology and Neuroscience, 3500 Camp Bowie Blvd, Fort Worth, Texas, 76107, USA
| | - David Julovich
- University of North Texas Health Science Center, Institute for Translational Research and Department of Pharmacology and Neuroscience, 3500 Camp Bowie Blvd, Fort Worth, Texas, 76107, USA
| | - Beau M. Ances
- Washington University School of Medicine in St. Louis, Center for Advanced Medicine Neuroscience, 4921 Parkview Place, St. Louis, Missouri, 63110, USA
| | - Nicole Schupf
- Columbia University Irving Medical Center, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain/G.H. Sergievsky Center, 630 W 168th St, New York, New York, 10032, USA
- Columbia University, Mailman School of Public Health, Department of Epidemiology, 722 West 168th Street, New York, New York, 10032, USA
- Columbia University Irving Medical Center, Department of Neurology, Neurological Institute 710 West 168 Street, New York, New York, 10032, USA
- Columbia University Medical Center, Department of Psychiatry, 1051 Riverside Drive, New York, New York, 10032, USA
| | - Sharon J. Krinsky-McHale
- NYS Institute for Basic Research in Developmental Disabilities, Department of Psychology, 1050 Forest Hill Road, Staten Island, New York, 10314, USA
| | - Mark Mapstone
- University of California, Irvine, Department of Neurology, 839 Health Sciences Road, Irvine, California, 92697, USA
| | - Wayne Silverman
- University of California, Irvine, School of Medicine, Department of Pediatrics, 101 The City Drive, Mail Code:4482, Orange, California, 92668, USA
| | - Ira Lott
- University of California, Irvine, School of Medicine, Department of Pediatrics, 101 The City Drive, Mail Code:4482, Orange, California, 92668, USA
| | - William Klunk
- University of Pittsburgh, Department of Psychiatry, 3811 O’Hara St., Pittsburgh, Pennsylvania, 15213, USA
| | - Elizabeth Head
- University of California, Irvine, Department of Pathology, 1261 Gillespie Neuroscience Facility, Irvine, California, 92697, USA
| | - Brad Christian
- University of Wisconsin Madison, Department of Medical Physics and Psychiatry, 1500 Highland Ave, Madison, Wisconsin, 53705, USA
| | - Tatiana Foroud
- Indiana University School of Medicine, Department of Medical & Molecular Genetics, 410 W. 10 Street, Indianapolis, IN. 46202. USA
| | - Florence Lai
- Massachusetts General Hospital, Department of Neurology, Harvard Medical School, 149 13 Street, Room 10128, Charlestown, Massachusetts, 02129, USA
| | - H. Diana Rosas
- Massachusetts General Hospital, Departments of Neurology and Radiology, Harvard Medical School, 149 13 Street Room 10126, Charlestown, Massachusetts, 02129, USA
| | - Shahid Zaman
- University of Cambridge, School of Clinical Medicine, Department of Psychiatry, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn Hospital, Cambridge, CB21 5EF, UK
| | - Mei-Cheng Wang
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205
| | - Benjamin Tycko
- Columbia University Irving Medical Center, Department of Pathology and Cell Biology, 630 West 168 Street, New York, NY 10032
| | - Joseph H. Lee
- Columbia University Irving Medical Center, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain/G.H. Sergievsky Center, 630 W 168th St, New York, New York, 10032, USA
| | - Benjamin Handen
- University of Pittsburgh, Department of Psychiatry, 3811 O’Hara St., Pittsburgh, Pennsylvania, 15213, USA
| | - Sigan Hartley
- University of Wisconsin, School of Human Ecology and Waisman Center, 1500 Highland Ave, Madison, WI 53705
| | - Juan Fortea
- Barcelona Down Medical Center. Fundació Catalana de Síndrome de Down. Barcelona, Spain
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sid O’Bryant
- University of North Texas Health Science Center, Institute for Translational Research and Department of Pharmacology and Neuroscience, 3500 Camp Bowie Blvd, Fort Worth, Texas, 76107, USA
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6
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Rafii MS, Ances BM, Schupf N, Krinsky‐McHale SJ, Mapstone M, Silverman W, Lott I, Klunk W, Head E, Christian B, Lai F, Rosas HD, Zaman S, Petersen ME, Strydom A, Fortea J, Handen B, O'Bryant S. The AT(N) framework for Alzheimer's disease in adults with Down syndrome. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12062. [PMID: 33134477 PMCID: PMC7588820 DOI: 10.1002/dad2.12062] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/04/2020] [Indexed: 12/15/2022]
Abstract
The National Institute on Aging in conjunction with the Alzheimer's Association (NIA-AA) recently proposed a biological framework for defining the Alzheimer's disease (AD) continuum. This new framework is based upon the key AD biomarkers (amyloid, tau, neurodegeneration, AT[N]) instead of clinical symptoms and represents the latest understanding that the pathological processes underlying AD begin decades before the manifestation of symptoms. By using these same biomarkers, individuals with Down syndrome (DS), who are genetically predisposed to developing AD, can also be placed more precisely along the AD continuum. The A/T(N) framework is therefore thought to provide an objective manner by which to select and enrich samples for clinical trials. This new framework is highly flexible and allows the addition of newly confirmed AD biomarkers into the existing AT(N) groups. As biomarkers for other pathological processes are validated, they can also be added to the AT(N) classification scheme, which will allow for better characterization and staging of AD in DS. These biological classifications can then be merged with clinical staging for an examination of factors that impact the biological and clinical progression of the disease. Here, we leverage previously published guidelines for the AT(N) framework to generate such a plan for AD among adults with DS.
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Affiliation(s)
- Michael S. Rafii
- Alzheimer's Therapeutic Research Institute (ATRI)Keck School of MedicineUniversity of Southern CaliforniaSan DiegoCaliforniaUSA
| | - Beau M. Ances
- Center for Advanced Medicine NeuroscienceWashington University School of Medicine in St. LouisSt. LouisMissouriUSA
| | - Nicole Schupf
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain/G.H. Sergievsky CenterColumbia University Irving Medical CenterNew YorkNew YorkUSA
- Department of EpidemiologyMailman School of Public HealthColumbia UniversityNew YorkNew YorkUSA
- Department of NeurologyNeurological Institute of New York, Columbia University Irving Medical CenterNew YorkNew YorkUSA
- Department of PsychiatryColumbia University Medical CenterNew YorkNew YorkUSA
| | - Sharon J. Krinsky‐McHale
- Department of PsychologyNYS Institute for Basic Research in Developmental DisabilitiesStaten IslandNew YorkUSA
| | - Mark Mapstone
- Department of NeurologyUniversity of CaliforniaIrvineCaliforniaUSA
| | - Wayne Silverman
- Department of PediatricsSchool of MedicineUniversity of CaliforniaIrvineCaliforniaUSA
| | - Ira Lott
- Department of PediatricsSchool of MedicineUniversity of CaliforniaIrvineCaliforniaUSA
| | - William Klunk
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Elizabeth Head
- Department of PathologyGillespie Neuroscience Research Facility, University of CaliforniaIrvineCaliforniaUSA
| | - Brad Christian
- Department of Medical Physics and PsychiatryUniversity of Wisconsin MadisonMadisonWisconsinUSA
| | - Florence Lai
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolCharlestownMassachusettsUSA
| | - H. Diana Rosas
- Departments of Neurology and RadiologyMassachusetts General HospitalHarvard Medical SchoolCharlestownMassachusettsUSA
| | - Shahid Zaman
- Department of PsychiatrySchool of Clinical MedicineUniversity of CambridgeCambridgeUK
- Cambridgeshire and Peterborough NHS Foundation TrustFulbourn HospitalCambridgeUK
| | - Melissa E. Petersen
- Department of Family Medicine and Institute for Translational ResearchUniversity of North Texas Health Science CenterFort WorthTexasUSA
| | - Andre Strydom
- Department of Forensic and Neurodevelopmental SciencesInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Juan Fortea
- Sant Pau Memory UnitDepartment of NeurologyHospital de la Santa Creu i Sant PauBiomedical Research Institute Sant PauUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - Benjamin Handen
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Sid O'Bryant
- Institute for Translational Research and Department of Pharmacology and NeuroscienceUniversity of North Texas Health Science CenterFort WorthTexasUSA
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7
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Abstract
Individuals with Down syndrome (DS) are at high risk for developing Alzheimer's disease (AD) pathology and this has provided significant insights into our understanding of the genetic basis of AD. The present review summarizes recent clinical, neuropathologic, imaging, and fluid biomarker studies of AD in DS (DSAD), highlighting the striking similarities, as well as some notable differences, between DSAD and the more common late-onset form of AD (LOAD) in the general population, as well as the much rarer, autosomal-dominant form of AD (ADAD). There has been significant progress in our understanding of the natural history of AD biomarkers in DS and their relationship to clinically meaningful changes. Additional work is needed to clearly define the continuum of AD that has been described in the general population, such as the preclinical, prodromal, and dementia stages of AD. Multiple therapeutic approaches, including those targeting not only β-amyloid but also tau and the amyloid precursor protein itself, require consideration. Recent developments in the field are presented within the context of such efforts to conduct clinical trials to treat and potentially prevent AD in DS.
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Affiliation(s)
- Michael S Rafii
- Alzheimer's Therapeutic Research Institute (ATRI), Keck School of Medicine, University of Southern California, 9860 Mesa Rim Road, San Diego, CA, 92121, USA.
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