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Lozupone M, Dibello V, Sardone R, Castellana F, Zupo R, Lampignano L, Bortone I, Daniele A, Bellomo A, Solfrizzi V, Panza F. The Impact of Apolipoprotein E ( APOE) Epigenetics on Aging and Sporadic Alzheimer's Disease. BIOLOGY 2023; 12:1529. [PMID: 38132357 PMCID: PMC10740847 DOI: 10.3390/biology12121529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Abstract
Sporadic Alzheimer's disease (AD) derives from an interplay among environmental factors and genetic variants, while epigenetic modifications have been expected to affect the onset and progression of its complex etiopathology. Carriers of one copy of the apolipoprotein E gene (APOE) ε4 allele have a 4-fold increased AD risk, while APOE ε4/ε4-carriers have a 12-fold increased risk of developing AD in comparison with the APOE ε3-carriers. The main longevity factor is the homozygous APOE ε3/ε3 genotype. In the present narrative review article, we summarized and described the role of APOE epigenetics in aging and AD pathophysiology. It is not fully understood how APOE variants may increase or decrease AD risk, but this gene may affect tau- and amyloid-mediated neurodegeneration directly or indirectly, also by affecting lipid metabolism and inflammation. For sporadic AD, epigenetic regulatory mechanisms may control and influence APOE expression in response to external insults. Diet, a major environmental factor, has been significantly associated with physical exercise, cognitive function, and the methylation level of several cytosine-phosphate-guanine (CpG) dinucleotide sites of APOE.
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Affiliation(s)
- Madia Lozupone
- Department of Translational Biomedicine and Neuroscience (DiBrain), University of Bari Aldo Moro, 70121 Bari, Italy;
| | - Vittorio Dibello
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands;
| | - Rodolfo Sardone
- Local Healthcare Authority of Taranto, 74121 Taranto, Italy;
| | - Fabio Castellana
- Department of Interdisciplinary Medicine, Clinica Medica e Geriatria “Cesare Frugoni”, University of Bari Aldo Moro, 70121 Bari, Italy; (F.C.); (R.Z.); (V.S.)
| | - Roberta Zupo
- Department of Interdisciplinary Medicine, Clinica Medica e Geriatria “Cesare Frugoni”, University of Bari Aldo Moro, 70121 Bari, Italy; (F.C.); (R.Z.); (V.S.)
| | - Luisa Lampignano
- Local Healthcare Authority of Bari, ASL Bari, 70132 Bari, Italy;
| | - Ilaria Bortone
- Department of Translational Biomedicine and Neuroscience (DiBrain), University of Bari Aldo Moro, 70121 Bari, Italy;
| | - Antonio Daniele
- Department of Neuroscience, Catholic University of Sacred Heart, 00168 Rome, Italy;
- Neurology Unit, IRCCS Fondazione Policlinico Universitario A. Gemelli, 00168 Rome, Italy
| | - Antonello Bellomo
- Psychiatric Unit, Department of Clinical & Experimental Medicine, University of Foggia, 71122 Foggia, Italy;
| | - Vincenzo Solfrizzi
- Department of Interdisciplinary Medicine, Clinica Medica e Geriatria “Cesare Frugoni”, University of Bari Aldo Moro, 70121 Bari, Italy; (F.C.); (R.Z.); (V.S.)
| | - Francesco Panza
- Department of Interdisciplinary Medicine, Clinica Medica e Geriatria “Cesare Frugoni”, University of Bari Aldo Moro, 70121 Bari, Italy; (F.C.); (R.Z.); (V.S.)
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Vecchio FL, Bisceglia P, Imbimbo BP, Lozupone M, Latino RR, Resta E, Leone M, Solfrizzi V, Greco A, Daniele A, Watling M, Panza F, Seripa D. Are apolipoprotein E fragments a promising new therapeutic target for Alzheimer’s disease? Ther Adv Chronic Dis 2022; 13:20406223221081605. [PMID: 35321401 PMCID: PMC8935560 DOI: 10.1177/20406223221081605] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/28/2022] [Indexed: 11/17/2022] Open
Abstract
Human apolipoprotein E (ApoE) is a 299-amino acid secreted glycoprotein that binds cholesterol and phospholipids. ApoE exists as three common isoforms (ApoE2, ApoE3, and ApoE4) and heterozygous carriers of the ε4 allele of the gene encoding ApoE (APOE) have a fourfold greater risk of developing Alzheimer’s disease (AD). The enzymes thrombin, cathepsin D, α-chymotrypsin-like serine protease, and high-temperature requirement serine protease A1 are responsible for ApoE proteolytic processing resulting in bioactive C-terminal-truncated fragments that vary depending on ApoE isoforms, brain region, aging, and neural injury. The objectives of the present narrative review were to describe ApoE processing, discussing current hypotheses about the potential role of various ApoE fragments in AD pathophysiology, and reviewing the current development status of different anti-ApoE drugs. The exact mechanism by which APOE gene variants increase/decrease AD risk and the role of ApoE fragments in the deposition are not fully understood, but APOE is known to directly affect tau-mediated neurodegeneration. ApoE fragments co-localize with neurofibrillary tangles and amyloid β (Aβ) plaques, and may cause neurodegeneration. Among anti-ApoE approaches, a fascinating strategy may be to therapeutically overexpress ApoE2 in APOE ε4/ε4 carriers through vector administration or liposomal delivery systems. Another approach involves reducing ApoE4 expression by intracerebroventricular antisense oligonucleotides that significantly decreased Aβ pathology in transgenic mice. Differences in the proteolytic processing of distinct ApoE isoforms and the use of ApoE fragments as mimetic peptides in AD treatment are also under investigation. Treatment with peptides that mimic the structural and biological properties of native ApoE may reduce Aβ deposition, tau hyperphosphorylation, and glial activation in mouse models of Aβ pathology. Alternative strategies involve the use of ApoE4 structure correctors, passive immunization to target a certain form of ApoE, conversion of the ApoE4 aminoacid sequence into that of ApoE3 or ApoE2, and inhibition of the ApoE-Aβ interaction.
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Affiliation(s)
- Filomena Lo Vecchio
- Research Laboratory, Complex Structure of Geriatrics, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia 71013, Italy
| | - Paola Bisceglia
- Research Laboratory, Complex Structure of Geriatrics, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | | | - Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Raffaela Rita Latino
- Complex Structure of Neurology, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Emanuela Resta
- Translational Medicine and Management of Health Systems, University of Foggia, Foggia, Italy
| | - Maurizio Leone
- Complex Structure of Neurology, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Vincenzo Solfrizzi
- ‘Cesare Frugoni’ Internal and Geriatric Medicine and Memory Unit, University of Bari ‘Aldo Moro’, Bari, Italy
| | - Antonio Greco
- Department of Neuroscience, Catholic University of the Sacred Heart, Rome, Italy; Neurology Unit, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
- Research Laboratory, Complex Structure of Geriatrics, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | | | - Mark Watling
- CNS & Pain Department, TranScrip Ltd, Reading, UK
| | - Francesco Panza
- Research Laboratory, Complex Structure of Geriatrics, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
- Population Health Unit, Healthy Aging Phenotypes Research Unit, ‘Salus in Apulia Study’, National Institute of Gastroenterology ‘Saverio de Bellis’, Research Hospital, Castellana Grotte, Bari 70013, Italy
| | - Davide Seripa
- Research Laboratory, Complex Structure of Geriatrics, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
- Hematology and Stem Cell Transplant Unit, ‘Vito Fazzi’ Hospital, Lecce, Italy
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Apolipoprotein E ϵ4 allele and neuropsychiatric symptoms among older adults in Central Africa (EPIDEMCA study). Int Psychogeriatr 2021; 33:295-306. [PMID: 33715647 DOI: 10.1017/s1041610220003993] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To evaluate the association between neuropsychiatric symptoms and apolipoprotein E (APOE) ϵ4 allele among older people in Central African Republic (CAR) and the Republic of Congo (ROC). DESIGN Multicenter population-based study following a two-phase design. SETTING From 2011 to 2012, rural and urban areas of CAR and ROC. PARTICIPANTS People aged 65 and over. MEASUREMENTS Following screening using the Community Screening Interview for Dementia, participants with low cognitive scores (CSI-D ≤ 24.5) underwent clinical assessment. Dementia diagnosis followed the DSM-IV criteria and Peterson's criteria were considered for Mild Cognitive Impairment (MCI). Neuropsychiatric symptoms were evaluated through the brief version of the Neuropsychiatric Inventory (NPI-Q). Blood samples were taken from all consenting participants before APOE genotyping was performed by polymerase chain reaction (PCR). Logistic regression models were used to evaluate the association between the APOE ϵ4 allele and neuropsychiatric symptoms. RESULTS Overall, 322 participants had complete information on both neuropsychiatric symptoms and APOE status. Median age was 75.0 years and 81.1% were female. Neuropsychiatric symptoms were reported by 192 participants (59.8%) and at least 1 APOE ϵ4 allele was present in 135 (41.9%). APOE ϵ4 allele was not significantly associated with neuropsychiatric symptoms but showed a trend toward a protective effect in some models. CONCLUSION This study is the first one investigating the association between APOE ϵ4 and neuropsychiatric symptoms among older people in sub-Saharan Africa (SSA). Preliminary findings indicate that the APOE ϵ4 allele was not associated with neuropsychiatric symptoms. Further research seems, however, needed to investigate the protective trend found in this study.
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Paroni G, Bisceglia P, Seripa D. Understanding the Amyloid Hypothesis in Alzheimer's Disease. J Alzheimers Dis 2020; 68:493-510. [PMID: 30883346 DOI: 10.3233/jad-180802] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The amyloid hypothesis (AH) is still the most accepted model to explain the pathogenesis of inherited Alzheimer's disease (IAD). However, despite the neuropathological overlapping with the non-inherited form (NIAD), AH waver in explaining NIAD. Thus, 30 years after its first statement several questions are still open, mainly regarding the role of amyloid plaques (AP) and apolipoprotein E (APOE). Accordingly, a pathogenetic model including the role of AP and APOE unifying IAD and NIAD pathogenesis is still missing. In the present understanding of the AH, we suggested that amyloid-β (Aβ) peptides production and AP formation is a physiological aging process resulting from a systemic age-related decrease in the efficiency of the proteins catabolism/clearance machinery. In this pathogenetic model Aβ peptides act as neurotoxic molecules, but only above a critical concentration [Aβ]c. A threshold mechanism triggers IAD/NIAD onset only when [Aβ]≥[Aβ]c. In this process, APOE modifies [Aβ]c threshold in an isoform-specific way. Consequently, all factors influencing Aβ anabolism, such as amyloid beta precursor protein (APP), presenilin 1 (PSEN1), and presenilin 2 (PSEN2) gene mutations, and/or Aβ catabolism/clearance could contribute to exceed the threshold [Aβ]c, being characteristic of each individual. In this model, AP formation does not depend on [Aβ]c. The present interpretation of the AH, unifying the pathogenetic theories for IAD and NIAD, will explain why AP and APOE4 may be observed in healthy aging and why they are not the cause of AD. It is clear that further studies are needed to confirm our pathogenetic model. Nevertheless, our suggestion may be useful to better understand the pathogenesis of AD.
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Affiliation(s)
- Giulia Paroni
- Research Laboratory, Complex Structure of Geriatrics, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Paola Bisceglia
- Research Laboratory, Complex Structure of Geriatrics, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Davide Seripa
- Research Laboratory, Complex Structure of Geriatrics, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
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Bajic VP, Essack M, Zivkovic L, Stewart A, Zafirovic S, Bajic VB, Gojobori T, Isenovic E, Spremo-Potparevic B. The X Files: "The Mystery of X Chromosome Instability in Alzheimer's Disease". Front Genet 2020; 10:1368. [PMID: 32047510 PMCID: PMC6997486 DOI: 10.3389/fgene.2019.01368] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 12/13/2019] [Indexed: 12/13/2022] Open
Abstract
Alzheimer's disease (AD) is a neurodegenerative disease that affects millions of individuals worldwide and can occur relatively early or later in life. It is well known that genetic components, such as the amyloid precursor protein gene on chromosome 21, are fundamental in early-onset AD (EOAD). To date, however, only the apolipoprotein E4 (ApoE4) gene has been proved to be a genetic risk factor for late-onset AD (LOAD). In recent years, despite the hypothesis that many additional unidentified genes are likely to play a role in AD development, it is surprising that additional gene polymorphisms associated with LOAD have failed to come to light. In this review, we examine the role of X chromosome epigenetics and, based upon GWAS studies, the PCDHX11 gene. Furthermore, we explore other genetic risk factors of AD that involve X-chromosome epigenetics.
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Affiliation(s)
- Vladan P Bajic
- Laboratory for Radiobiology and Molecular Genetics, Vinca Institute of Nuclear Sciences, University of Belgrade, Belgrade, Serbia
| | - Magbubah Essack
- Computational Bioscience Research Center (CBRC), Computer, Electrical and Mathematical Sciences and Engineering (CEMSE) Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia
| | - Lada Zivkovic
- Department of Physiology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Alan Stewart
- School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | - Sonja Zafirovic
- Laboratory for Radiobiology and Molecular Genetics, Vinca Institute of Nuclear Sciences, University of Belgrade, Belgrade, Serbia
| | - Vladimir B Bajic
- Computational Bioscience Research Center (CBRC), Computer, Electrical and Mathematical Sciences and Engineering (CEMSE) Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia
| | - Takashi Gojobori
- Computational Bioscience Research Center (CBRC), Computer, Electrical and Mathematical Sciences and Engineering (CEMSE) Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia.,Biological and Environmental Sciences and Engineering Division (BESE), King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia
| | - Esma Isenovic
- Laboratory for Radiobiology and Molecular Genetics, Vinca Institute of Nuclear Sciences, University of Belgrade, Belgrade, Serbia
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Gong L, Xu R, Liu D, Lan L, Zhang B, Zhang C. The Specific Impact of Apolipoprotein E Epsilon 2 on Cognition and Brain Function in Cognitively Normal Elders and Mild Cognitive Impairment Patients. Front Aging Neurosci 2020; 11:374. [PMID: 32226373 PMCID: PMC7081769 DOI: 10.3389/fnagi.2019.00374] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 12/19/2019] [Indexed: 12/17/2022] Open
Abstract
Variants in the apolipoprotein E (APOE) gene play an important role in the development of Alzheimer’s disease (AD). Specifically, the APOE ε4 allele is an established genetic risk factor for AD, while the APOE ε2 allele is a protective factor against AD. However, the mechanism underlying this impact of APOE genotype on the pathogenesis of AD remain unclear. This study sought to investigate the influence of APOE genotype on cognition and neuroimaging features in cognitively normal (CN) elderly individuals and patients with mild cognitive impairment (MCI). A total of 177 participants were selected from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database, including 101 MCI patients and 76 CN individuals. A 2 × 3 (consisting of two groups and three APOE genotypes) analysis of covariance was carried out to measure the influences of diagnosis and APOE genotype on cognition and brain features, assessed based on global functional connectivity density (gFCD) and hippocampal volume. In addition, a mediation analysis was carried out to investigate the indirect influence of neuroimaging features on the relationship between APOE genotype and cognitive performance in the MCI group. This analysis revealed that APOE genotype had an influence on brain function in the bilateral precentral gyrus, right thalamus, and posterior cingulate cortex (PCC). In addition, an interactive influence between diagnosis and APOE genotype was found on general cognition, immediate memory, executive function, hippocampal volume, and gFCD in the right dorsolateral prefrontal cortex and medial prefrontal cortex (MPFC). Finally, this mediation analysis revealed that hippocampal volume and gFCD in the thalamus may mediate the relationship between APOE genotype and cognitive performance in the MCI group. Taken together, our findings provide novel insights into the neural mechanisms underlying the genetically guided pathogenic mechanisms of AD.
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Affiliation(s)
- Liang Gong
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, China
| | - Ronghua Xu
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, China
| | - Duan Liu
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, China
| | - Lin Lan
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, China
| | - Bei Zhang
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, China
| | - Chuantao Zhang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Han F, Xu H, Shen JX, Pan C, Yu ZH, Chen JJ, Zhu XL, Cai YF, Lu YP. RhoA/Rock2/Limk1/cofilin1 pathway is involved in attenuation of neuronal dendritic spine loss by paeonol in the frontal cortex of D-galactose and aluminum-induced Alzheimer’s disease-like rat model. Acta Neurobiol Exp (Wars) 2020. [DOI: 10.21307/ane-2020-021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Meta-Analysis of the Relationship between the APOE Gene and the Onset of Parkinson's Disease Dementia. PARKINSONS DISEASE 2018; 2018:9497147. [PMID: 30405900 PMCID: PMC6204165 DOI: 10.1155/2018/9497147] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 08/17/2018] [Accepted: 08/30/2018] [Indexed: 12/18/2022]
Abstract
Purpose To clarify the relationship between certain genotypes or alleles of the APOE gene and the onset risk of Parkinson's disease dementia (PDD). Methods The PubMed, Cochrane, Embase, CBM, CNKI, and Wanfang databases were searched to identify all case-control studies and cohort studies published before October 30, 2017, that investigated the association between the APOE gene and the onset of PDD. Manual information retrieval was also performed. All studies that met the quality requirements were included in a meta-analysis performed using RevMan 5.3 software. Results The meta-analysis included 17 studies, with a total of 820 patients in the PDD group and 1,922 in the non-PDD group. The influence of the APOE gene on PDD onset was analyzed from three aspects: five genotypes vs. ε3/3, ε2+/ε4+ vs. ε3/3, and ε4+ vs. ε4-. The risk factors for PDD may include the genotypes ε3/4 (OR 1.47, 95% CI 1.14-1.89) and ε4/4 (OR 2.93, 95% CI 1.20-7.14). In patients with PDD, there was no significant difference in the distribution of ε2+ vs. ε3/3 (OR 1.35, 95% CI 0.97-1.87, P=0.07). The risk of PDD was 1.61 times greater in ε4+ compared with ε3/3 (OR 1.61, 95% CI 1.24-2.08, P=0.0003). As the results indicated that ε2+ did not play a role as a risk factor or a protective factor, we divided the population into ε4+ and ε4- for the meta-analysis and found that, among patients with Parkinson's disease, the dementia risk of those with ε4+ was 1.72 times greater than that of those with ε4- (OR 1.72, 95% CI 1.41-2.10, P < 0.00001). Subgroup analysis in accordance with different geographical regions revealed that ε4+ was a risk factor for PDD in people from all regions. Conclusions Among the APOE genotypes, ε2+ is neither a risk factor nor a protective factor for PDD, while ε4+ is a risk factor for PDD. The present results are applicable to Asian, European, and American patients with Parkinson's disease. Regarding the single APOE genotypes, ε3/4 and ε4/4 may be risk factors for PDD; however, further studies with large sample sizes are needed to verify this.
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Abrahams S, Mc Fie S, Patricios J, Suter J, Posthumus M, September AV. An association between polymorphisms within the APOE gene and concussion aetiology in rugby union players. J Sci Med Sport 2017. [PMID: 28645497 DOI: 10.1016/j.jsams.2017.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Concussion refers to changes in neurological function due to biomechanical forces transmitted to the head. The APOE ε4 allele is associated with brain injury severity. The objective was to determine if APOE gene variants are associated with concussion history and severity in rugby players. DESIGN In total, 128 non-concussed controls and 160 previously concussed participants (all cases N=160; diagnosed N=139) were recruited from high school (junior, N=121), club (N=116) and professional rugby teams (N=51). METHODS Participants were genotyped for rs405509 (G>T), rs429358 (T>C) and rs7412 (C>T) APOE variants. Statistical analyses were performed using the R environment. RESULTS The rs405509 TT genotype was over-represented in controls compared to all cases (P=0.043; control: 29%, all cases: 18%; odds ratio: 0.55, 95% confidence interval 0.31-0.98). The APOE-ε isoform frequencies were not significantly different between groups (P>0.05). Additionally, the inferred APOE (rs405509-ε2/ε3/ε4) T-ε3 haplotype was over-represented in controls (41%) compared to diagnosed (32%, P=0.042). The G-ε3 haplotype was under-represented in controls (36%) compared to all cases (44%, P=0.019) and diagnosed (44%, P=0.021). The TT genotype was significantly associated with rapid recovery (P=0.048, <1 week: 51%, N=70, ≥1 week: 36%, N=29; odds ratio: 0.55, 95% confidence interval 0.30-1.01). CONCLUSIONS These findings support the further elucidation of the APOE gene or closely-related genes in concussion aetiology. Although similar preliminary results were found when juniors were separately analysed, the under-powered sample size for junior subgroup requires future investigation in larger cohorts of junior-level athletes.
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Affiliation(s)
- Shameemah Abrahams
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science, University of Cape Town, South Africa
| | - Sarah Mc Fie
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science, University of Cape Town, South Africa
| | - Jon Patricios
- Morningside Sports Medicine Clinic, South Africa; Section of Sports Medicine, University of Pretoria, South Africa; Department of Emergency Medicine, University of the Witwatersrand, South Africa
| | - Jason Suter
- Sports Science and Exercise Medicine Clinic, South Africa
| | - Michael Posthumus
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science, University of Cape Town, South Africa
| | - Alison V September
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science, University of Cape Town, South Africa.
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Gu LH, Chen J, Gao LJ, Shu H, Wang Z, Liu D, Yan YN, Li SJ, Zhang ZJ. The Effect of Apolipoprotein E ε4 (APOE ε4) on Visuospatial Working Memory in Healthy Elderly and Amnestic Mild Cognitive Impairment Patients: An Event-Related Potentials Study. Front Aging Neurosci 2017; 9:145. [PMID: 28567013 PMCID: PMC5434145 DOI: 10.3389/fnagi.2017.00145] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 04/30/2017] [Indexed: 12/17/2022] Open
Abstract
Background: Apolipoprotein E (APOE) ε4 is the only established risk gene for late-onset, sporadic Alzheimer’s disease (AD). Previous studies have provided inconsistent evidence for the effect of APOE ε4 status on the visuospatial working memory (VSWM). Objective: The aim was to investigate the effect of APOE ε4 on VSWM with an event-related potential (ERP) study in healthy controls (HC) and amnestic mild cognitive impairment (aMCI) patients. Methods: The study recorded 39 aMCI patients (27 APOE ε4 non-carriers and 12 APOE ε4 carriers) and their 43 matched controls (25 APOE ε4 non-carriers and 18 APOE ε4 carriers) with an 64-channel electroencephalogram. Participants performed an N-back task, a VSWM paradigm that manipulated the number of items to be stored in memory. Results: The present study detected reduced accuracy and delayed mean correct response time (RT) in aMCI patients compared to HC. P300, a positive component that peaks between 300 and 500 ms, was elicited by the VSWM task. In addition, aMCI patients showed decreased P300 amplitude at the central–parietal (CP1, CPz, and CP2) and parietal (P1, Pz, and P2) electrodes in 0- and 1-back task compared to HC. In both HC and aMCI patients, APOE ε4 carriers showed reduced P300 amplitude with respect to non-carriers, whereas no significant differences in accuracy or RT were detected between APOE ε4 carriers and non-carriers. Additionally, standardized low-resolution brain electromagnetic tomography analysis (s-LORETA) showed enhanced brain activation in the right parahippocampal gyrus (PHG) during P300 time range in APOE ε4 carriers with respect to non-carriers in aMCI patients. Conclusion: It demonstrated that P300 amplitude could predict VSWM deficits in aMCI patients and contribute to early detection of VSWM deficits in APOE ε4 carriers.
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Affiliation(s)
- Li-Hua Gu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast UniversityNanjing, China
| | - Jiu Chen
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast UniversityNanjing, China
| | - Li-Juan Gao
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast UniversityNanjing, China
| | - Hao Shu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast UniversityNanjing, China
| | - Zan Wang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast UniversityNanjing, China
| | - Duan Liu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast UniversityNanjing, China
| | - Yan-Na Yan
- Department of Psychology, Xinxiang Medical UniversityXinxiang, China
| | - Shi-Jiang Li
- Department of Biophysics, Medical College of Wisconsin, MilwaukeeWI, United States
| | - Zhi-Jun Zhang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast UniversityNanjing, China.,Department of Psychology, Xinxiang Medical UniversityXinxiang, China
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Shakeri A, Sahebkar A. Optimized curcumin formulations for the treatment of Alzheimer's disease: A patent evaluation. J Neurosci Res 2015; 94:111-3. [PMID: 26577706 DOI: 10.1002/jnr.23696] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 10/18/2015] [Indexed: 12/31/2022]
Affiliation(s)
- Abolfazl Shakeri
- Department of Pharmacognosy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Metabolic Research Centre, School of Medicine and Pharmacology, Royal Perth Hospital, University of Western Australia, Perth, Western Australia, Australia
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Sindi S, Mangialasche F, Kivipelto M. Advances in the prevention of Alzheimer's Disease. F1000PRIME REPORTS 2015; 7:50. [PMID: 26097723 PMCID: PMC4447057 DOI: 10.12703/p7-50] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Alzheimer's disease (AD), the leading cause of dementia, has reached epidemic proportions, with major social, medical and economical burdens. With no currently available curative treatments, both the World Health Organization and the G8 Dementia Summit recently identified dementia and AD prevention as a major public health priority. Dementia and AD have a wide range of risk factors (genetic, vascular/metabolic and lifestyle-related), which often co-occur and thus interact with each other. Previous intervention efforts aimed at preventing dementia and AD focused on the management of single risk factors, with relatively modest findings. Also, the effect of risk factors depends on age at exposure, indicating that the timing of preventive interventions needs to be carefully considered. In view of the complex multifactorial nature of AD, as well as its long pre-clinical (asymptomatic) phase, interventions simultaneously targeting multiple risk factors and disease mechanisms at an early stage of the disease are most likely to be effective. Three large European multidomain prevention trials have been launched with the goal of preventing cognitive decline, dementia and AD in older adults with different risk profiles. Pharmacological trials are also shifting towards prevention of Alzheimer dementia, by targeting at-risk individuals prior to the onset of cognitive symptoms. The current review will summarize and discuss the evidence on risk and protective factors from observational studies, ongoing lifestyle-related and pharmacological randomized controlled trials (RCTs), as well as future directions for dementia and AD prevention.
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Affiliation(s)
- Shireen Sindi
- Karolinska Institutet Center for Alzheimer ResearchNovum, 5 floor, 141 86 HuddingeSweden
- Aging Research Center, Karolinska Institutet and Stockholm UniversityGävelagatan 16, 8 floor, 113 30 StockholmSweden
| | - Francesca Mangialasche
- Karolinska Institutet Center for Alzheimer ResearchNovum, 5 floor, 141 86 HuddingeSweden
- Aging Research Center, Karolinska Institutet and Stockholm UniversityGävelagatan 16, 8 floor, 113 30 StockholmSweden
| | - Miia Kivipelto
- Karolinska Institutet Center for Alzheimer ResearchNovum, 5 floor, 141 86 HuddingeSweden
- Aging Research Center, Karolinska Institutet and Stockholm UniversityGävelagatan 16, 8 floor, 113 30 StockholmSweden
- Department of Neurology, University of Eastern FinlandYliopistonranta 1 B, 70211 KuopioFinland
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Shu H, Shi Y, Chen G, Wang Z, Liu D, Yue C, Ward BD, Li W, Xu Z, Chen G, Guo Q, Xu J, Li SJ, Zhang Z. Opposite Neural Trajectories of Apolipoprotein E ϵ4 and ϵ2 Alleles with Aging Associated with Different Risks of Alzheimer's Disease. Cereb Cortex 2014; 26:1421-1429. [PMID: 25336599 DOI: 10.1093/cercor/bhu237] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The apolipoprotein E (APOE) ϵ4 allele is a confirmed genetic risk factor and the APOE ϵ2 allele is a protective factor related to late-onset Alzheimer's disease (AD). Intriguingly, recent studies demonstrated similar brain function alterations between APOE ϵ2 and ϵ4 alleles, despite their opposite susceptibilities to AD. To address this apparent discrepancy, we recruited 129 cognitively normal elderly subjects, including 36 ϵ2 carriers, 44 ϵ3 homozygotes, and 49 ϵ4 carriers. All subjects underwent resting-state functional MRI scans. We hypothesized that aging could influence the APOE ϵ2 and ϵ4 allele effects that contribute to their appropriate AD risks differently. Using the stepwise regression analysis, we demonstrated that although both ϵ2 and ϵ4 carriers showed decreased functional connectivity (FC) compared with ϵ3 homozygotes, they have opposite aging trajectories in the default mode network-primarily in the bilateral anterior cingulate cortex. As age increased, ϵ2 carriers showed elevated FC, whereas ϵ4 carriers exhibited decreased FC. Behaviorally, the altered DMN FC positively correlated with information processing speed in both ϵ2 and ϵ4 carriers. It is suggested that the opposite aging trajectories between APOE ϵ2 and ϵ4 alleles in the DMN may reflect the antagonistic pleiotropic properties and associate with their different AD risks.
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Affiliation(s)
- Hao Shu
- Department of Neurology, Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, Jiangsu, China.,Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Yongmei Shi
- Department of Neurology, Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, Jiangsu, China
| | - Gang Chen
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Zan Wang
- Department of Neurology, Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, Jiangsu, China
| | - Duan Liu
- Department of Neurology, Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, Jiangsu, China
| | - Chunxian Yue
- Department of Neurology, Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, Jiangsu, China
| | - B Douglas Ward
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Wenjun Li
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Zhan Xu
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Guangyu Chen
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Qihao Guo
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jun Xu
- Brain Center, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, China
| | - Shi-Jiang Li
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Zhijun Zhang
- Department of Neurology, Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, Jiangsu, China
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14
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Shu H, Yuan Y, Xie C, Bai F, You J, Li L, Li SJ, Zhang Z. Imbalanced hippocampal functional networks associated with remitted geriatric depression and apolipoprotein E ε4 allele in nondemented elderly: a preliminary study. J Affect Disord 2014; 164:5-13. [PMID: 24856546 PMCID: PMC4460794 DOI: 10.1016/j.jad.2014.03.048] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 03/26/2014] [Accepted: 03/26/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Apolipoprotein E (APOE) ε4 allele and a history of geriatric depression are confirmed risk factors of Alzheimer׳s disease (AD). Coexistence of both factors could notably enhance the risk of cognitive impairment in nondemented elderly. However, neural basis of the association remains unclear. METHODS Thirty-one remitted geriatric depression (RGD) patients and 29 cognitively normal subjects were recruited and underwent resting-state functional MRI scans. They were further divided into four groups according to their APOE genotypes. Hippocampal seed-based network analysis and two-way factorial analysis of covariance were employed to detect the main effects and interactive effects of RGD and APOE ε4 allele on the hippocampal functional connectivity (HFC) networks. Partial correlation analysis was applied to examine the cognitive significance of these altered HFC networks. RESULTS The HFC networks of RGD patients were decreased in the dorsal frontal and increased in the right temporal-occipital regions. For APOE ε4 carriers, the HFC networks were reduced primarily in medial prefrontal regions and enhanced in the bilateral insula. Additionally, when both factors coexisted, the left HFC network was significantly disrupted in the dorsal anterior cingulate cortex and increased in somatomotor and occipital regions. Importantly, the extent of network alterations was linked to inferior cognitive performances in RGD patients and APOE ε4 carriers. LIMITATIONS The small sample size may limit the generalizability of our findings. CONCLUSIONS RGD and APOE ε4 allele, and their interaction, are associated with the imbalanced HFC network, which may contribute to cognitive deterioration for subjects with a high risk of AD.
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Affiliation(s)
- Hao Shu
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, China,Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Yonggui Yuan
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, China
| | - Chunming Xie
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, China
| | - Feng Bai
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, China
| | - Jiayong You
- Department of Psychiatry, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Lingjiang Li
- Mental Health Institute, Second Xiangya Hospital of Central South University, Changsha, China
| | - Shi-Jiang Li
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Zhijun Zhang
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, China.
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15
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Guaita A, Colombo M, Vaccaro R, Fossi S, Vitali SF, Forloni G, Polito L, Davin A, Ferretti VV, Villani S. Brain aging and dementia during the transition from late adulthood to old age: design and methodology of the "Invece.Ab" population-based study. BMC Geriatr 2013; 13:98. [PMID: 24063518 PMCID: PMC3849204 DOI: 10.1186/1471-2318-13-98] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 09/18/2013] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Developed countries are experiencing an unprecedented increase in life expectancy that is accompanied by a tremendous rise in the number of people with dementia. The purpose of this paper is to report on the study design and methodology of an Italian population-based study on brain aging and dementia in the elderly. This multi-domain study is structured in two phases. Our goal is to gather sufficient data to estimate the prevalence (phase I: cross-sectional study), the incidence and the progression of dementia and its subtypes as well as cognitive impairment (phase II: follow-up study) and to identify socio-demographic, clinical, and lifestyle factors associated with dementia and the quality of brain aging in people aged 70-74 years, a crucial point between late adulthood and old age. METHODS/DESIGN We chose to contact all 1773 people born between 1935-39 residing in Abbiategrasso, Milan, Italy. Those who agreed to participate in the "Invece.Ab" study were enrolled in a cross-sectional assessment and will be contacted two and four years after the initial data collection to participate in the longitudinal survey. Both the cross-sectional and longitudinal assessments include a medical evaluation, a neuropsychological test battery, several anthropometric measurements, a social and lifestyle interview, blood analyses, and the storage of a blood sample for the evaluation of putative biological markers. DISCUSSION Now at the end of the recruitment phase, the evaluable population has amounted to 1644 people. Among these, 1321 (80.35%) of the participants have completed phase I. This high return rate was likely due to the style of recruitment and personalization of the contacts.
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Affiliation(s)
- Antonio Guaita
- “Golgi Cenci” Foundation, Corso San Martino 8, 20081 Abbiategrasso, Italy
| | - Mauro Colombo
- “Mario Negri” Institute for Pharmacological Research, Via La Masa 19, 20156 Milan, Italy
| | - Roberta Vaccaro
- “Golgi Cenci” Foundation, Corso San Martino 8, 20081 Abbiategrasso, Italy
| | - Silvia Fossi
- “Golgi Cenci” Foundation, Corso San Martino 8, 20081 Abbiategrasso, Italy
| | | | - Gianluigi Forloni
- “C.Golgi” Geriatric Institute, Piazza Golgi 11, 20081 Abbiategrasso, Italy
| | - Letizia Polito
- “Golgi Cenci” Foundation, Corso San Martino 8, 20081 Abbiategrasso, Italy
| | - Annalisa Davin
- “Golgi Cenci” Foundation, Corso San Martino 8, 20081 Abbiategrasso, Italy
| | - Virginia Valeria Ferretti
- Biostatistics and Clinical Epidemiology, Department of Public Health, Neurosciences, Experimental and Forensic Medicine, University of Pavia, Via Mondino 2, 27100 Pavia, Italy
| | - Simona Villani
- Biostatistics and Clinical Epidemiology, Department of Public Health, Neurosciences, Experimental and Forensic Medicine, University of Pavia, Via Mondino 2, 27100 Pavia, Italy
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16
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Daulatzai MA. Neurotoxic Saboteurs: Straws that Break the Hippo’s (Hippocampus) Back Drive Cognitive Impairment and Alzheimer’s Disease. Neurotox Res 2013; 24:407-59. [DOI: 10.1007/s12640-013-9407-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 06/06/2013] [Accepted: 06/17/2013] [Indexed: 12/29/2022]
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17
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Abstract
Dementia (Smritibuddhihrass) is a chronic organic mental disorder, characterized by progressive usually irreversible, global cognitive deficit. Presently no reliable treatment is available to check the progression of the disease in the conventional medicine. Although this condition is not described as a disease moiety in a separate chapter among Ayurvedic classics but the signs and symptoms along with pathogenesis of dementia can be understood in terms of Ayurvedic concepts. As a large part of pathogenesis of dementia involves neurodegeneration, Rasayana and Panchkarma therapy play an a very important role in the management of dementia. These therapeutic techniques have the potential to check the progression of disease as well as can improve the deficit in cognitive functions of these patients. In the present paper the possible pathogenesis of Dementia in the terms of Ayurvedic concepts has been discussed and suggested the management profiles from Ayurvedic perspectives which can be beneficially utilized for this important class of geriatric disorders.
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Affiliation(s)
- Radhey Shyam Tiwari
- Senior Resident, Department of Kayachikitsa, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Jyoti Shankar Tripathi
- Associate Professor and Incharge, Division of Manas Chikitsa, Department of Kayachikitsa, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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18
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Andrawis JP, Hwang KS, Green AE, Kotlerman J, Elashoff D, Morra JH, Cummings JL, Toga AW, Thompson PM, Apostolova LG. Effects of ApoE4 and maternal history of dementia on hippocampal atrophy. Neurobiol Aging 2012; 33:856-66. [PMID: 20833446 PMCID: PMC3010297 DOI: 10.1016/j.neurobiolaging.2010.07.020] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Revised: 07/21/2010] [Accepted: 07/30/2010] [Indexed: 11/30/2022]
Abstract
We applied an automated hippocampal segmentation technique based on adaptive boosting (AdaBoost) to the 1.5 T magnetic resonance imaging (MRI) baseline and 1-year follow-up data of 243 subjects with mild cognitive impairment (MCI), 96 with Alzheimer's disease (AD), and 145 normal controls (NC) scanned as part of the Alzheimer's Disease Neuroimaging Initiative (ADNI). MCI subjects with positive maternal history of dementia had smaller hippocampal volumes at baseline and at follow-up, and greater 12-month atrophy rates than subjects with negative maternal history. Three-dimensional maps and volumetric multiple regression analyses demonstrated a significant effect of positive maternal history of dementia on hippocampal atrophy in MCI and AD after controlling for age, ApoE4 genotype, and paternal history of dementia, respectively. ApoE4 showed an independent effect on hippocampal atrophy in MCI and AD and in the pooled sample.
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Affiliation(s)
| | - Kristy S. Hwang
- Department of Neurology, David Geffen School of Medicine, UCLA
- Laboratory of Neuroimaging, David Geffen School of Medicine, UCLA
| | - Amity E. Green
- Department of Neurology, David Geffen School of Medicine, UCLA
- Laboratory of Neuroimaging, David Geffen School of Medicine, UCLA
| | - Jenny Kotlerman
- Division of General Internal Medicine and Health Services Research, UCLA
| | - David Elashoff
- Division of General Internal Medicine and Health Services Research, UCLA
| | | | - Jeffrey L. Cummings
- Department of Neurology, David Geffen School of Medicine, UCLA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA
| | - Arthur W. Toga
- Department of Neurology, David Geffen School of Medicine, UCLA
- Laboratory of Neuroimaging, David Geffen School of Medicine, UCLA
| | - Paul M. Thompson
- Department of Neurology, David Geffen School of Medicine, UCLA
- Laboratory of Neuroimaging, David Geffen School of Medicine, UCLA
| | - Liana G. Apostolova
- Department of Neurology, David Geffen School of Medicine, UCLA
- Laboratory of Neuroimaging, David Geffen School of Medicine, UCLA
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19
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Panza F, Frisardi V, Seripa D, D'Onofrio G, Santamato A, Masullo C, Logroscino G, Solfrizzi V, Pilotto A. Apolipoprotein E genotypes and neuropsychiatric symptoms and syndromes in late-onset Alzheimer's disease. Ageing Res Rev 2012; 11:87-103. [PMID: 21763789 DOI: 10.1016/j.arr.2011.06.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2010] [Revised: 05/29/2011] [Accepted: 06/30/2011] [Indexed: 12/31/2022]
Abstract
Neuropsychiatric symptoms (NPS) in dementia, previously denominated as behavioural and psychological symptoms of dementia, are often more distressing, impairing, and costly than cognitive symptoms, representing a major health burden for older adults. These symptoms are common features of Alzheimer's disease (AD), and are one of the major risk factors for institutionalization. There is a high prevalence of neuropsychiatric disturbances in patients with AD, including depression, anxiety, apathy, psychosis, aggression, and agitation. At present, the role of the apolipoprotein E (APOE) genotypes in the development of NPS or neuropsychiatric syndromes/endophenotypes in AD patients is unclear. In this article, we summarized the findings of the studies of NPS and neuropsychiatric syndromes in AD in relation to APOE genotypes, with special attention to the possible underlying mechanisms. While some studies failed to find a significant association between the APOE polymorphism and NPS in late-onset AD, other studies reported a significant association between the APOE ɛ4 allele and an increase in agitation/aggression, hallucinations, delusions, and late-life depression or anxiety. However, current cumulative evidence coming from the few existing longitudinal studies shows no association of APOE genotypes with NPS as a whole in AD. Some negative studies that focused on the distribution of APOE genotypes between AD patients with or without NPS further emphasized the importance of sub-grouping NPS in distinct neuropsychiatric syndromes. Explanations for the variable findings in the existing studies included differences in patient populations, differences in the assessment of neuropsychiatric symptomatology, possible lack of statistical power to detect associations in the negative studies, and small sample sizes generating false positives that cannot be consistently replicated. Finally, many reviewed studies were cross-sectional, whereas it would be of paramount importance to evaluate the risk for incident NPS in relation to the APOE genotype in prospectively followed cohorts of AD patients. In fact, identifying predisposing genetic risk factors may allow us to understand the pathophysiological features of neuropsychiatric syndromes or symptoms in AD, so optimizing possible therapeutic options.
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Affiliation(s)
- Francesco Panza
- Geriatric Unit & Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy.
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20
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D'Onofrio G, Panza F, Frisardi V, Solfrizzi V, Imbimbo BP, Paroni G, Cascavilla L, Seripa D, Pilotto A. Advances in the identification of γ-secretase inhibitors for the treatment of Alzheimer's disease. Expert Opin Drug Discov 2011; 7:19-37. [DOI: 10.1517/17460441.2012.645534] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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21
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Seripa D, D'Onofrio G, Panza F, Cascavilla L, Masullo C, Pilotto A. The Genetics of the Human APOE Polymorphism. Rejuvenation Res 2011; 14:491-500. [DOI: 10.1089/rej.2011.1169] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Davide Seripa
- Geriatric Unit & Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS “Casa Sollievo della Sofferenza,” San Giovanni Rotondo (FG), Italy
| | - Grazia D'Onofrio
- Geriatric Unit & Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS “Casa Sollievo della Sofferenza,” San Giovanni Rotondo (FG), Italy
| | - Francesco Panza
- Geriatric Unit & Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS “Casa Sollievo della Sofferenza,” San Giovanni Rotondo (FG), Italy
| | - Leandro Cascavilla
- Geriatric Unit & Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS “Casa Sollievo della Sofferenza,” San Giovanni Rotondo (FG), Italy
| | - Carlo Masullo
- Institute of Neurology, Catholic University School of Medicine, Rome, Italy
| | - Alberto Pilotto
- Geriatric Unit & Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS “Casa Sollievo della Sofferenza,” San Giovanni Rotondo (FG), Italy
- Geriatrics Unit, S. Antonio Hospital, Padova, Italy
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22
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Mancuso C, Siciliano R, Barone E, Preziosi P. Natural substances and Alzheimer's disease: from preclinical studies to evidence based medicine. Biochim Biophys Acta Mol Basis Dis 2011; 1822:616-24. [PMID: 21939756 DOI: 10.1016/j.bbadis.2011.09.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 09/02/2011] [Accepted: 09/05/2011] [Indexed: 12/14/2022]
Abstract
Over the last 10 years, the potential therapeutic effects of nutraceuticals to prevent or delay Alzheimer's disease were proposed. Among dietary antioxidants curcumin, Ginkgo biloba and carnitines were extensively studied for their neuroprotective effects. The rationale for this alternative therapeutic approach was based on several preclinical studies which suggested the neuroprotective effects for curcumin, Ginkgo biloba and acetyl-l-carnitine due to either a free radical scavenging activity or the inhibition of pro-inflammatory pathways or the potentiation of the cell stress response. However, although these are interesting premises, clinical studies were not able to demonstrate significant beneficial effects of curcumin, Ginkgo biloba and acetyl-l-carnitine in improving cognitive functions in Alzheimer's disease patients. The aim of this review is to summarize the main pharmacologic features of curcumin, Ginkgo biloba and carnitines as well as to underlie the main outcomes reached by clinical studies designed to demonstrate the efficacy of these natural substances in Alzheimer's disease patients. This article is part of a Special Issue entitled: Antioxidants and Antioxidant Treatment in Disease.
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Affiliation(s)
- Cesare Mancuso
- Institute of Pharmacology, Catholic University School of Medicine, Largo Francesco Vito, 1-00168 Rome, Italy.
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23
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Mancuso C, Siciliano R, Barone E, Butterfield DA, Preziosi P. Pharmacologists and Alzheimer disease therapy: to boldly go where no scientist has gone before. Expert Opin Investig Drugs 2011; 20:1243-61. [DOI: 10.1517/13543784.2011.601740] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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24
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γ-secretase inhibitors for treating Alzheimer’s disease: rationale and clinical data. ACTA ACUST UNITED AC 2011. [DOI: 10.4155/cli.11.86] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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25
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High APOE epsilon 4 allele frequencies associated with Alzheimer disease in a Tunisian population. Neurol Sci 2011; 33:33-7. [PMID: 21710128 DOI: 10.1007/s10072-011-0663-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Accepted: 06/11/2011] [Indexed: 10/18/2022]
Abstract
The goal of the study was to examine the Apolipoprotein E (APOE) genotypes in a Tunisian sample of patients with Alzheimer disease (AD) and normal controls, and to compare the results with the findings from the literature. A hospital-based case-control study of two groups (58 patients with AD, 71 controls) was conducted. Patients received a detailed clinical history, neurological examination, neuropsychological testing and brain imaging. A neurological examination and the Arabic version of the Mini-Mental State Examination were made for controls. Genotyping was performed using the PCR restriction fragment length polymorphism (PCR-RFLP) method. There were no statistical differences in age (p = 0.05) and gender (p = 0.046) between the two groups. The APOE ε4/4 genotype was over represented in the AD group in comparison with the controls (13.3 vs. 2.8%). A significant increased risk of AD among APOE ε4 allele carriers was observed. The odds ratio for the association of AD patients with homozygous and heterozygous ε4 allele was, respectively, 5.40 (1.35-21.48) and 2.90 (1.27-6.62). Our results in addition to previously published genetic studies suggest that AD disease is multifactor in origin. Ethnicity, genetic and environmental factors contribute to AD risk in different ethnic groups.
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26
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Panza F, Seripa D, D'Onofrio G, Frisardi V, Solfrizzi V, Mecocci P, Pilotto A. Neuropsychiatric Symptoms, Endophenotypes, and Syndromes in Late-Onset Alzheimer's Disease: Focus on APOE Gene. Int J Alzheimers Dis 2011; 2011:721457. [PMID: 21559196 PMCID: PMC3090058 DOI: 10.4061/2011/721457] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Revised: 02/11/2011] [Accepted: 02/11/2011] [Indexed: 01/31/2023] Open
Abstract
Neuropsychiatric symptoms, previously denominated as behavioural and psychological symptoms of dementia, are common features of Alzheimer's disease (AD) and are one of the major risk factors for institutionalization. At present, the role of the apolipoprotein E (APOE) gene in the development of neuropsychiatric symptoms in AD patients is unclear. In this paper, we summarized the findings of the studies of neuropsychiatric symptoms and neuropsychiatric syndromes/endophenotypes in AD in relation to APOE genotypes, with special attention to the possible underlying mechanisms. While some studies failed to find a significant association between APOE and neuropsychiatric symptoms in late-onset AD, other studies reported a significant association between the APOE ε4 allele and an increase in agitation/aggression, hallucinations, delusions, and late-life depression or anxiety. Furthermore, some negative studies that focused on the distribution of APOE genotypes between AD patients with or without neuropsychiatric symptoms further emphasized the importance of subgrouping neuropsychiatric symptoms in distinct neuropsychiatric syndromes. Explanations for the variable findings in the existing studies included differences in patient populations, differences in the assessment of neuropsychiatric symptomatology, and possible lack of statistical power to detect associations in the negative studies.
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Affiliation(s)
- Francesco Panza
- Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, 71013 Foggia, Italy
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27
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Addante F, Sancarlo D, Copetti M, Scarcelli C, Longo MG, Niro V, Paroni G, Pellegrini F, Fontana L, Pilotto A. Effect of obesity, serum lipoproteins, and apolipoprotein E genotypes on mortality in hospitalized elderly patients. Rejuvenation Res 2011; 14:111-8. [PMID: 21595502 PMCID: PMC3092981 DOI: 10.1089/rej.2010.1058] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Accepted: 05/14/2010] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the relationship among apolipoprotein E (APOE) polymorphism, body mass index (BMI), and dyslipidemia and how these factors modify overall mortality in a cohort of hospitalized elderly patients. METHODS Plasma concentrations of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), BMI, and APOE genotype were evaluated in 1,012 hospitalized elderly patients, who were stratified into three groups according to their baseline BMI and APOE allele status. Multivariate logistic regression analysis was used to assess whether APOE genotype, BMI, and dyslipidemia are associated with mortality, adjusting for potential confounders. Interaction analysis was also performed. RESULTS Obese patients have significantly higher levels of TC and LDL-C compared to normal-weight and overweight subjects, for both sexes. APOE ε4 carriers have significantly higher levels of TC and LDL-C compared with ε2 and ε3 carrier both in males and females. Interaction analysis showed that women with TC < 180 mg/dL, LDL-C < 100 mg/dL, normal weight, and ε3 carrier (odds ratio [OR] = 3.42, 95% confidence interval [CI] 1.36-8.60) and men with LDL-C < 100 mg/dL, HDL-C < 40 mg/dL, and ε3 carrier (OR = 1.97, 95% CI 1.04-3.74) were at highest risk of mortality. CONCLUSIONS In elderly hospitalized patients, obesity and APOE genotype influence the lipid profile and mortality risk. A significant interaction among BMI, dyslipidemia, and APOE genotype was observed that could identify elderly patients with different risks of mortality.
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Affiliation(s)
- Filomena Addante
- Geriatric Unit & Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Daniele Sancarlo
- Geriatric Unit & Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Massimiliano Copetti
- Unit of Biostatistics, Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Carlo Scarcelli
- Geriatric Unit & Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Maria Grazia Longo
- Geriatric Unit & Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Valeria Niro
- Geriatric Unit & Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Giulia Paroni
- Geriatric Unit & Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Fabio Pellegrini
- Unit of Biostatistics, Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
- Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S.Maria Imbaro (CH), Italy
| | - Luigi Fontana
- Division of Nutrition and Aging, Istituto Superiore di Sanità, Rome, Italy and Division of Geriatrics and Nutritional Science, Washington University in St. Louis, Missouri
| | - Alberto Pilotto
- Geriatric Unit & Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
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Ritchie K, Carrière I, Ritchie CW, Berr C, Artero S, Ancelin ML. Designing prevention programmes to reduce incidence of dementia: prospective cohort study of modifiable risk factors. BMJ 2010; 341:c3885. [PMID: 20688841 PMCID: PMC2917002 DOI: 10.1136/bmj.c3885] [Citation(s) in RCA: 157] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To estimate the percentage reduction in incidence of dementia that would be obtained if specific risk factors were eliminated. DESIGN Prospective seven year cohort study. SETTING General population, Montpellier, France. PARTICIPANTS 1433 people aged over 65 with a mean baseline age of 72.5 (SD 5.1) years. MAIN OUTCOME MEASURES Diagnosis of mild cognitive impairment or dementia established by a standardised neurological examination. RESULTS Cox models were constructed to derive hazard ratios and determine confounding and interaction effects for potentially modifiable risk factors for dementia. Mean percentage population attributable fractions were calculated with 95% confidence intervals derived from bootstrapping for seven year incidence of mild cognitive impairment or dementia. The final model retained crystallised intelligence (population attributable fraction 18.11%, 95% confidence interval 10.91% to 25.42%), depression (10.31%, 3.66% to 17.17%), fruit and vegetable consumption (6.46%, 0.15% to 13.06%), diabetes (4.88%, 1.87% to 7.98%), and apolipoprotein E epsilon4 allele (7.11%, 2.44% to 11.98%). CONCLUSIONS Increasing crystallised intelligence and fruit and vegetable consumption and eliminating depression and diabetes are likely to have the biggest impact on reducing the incidence of dementia, outweighing even the effect of removing the principal known genetic risk factor. Although causal relations cannot be concluded with certainty, the study suggests priorities that may inform public health programmes.
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Affiliation(s)
- K Ritchie
- Inserm, U888 Nervous System Pathologies: Epidemiological and Clinical Research, La Colombière Hospital, 34093 Montpellier Cedex 5, France.
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