1
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Assfaw AD, Schindler SE, Morris JC. Advances in blood biomarkers for Alzheimer disease (AD): A review. Kaohsiung J Med Sci 2024. [PMID: 38888066 DOI: 10.1002/kjm2.12870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 06/04/2024] [Indexed: 06/20/2024] Open
Abstract
Alzheimer disease (AD) and Alzheimer Disease and Related Dementias (AD/ADRD) are growing public health challenges globally affecting millions of older adults, necessitating concerted efforts to advance our understanding and management of these conditions. AD is a progressive neurodegenerative disorder characterized pathologically by amyloid plaques and tau neurofibrillary tangles that are the primary cause of dementia in older individuals. Early and accurate diagnosis of AD dementia is crucial for effective intervention and treatment but has proven challenging to accomplish. Although testing for AD brain pathology with cerebrospinal fluid (CSF) or positron emission tomography (PET) has been available for over 2 decades, most patients never underwent this testing because of inaccessibility, high out-of-pocket costs, perceived risks, and the lack of AD-specific treatments. However, in recent years, rapid progress has been made in developing blood biomarkers for AD/ADRD. Consequently, blood biomarkers have emerged as promising tools for non-invasive and cost-effective diagnosis, prognosis, and monitoring of AD progression. This review presents the evolving landscape of blood biomarkers in AD/ADRD and explores their potential applications in clinical practice for early detection, prognosis, and therapeutic interventions. It covers recent advances in blood biomarkers, including amyloid beta (Aβ) peptides, tau protein, neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP). It also discusses their diagnostic and prognostic utility while addressing associated challenges and limitations. Future research directions in this rapidly evolving field are also proposed.
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Affiliation(s)
- Araya Dimtsu Assfaw
- Department of Neurology, Knight Alzheimer Disease Research Center (Knight ADRC), Washington University School of Medicine, St. Louis, Missouri, USA
| | - Suzanne E Schindler
- Department of Neurology, Knight Alzheimer Disease Research Center (Knight ADRC), Washington University School of Medicine, St. Louis, Missouri, USA
| | - John C Morris
- Department of Neurology, Knight Alzheimer Disease Research Center (Knight ADRC), Washington University School of Medicine, St. Louis, Missouri, USA
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2
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Vance JM, Farrer LA, Huang Y, Cruchaga C, Hyman BT, Pericak-Vance MA, Goate AM, Greicius MD, Griswold AJ, Haines JL, Tcw J, Schellenberg GD, Tsai LH, Herz J, Holtzman DM. Report of the APOE4 National Institute on Aging/Alzheimer Disease Sequencing Project Consortium Working Group: Reducing APOE4 in Carriers is a Therapeutic Goal for Alzheimer's Disease. Ann Neurol 2024; 95:625-634. [PMID: 38180638 DOI: 10.1002/ana.26864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/06/2023] [Accepted: 12/09/2023] [Indexed: 01/06/2024]
Abstract
Alzheimer's disease (AD) is the most common neurodegenerative disorder and one of the leading causes of disability worldwide. The apolipoprotein E4 gene (APOE4) is the strongest genetic risk factor for AD. In 2023, the APOE4 National Institute on Aging/Alzheimer's Disease Sequencing Project working group came together to gather data and discuss the question of whether to reduce or increase APOE4 as a therapeutic intervention for AD. It was the unanimous consensus that cumulative data from multiple studies in humans and animal models support that lowering APOE4 should be a target for therapeutic approaches for APOE4 carriers. ANN NEUROL 2024;95:625-634.
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Affiliation(s)
- Jeffery M Vance
- John T. McDonald Department of Human Genetics, John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Lindsay A Farrer
- Departments of Medicine (Biomedical Genetics), Neurology and Ophthalmology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Departments of Epidemiology and Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Yadong Huang
- Department of Neurology, Gladstone Center for Translational Advancement, Gladstone Institute of Neurological Disease, University of California, San Francisco, San Francisco, CA, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - Bradley T Hyman
- Alzheimer Research Unit, Department of Neurology, The Massachusetts General Hospital Institute for Neurodegenerative Disease, Harvard Medical School, Boston, MA, USA
| | - Margaret A Pericak-Vance
- John T. McDonald Department of Human Genetics, John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Alison M Goate
- Departments of Genetics & Genomic Sciences, Ronald M. Loeb Center for Alzheimer's disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael D Greicius
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Anthony J Griswold
- John P. Hussman Institute for Human Genomics, The Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jonathan L Haines
- Department of Population & Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Julia Tcw
- Departments of Pharmacology, Physiology & Biophysics, Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Bioinformatics Program, Faculty of Computing & Data Sciences, Boston University, Boston, MA, USA
| | - Gerard D Schellenberg
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Li-Huei Tsai
- Picower Institute for Learning and Memory, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Joachim Herz
- Departments of Molecular Genetics, Neuroscience, Neurology, Center for Translational Neurodegeneration Research, UT Southwestern, Dallas, TX, USA
| | - David M Holtzman
- Department of Neurology, Hope Center for Neurological Disorders, Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA
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3
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Lepinay E, Cicchetti F. Tau: a biomarker of Huntington's disease. Mol Psychiatry 2023; 28:4070-4083. [PMID: 37749233 DOI: 10.1038/s41380-023-02230-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 07/31/2023] [Accepted: 08/11/2023] [Indexed: 09/27/2023]
Abstract
Developing effective treatments for patients with Huntington's disease (HD)-a neurodegenerative disorder characterized by severe cognitive, motor and psychiatric impairments-is proving extremely challenging. While the monogenic nature of this condition enables to identify individuals at risk, robust biomarkers would still be extremely valuable to help diagnose disease onset and progression, and especially to confirm treatment efficacy. If measurements of cerebrospinal fluid neurofilament levels, for example, have demonstrated use in recent clinical trials, other proteins may prove equal, if not greater, relevance as biomarkers. In fact, proteins such as tau could specifically be used to detect/predict cognitive affectations. We have herein reviewed the literature pertaining to the association between tau levels and cognitive states, zooming in on Alzheimer's disease, Parkinson's disease and traumatic brain injury in which imaging, cerebrospinal fluid, and blood samples have been interrogated or used to unveil a strong association between tau and cognition. Collectively, these areas of research have accrued compelling evidence to suggest tau-related measurements as both diagnostic and prognostic tools for clinical practice. The abundance of information retrieved in this niche of study has laid the groundwork for further understanding whether tau-related biomarkers may be applied to HD and guide future investigations to better understand and treat this disease.
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Affiliation(s)
- Eva Lepinay
- Centre de Recherche du CHU de Québec, Axe Neurosciences, Québec, QC, Canada
- Département de Psychiatrie & Neurosciences, Université Laval, Québec, QC, Canada
| | - Francesca Cicchetti
- Centre de Recherche du CHU de Québec, Axe Neurosciences, Québec, QC, Canada.
- Département de Psychiatrie & Neurosciences, Université Laval, Québec, QC, Canada.
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4
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Palmer JM, Huentelman M, Ryan L. More than just risk for Alzheimer's disease: APOE ε4's impact on the aging brain. Trends Neurosci 2023; 46:750-763. [PMID: 37460334 DOI: 10.1016/j.tins.2023.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/16/2023] [Accepted: 06/12/2023] [Indexed: 08/18/2023]
Abstract
The apolipoprotein ε4 (APOE ε4) allele is most commonly associated with increased risk for late-onset Alzheimer's disease (AD). However, recent longitudinal studies suggest that these risks are overestimated; most ε4 carriers will not develop dementia in their lifetime. In this article, we review new evidence regarding the impact of APOE ε4 on cognition among healthy older adults. We discuss emerging work from animal models suggesting that ε4 impacts brain structure and function in multiple ways that may lead to age-related cognitive impairment, independent from AD pathology. We discuss the importance of taking an individualized approach in future studies by incorporating biomarkers and neuroimaging methods that may better disentangle the phenotypic influences of APOE ε4 on the aging brain from prodromal AD pathology.
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Affiliation(s)
- Justin M Palmer
- The University of Arizona, Tucson, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA.
| | - Matthew Huentelman
- Translational Genomics Research Institute, Phoenix, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Lee Ryan
- The University of Arizona, Tucson, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA.
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5
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Toniolo S, Di Lorenzo F, Bernardini S, Mercuri NB, Sancesario GM. Blood-Brain Barrier Dysfunction and Aβ42/40 Ratio Dose-Dependent Modulation with the ApoE Genotype within the ATN Framework. Int J Mol Sci 2023; 24:12151. [PMID: 37569528 PMCID: PMC10418506 DOI: 10.3390/ijms241512151] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 08/13/2023] Open
Abstract
The definition of Alzheimer's disease (AD) now considers the presence of the markers of amyloid (A), tau deposition (T), and neurodegeneration (N) essential for diagnosis. AD patients have been reported to have increased blood-brain barrier (BBB) dysfunction, but that has not been tested within the ATN framework so far. As the field is moving towards the use of blood-based biomarkers, the relationship between BBB disruption and AD-specific biomarkers requires considerable attention. Moreover, other factors have been previously implicated in modulating BBB permeability, including age, gender, and ApoE status. A total of 172 cognitively impaired individuals underwent cerebrospinal fluid (CSF) analysis for AD biomarkers, and data on BBB dysfunction, demographics, and ApoE status were collected. Our data showed that there was no difference in BBB dysfunction across different ATN subtypes, and that BBB damage was not correlated with cognitive impairment. However, patients with BBB disruption, if measured with a high Qalb, had low Aβ40 levels. ApoE status did not affect BBB function but had a dose-dependent effect on the Aβ42/40 ratio. These results might highlight the importance of understanding dynamic changes across the BBB in future studies in patients with AD.
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Affiliation(s)
- Sofia Toniolo
- Cognitive Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX1 3AZ, UK
- Department of Systems Medicine, University of Rome ‘Tor Vergata’, 00133 Rome, Italy (G.M.S.)
| | - Francesco Di Lorenzo
- Department of Systems Medicine, University of Rome ‘Tor Vergata’, 00133 Rome, Italy (G.M.S.)
- Non-Invasive Brain Simulation Unit, IRCSS Santa Lucia Foundation, 00179 Rome, Italy
| | - Sergio Bernardini
- Department of Systems Medicine, University of Rome ‘Tor Vergata’, 00133 Rome, Italy (G.M.S.)
| | - Nicola Biagio Mercuri
- Department of Systems Medicine, University of Rome ‘Tor Vergata’, 00133 Rome, Italy (G.M.S.)
| | - Giulia Maria Sancesario
- Department of Systems Medicine, University of Rome ‘Tor Vergata’, 00133 Rome, Italy (G.M.S.)
- Biobank Unit, IRCSS Santa Lucia Foundation, 00179 Rome, Italy
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6
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Dincer A, Chen CD, McKay NS, Koenig LN, McCullough A, Flores S, Keefe SJ, Schultz SA, Feldman RL, Joseph-Mathurin N, Hornbeck RC, Cruchaga C, Schindler SE, Holtzman DM, Morris JC, Fagan AM, Benzinger TLS, Gordon BA. APOE ε4 genotype, amyloid-β, and sex interact to predict tau in regions of high APOE mRNA expression. Sci Transl Med 2022; 14:eabl7646. [PMID: 36383681 PMCID: PMC9912474 DOI: 10.1126/scitranslmed.abl7646] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The apolipoprotein E (APOE) ε4 allele is strongly linked with cerebral β-amyloidosis, but its relationship with tauopathy is less established. We investigated the relationship between APOE ε4 carrier status, regional amyloid-β (Aβ), magnetic resonance imaging (MRI) volumetrics, tau positron emission tomography (PET), APOE messenger RNA (mRNA) expression maps, and cerebrospinal fluid phosphorylated tau (CSF ptau181). Three hundred fifty participants underwent imaging, and 270 had ptau181. We used computational models to evaluate the main effect of APOE ε4 carrier status on regional neuroimaging values and then the interaction of ε4 status and global Aβ on regional tau PET and brain volumes as well as CSF ptau181. Separately, we also examined the additional interactive influence of sex. We found that, for the same degree of Aβ burden, APOE ε4 carriers showed greater tau PET signal relative to noncarriers in temporal regions, but no interaction was present for MRI volumes or CSF ptau181. This potentiation of tau aggregation irrespective of sex occurred in brain regions with high APOE mRNA expression, suggesting local vulnerabilities to tauopathy. There were greater effects of APOE genotype in females, although the interactive sex effects did not strongly mirror mRNA expression. Pathology is not homogeneously expressed throughout the brain but mirrors underlying biological patterns such as gene expression.
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Affiliation(s)
- Aylin Dincer
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA
| | - Charles D Chen
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA
| | - Nicole S McKay
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA
| | - Lauren N Koenig
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA
| | - Austin McCullough
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA
| | - Shaney Flores
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA
| | - Sarah J Keefe
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA
| | - Stephanie A Schultz
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA
| | - Rebecca L Feldman
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA
| | - Nelly Joseph-Mathurin
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA
| | - Russ C Hornbeck
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA
| | - Carlos Cruchaga
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA.,Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
| | - Suzanne E Schindler
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - David M Holtzman
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA.,Hope Center for Neurological Disorders, Washington University School of Medicine, Saint Louis, MO, USA
| | - John C Morris
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Anne M Fagan
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Tammie LS Benzinger
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA
| | - Brian A Gordon
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA.,Hope Center for Neurological Disorders, Washington University School of Medicine, Saint Louis, MO, USA.,Department of Psychological & Brain Sciences, Washington University, Saint Louis, MO, USA
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7
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Fernández-Calle R, Konings SC, Frontiñán-Rubio J, García-Revilla J, Camprubí-Ferrer L, Svensson M, Martinson I, Boza-Serrano A, Venero JL, Nielsen HM, Gouras GK, Deierborg T. APOE in the bullseye of neurodegenerative diseases: impact of the APOE genotype in Alzheimer’s disease pathology and brain diseases. Mol Neurodegener 2022; 17:62. [PMID: 36153580 PMCID: PMC9509584 DOI: 10.1186/s13024-022-00566-4] [Citation(s) in RCA: 64] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 08/29/2022] [Indexed: 02/06/2023] Open
Abstract
ApoE is the major lipid and cholesterol carrier in the CNS. There are three major human polymorphisms, apoE2, apoE3, and apoE4, and the genetic expression of APOE4 is one of the most influential risk factors for the development of late-onset Alzheimer's disease (AD). Neuroinflammation has become the third hallmark of AD, together with Amyloid-β plaques and neurofibrillary tangles of hyperphosphorylated aggregated tau protein. This review aims to broadly and extensively describe the differential aspects concerning apoE. Starting from the evolution of apoE to how APOE's single-nucleotide polymorphisms affect its structure, function, and involvement during health and disease. This review reflects on how APOE's polymorphisms impact critical aspects of AD pathology, such as the neuroinflammatory response, particularly the effect of APOE on astrocytic and microglial function and microglial dynamics, synaptic function, amyloid-β load, tau pathology, autophagy, and cell–cell communication. We discuss influential factors affecting AD pathology combined with the APOE genotype, such as sex, age, diet, physical exercise, current therapies and clinical trials in the AD field. The impact of the APOE genotype in other neurodegenerative diseases characterized by overt inflammation, e.g., alpha- synucleinopathies and Parkinson's disease, traumatic brain injury, stroke, amyotrophic lateral sclerosis, and multiple sclerosis, is also addressed. Therefore, this review gathers the most relevant findings related to the APOE genotype up to date and its implications on AD and CNS pathologies to provide a deeper understanding of the knowledge in the APOE field.
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8
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Petersen KK, Grober E, Lipton RB, Sperling RA, Buckley RF, Aisen PS, Ezzati A. Impact of sex and APOE ε4 on the association of cognition and hippocampal volume in clinically normal, amyloid positive adults. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12271. [PMID: 35155730 PMCID: PMC8828988 DOI: 10.1002/dad2.12271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/08/2021] [Accepted: 11/15/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Cognitive decline follows pathological changes including neurodegeneration on the Alzheimer's disease continuum. However, it is unclear which cognitive domains first become affected by neurodegeneration in amyloid-positive individuals and if sex or apolipoprotein (APOE) ε4 status differences affect this relationship. METHODS Data from 1233 cognitively unimpaired, amyloid-positive individuals 65 to 85 years of age were studied to assess the effect of hippocampal volume (HV) on cognition and to evaluate differences due to sex and APOE ε4 status. RESULTS Lower HV was linked with worse performance on measures of memory (free recall, total recall, logical memory delayed recall, Mini-Mental State Examination [MMSE]), executive functioning (digit symbol substitution, DSS), and the Preclinical Alzheimer's Cognitive Composite (PACC). Among both women and APOE ε4+ individuals, all cognitive measures, except MMSE, were associated with HV. DSS and PACC had the largest effect sizes in differentiating early and intermediate stage neurodegeneration. DISCUSSION Despite all cognitive measures being associated with HV, cognitive tests show differences in detecting early or late signs of neurodegeneration. Differences exist in association between cognition and neurodegeneration based on sex and APOE ε4 status.
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Affiliation(s)
- Kellen K. Petersen
- Department of NeurologyAlbert Einstein College of MedicineNew York CityNew YorkUSA
| | - Ellen Grober
- Department of NeurologyAlbert Einstein College of MedicineNew York CityNew YorkUSA
| | - Richard B. Lipton
- Department of NeurologyAlbert Einstein College of MedicineNew York CityNew YorkUSA
| | - Reisa A. Sperling
- Department of NeurologyHarvard Aging Brain StudyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyCenter for Alzheimer Research and TreatmentBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Rachel F. Buckley
- Department of NeurologyMassachusetts General Hospital/Brigham and Women's Hospital/Harvard Medical SchoolBostonMassachusettsUSA
| | - Paul S. Aisen
- Alzheimer Therapeutic Research InstituteKeck School of MedicineUniversity of Southern CaliforniaSan DiegoCaliforniaUSA
| | - Ali Ezzati
- Department of NeurologyAlbert Einstein College of MedicineNew York CityNew YorkUSA
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9
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Nowak A, Kojder K, Zielonka-Brzezicka J, Wróbel J, Bosiacki M, Fabiańska M, Wróbel M, Sołek-Pastuszka J, Klimowicz A. The Use of Ginkgo Biloba L. as a Neuroprotective Agent in the Alzheimer's Disease. Front Pharmacol 2021; 12:775034. [PMID: 34803717 PMCID: PMC8599153 DOI: 10.3389/fphar.2021.775034] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 10/22/2021] [Indexed: 12/19/2022] Open
Abstract
Alzheimer's disease, a neurodegenerative disease, is one of the most common causes of dementia if elderly people worldwide. Alzheimer's disease leads to the alienation of individuals and their exclusion from social and professional life. It is characterized mainly by the degradation of memory and disorientation, which occurs as a result of the loss of neuronal structure and function in different brain areas. In recent years, more and more attention has been paid to use in the treatment of natural bioactive compounds that will be effective in neurodegenerative diseases, including Alzheimer's disease. G. biloba L. and its most frequently used standardized extract (EGb 761), have been used for many years in supportive therapy and in the prevention of cognitive disorders. The paper presents an overview of reports on the pathogenesis of Alzheimer's disease, as well as a summary of the properties of G. biloba extract and its effects on the possible pathogenesis of the disease. By exploring more about the pathogenesis of the disease and the benefits of G. biloba extract for patients with Alzheimer's disease, it will be possible to create an individualized therapeutic protocol to optimize the treatment.
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Affiliation(s)
- Anna Nowak
- Department of Cosmetic and Pharmaceutical Chemistry, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Klaudyna Kojder
- Department of Anesthesiology and Intensive Care, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Joanna Zielonka-Brzezicka
- Department of Cosmetic and Pharmaceutical Chemistry, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Jacek Wróbel
- Department of Bioengineering, West Pomeranian University of Technology in Szczecin, Szczecin, Poland
| | - Mateusz Bosiacki
- Department of Functional Diagnostics and Physical Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Marta Fabiańska
- Institute of Philosophy and Cognitive Science, University of Szczecin, Szczecin, Poland
| | - Mariola Wróbel
- Department of Landscape Architecture, West Pomeranian University of Technology in Szczecin, Szczecin, Poland
| | - Joanna Sołek-Pastuszka
- Department of Anesthesiology and Intensive Care, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Adam Klimowicz
- Department of Cosmetic and Pharmaceutical Chemistry, Pomeranian Medical University in Szczecin, Szczecin, Poland
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10
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Jabeen K, Rehman K, Akash MSH. Genetic mutations of APOEε4 carriers in cardiovascular patients lead to the development of insulin resistance and risk of Alzheimer's disease. J Biochem Mol Toxicol 2021; 36:e22953. [PMID: 34757642 DOI: 10.1002/jbt.22953] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/11/2021] [Accepted: 11/01/2021] [Indexed: 12/19/2022]
Abstract
Type 2 diabetes mellitus and Alzheimer's disease (AD), both are chronic and progressive diseases. Many cardiovascular and genetic risk factors are considered responsible for the development of AD and diabetes mellitus (DM). Genetic risk factor such as apolipoprotein E (APOE) plays a critical role in the progression of AD. Specifically, APOEε4 is genetically the strongest isoform associated with neuronal insulin deficiency, altered lipid homeostasis, and metabolism, decreased glucose uptake, impaired gray matter volume, and cerebrovascular functions. In this article, we have summarized the mechanisms of cardiovascular disturbances associated with AD and DM, impact of amyloid-β aggregation, and neurofibrillary tangles formation in AD. Moreover, cardiovascular risk factors leading to insulin resistance (IR) and amyloid-β aggregation are highlighted along with the effects of APOE risk alleles on cerebral, lipid, and cholesterol metabolism leading to CVD-mediated IR. Correspondingly, the contribution of IR, genetic and cardiovascular risk factors in amyloid-β aggregation, which may lead to the late onset of AD and DM, has been also discussed. In short, IR is related to significantly lower cerebral glucose metabolism, which sequentially forecasts poorer memory performance. Hence, there will be more chances for neural glucose intolerance and impairment of cognitive function in cardiac patients, particularly APOEε4 carriers having IR. Hence, this review provides a better understanding of the corresponding crosstalk among different pathways. This will help to investigate the rational application of preventive measures against IR and cognitive dysfunction, specifically in APOEε4 carriers' cardio-metabolic patients.
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Affiliation(s)
- Komal Jabeen
- Department of Pharmacy, University of Agriculture, Faisalabad, Pakistan.,Institute of Physiology and Pharmacology, University of Agriculture, Faisalabad, Pakistan
| | - Kanwal Rehman
- Department of Pharmacy, University of Agriculture, Faisalabad, Pakistan
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11
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Powell F, Tosun D, Raj A. Network-constrained technique to characterize pathology progression rate in Alzheimer's disease. Brain Commun 2021; 3:fcab144. [PMID: 34704025 PMCID: PMC8376686 DOI: 10.1093/braincomms/fcab144] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 02/12/2021] [Accepted: 03/19/2021] [Indexed: 11/30/2022] Open
Abstract
Current methods for measuring the chronic rates of cognitive decline and degeneration in Alzheimer’s disease rely on the sensitivity of longitudinal neuropsychological batteries and clinical neuroimaging, particularly structural magnetic resonance imaging of brain atrophy, either at a global or regional scale. There is particular interest in approaches predictive of future disease progression and clinical outcomes using a single time point. If successful, such approaches could have great impact on differential diagnosis, therapeutic treatment and clinical trial inclusion. Unfortunately, it has proven quite challenging to accurately predict clinical and degeneration progression rates from baseline data. Specifically, a key limitation of the previously proposed approaches for disease progression based on the brain atrophy measures has been the limited incorporation of the knowledge from disease pathology progression models, which suggest a prion-like spread of disease pathology and hence the neurodegeneration. Here, we present a new metric for disease progression rate in Alzheimer that uses only MRI-derived atrophy data yet is able to infer the underlying rate of pathology transmission. This is enabled by imposing a spread process driven by the brain networks using a Network Diffusion Model. We first fit this model to each patient’s longitudinal brain atrophy data defined on a brain network structure to estimate a patient-specific rate of pathology diffusion, called the pathology progression rate. Using machine learning algorithms, we then build a baseline data model and tested this rate metric on data from longitudinal Alzheimer’s Disease Neuroimaging Initiative study including 810 subjects. Our measure of disease progression differed significantly across diagnostic groups as well as between groups with different genetic risk factors. Remarkably, hierarchical clustering revealed 3 distinct clusters based on CSF profiles with >90% accuracy. These pathological clusters exhibit progressive atrophy and clinical impairments that correspond to the proposed rate measure. We demonstrate that a subject’s degeneration speed can be best predicted from baseline neuroimaging volumetrics and fluid biomarkers for subjects in the middle of their degenerative course, which may be a practical, inexpensive screening tool for future prognostic applications.
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Affiliation(s)
- Fon Powell
- Department of Radiology, Weill Cornell Medical College of Cornell University, New York, NY 10065, USA
| | - Duygu Tosun
- Department of Radiology and Biomedical Imaging, University of California San Francisco, AC-116, Parnassus, Box 0628, San Francisco, CA 94122, USA.,San Francisco Veterans Affairs Medical Center, San Francisco, CA 94121, USA
| | - Ashish Raj
- Department of Radiology, Weill Cornell Medical College of Cornell University, New York, NY 10065, USA.,Department of Radiology and Biomedical Imaging, University of California San Francisco, AC-116, Parnassus, Box 0628, San Francisco, CA 94122, USA
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12
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Lloret A, Esteve D, Lloret MA, Cervera-Ferri A, Lopez B, Nepomuceno M, Monllor P. When Does Alzheimer's Disease Really Start? The Role of Biomarkers. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2021; 19:355-364. [PMID: 34690605 DOI: 10.1176/appi.focus.19305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
(Appeared originally in Int J Mol Sci 2019, 20 5536).
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Affiliation(s)
- Ana Lloret
- Department of Physiology, Faculty of Medicine, University of Valencia, Health Research Institute INCLIVA, Avda. Blasco Ibanez, 17, 46010 Valencia, Spain; Department of Clinic Neurophysiology. University Clinic Hospital of Valencia, Avda. Blasco Ibanez, 19, 46010 Valencia, Spain; Department of Human Anatomy and Embriology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; Department of Neurology. University Clinic Hospital of Valencia, Avda. Blasco Ibanez, 19, 46010 Valencia, Spain
| | - Daniel Esteve
- Department of Physiology, Faculty of Medicine, University of Valencia, Health Research Institute INCLIVA, Avda. Blasco Ibanez, 17, 46010 Valencia, Spain; Department of Clinic Neurophysiology. University Clinic Hospital of Valencia, Avda. Blasco Ibanez, 19, 46010 Valencia, Spain; Department of Human Anatomy and Embriology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; Department of Neurology. University Clinic Hospital of Valencia, Avda. Blasco Ibanez, 19, 46010 Valencia, Spain
| | - Maria-Angeles Lloret
- Department of Physiology, Faculty of Medicine, University of Valencia, Health Research Institute INCLIVA, Avda. Blasco Ibanez, 17, 46010 Valencia, Spain; Department of Clinic Neurophysiology. University Clinic Hospital of Valencia, Avda. Blasco Ibanez, 19, 46010 Valencia, Spain; Department of Human Anatomy and Embriology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; Department of Neurology. University Clinic Hospital of Valencia, Avda. Blasco Ibanez, 19, 46010 Valencia, Spain
| | - Ana Cervera-Ferri
- Department of Physiology, Faculty of Medicine, University of Valencia, Health Research Institute INCLIVA, Avda. Blasco Ibanez, 17, 46010 Valencia, Spain; Department of Clinic Neurophysiology. University Clinic Hospital of Valencia, Avda. Blasco Ibanez, 19, 46010 Valencia, Spain; Department of Human Anatomy and Embriology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; Department of Neurology. University Clinic Hospital of Valencia, Avda. Blasco Ibanez, 19, 46010 Valencia, Spain
| | - Begoña Lopez
- Department of Physiology, Faculty of Medicine, University of Valencia, Health Research Institute INCLIVA, Avda. Blasco Ibanez, 17, 46010 Valencia, Spain; Department of Clinic Neurophysiology. University Clinic Hospital of Valencia, Avda. Blasco Ibanez, 19, 46010 Valencia, Spain; Department of Human Anatomy and Embriology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; Department of Neurology. University Clinic Hospital of Valencia, Avda. Blasco Ibanez, 19, 46010 Valencia, Spain
| | - Mariana Nepomuceno
- Department of Physiology, Faculty of Medicine, University of Valencia, Health Research Institute INCLIVA, Avda. Blasco Ibanez, 17, 46010 Valencia, Spain; Department of Clinic Neurophysiology. University Clinic Hospital of Valencia, Avda. Blasco Ibanez, 19, 46010 Valencia, Spain; Department of Human Anatomy and Embriology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; Department of Neurology. University Clinic Hospital of Valencia, Avda. Blasco Ibanez, 19, 46010 Valencia, Spain
| | - Paloma Monllor
- Department of Physiology, Faculty of Medicine, University of Valencia, Health Research Institute INCLIVA, Avda. Blasco Ibanez, 17, 46010 Valencia, Spain; Department of Clinic Neurophysiology. University Clinic Hospital of Valencia, Avda. Blasco Ibanez, 19, 46010 Valencia, Spain; Department of Human Anatomy and Embriology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; Department of Neurology. University Clinic Hospital of Valencia, Avda. Blasco Ibanez, 19, 46010 Valencia, Spain
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13
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Hampel H, Hardy J, Blennow K, Chen C, Perry G, Kim SH, Villemagne VL, Aisen P, Vendruscolo M, Iwatsubo T, Masters CL, Cho M, Lannfelt L, Cummings JL, Vergallo A. The Amyloid-β Pathway in Alzheimer's Disease. Mol Psychiatry 2021; 26:5481-5503. [PMID: 34456336 PMCID: PMC8758495 DOI: 10.1038/s41380-021-01249-0] [Citation(s) in RCA: 456] [Impact Index Per Article: 152.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 07/19/2021] [Accepted: 07/28/2021] [Indexed: 02/06/2023]
Abstract
Breakthroughs in molecular medicine have positioned the amyloid-β (Aβ) pathway at the center of Alzheimer's disease (AD) pathophysiology. While the detailed molecular mechanisms of the pathway and the spatial-temporal dynamics leading to synaptic failure, neurodegeneration, and clinical onset are still under intense investigation, the established biochemical alterations of the Aβ cycle remain the core biological hallmark of AD and are promising targets for the development of disease-modifying therapies. Here, we systematically review and update the vast state-of-the-art literature of Aβ science with evidence from basic research studies to human genetic and multi-modal biomarker investigations, which supports a crucial role of Aβ pathway dyshomeostasis in AD pathophysiological dynamics. We discuss the evidence highlighting a differentiated interaction of distinct Aβ species with other AD-related biological mechanisms, such as tau-mediated, neuroimmune and inflammatory changes, as well as a neurochemical imbalance. Through the lens of the latest development of multimodal in vivo biomarkers of AD, this cross-disciplinary review examines the compelling hypothesis- and data-driven rationale for Aβ-targeting therapeutic strategies in development for the early treatment of AD.
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Affiliation(s)
- Harald Hampel
- Eisai Inc., Neurology Business Group, Woodcliff Lake, NJ, USA.
| | - John Hardy
- UK Dementia Research Institute at UCL and Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Christopher Chen
- Memory Aging and Cognition Centre, Departments of Pharmacology and Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - George Perry
- Department of Biology and Neurosciences Institute, University of Texas at San Antonio (UTSA), San Antonio, TX, USA
| | - Seung Hyun Kim
- Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea; Cell Therapy Center, Hanyang University Hospital, Seoul, Republic of Korea
| | - Victor L Villemagne
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia
| | - Paul Aisen
- USC Alzheimer's Therapeutic Research Institute, San Diego, CA, USA
| | - Michele Vendruscolo
- Centre for Misfolding Diseases, Department of Chemistry, University of Cambridge, Cambridge, UK
| | - Takeshi Iwatsubo
- Department of Neuropathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Colin L Masters
- Laureate Professor of Dementia Research, Florey Institute and The University of Melbourne, Parkville, VIC, Australia
| | - Min Cho
- Eisai Inc., Neurology Business Group, Woodcliff Lake, NJ, USA
| | - Lars Lannfelt
- Uppsala University, Department of of Public Health/Geriatrics, Uppsala, Sweden
- BioArctic AB, Stockholm, Sweden
| | - Jeffrey L Cummings
- Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada Las Vegas (UNLV), Las Vegas, NV, USA
| | - Andrea Vergallo
- Eisai Inc., Neurology Business Group, Woodcliff Lake, NJ, USA.
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14
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Diagnosis Test Meta-Analysis for Apolipoprotein E in Alzheimer's Disease. DISEASE MARKERS 2021; 2020:6486031. [PMID: 33101544 PMCID: PMC7569444 DOI: 10.1155/2020/6486031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 08/17/2020] [Accepted: 09/13/2020] [Indexed: 11/25/2022]
Abstract
Objective To evaluate the diagnostic value of apolipoprotein E (APOE) gene in Alzheimer's disease (AD). Methods Databases including PubMed, EMBASE, Google Scholar, Wanfang Med online, China National Knowledge Infrastructure (CNKI), and China Biomedical Literature Database (CBM) were searched for literatures in English or Chinese. No limitations on the date. The sensitivity, specificity, likelihood ratio, and diagnostic odds ratio were pooled for meta-analysis. The symmetric receiver operator characteristic curve (SROC) and Fagan's Nomogram were drawn, and metaregression and subgroup analysis were used to explore the source of heterogeneity. Results A total of 13 studies, including 2662 cases and 8843 controls, were analyzed. The combined sensitivity (SEN) was 0.62 (95% CI (0.58-0.66)), specificity (SPE) was 0.84 (95% CI (0.81-0.86)), the positive likelihood ratio was 3.8 (95% CI (3.3-4.3)), and the negative likelihood ratio was 0.45 (95% CI (0.41-0.49)). The area under the ROC curve was 0.80, and the diagnostic ratio (DOR) was 8. Neither publication bias was detected in Deeks' funnel plot, nor threshold effect was shown in the SROC. Metaregression analysis showed that the diagnostic methods, experimental design, and sample size contributed to the heterogeneity in SEN, while the diagnostic methods, experimental design, blind evaluation on test results, and sample size contributed to the heterogeneity in SPE. When the pretest probability was set as 50%, the posterior probability in Fagan's Nomogram was 79%, the positive likelihood ratio (LRP) was 5, and the negative likelihood ratio (LRN) was 0.42. Conclusions AD could neither be confirmed nor excluded by the APOE genotype test. The sensitivity and specificity of the APOE gene test were relatively low in the diagnosis of AD. The diagnostic value of APOE ε4 gene in AD was moderate; it might play an important role in the prevention of AD.
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15
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2020 update on the clinical validity of cerebrospinal fluid amyloid, tau, and phospho-tau as biomarkers for Alzheimer's disease in the context of a structured 5-phase development framework. Eur J Nucl Med Mol Imaging 2021; 48:2121-2139. [PMID: 33674895 PMCID: PMC8175301 DOI: 10.1007/s00259-021-05258-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/11/2021] [Indexed: 12/15/2022]
Abstract
Purpose In the last decade, the research community has focused on defining reliable biomarkers for the early detection of Alzheimer’s disease (AD) pathology. In 2017, the Geneva AD Biomarker Roadmap Initiative adapted a framework for the systematic validation of oncological biomarkers to cerebrospinal fluid (CSF) AD biomarkers—encompassing the 42 amino-acid isoform of amyloid-β (Aβ42), phosphorylated-tau (P-tau), and Total-tau (T-tau)—with the aim to accelerate their development and clinical implementation. The aim of this work is to update the current validation status of CSF AD biomarkers based on the Biomarker Roadmap methodology. Methods A panel of experts in AD biomarkers convened in November 2019 at a 2-day workshop in Geneva. The level of maturity (fully achieved, partly achieved, preliminary evidence, not achieved, unsuccessful) of CSF AD biomarkers was assessed based on the Biomarker Roadmap methodology before the meeting and presented and discussed during the workshop. Results By comparison to the previous 2017 Geneva Roadmap meeting, the primary advances in CSF AD biomarkers have been in the area of a unified protocol for CSF sampling, handling and storage, the introduction of certified reference methods and materials for Aβ42, and the introduction of fully automated assays. Additional advances have occurred in the form of defining thresholds for biomarker positivity and assessing the impact of covariates on their discriminatory ability. Conclusions Though much has been achieved for phases one through three, much work remains in phases four (real world performance) and five (assessment of impact/cost). To a large degree, this will depend on the availability of disease-modifying treatments for AD, given these will make accurate and generally available diagnostic tools key to initiate therapy. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-021-05258-7.
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16
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Lehmann S, Dumurgier J, Ayrignac X, Marelli C, Alcolea D, Ormaechea JF, Thouvenot E, Delaby C, Hirtz C, Vialaret J, Ginestet N, Bouaziz-Amar E, Laplanche JL, Labauge P, Paquet C, Lleo A, Gabelle A. Cerebrospinal fluid A beta 1-40 peptides increase in Alzheimer's disease and are highly correlated with phospho-tau in control individuals. ALZHEIMERS RESEARCH & THERAPY 2020; 12:123. [PMID: 33008460 PMCID: PMC7532565 DOI: 10.1186/s13195-020-00696-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/23/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Amyloid pathology, which is one of the characteristics of Alzheimer's disease (AD), results from altered metabolism of the beta-amyloid (Aβ) peptide in terms of synthesis, clearance, or aggregation. A decrease in cerebrospinal fluid (CSF) level Aβ1-42 is evident in AD, and the CSF ratio Aβ42/Aβ40 has recently been identified as one of the most reliable diagnostic biomarkers of amyloid pathology. Variations in inter-individual levels of Aβ1-40 in the CSF have been observed in the past, but their origins remain unclear. In addition, the variation of Aβ40 in the context of AD studied in several studies has yielded conflicting results. METHODS Here, we analyzed the levels of Aβ1-40 using multicenter data obtained on 2466 samples from six different cohorts in which CSF was collected under standardized protocols, centrifugation, and storage conditions. Tau and p-tau (181) concentrations were measured using commercially available in vitro diagnostic immunoassays. Concentrations of CSF Aβ1-42 and Aβ1-40 were measured by ELISA, xMAP technology, chemiluminescence immunoassay (CLIA), and mass spectrometry. Statistical analyses were calculated for parametric and non-parametric comparisons, linear regression, correlation, and odds ratios. The statistical tests were adjusted for the effects of covariates (age, in particular). RESULTS Regardless of the analysis method used and the cohorts, a slight but significant age-independent increase in the levels of Aβ40 in CSF was observed in AD. We also found a strong positive correlation between the levels of Aβ1-40 and p-tau (181) in CSF, particularly in control patients. CONCLUSIONS These results indicate that an increase in the baseline level of amyloid peptides, which are associated with an increase in p-tau (181), may be a biological characteristic and possibly a risk factor for AD. Further studies will be needed to establish a causal link between increased baseline levels of Aβ40 and the development of the disease.
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Affiliation(s)
- Sylvain Lehmann
- Univ Montpellier, CHU Montpellier (LBPC-PPC), INSERM (IRMB, INM), Montpellier, France.
| | - Julien Dumurgier
- Centre de Neurologie Cognitive et Service de Biochimie et de Biologie Moléculaire, Groupe Hospitalier Lariboisière Fernand-Widal, INSERMU942, Université Paris Diderot, Paris, France
| | - Xavier Ayrignac
- CHU de Montpellier, Département de Neurologie, INSERM, Univ Montpellier, Montpellier, France
| | - Cecilia Marelli
- CHU de Montpellier, Département de Neurologie, INSERM, Univ Montpellier, Montpellier, France
| | - Daniel Alcolea
- Sant Pau Memory Unit, Department of Neurology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Juan Fortea Ormaechea
- Sant Pau Memory Unit, Department of Neurology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eric Thouvenot
- CHU de Nîmes, Département de Neurologie, INSERM, Univ Montpellier, Montpellier, France
| | - Constance Delaby
- Univ Montpellier, CHU Montpellier (LBPC-PPC), INSERM (IRMB, INM), Montpellier, France
| | - Christophe Hirtz
- Univ Montpellier, CHU Montpellier (LBPC-PPC), INSERM (IRMB, INM), Montpellier, France
| | - Jérôme Vialaret
- Univ Montpellier, CHU Montpellier (LBPC-PPC), INSERM (IRMB, INM), Montpellier, France
| | - Nelly Ginestet
- Univ Montpellier, CHU Montpellier (LBPC-PPC), INSERM (IRMB, INM), Montpellier, France
| | - Elodie Bouaziz-Amar
- Centre de Neurologie Cognitive et Service de Biochimie et de Biologie Moléculaire, Groupe Hospitalier Lariboisière Fernand-Widal, INSERMU942, Université Paris Diderot, Paris, France
| | - Jean-Louis Laplanche
- Centre de Neurologie Cognitive et Service de Biochimie et de Biologie Moléculaire, Groupe Hospitalier Lariboisière Fernand-Widal, INSERMU942, Université Paris Diderot, Paris, France
| | - Pierre Labauge
- CHU de Montpellier, Département de Neurologie, INSERM, Univ Montpellier, Montpellier, France
| | - Claire Paquet
- Centre de Neurologie Cognitive et Service de Biochimie et de Biologie Moléculaire, Groupe Hospitalier Lariboisière Fernand-Widal, INSERMU942, Université Paris Diderot, Paris, France
| | - Alberto Lleo
- Sant Pau Memory Unit, Department of Neurology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Audrey Gabelle
- Univ Montpellier, INSERM, CHU Montpellier (CMRR), Montpellier, France
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17
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Ahmad S, Orellana A, Kohler I, Frölich L, de Rojas I, Gil S, Boada M, Hernández I, Hausner L, Bakker MHM, Cabrera-Socorro A, Amin N, Ramírez A, Ruiz A, Hankemeier T, Van Duijn CM. Association of lysophosphatidic acids with cerebrospinal fluid biomarkers and progression to Alzheimer's disease. ALZHEIMERS RESEARCH & THERAPY 2020; 12:124. [PMID: 33008436 PMCID: PMC7532619 DOI: 10.1186/s13195-020-00680-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 09/09/2020] [Indexed: 01/15/2023]
Abstract
Background Lysophosphatidic acids (LPAs) are bioactive signaling phospholipids that have been implicated in Alzheimer’s disease (AD). It is largely unknown whether LPAs are associated with AD pathology and progression from mild cognitive impairment (MCI) to AD. Methods The current study was performed on cerebrospinal fluid (CSF) and plasma samples of 182 MCI patients from two independent cohorts. We profiled LPA-derived metabolites using liquid chromatography-mass spectrometry. We evaluated the association of LPAs with CSF biomarkers of AD, Aβ-42, p-tau, and total tau levels overall and stratified by APOE genotype and with MCI to AD progression. Results Five LPAs (C16:0, C16:1, C22:4, C22:6, and isomer-LPA C22:5) showed significant positive association with CSF biomarkers of AD, Aβ-42, p-tau, and total tau, while LPA C14:0 and C20:1 associated only with Aβ-42 and alkyl-LPA C18:1, and LPA C20:1 associated with tau pathology biomarkers. Association of cyclic-LPA C16:0 and two LPAs (C20:4, C22:4) with Aβ-42 levels was found only in APOE ε4 carriers. Furthermore, LPA C16:0 and C16:1 also showed association with MCI to AD dementia progression, but results did not replicate in an independent cohort. Conclusions Our findings provide evidence that LPAs may contribute to early AD pathogenesis. Future studies are needed to determine whether LPAs play a role in upstream of AD pathology or are downstream markers of neurodegeneration.
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Affiliation(s)
- Shahzad Ahmad
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
| | - Adelina Orellana
- Research Center and Memory Clinic Fundació ACE, Institut Català de Neurociències, Aplicades. Universitat Internacional de Catalunya, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Isabelle Kohler
- Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, 68159, Mannheim, Germany
| | - Itziar de Rojas
- Research Center and Memory Clinic Fundació ACE, Institut Català de Neurociències, Aplicades. Universitat Internacional de Catalunya, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Silvia Gil
- Research Center and Memory Clinic Fundació ACE, Institut Català de Neurociències, Aplicades. Universitat Internacional de Catalunya, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Mercè Boada
- Research Center and Memory Clinic Fundació ACE, Institut Català de Neurociències, Aplicades. Universitat Internacional de Catalunya, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Isabel Hernández
- Research Center and Memory Clinic Fundació ACE, Institut Català de Neurociències, Aplicades. Universitat Internacional de Catalunya, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Lucrezia Hausner
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, 68159, Mannheim, Germany.,Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159, Mannheim, Germany
| | - Margot H M Bakker
- Discovery Research, AbbVie Deutschland GmbH & Co. KG, Knollstrasse, 67061, Ludwigshafen, Germany
| | | | - Najaf Amin
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Alfredo Ramírez
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany.,Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
| | - Agustín Ruiz
- Research Center and Memory Clinic Fundació ACE, Institut Català de Neurociències, Aplicades. Universitat Internacional de Catalunya, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Thomas Hankemeier
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands. .,Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands.
| | - Cornelia M Van Duijn
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands. .,Nuffield Department of Population Health, Oxford University, Oxford, UK.
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Uddin MS, Kabir MT, Rahman MS, Behl T, Jeandet P, Ashraf GM, Najda A, Bin-Jumah MN, El-Seedi HR, Abdel-Daim MM. Revisiting the Amyloid Cascade Hypothesis: From Anti-Aβ Therapeutics to Auspicious New Ways for Alzheimer's Disease. Int J Mol Sci 2020; 21:ijms21165858. [PMID: 32824102 PMCID: PMC7461598 DOI: 10.3390/ijms21165858] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/03/2020] [Accepted: 08/12/2020] [Indexed: 12/18/2022] Open
Abstract
Alzheimer’s disease (AD) is the most prevalent neurodegenerative disorder related to age, characterized by the cerebral deposition of fibrils, which are made from the amyloid-β (Aβ), a peptide of 40–42 amino acids. The conversion of Aβ into neurotoxic oligomeric, fibrillar, and protofibrillar assemblies is supposed to be the main pathological event in AD. After Aβ accumulation, the clinical symptoms fall out predominantly due to the deficient brain clearance of the peptide. For several years, researchers have attempted to decline the Aβ monomer, oligomer, and aggregate levels, as well as plaques, employing agents that facilitate the reduction of Aβ and antagonize Aβ aggregation, or raise Aβ clearance from brain. Unluckily, broad clinical trials with mild to moderate AD participants have shown that these approaches were unsuccessful. Several clinical trials are running involving patients whose disease is at an early stage, but the preliminary outcomes are not clinically impressive. Many studies have been conducted against oligomers of Aβ which are the utmost neurotoxic molecular species. Trials with monoclonal antibodies directed against Aβ oligomers have exhibited exciting findings. Nevertheless, Aβ oligomers maintain equivalent states in both monomeric and aggregation forms; so, previously administered drugs that precisely decrease Aβ monomer or Aβ plaques ought to have displayed valuable clinical benefits. In this article, Aβ-based therapeutic strategies are discussed and several promising new ways to fight against AD are appraised.
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Affiliation(s)
- Md. Sahab Uddin
- Department of Pharmacy, Southeast University, Dhaka 1213, Bangladesh
- Pharmakon Neuroscience Research Network, Dhaka 1207, Bangladesh
- Correspondence: ; Tel.: +880-171-022-0110
| | - Md. Tanvir Kabir
- Department of Pharmacy, BRAC University, Dhaka 1212, Bangladesh;
| | - Md. Sohanur Rahman
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh;
| | - Tapan Behl
- Chitkara College of Pharmacy, Chitkara University, Punjab 140401, India;
| | - Philippe Jeandet
- Research Unit, Induced Resistance and Plant Bioprotection, EA 4707, SFR Condorcet FR CNRS 3417, Faculty of Sciences, University of Reims Champagne-Ardenne, PO Box 1039, 51687 Reims CEDEX 2, France;
| | - Ghulam Md Ashraf
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Agnieszka Najda
- Laboratory of Quality of Vegetables and Medicinal Plants, Department of Vegetable Crops and Medicinal Plants, University of Life Sciences in Lublin, 15 Akademicka Street, 20-950 Lublin, Poland;
| | - May N. Bin-Jumah
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, Riyadh 11474, Saudi Arabia;
| | - Hesham R. El-Seedi
- International Research Center for Food Nutrition and Safety, Jiangsu University, Zhenjiang 212013, China;
- Pharmacognosy Group, Department of Pharmaceutical Biosciences, Uppsala University, SE-751 23 Uppsala, Sweden
- Department of Chemistry, Faculty of Science, Menoufia University, Shebin El-Koom 32512, Egypt
| | - Mohamed M. Abdel-Daim
- Department of Zoology, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia;
- Pharmacology Department, Faculty of Veterinary Medicine, Suez Canal University, Ismailia 41522, Egypt
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19
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Sundermann EE, Panizzon MS, Chen X, Andrews M, Galasko D, Banks SJ. Sex differences in Alzheimer's-related Tau biomarkers and a mediating effect of testosterone. Biol Sex Differ 2020; 11:33. [PMID: 32560743 PMCID: PMC7304096 DOI: 10.1186/s13293-020-00310-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/12/2020] [Indexed: 02/06/2023] Open
Abstract
Women show greater pathological Tau biomarkers than men along the Alzheimer's disease (AD) continuum, particularly among apolipoprotein ε-E4 (APOE4) carriers; however, the reason for this sex difference in unknown. Sex differences often indicate an underlying role of sex hormones. We examined whether testosterone levels might influence this sex difference and the modifying role of APOE4 status. Analyses included 172 participants (25 cognitively normal, 97 mild cognitive impairment, 50 AD participants) from the Alzheimer's Disease Neuroimaging Initiative (34% female, 54% APOE4 carriers, aged 55-90). We examined the separate and interactive effects of plasma testosterone levels and APOE4 on cerebrospinal fluid phosphorylated-tau181 (p-Tau) levels in the overall sample and the sex difference in p-Tau levels before and after adjusting for testosterone. A significant APOE4-by-testosterone interaction revealed that lower testosterone levels related to higher p-Tau levels among APOE4 carriers regardless of sex. As expected, women had higher p-Tau levels than men among APOE4 carriers only, yet this difference was eliminated upon adjustment for testosterone. Results suggest that testosterone is protective against p-Tau particularly among APOE4 carriers. The lower testosterone levels that typically characterize women may predispose them to pathological Tau, particularly among female APOE4 carriers.
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Affiliation(s)
- Erin E. Sundermann
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093 USA
| | - Matthew S. Panizzon
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093 USA
| | - Xu Chen
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093 USA
| | - Murray Andrews
- Department of Neuroscience, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093 USA
| | - Douglas Galasko
- Department of Neuroscience, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093 USA
| | - Sarah J. Banks
- Department of Neuroscience, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093 USA
| | - for the Alzheimer’s Disease Neuroimaging Initiative
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093 USA
- Department of Neuroscience, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093 USA
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20
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Ahmad S, Milan MDC, Hansson O, Demirkan A, Agustin R, Sáez ME, Giagtzoglou N, Cabrera-Socorro A, Bakker MHM, Ramirez A, Hankemeier T, Stomrud E, Mattsson-Carlgren N, Scheltens P, van der Flier WM, Ikram MA, Malarstig A, Teunissen CE, Amin N, van Duijn CM. CDH6 and HAGH protein levels in plasma associate with Alzheimer's disease in APOE ε4 carriers. Sci Rep 2020; 10:8233. [PMID: 32427856 PMCID: PMC7237496 DOI: 10.1038/s41598-020-65038-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 04/24/2020] [Indexed: 02/06/2023] Open
Abstract
Many Alzheimer’s disease (AD) genes including Apolipoprotein E (APOE) are found to be expressed in blood-derived macrophages and thus may alter blood protein levels. We measured 91 neuro-proteins in plasma from 316 participants of the Rotterdam Study (incident AD = 161) using Proximity Extension Ligation assay. We studied the association of plasma proteins with AD in the overall sample and stratified by APOE. Findings from the Rotterdam study were replicated in 186 AD patients of the BioFINDER study. We further evaluated the correlation of these protein biomarkers with total tau (t-tau), phosphorylated tau (p-tau) and amyloid-beta (Aβ) 42 levels in cerebrospinal fluid (CSF) in the Amsterdam Dementia Cohort (N = 441). Finally, we conducted a genome-wide association study (GWAS) to identify the genetic variants determining the blood levels of AD-associated proteins. Plasma levels of the proteins, CDH6 (β = 0.638, P = 3.33 × 10−4) and HAGH (β = 0.481, P = 7.20 × 10−4), were significantly elevated in APOE ε4 carrier AD patients. The findings in the Rotterdam Study were replicated in the BioFINDER study for both CDH6 (β = 1.365, P = 3.97 × 10−3) and HAGH proteins (β = 0.506, P = 9.31 × 10−7) when comparing cases and controls in APOE ε4 carriers. In the CSF, CDH6 levels were positively correlated with t-tau and p-tau in the total sample as well as in APOE ε4 stratum (P < 1 × 10−3). The HAGH protein was not detected in CSF. GWAS of plasma CDH6 protein levels showed significant association with a cis-regulatory locus (rs111283466, P = 1.92 × 10−9). CDH6 protein is implicated in cell adhesion and synaptogenesis while HAGH protein is related to the oxidative stress pathway. Our findings suggest that these pathways may be altered during presymptomatic AD and that CDH6 and HAGH may be new blood-based biomarkers.
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Affiliation(s)
- Shahzad Ahmad
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.
| | - Marta Del Campo Milan
- Neurochemistry laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers (AUMC), Vrije Universiteit, Amsterdam, The Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Ayse Demirkan
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Ruiz Agustin
- Research Center and Memory clinic Fundació ACE. Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain.,CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Maria E Sáez
- Centro Andaluz de Estudios Bioinformáticos CAEBi, Sevilla, Spain
| | | | | | - Margot H M Bakker
- Discovery Research, AbbVie Deutschland GmbH & Co. KG, Knollstrasse, 67061, Ludwigshafen, Germany
| | - Alfredo Ramirez
- Department of Neurodegeneration and Geriatric Psychiatry, University of Bonn, 53127, Bonn, Germany.,Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, University of Cologne, Medical Faculty, 50937, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), 53127, Bonn, Germany
| | - Thomas Hankemeier
- Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Erik Stomrud
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Philip Scheltens
- Alzheimer center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, UMC, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, UMC, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Anders Malarstig
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Pfizer Worldwide R&D, Stockholm, Sweden
| | - Charlotte E Teunissen
- Neurochemistry laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers (AUMC), Vrije Universiteit, Amsterdam, The Netherlands
| | - Najaf Amin
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Cornelia M van Duijn
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands. .,Nuffield Department of Population Health, Oxford University, Oxford, UK.
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21
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Kubis-Kubiak A, Dyba A, Piwowar A. The Interplay between Diabetes and Alzheimer's Disease-In the Hunt for Biomarkers. Int J Mol Sci 2020; 21:ijms21082744. [PMID: 32326589 PMCID: PMC7215807 DOI: 10.3390/ijms21082744] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/09/2020] [Accepted: 04/12/2020] [Indexed: 02/07/2023] Open
Abstract
The brain is an organ in which energy metabolism occurs most intensively and glucose is an essential and dominant energy substrate. There have been many studies in recent years suggesting a close relationship between type 2 diabetes mellitus (T2DM) and Alzheimer’s disease (AD) as they have many pathophysiological features in common. The condition of hyperglycemia exposes brain cells to the detrimental effects of glucose, increasing protein glycation and is the cause of different non-psychiatric complications. Numerous observational studies show that not only hyperglycemia but also blood glucose levels near lower fasting limits (72 to 99 mg/dL) increase the incidence of AD, regardless of whether T2DM will develop in the future. As the comorbidity of these diseases and earlier development of AD in T2DM sufferers exist, new AD biomarkers are being sought for etiopathogenetic changes associated with early neurodegenerative processes as a result of carbohydrate disorders. The S100B protein seem to be interesting in this respect as it may be a potential candidate, especially important in early diagnostics of these diseases, given that it plays a role in both carbohydrate metabolism disorders and neurodegenerative processes. It is therefore necessary to clarify the relationship between the concentration of the S100B protein and glucose and insulin levels. This paper draws attention to a valuable research objective that may in the future contribute to a better diagnosis of early neurodegenerative changes, in particular in subjects with T2DM and may be a good basis for planning experiments related to this issue as well as a more detailed explanation of the relationship between the neuropathological disturbances and changes of glucose and insulin concentrations in the brain.
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Affiliation(s)
- Adriana Kubis-Kubiak
- Department of Toxicology, Faculty of Pharmacy, Wroclaw Medical University, 50367 Wroclaw, Poland;
- Correspondence:
| | - Aleksandra Dyba
- Students Science Club of the Department of Toxicology, Faculty of Pharmacy, Wroclaw Medical University, 50367 Wroclaw, Poland;
| | - Agnieszka Piwowar
- Department of Toxicology, Faculty of Pharmacy, Wroclaw Medical University, 50367 Wroclaw, Poland;
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22
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Marizzoni M, Ferrari C, Babiloni C, Albani D, Barkhof F, Cavaliere L, Didic M, Forloni G, Fusco F, Galluzzi S, Hensch T, Jovicich J, Marra C, Molinuevo JL, Nobili F, Parnetti L, Payoux P, Ranjeva JP, Ribaldi F, Rolandi E, Rossini PM, Salvatore M, Soricelli A, Tsolaki M, Visser PJ, Wiltfang J, Richardson JC, Bordet R, Blin O, Frisoni GB. CSF cutoffs for MCI due to AD depend on APOEε4 carrier status. Neurobiol Aging 2019; 89:55-62. [PMID: 32029236 DOI: 10.1016/j.neurobiolaging.2019.12.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 12/20/2019] [Accepted: 12/21/2019] [Indexed: 12/14/2022]
Abstract
Amyloid and tau pathological accumulation should be considered for Alzheimer's disease (AD) definition and before subjects' enrollment in disease-modifying trials. Although age, APOEε4, and sex influence cerebrospinal fluid (CSF) biomarker levels, none of these variables are considered by current normality/abnormality cutoffs. Using baseline CSF data from 2 independent cohorts (PharmaCOG/European Alzheimer's Disease Neuroimaging Initiative and Alzheimer's Disease Neuroimaging Initiative), we investigated the effect of age, APOEε4 status, and sex on CSF Aβ42/P-tau distribution and cutoff extraction by applying mixture models with covariates. The Aβ42/P-tau distribution revealed the presence of 3 subgroups (AD-like, intermediate, control-like) and 2 cutoffs. The identification of the intermediate subgroup and of the higher cutoff was APOEε4 dependent in both cohorts. APOE-specific classification (higher cutoff for APOEε4+, lower cutoff for APOEε4-) showed higher diagnostic accuracy in identifying MCI due to AD compared to single Aβ42 and Aβ42/P-tau cutoffs. APOEε4 influences amyloid and tau CSF markers and AD progression in MCI patients supporting i) the use of APOE-specific cutoffs to identify MCI due to AD and ii) the utility of considering APOE genotype for early AD diagnosis.
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Affiliation(s)
- Moira Marizzoni
- Laboratory of Neuroimaging and Alzheimer's Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
| | - Clarissa Ferrari
- Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Claudio Babiloni
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy; Hospital San Raffaele Cassino (FR), Cassino, Italy
| | - Diego Albani
- Neuroscience Department, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location VUmc, Amsterdam, the Netherlands; Institutes of Neurology and Healthcare Engineering, UCL, London, UK
| | - Libera Cavaliere
- Laboratory of Neuroimaging and Alzheimer's Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Mira Didic
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Timone, Service de Neurologie et Neuropsychologie, APHM Hôpital Timone Adultes, Marseille, France
| | - Gianluigi Forloni
- Neuroscience Department, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy
| | - Federica Fusco
- Neuroscience Department, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy
| | - Samantha Galluzzi
- Laboratory of Neuroimaging and Alzheimer's Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Tilman Hensch
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Jorge Jovicich
- Center for Mind/Brain Sciences, University of Trento, Trento, Italy
| | - Camillo Marra
- Department of Gerontology, Neurosciences & Orthopedics, Catholic University, Rome, Italy
| | - José Luis Molinuevo
- Alzheimer's Disease Unit and Other Cognitive Disorders Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalunya, Spain
| | - Flavio Nobili
- Dept. of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy; Clinica Neurologica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lucilla Parnetti
- Clinica Neurologica, Università di Perugia, Ospedale Santa Maria della Misericordia, Perugia, Italy
| | - Pierre Payoux
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - Jean-Philippe Ranjeva
- Aix-Marseille Université, INSERM, Marseille, France; Service de Neurologie et Neuropsychologie, APHM Hôpital Timone Adultes, Marseille, France
| | - Federica Ribaldi
- Laboratory of Neuroimaging and Alzheimer's Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy; Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Elena Rolandi
- Laboratory of Neuroimaging and Alzheimer's Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - Marco Salvatore
- SDN Istituto di Ricerca Diagnostica e Nucleare, Napoli, Italy
| | | | - Magda Tsolaki
- 1st University Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Makedonia, Greece
| | - Pieter Jelle Visser
- Department of Neurology, Alzheimer Centre, VU Medical Centre, Amsterdam, the Netherlands
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, LVR-Hospital Essen, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany; Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August-University, Goettingen, Germany; Medical Sciences Department, iBiMED, University of Aveiro, Aveiro, Portugal
| | | | - Régis Bordet
- University of Lille, Inserm, CHU, Lille, France; U1171 - Degenerative and Vascular Cognitive Disorders, Lille, France
| | - Olivier Blin
- Aix Marseille University, UMR-INSERM 1106, Service de Pharmacologie Clinique, APHM, Marseille, France
| | - Giovanni B Frisoni
- Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
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23
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Berkowitz CL, Mosconi L, Rahman A, Scheyer O, Hristov H, Isaacson RS. Clinical Application of APOE in Alzheimer's Prevention: A Precision Medicine Approach. JPAD-JOURNAL OF PREVENTION OF ALZHEIMERS DISEASE 2019; 5:245-252. [PMID: 30298183 DOI: 10.14283/jpad.2018.35] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Population-attributable risk models estimate that up to one-third of Alzheimer's disease (AD) cases may be preventable through risk factor modification. The field of AD prevention has largely focused on addressing these factors through universal risk reduction strategies for the general population. However, targeting these strategies in a clinical precision medicine fashion, including the use of genetic risk factors, allows for potentially greater impact on AD risk reduction. Apolipoprotein E (APOE), and specifically the APOE ε4 variant, is one of the most well-established genetic influencers on late-onset AD risk. In this review, we evaluate the impact of APOE ε4 carrier status on AD prevention interventions, including lifestyle, nutrigenomic, pharmacogenomic, AD comorbidities, and other biological and behavioral considerations. Using a clinical precision medicine strategy that incorporates APOE ε4 carrier status may provide a highly targeted and distinct approach to AD prevention with greater potential for success.
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Affiliation(s)
- C L Berkowitz
- Richard S. Isaacson, MD, Department of Neurology, Weill Cornell Medicine and NewYork-Presbyterian, 428 East 72nd St, Suite 500, Room 407, New York, NY, 10021; Tel: (212) 746-3645,
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24
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When Does Alzheimer's Disease Really Start? The Role of Biomarkers. Int J Mol Sci 2019; 20:ijms20225536. [PMID: 31698826 PMCID: PMC6888399 DOI: 10.3390/ijms20225536] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/01/2019] [Accepted: 11/04/2019] [Indexed: 12/16/2022] Open
Abstract
While Alzheimer’s disease (AD) classical diagnostic criteria rely on clinical data from a stablished symptomatic disease, newer criteria aim to identify the disease in its earlier stages. For that, they incorporated the use of AD’s specific biomarkers to reach a diagnosis, including the identification of Aβ and tau depositions, glucose hypometabolism, and cerebral atrophy. These biomarkers created a new concept of the disease, in which AD’s main pathological processes have already taken place decades before we can clinically diagnose the first symptoms. Therefore, AD is now considered a dynamic disease with a gradual progression, and dementia is its final stage. With that in mind, new models were proposed, considering the orderly increment of biomarkers and the disease as a continuum, or the variable time needed for the disease’s progression. In 2011, the National Institute on Aging and the Alzheimer’s Association (NIA-AA) created separate diagnostic recommendations for each stage of the disease continuum—preclinical, mild cognitive impairment, and dementia. However, new scientific advances have led them to create a unifying research framework in 2018 that, although not intended for clinical use as of yet, is a step toward shifting the focus from the clinical symptoms to the biological alterations and toward changing the future diagnostic and treatment possibilities. This review aims to discuss the role of biomarkers in the onset of AD.
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25
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Apolipoprotein E and Alzheimer disease: pathobiology and targeting strategies. Nat Rev Neurol 2019; 15:501-518. [PMID: 31367008 DOI: 10.1038/s41582-019-0228-7] [Citation(s) in RCA: 651] [Impact Index Per Article: 130.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2019] [Indexed: 02/06/2023]
Abstract
Polymorphism in the apolipoprotein E (APOE) gene is a major genetic risk determinant of late-onset Alzheimer disease (AD), with the APOE*ε4 allele conferring an increased risk and the APOE*ε2 allele conferring a decreased risk relative to the common APOE*ε3 allele. Strong evidence from clinical and basic research suggests that a major pathway by which APOE4 increases the risk of AD is by driving earlier and more abundant amyloid pathology in the brains of APOE*ε4 carriers. The number of amyloid-β (Aβ)-dependent and Aβ-independent pathways that are known to be differentially modulated by APOE isoforms is increasing. For example, evidence is accumulating that APOE influences tau pathology, tau-mediated neurodegeneration and microglial responses to AD-related pathologies. In addition, APOE4 is either pathogenic or shows reduced efficiency in multiple brain homeostatic pathways, including lipid transport, synaptic integrity and plasticity, glucose metabolism and cerebrovascular function. Here, we review the recent progress in clinical and basic research into the role of APOE in AD pathogenesis. We also discuss how APOE can be targeted for AD therapy using a precision medicine approach.
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26
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Jiang L, Oualkacha K, Didelez V, Ciampi A, Rosa-Neto P, Benedet AL, Mathotaarachchi S, Richards JB, Greenwood CMT. Constrained instruments and their application to Mendelian randomization with pleiotropy. Genet Epidemiol 2019; 43:373-401. [PMID: 30635941 PMCID: PMC6537099 DOI: 10.1002/gepi.22184] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 11/11/2018] [Accepted: 12/02/2018] [Indexed: 01/31/2023]
Abstract
In Mendelian randomization (MR), inference about causal relationship between a phenotype of interest and a response or disease outcome can be obtained by constructing instrumental variables from genetic variants. However, MR inference requires three assumptions, one of which is that the genetic variants only influence the outcome through phenotype of interest. Pleiotropy, that is, the situation in which some genetic variants affect more than one phenotype, can invalidate these genetic variants for use as instrumental variables; thus a naive analysis will give biased estimates of the causal relation. Here, we present new methods (constrained instrumental variable [CIV] methods) to construct valid instrumental variables and perform adjusted causal effect estimation when pleiotropy exists and when the pleiotropic phenotypes are available. We demonstrate that a smoothed version of CIV performs approximate selection of genetic variants that are valid instruments, and provides unbiased estimates of the causal effects. We provide details on a number of existing methods, together with a comparison of their performance in a large series of simulations. CIV performs robustly across different pleiotropic violations of the MR assumptions. We also analyzed the data from the Alzheimer’s disease (AD) neuroimaging initiative (ADNI; Mueller et al., 2005. Alzheimer's Dementia, 11(1), 55–66) to disentangle causal relationships of several biomarkers with AD progression.
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Affiliation(s)
- Lai Jiang
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health and Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada
| | - Karim Oualkacha
- Department of Mathematics, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Vanessa Didelez
- BIPS & Department of Mathematics, Leibinz Institute for Prevention Research and Epidemiology, University of Bremen, Bremen, Germany
| | - Antonio Ciampi
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health and Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada
| | - Pedro Rosa-Neto
- Department of Neurology & Neurosurgery, McGill University, Montreal, Quebec, Canada.,Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montreal, Quebec, Canada
| | - Andrea L Benedet
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montreal, Quebec, Canada
| | - Sulantha Mathotaarachchi
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montreal, Quebec, Canada
| | | | - Celia M T Greenwood
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health and Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada
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27
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Intrinsic functional connectivity alterations in cognitively intact elderly APOE ε4 carriers measured by eigenvector centrality mapping are related to cognition and CSF biomarkers: a preliminary study. Brain Imaging Behav 2018; 11:1290-1301. [PMID: 27714554 DOI: 10.1007/s11682-016-9600-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Apolipoprotein E (APOE) ε4 allele is the best established genetic risk factor for sporadic Alzheimer's disease (AD). However, there is a need to understand the effects of this genotype on the brain by simultaneously assessing intrinsic brain network and cerebral spinal fluid (CSF) biomarkers changes in healthy older ε4 carriers. Thirteen cognitively intact, elderly APOE ε4 carriers and 22 ε3 homozygotes were included in the present study. Eigenvector centrality mapping (ECM) was used to identify brain network hub organization based on resting-state functional MRI (rsfMRI). We evaluated comprehensive cognitive ability and tested levels of Aβ1-42, total-tau (t-tau) and phosphorylated-tau (p-tau181) in CSF. Comparisons of ECM between two groups were conducted, followed by correlations analyses between EC values with significant group differences and cognitive ability/CSF biomarkers. APOE ε4 carriers showed significantly decreased EC values in left medial temporal lobe (MTL), left lingual gyrus (LG) and increased EC values in left middle frontal gyrus (MFG) as compared to non-carriers. Correlation analysis demonstrated that left LG EC value correlated with Rey Auditory Verbal Learning Test total learning (RAVLT, r = 0.57, p < 0.05) and t-tau level (r = -0.57, p < 0.05), while left MFG EC values correlated with log-transformed Trail-Making Test B (TMT-B, r = -0.67, p < 0.05) in APOE ε4 carriers. This study suggests the APOE ε4 allele contributes to disruption of brain connectedness in certain functional nodes, which may result from neuronal death caused by toxicity of neurofibrillary tangles.
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28
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Mishra S, Blazey TM, Holtzman DM, Cruchaga C, Su Y, Morris JC, Benzinger TLS, Gordon BA. Longitudinal brain imaging in preclinical Alzheimer disease: impact of APOE ε4 genotype. Brain 2018; 141:1828-1839. [PMID: 29672664 PMCID: PMC5972633 DOI: 10.1093/brain/awy103] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 01/29/2018] [Accepted: 02/17/2018] [Indexed: 02/07/2023] Open
Abstract
While prior work reliably demonstrates that the APOE ɛ4 allele has deleterious group level effects on Alzheimer disease pathology, the homogeneity of its influence across the lifespan and spatially in the brain remains unknown. Further it is unclear what combinations of factors at an individual level lead to observed group level effects of APOE genotype. To evaluate the impact of the APOE genotype on disease trajectories, we examined longitudinal MRI and PET imaging in a cohort of 497 cognitively normal middle and older aged participants. A whole-brain regional approach was used to evaluate the spatial effects of genotype on longitudinal change of amyloid-β pathology and cortical atrophy. Carriers of the ɛ4 allele had increased longitudinal accumulation of amyloid-β pathology diffusely through the cortex, but the emergence of this effect across the lifespan differed greatly by region (e.g. age 49 in precuneus, but 65 in the visual cortex) with the detrimental influence already being evident in some regions in middle age. This increased group level effect on accumulation was due to a greater proportion of ɛ4 carriers developing amyloid-β pathology, on average doing so at an earlier age, and having faster amyloid-β accumulation even after accounting for baseline amyloid-β levels. APOE ɛ4 carriers displayed faster rates of structural loss in primarily constrained to the medial temporal lobe structures at around 50 years, although this increase was modest and proportional to the elevated disease severity in APOE ɛ4 carriers. This work indicates that influence of the APOE gene on pathology can be detected starting in middle age.
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Affiliation(s)
- Shruti Mishra
- Department of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - Tyler M Blazey
- Department of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - David M Holtzman
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St Louis, MO, USA
| | - Carlos Cruchaga
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St Louis, MO, USA
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Yi Su
- Department of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St Louis, MO, USA
| | - Tammie L S Benzinger
- Department of Radiology, Washington University School of Medicine, St Louis, MO, USA
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St Louis, MO, USA
| | - Brian A Gordon
- Department of Radiology, Washington University School of Medicine, St Louis, MO, USA
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St Louis, MO, USA
- Department of Psychological and Brain Sciences, Washington University School of Medicine, St Louis, MO, USA
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29
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Lautner R, Insel PS, Skillbäck T, Olsson B, Landén M, Frisoni GB, Herukka SK, Hampel H, Wallin A, Minthon L, Hansson O, Blennow K, Mattsson N, Zetterberg H. Preclinical effects of APOE ε4 on cerebrospinal fluid Aβ42 concentrations. ALZHEIMERS RESEARCH & THERAPY 2017; 9:87. [PMID: 29061195 PMCID: PMC5654097 DOI: 10.1186/s13195-017-0313-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 10/03/2017] [Indexed: 11/22/2022]
Abstract
Background From earlier studies it is known that the APOE ε2/ε3/ε4 polymorphism modulates the concentrations of cerebrospinal fluid (CSF) beta-amyloid1–42 (Aβ42) in patients with cognitive decline due to Alzheimer’s disease (AD), as well as in cognitively healthy controls. Here, in a large cohort consisting solely of cognitively healthy individuals, we aimed to evaluate how the effect of APOE on CSF Aβ42 varies by age, to understand the association between APOE and the onset of preclinical AD. Methods APOE genotype and CSF Aβ42 concentration were determined in a cohort comprising 716 cognitively healthy individuals aged 17–99 from nine different clinical research centers. Results CSF concentrations of Aβ42 were lower in APOE ε4 carriers than in noncarriers in a gene dose-dependent manner. The effect of APOE ε4 on CSF Aβ42 was age dependent. The age at which CSF Aβ42 concentrations started to decrease was estimated at 50 years in APOE ε4-negative individuals and 43 years in heterozygous APOE ε4 carriers. Homozygous APOE ε4 carriers showed a steady decline in CSF Aβ42 concentrations with increasing age throughout the examined age span. Conclusions People possessing the APOE ε4 allele start to show a decrease in CSF Aβ42 concentration almost a decade before APOE ε4 noncarriers already in early middle age. Homozygous APOE ε4 carriers might deposit Aβ42 throughout the examined age span. These results suggest that there is an APOE ε4-dependent period of early alterations in amyloid homeostasis, when amyloid slowly accumulates, that several years later, together with other downstream pathological events such as tau pathology, translates into cognitive decline.
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Affiliation(s)
- Ronald Lautner
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden. .,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.
| | - Philip S Insel
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA.,Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Tobias Skillbäck
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Bob Olsson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Mikael Landén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Giovanni B Frisoni
- Istituto di Ricovero e Cura a Carattere Scientifico Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Sanna-Kaisa Herukka
- Department of Neurology, University of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Harald Hampel
- AXA Research Fund and UPMC Chair, Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Paris 06, Inserm, CNRS, Institut du cerveau et de la moelle (ICM), Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Hôpital Pitié-Salpêtrière, Boulevard de l'hôpital, F-75013, Paris, France
| | - Anders Wallin
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Lennart Minthon
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Niklas Mattsson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
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30
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Sun G, He Y, Ma XK, Li S, Chen D, Gao M, Qiu S, Yin J, Shi J, Wu J. Hippocampal synaptic and neural network deficits in young mice carrying the human APOE4 gene. CNS Neurosci Ther 2017; 23:748-758. [PMID: 28786172 PMCID: PMC6492660 DOI: 10.1111/cns.12720] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 06/24/2017] [Accepted: 06/25/2017] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Apolipoprotein E4 (APOE4) is a major genetic risk factor for late-onset sporadic Alzheimer disease. Emerging evidence demonstrates a hippocampus-associated learning and memory deficit in aged APOE4 human carriers and also in aged mice carrying human APOE4 gene. This suggests that either exogenous APOE4 or endogenous APOE4 alters the cognitive profile and hippocampal structure and function. However, little is known regarding how Apoe4 modulates hippocampal dendritic morphology, synaptic function, and neural network activity in young mice. AIM In this study, we compared hippocampal dendritic and spine morphology and synaptic function of young (4 months) mice with transgenic expression of the human APOE4 and APOE3 genes. METHODS Hippocampal dendritic and spine morphology and synaptic function were assessed by neuronal imaging and electrophysiological approaches. RESULTS Morphology results showed that shortened dendritic length and reduced spine density occurred at hippocampal CA1 neurons in Apoe4 mice compared to Apoe3 mice. Electrophysiological results demonstrated that in the hippocampal CA3-CA1 synapses of young Apoe4 mice, basic synaptic transmission, and paired-pulse facilitation were enhanced but long-term potentiation and carbachol-induced hippocampal theta oscillations were impaired compared to young Apoe3 mice. However, both Apoe genotypes responded similarly to persistent stimulations (4, 10, and 40 Hz for 4 seconds). CONCLUSION Our results suggest significant alterations in hippocampal dendritic structure and synaptic function in Apoe4 mice, even at an early age.
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Affiliation(s)
- Guo‐Zhu Sun
- Department of NeurosurgeryThe Second Hospital of Hebei Medical UniversityShijiazhuangHebeiChina
- Department of NeurobiologyBarrow Neurological InstituteSt. Joseph's Hospital and Medical CenterPhoenixAZUSA
| | - Yong‐Chang He
- Department of NeurosurgeryThe Second Hospital of Hebei Medical UniversityShijiazhuangHebeiChina
- Department of NeurobiologyBarrow Neurological InstituteSt. Joseph's Hospital and Medical CenterPhoenixAZUSA
| | - Xiao Kuang Ma
- Department of NeurobiologyBarrow Neurological InstituteSt. Joseph's Hospital and Medical CenterPhoenixAZUSA
- Department of PhysiologyShantou University Medical CollegeShantouGuangdongChina
- Department of Basic Medical SciencesUniversity of Arizona College of MedicinePhoenixAZUSA
| | - Shuang‐Tao Li
- Department of NeurobiologyBarrow Neurological InstituteSt. Joseph's Hospital and Medical CenterPhoenixAZUSA
- Department of PhysiologyShantou University Medical CollegeShantouGuangdongChina
| | - De‐Jie Chen
- Department of NeurobiologyBarrow Neurological InstituteSt. Joseph's Hospital and Medical CenterPhoenixAZUSA
| | - Ming Gao
- Department of NeurobiologyBarrow Neurological InstituteSt. Joseph's Hospital and Medical CenterPhoenixAZUSA
| | - Shen‐Feng Qiu
- Department of Basic Medical SciencesUniversity of Arizona College of MedicinePhoenixAZUSA
| | - Jun‐Xiang Yin
- Department of NeurologyBarrow Neurological InstituteSt. Joseph's Hospital and Medical CenterPhoenixAZUSA
| | - Jiong Shi
- Department of NeurologyBarrow Neurological InstituteSt. Joseph's Hospital and Medical CenterPhoenixAZUSA
- Department of NeurologyTianjin Neurological InstituteTianjin Medical University General HospitalTianjinChina
| | - Jie Wu
- Department of NeurobiologyBarrow Neurological InstituteSt. Joseph's Hospital and Medical CenterPhoenixAZUSA
- Department of PhysiologyShantou University Medical CollegeShantouGuangdongChina
- Department of Basic Medical SciencesUniversity of Arizona College of MedicinePhoenixAZUSA
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31
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Han X, Zhang Y, Shao Y. On comparing 2 correlated C indices with censored survival data. Stat Med 2017; 36:4041-4049. [PMID: 28758216 DOI: 10.1002/sim.7414] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 06/01/2017] [Accepted: 06/21/2017] [Indexed: 12/21/2022]
Abstract
As new biomarkers and risk prediction procedures are in rapid development, it is of great interest to develop valid methods for comparing predictive power of 2 biomarkers or risk score systems. Harrell C statistic has been routinely used as a global adequacy assessment of a risk score system, and the difference of 2 Harrell C statistics as a test statistic has been suggested in recent literature for comparison of predictive power of 2 biomarkers for censored outcome. In this study, we showed that such a test can have severely inflated type I errors as the difference between the 2 Harrell C statistics does not converge to zero under the null hypothesis of equal predictive power measured by concordance probabilities, as illustrated by 2 counterexamples and corresponding numerical simulations. We further investigate a necessary and sufficient condition under which the difference of 2 Harrell C statistics converges to zero under the null hypothesis.
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Affiliation(s)
- Xiaoxia Han
- Departments of Population Health, New York University School of Medicine, New York, NY10016, USA
| | - Yilong Zhang
- Merck Research Laboratories, Rahway, 07065, NJ, USA
| | - Yongzhao Shao
- Departments of Population Health, New York University School of Medicine, New York, NY10016, USA
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32
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Abstract
The utility of the levels of amyloid beta (Aβ) peptide and tau in blood for diagnosis, drug development, and assessment of clinical trials for Alzheimer's disease (AD) has not been established. The lack of availability of ultra-sensitive assays is one critical issue that has impeded progress. The levels of Aβ species and tau in plasma and serum are much lower than levels in cerebrospinal fluid. Furthermore, plasma or serum contain high levels of assay-interfering factors, resulting in difficulties in the commonly used singulex or multiplex ELISA platforms. In this review, we focus on two modern immune-complex-based technologies that show promise to advance this field. These innovative technologies are immunomagnetic reduction technology and single molecule array technology. We describe the technologies and discuss the published studies using these technologies. Currently, the potential of utilizing these technologies to advance Aβ and tau as blood-based biomarkers for AD requires further validation using already collected large sets of samples, as well as new cohorts and population-based longitudinal studies.
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33
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Abstract
OBJECTIVES The apolipoprotein E (APOE) ε4 allele is an established risk factor for dementia, yet this genetic variant is associated with a mixed cognitive profile across the lifespan. This study undertakes both a systematic and meta-analytic review of research investigating APOE-related differences in cognition in mid-adulthood, when detrimental effects of the allele may first be detectable. METHODS Thirty-six papers investigating the behavioral effects of APOE ε4 in mid-adulthood (defined as a mean sample age between 35 and 60 years) were reviewed. In addition, the effect of carrying an ε4 allele on individual cognitive domains was assessed in separate meta-analyses. RESULTS The average effect size of APOE ε4 status was non-significant across cognitive domains. Further consideration of genotype effects indicates preclinical effects of APOE ε4 may be observable in memory and executive functioning. CONCLUSIONS The cognitive profile of APOE ε4 carriers at mid-age remains elusive. Although there is support for comparable performance by ε4 and non-e4 carriers in the 5th decade, studies administering sensitive cognitive paradigms indicate a more nuanced profile of cognitive differences. Methodological issues in this field preclude strong conclusions, which future research must address, as well as considering the influence of further vulnerability factors on genotype effects. (JINS, 2016, 23, 239-253).
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34
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Huynh TPV, Davis AA, Ulrich JD, Holtzman DM. Apolipoprotein E and Alzheimer's disease: the influence of apolipoprotein E on amyloid-β and other amyloidogenic proteins. J Lipid Res 2017; 58:824-836. [PMID: 28246336 DOI: 10.1194/jlr.r075481] [Citation(s) in RCA: 134] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 02/25/2017] [Indexed: 12/13/2022] Open
Abstract
Alzheimer's disease (AD) is one of the fastest-growing causes of death and disability in persons 65 years of age or older, affecting more than 5 million Americans alone. Clinical manifestations of AD include progressive decline in memory, executive function, language, and other cognitive domains. Research efforts within the last three decades have identified APOE as the most significant genetic risk factor for late-onset AD, which accounts for >99% of cases. The apoE protein is hypothesized to affect AD pathogenesis through a variety of mechanisms, from its effects on the blood-brain barrier, the innate immune system, and synaptic function to the accumulation of amyloid-β (Aβ). Here, we discuss the role of apoE on the biophysical properties and metabolism of the Aβ peptide, the principal component of amyloid plaques and cerebral amyloid angiopathy (CAA). CAA is characterized by the deposition of amyloid proteins (including Aβ) in the leptomeningeal medium and small arteries, which is found in most AD cases but sometimes occurs as an independent entity. Accumulation of these pathologies in the brain is one of the pathological hallmarks of AD. Beyond Aβ, we will extend the discussion to the potential role of apoE on other amyloidogenic proteins found in AD, and also a number of diverse neurodegenerative diseases.
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Affiliation(s)
- Tien-Phat V Huynh
- Department of Neurology, Hope Center for Neurological Disorders, Knight Alzheimer's Disease Research Center, Washington University, St. Louis, MO 63110
| | - Albert A Davis
- Department of Neurology, Hope Center for Neurological Disorders, Knight Alzheimer's Disease Research Center, Washington University, St. Louis, MO 63110
| | - Jason D Ulrich
- Department of Neurology, Hope Center for Neurological Disorders, Knight Alzheimer's Disease Research Center, Washington University, St. Louis, MO 63110
| | - David M Holtzman
- Department of Neurology, Hope Center for Neurological Disorders, Knight Alzheimer's Disease Research Center, Washington University, St. Louis, MO 63110
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35
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Slot RE, Van Harten AC, Kester MI, Jongbloed W, Bouwman FH, Teunissen CE, Scheltens P, Veerhuis R, van der Flier WM. Apolipoprotein A1 in Cerebrospinal Fluid and Plasma and Progression to Alzheimer’s Disease in Non-Demented Elderly. J Alzheimers Dis 2017; 56:687-697. [DOI: 10.3233/jad-151068] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Rosalinde E.R. Slot
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Argonde C. Van Harten
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Maartje I. Kester
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Wesley Jongbloed
- Department of Clinical Chemistry, Neurochemistry Laboratory, VU University Medical Center, Amsterdam, The Netherlands
| | - Femke H. Bouwman
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Charlotte E. Teunissen
- Department of Clinical Chemistry, Neurochemistry Laboratory, VU University Medical Center, Amsterdam, The Netherlands
| | - Philip Scheltens
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Robert Veerhuis
- Department of Clinical Chemistry, Neurochemistry Laboratory, VU University Medical Center, Amsterdam, The Netherlands
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Wiesje M. van der Flier
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
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36
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Höglund K, Kern S, Zettergren A, Börjesson-Hansson A, Zetterberg H, Skoog I, Blennow K. Preclinical amyloid pathology biomarker positivity: effects on tau pathology and neurodegeneration. Transl Psychiatry 2017; 7:e995. [PMID: 28072416 PMCID: PMC5545720 DOI: 10.1038/tp.2016.252] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 06/01/2016] [Accepted: 06/30/2016] [Indexed: 11/15/2022] Open
Abstract
Brain autopsy and biomarker studies indicate that the pathology of Alzheimer's disease (AD) is initiated at least 10-20 years before clinical symptoms. This provides a window of opportunity to initiate preventive treatment. However, this emphasizes the necessity for biomarkers that identify individuals at risk for developing AD later in life. In this cross-sectional study, originating from three epidemiologic studies in Sweden (n=1428), the objective was to examine whether amyloid pathology, as determined by low cerebrospinal fluid (CSF) concentration of the 42 amino acid form of β-amyloid (Aβ42), is associated with biomarker evidence of other pathological changes in cognitively healthy elderly. A total of 129 patients were included and CSF levels of Aβ42, total tau, tau phosphorylated at threonine 181 (p-tau), neurogranin, VILIP-1, VEGF, FABP3, Aβ40, neurofilament light, MBP, orexin A, BDNF and YKL-40 were measured. Among these healthy elderly, 35.6% (N=46) had CSF Aβ42 levels below 530 pg ml-1. These individuals displayed significantly higher CSF concentrations of t-tau (P<0.001), p-tau (181) (P<0.001), neurogranin (P=0.009) and FABP3 (P=0.044) compared with amyloid-negative individuals. Our study indicates that there is a subpopulation among healthy older individuals who have amyloid pathology along with signs of ongoing neuronal and synaptic degeneration, as well as tangle pathology. Previous studies have demonstrated that increase in CSF tau and p-tau is a specific sign of AD progression that occurs downstream of the deposition of Aβ. On the basis of this, our data suggest that these subjects are at risk for developing AD. We also confirm the association between APOE ɛ4 and amyloid pathology in healthy older individuals.
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Affiliation(s)
- K Höglund
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, Centre for ageing and Health, AgeCap, University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden,Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Disease Research, Neurogeriatrics Division, Karolinska Institutet, Novum, Stockholm, Sweden,Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal SE-431 80, Sweden. E-mail:
| | - S Kern
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, Centre for ageing and Health, AgeCap, University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden,Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, UK
| | - A Zettergren
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, Centre for ageing and Health, AgeCap, University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden,Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, UK
| | - A Börjesson-Hansson
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, Centre for ageing and Health, AgeCap, University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden,Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, UK
| | - H Zetterberg
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, Centre for ageing and Health, AgeCap, University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden,Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, Centre for Ageing and Health, AgeCap, University of Gothenburg, Mölndal, Sweden
| | - I Skoog
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, Centre for ageing and Health, AgeCap, University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden,Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, UK
| | - K Blennow
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, Centre for ageing and Health, AgeCap, University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
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37
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Solé-Domènech S, Cruz DL, Capetillo-Zarate E, Maxfield FR. The endocytic pathway in microglia during health, aging and Alzheimer's disease. Ageing Res Rev 2016; 32:89-103. [PMID: 27421577 DOI: 10.1016/j.arr.2016.07.002] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 07/01/2016] [Accepted: 07/05/2016] [Indexed: 12/14/2022]
Abstract
Microglia, the main phagocytes of the central nervous system (CNS), are involved in the surveillance and maintenance of nervous tissue. During normal tissue homeostasis, microglia migrates within the CNS, phagocytose dead cells and tissue debris, and modulate synapse pruning and spine formation via controlled phagocytosis. In the event of an invasion by a foreign body, microglia are able to phagocytose the invading pathogen and process it proteolytically for antigen presentation. Internalized substrates are incorporated and sorted within the endocytic pathway and thereafter transported via complex vesicular routes. When targeted for degradation, substrates are delivered to acidic late endosomes and lysosomes. In these, the enzymatic degradation relies on pH and enzyme content. Endocytosis, sorting, transport, compartment acidification and degradation are regulated by complex signaling mechanisms, and these may be altered during aging and pathology. In this review, we discuss the endocytic pathway in microglia, with insight into the mechanisms controlling lysosomal biogenesis and pH regulation. We also discuss microglial lysosome function associated with Alzheimer's disease (AD) and the mechanisms of amyloid-beta (Aβ) internalization and degradation. Finally, we explore some therapies currently being investigated to treat AD and their effects on microglial response to Aβ, with insight in those involving enhancement of lysosomal function.
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38
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Herukka SK, Simonsen AH, Andreasen N, Baldeiras I, Bjerke M, Blennow K, Engelborghs S, Frisoni GB, Gabryelewicz T, Galluzzi S, Handels R, Kramberger MG, Kulczyńska A, Molinuevo JL, Mroczko B, Nordberg A, Oliveira CR, Otto M, Rinne JO, Rot U, Saka E, Soininen H, Struyfs H, Suardi S, Visser PJ, Winblad B, Zetterberg H, Waldemar G. Recommendations for cerebrospinal fluid Alzheimer's disease biomarkers in the diagnostic evaluation of mild cognitive impairment. Alzheimers Dement 2016; 13:285-295. [DOI: 10.1016/j.jalz.2016.09.009] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 09/19/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Sanna-Kaisa Herukka
- Department of Neurology University of Eastern Finland and Kuopio University Hospital Kuopio Finland
| | - Anja Hviid Simonsen
- Danish Dementia Research Centre Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark
| | - Niels Andreasen
- Department of Geriatric Medicine Karolinska University Hospital Huddinge Sweden
| | - Ines Baldeiras
- Neurochemistry Laboratory, Faculty of Medicine, CHUC—Coimbra University Hospital, CNC, CNC.IBILI—Center for Neuroscience and Cell Biology University of Coimbra Coimbra Portugal
| | - Maria Bjerke
- Reference Center for Biological Markers of Dementia (BIODEM), Institute Born-Bunge University of Antwerp Antwerp Belgium
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology The Sahlgrenska Academy at the University of Gothenburg Mölndal Sweden
| | - Sebastiaan Engelborghs
- Reference Center for Biological Markers of Dementia (BIODEM), Institute Born-Bunge University of Antwerp Antwerp Belgium
- Department of Neurology and Memory Clinic Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken Antwerp Belgium
| | - Giovanni B. Frisoni
- Geneva Neuroscience Center University Hospitals and University of Geneva Geneva Switzerland
- IRCCS Fatebenefratelli Brescia Italy
| | - Tomasz Gabryelewicz
- Department of Neurodegenerative Disorders Mossakowski Medical Research Centre Polish Academy of Sciences Warsaw Poland
| | | | - Ron Handels
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience Maastricht University Maastricht The Netherlands
| | - Milica G. Kramberger
- Center for Cognitive Impairments, Department of Neurology University Medical Center Ljubljana Ljubljana Slovenia
| | - Agnieszka Kulczyńska
- Department of Neurodegeneration Diagnostics Medical University of Białystok Białystok Poland
| | - Jose Luis Molinuevo
- Alzheimer's Disease and Other Cognitive Disorders Unit Hospital Clinic i Universitari, IDIBAPS Barcelona Spain
- Beta Brain Research Center Fundació Pasqual Maragall Barcelona Spain
| | - Barbara Mroczko
- Department of Neurodegeneration Diagnostics Medical University of Białystok Białystok Poland
- Department of Biochemical Diagnostics University Hospital in Białystok Białystok Poland
| | - Agneta Nordberg
- Department of NVS, Center for Alzheimer Research Translational Alzheimer Neurobiology, Karolinska Institutet Huddinge Sweden
| | - Catarina Resende Oliveira
- Neurochemistry Laboratory, Faculty of Medicine, CHUC—Coimbra University Hospital, CNC, CNC.IBILI—Center for Neuroscience and Cell Biology University of Coimbra Coimbra Portugal
| | - Markus Otto
- Department of Neurology University of Ulm Ulm Germany
| | - Juha O. Rinne
- Turku PET Centre Turku University Hospital and University of Turku Turku Finland
| | - Uroš Rot
- Center for Cognitive Impairments, Department of Neurology University Medical Center Ljubljana Ljubljana Slovenia
| | - Esen Saka
- Department of Neurology Hacettepe University Hospitals Ankara Turkey
| | - Hilkka Soininen
- Department of Neurology University of Eastern Finland and Kuopio University Hospital Kuopio Finland
| | - Hanne Struyfs
- Reference Center for Biological Markers of Dementia (BIODEM), Institute Born-Bunge University of Antwerp Antwerp Belgium
| | - Silvia Suardi
- Neuropathology Laboratory Neurological Institute C. Besta Milan Italy
| | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience Maastricht University Maastricht The Netherlands
- Department of Neurology, Alzheimer Centre VUMC Amsterdam The Netherlands
| | - Bengt Winblad
- Department NVS Karolinska Institutet, Center for Alzheimer Research, Division of Neurogeriatrics Huddinge Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology The Sahlgrenska Academy at the University of Gothenburg Mölndal Sweden
- Department of Molecular Neuroscience UCL Institute of Neurology London UK
| | - Gunhild Waldemar
- Danish Dementia Research Centre Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark
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Apolipoprotein E4: A Risk Factor for Successful Cognitive Aging. Dement Neurocogn Disord 2016; 15:61-67. [PMID: 30906344 PMCID: PMC6427966 DOI: 10.12779/dnd.2016.15.3.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 09/29/2016] [Accepted: 09/29/2016] [Indexed: 11/27/2022] Open
Abstract
Apolipoprotein E is a plasma protein that has an important role in transport and metabolism of lipids in serum as well as central nervous system. Among the 3 common alleles, the ε2 allele has the most stable structure followed by ε3 and ε4 in order. There is evidence for a deleterious role of ε4 allele by atherosclerosis and amyloid beta accumulation in brain and body. The presence and gene dose of ε4 allele are risk factors for late-onset Alzheimer's disease. Apolipoprotein E ε4 may have a role in the pathology of amyloid beta and tau and it has a strong relationship with the early onset of late-onset Alzheimer's disease. However, early-onset Alzheimer's disease has a weaker relationship with ε4 allele of apolipoprotein E.
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Sampedro F, Vilaplana E, de Leon MJ, Alcolea D, Pegueroles J, Montal V, Carmona-Iragui M, Sala I, Sánchez-Saudinos MB, Antón-Aguirre S, Morenas-Rodríguez E, Camacho V, Falcón C, Pavía J, Ros D, Clarimón J, Blesa R, Lleó A, Fortea J. APOE-by-sex interactions on brain structure and metabolism in healthy elderly controls. Oncotarget 2016; 6:26663-74. [PMID: 26397226 PMCID: PMC4694943 DOI: 10.18632/oncotarget.5185] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 08/28/2015] [Indexed: 11/25/2022] Open
Abstract
Background The APOE effect on Alzheimer Disease (AD) risk is stronger in women than in men but its mechanisms have not been established. We assessed the APOE-by-sex interaction on core CSF biomarkers, brain metabolism and structure in healthy elderly control individuals (HC). Methods Cross-sectional study. HC from the Alzheimer’s Disease Neuroimaging Initiative with available CSF (n = 274) and/or 3T-MRI (n = 168) and/or a FDG-PET analyses (n = 328) were selected. CSF amyloid-β1–42 (Aβ1–42), total-tau (t-tau) and phospho-tau (p-tau181p) levels were measured by Luminex assays. We analyzed the APOE-by-sex interaction on the CSF biomarkers in an analysis of covariance (ANCOVA). FDG uptake was analyzed by SPM8 and cortical thickness (CTh) was measured by FreeSurfer. FDG and CTh difference maps were derived from interaction and group analyses. Results APOE4 carriers had lower CSF Aβ1–42 and higher CSF p-tau181p values than non-carriers, but there was no APOE-by-sex interaction on CSF biomarkers. The APOE-by-sex interaction on brain metabolism and brain structure was significant. Sex stratification showed that female APOE4 carriers presented widespread brain hypometabolism and cortical thinning compared to female non-carriers whereas male APOE4 carriers showed only a small cluster of hypometabolism and regions of cortical thickening compared to male non-carriers. Conclusions The impact of APOE4 on brain metabolism and structure is modified by sex. Female APOE4 carriers show greater hypometabolism and atrophy than male carriers. This APOE-by-sex interaction should be considered in clinical trials in preclinical AD where APOE4 status is a selection criterion.
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Affiliation(s)
- Frederic Sampedro
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau - Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain.,Nuclear Medicine Department, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau - Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eduard Vilaplana
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau - Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Mony J de Leon
- New York University School of Medicine, New York, NY, USA
| | - Daniel Alcolea
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau - Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Jordi Pegueroles
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau - Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Victor Montal
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau - Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - María Carmona-Iragui
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau - Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Isabel Sala
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau - Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - María-Belén Sánchez-Saudinos
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau - Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Sofía Antón-Aguirre
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau - Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Estrella Morenas-Rodríguez
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau - Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Valle Camacho
- Nuclear Medicine Department, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau - Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carles Falcón
- Unitat de Biofísica i Bioenginyeria, Departament de Ciències Fisiològiques I, Facultat de Medicina, Universitat de Barcelona - IDIBAPS, Barcelona, Spain.,Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine - CIBER-BBN, Barcelona, Spain
| | - Javier Pavía
- Nuclear Medicine Department. Hospital Clínic de Barcelona, Barcelona, Spain.,Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine - CIBER-BBN, Barcelona, Spain
| | - Domènec Ros
- Unitat de Biofísica i Bioenginyeria, Departament de Ciències Fisiològiques I, Facultat de Medicina, Universitat de Barcelona - IDIBAPS, Barcelona, Spain.,Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine - CIBER-BBN, Barcelona, Spain
| | - Jordi Clarimón
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau - Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Rafael Blesa
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau - Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Alberto Lleó
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau - Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Juan Fortea
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau - Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
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Sharma N, Singh AN. Exploring Biomarkers for Alzheimer's Disease. J Clin Diagn Res 2016; 10:KE01-6. [PMID: 27630867 PMCID: PMC5020308 DOI: 10.7860/jcdr/2016/18828.8166] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 05/03/2016] [Indexed: 11/24/2022]
Abstract
Alzheimer's Disease (AD) is one of the most common form of dementia occurring in elderly population worldwide. Currently Aβ42, tau and p-tau in the cerebrospinal fluid is estimated for confirmation of AD. CSF which is being used as the potent source for biomarker screening is obtained by invasive lumbar punctures. Thus, there is an urgent need of minimal invasive methods for identification of diagnostic markers for early detection of AD. Blood serum and plasma serves as an appropriate source, due to minimal discomfort to the patients, promoting frequent testing, better follow-up and better consent to clinical trials. Hence, the need of the hour demands discovery of diagnostic and prognostic patient specific signature biomarkers by using emerging technologies of mass spectrometry, microarrays and peptidomics. In this review we summarize the present scenario of AD biomarkers such as circulatory biomarkers, blood based amyloid markers, inflammatory markers and oxidative stress markers being investigated and also some of the potent biomarkers which might be able to predict early onset of Alzheimer's and delay cognitive impairment.
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Affiliation(s)
- Neeti Sharma
- Assistant Professor, Symbiosis School of Biomedical Sciences, Symbiosis International University, Lavale, Pune, Maharashtra, India
| | - Anshika Nikita Singh
- DST- Inspire Junior Research Fellow, Symbiosis School of Biomedical Sciences, Symbiosis International University, Lavale, Pune, Maharashtra, India
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42
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HYDRA: Revealing heterogeneity of imaging and genetic patterns through a multiple max-margin discriminative analysis framework. Neuroimage 2016; 145:346-364. [PMID: 26923371 DOI: 10.1016/j.neuroimage.2016.02.041] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 02/11/2016] [Accepted: 02/12/2016] [Indexed: 11/23/2022] Open
Abstract
Multivariate pattern analysis techniques have been increasingly used over the past decade to derive highly sensitive and specific biomarkers of diseases on an individual basis. The driving assumption behind the vast majority of the existing methodologies is that a single imaging pattern can distinguish between healthy and diseased populations, or between two subgroups of patients (e.g., progressors vs. non-progressors). This assumption effectively ignores the ample evidence for the heterogeneous nature of brain diseases. Neurodegenerative, neuropsychiatric and neurodevelopmental disorders are largely characterized by high clinical heterogeneity, which likely stems in part from underlying neuroanatomical heterogeneity of various pathologies. Detecting and characterizing heterogeneity may deepen our understanding of disease mechanisms and lead to patient-specific treatments. However, few approaches tackle disease subtype discovery in a principled machine learning framework. To address this challenge, we present a novel non-linear learning algorithm for simultaneous binary classification and subtype identification, termed HYDRA (Heterogeneity through Discriminative Analysis). Neuroanatomical subtypes are effectively captured by multiple linear hyperplanes, which form a convex polytope that separates two groups (e.g., healthy controls from pathologic samples); each face of this polytope effectively defines a disease subtype. We validated HYDRA on simulated and clinical data. In the latter case, we applied the proposed method independently to the imaging and genetic datasets of the Alzheimer's Disease Neuroimaging Initiative (ADNI 1) study. The imaging dataset consisted of T1-weighted volumetric magnetic resonance images of 123 AD patients and 177 controls. The genetic dataset consisted of single nucleotide polymorphism information of 103 AD patients and 139 controls. We identified 3 reproducible subtypes of atrophy in AD relative to controls: (1) diffuse and extensive atrophy, (2) precuneus and extensive temporal lobe atrophy, as well some prefrontal atrophy, (3) atrophy pattern very much confined to the hippocampus and the medial temporal lobe. The genetics dataset yielded two subtypes of AD characterized mainly by the presence/absence of the apolipoprotein E (APOE) ε4 genotype, but also involving differential presence of risk alleles of CD2AP, SPON1 and LOC39095 SNPs that were associated with differences in the respective patterns of brain atrophy, especially in the precuneus. The results demonstrate the potential of the proposed approach to map disease heterogeneity in neuroimaging and genetic studies.
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Bourdenx M, Koulakiotis NS, Sanoudou D, Bezard E, Dehay B, Tsarbopoulos A. Protein aggregation and neurodegeneration in prototypical neurodegenerative diseases: Examples of amyloidopathies, tauopathies and synucleinopathies. Prog Neurobiol 2015. [PMID: 26209472 DOI: 10.1016/j.pneurobio.2015.07.003] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Alzheimer's and Parkinson's diseases are the most prevalent neurodegenerative diseases that generate important health-related direct and indirect socio-economic costs. They are characterized by severe neuronal losses in several disease-specific brain regions associated with deposits of aggregated proteins. In Alzheimer's disease, β-amyloid peptide-containing plaques and intraneuronal neurofibrillary tangles composed of hyperphosphorylated microtubule-associated protein tau are the two main neuropathological lesions, while Parkinson's disease is defined by the presence of Lewy Bodies that are intraneuronal proteinaceous cytoplasmic inclusions. α-Synuclein has been identified as a major protein component of Lewy Bodies and heavily implicated in the pathogenesis of Parkinson's disease. In the past few years, evidence has emerged to explain how these aggregate-prone proteins can undergo spontaneous self-aggregation, propagate from cell to cell, and mediate neurotoxicity. Current research now indicates that oligomeric forms are probably the toxic species. This article discusses recent progress in the understanding of the pathogenesis of these diseases, with a focus on the underlying mechanisms of protein aggregation, and emphasizes the pathophysiological molecular mechanisms leading to cellular toxicity. Finally, we present the putative direct link between β-amyloid peptide and tau in causing toxicity in Alzheimer's disease as well as α-synuclein in Parkinson's disease, along with some of the most promising therapeutic strategies currently in development for those incurable neurodegenerative disorders.
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Affiliation(s)
- Mathieu Bourdenx
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France
| | | | - Despina Sanoudou
- National and Kapodistrian University of Athens Medical School, Department of Internal Medicine, 75 Mikras Asias Street, Athens 11527, Greece
| | - Erwan Bezard
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France
| | - Benjamin Dehay
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France.
| | - Anthony Tsarbopoulos
- GAIA Research Center, Bioanalytical Department, The Goulandris Natural History Museum, Kifissia 14562, Greece; National and Kapodistrian University of Athens Medical School, Department of Pharmacology, 75 Mikras Asias Street, Athens 11527, Greece.
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Alcolea D, Martínez-Lage P, Sánchez-Juan P, Olazarán J, Antúnez C, Izagirre A, Ecay-Torres M, Estanga A, Clerigué M, Guisasola MC, Sánchez Ruiz D, Marín Muñoz J, Calero M, Blesa R, Clarimón J, Carmona-Iragui M, Morenas-Rodríguez E, Rodríguez-Rodríguez E, Vázquez Higuera JL, Fortea J, Lleó A. Amyloid precursor protein metabolism and inflammation markers in preclinical Alzheimer disease. Neurology 2015; 85:626-33. [PMID: 26180139 DOI: 10.1212/wnl.0000000000001859] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Accepted: 04/24/2015] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To investigate CSF markers involved in amyloid precursor protein processing, neuronal damage, and neuroinflammation in the preclinical stages of Alzheimer disease (AD) and participants with suspected non-Alzheimer pathology (SNAP). METHODS We collected CSF from 266 cognitively normal volunteers participating in a cross-sectional multicenter study (the SIGNAL study) to investigate markers involved in amyloid precursor protein processing (Aβ42, sAPPβ, β-secretase activity), neuronal damage (total-tau [t-tau], phospho-tau [p-tau]), and neuroinflammation (YKL-40). We analyzed the relationship among biomarkers, clinical variables, and the APOE genotype, and compared biomarker levels across the preclinical stages of the National Institute on Aging-Alzheimer's Association classification: stage 0, 1, 2, 3, and SNAP. RESULTS The median age in the whole cohort was 58.8 years (range 39.8-81.6). Participants in stages 2-3 and SNAP had higher levels of YKL-40 than those in stages 0 and 1. Participants with SNAP had higher levels of sAPPβ than participants in stage 0 and 1. No differences were found between stages 0, 1, and 2-3 in sAPPβ and β-secretase activity in CSF. Age correlated with t-tau, p-tau, and YKL-40. It also correlated with Aβ42, but only in APOE ε4 carriers. Aβ42 correlated positively with t-tau, sAPPβ, and YKL-40 in participants with normal Aβ42. CONCLUSIONS Our findings suggest that inflammation in the CNS increases in normal aging and is intimately related to markers of neurodegeneration in the preclinical stages of AD and SNAP. sAPPβ and β-secretase activity are not useful diagnostic or staging markers in preclinical AD.
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Affiliation(s)
- Daniel Alcolea
- From the Department of Neurology (D.A., R.B., J.C., M.C.-I., E.M.-R., J.F., A.L.), Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona; Fundación CITA-Alzhéimer Fundazioa (P.M.-L., A.I., M.E.-T., A.E., M.C.), San Sebastián; Servicio de Neurología (P.S.-J., E.R.-R., J.L.V.H.), Hospital Universitario Marqués de Valdecilla, Santander; Servicio de Neurología (J.O., D.S.R.) and Unidad de Medicina Experimental (M.C.G.), Hospital General Gregorio Marañón, Madrid; Unidad de Demencias (C.A., J.M.M.), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia; Instituto de Salud Carlos III (M.C.), CIBERNED, Madrid; Fundación CIEN (J.O., M.C.), Fundación Reina Sofía, Madrid; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED (The SIGNAL Study), Spain
| | - Pablo Martínez-Lage
- From the Department of Neurology (D.A., R.B., J.C., M.C.-I., E.M.-R., J.F., A.L.), Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona; Fundación CITA-Alzhéimer Fundazioa (P.M.-L., A.I., M.E.-T., A.E., M.C.), San Sebastián; Servicio de Neurología (P.S.-J., E.R.-R., J.L.V.H.), Hospital Universitario Marqués de Valdecilla, Santander; Servicio de Neurología (J.O., D.S.R.) and Unidad de Medicina Experimental (M.C.G.), Hospital General Gregorio Marañón, Madrid; Unidad de Demencias (C.A., J.M.M.), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia; Instituto de Salud Carlos III (M.C.), CIBERNED, Madrid; Fundación CIEN (J.O., M.C.), Fundación Reina Sofía, Madrid; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED (The SIGNAL Study), Spain
| | - Pascual Sánchez-Juan
- From the Department of Neurology (D.A., R.B., J.C., M.C.-I., E.M.-R., J.F., A.L.), Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona; Fundación CITA-Alzhéimer Fundazioa (P.M.-L., A.I., M.E.-T., A.E., M.C.), San Sebastián; Servicio de Neurología (P.S.-J., E.R.-R., J.L.V.H.), Hospital Universitario Marqués de Valdecilla, Santander; Servicio de Neurología (J.O., D.S.R.) and Unidad de Medicina Experimental (M.C.G.), Hospital General Gregorio Marañón, Madrid; Unidad de Demencias (C.A., J.M.M.), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia; Instituto de Salud Carlos III (M.C.), CIBERNED, Madrid; Fundación CIEN (J.O., M.C.), Fundación Reina Sofía, Madrid; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED (The SIGNAL Study), Spain
| | - Javier Olazarán
- From the Department of Neurology (D.A., R.B., J.C., M.C.-I., E.M.-R., J.F., A.L.), Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona; Fundación CITA-Alzhéimer Fundazioa (P.M.-L., A.I., M.E.-T., A.E., M.C.), San Sebastián; Servicio de Neurología (P.S.-J., E.R.-R., J.L.V.H.), Hospital Universitario Marqués de Valdecilla, Santander; Servicio de Neurología (J.O., D.S.R.) and Unidad de Medicina Experimental (M.C.G.), Hospital General Gregorio Marañón, Madrid; Unidad de Demencias (C.A., J.M.M.), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia; Instituto de Salud Carlos III (M.C.), CIBERNED, Madrid; Fundación CIEN (J.O., M.C.), Fundación Reina Sofía, Madrid; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED (The SIGNAL Study), Spain
| | - Carmen Antúnez
- From the Department of Neurology (D.A., R.B., J.C., M.C.-I., E.M.-R., J.F., A.L.), Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona; Fundación CITA-Alzhéimer Fundazioa (P.M.-L., A.I., M.E.-T., A.E., M.C.), San Sebastián; Servicio de Neurología (P.S.-J., E.R.-R., J.L.V.H.), Hospital Universitario Marqués de Valdecilla, Santander; Servicio de Neurología (J.O., D.S.R.) and Unidad de Medicina Experimental (M.C.G.), Hospital General Gregorio Marañón, Madrid; Unidad de Demencias (C.A., J.M.M.), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia; Instituto de Salud Carlos III (M.C.), CIBERNED, Madrid; Fundación CIEN (J.O., M.C.), Fundación Reina Sofía, Madrid; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED (The SIGNAL Study), Spain
| | - Andrea Izagirre
- From the Department of Neurology (D.A., R.B., J.C., M.C.-I., E.M.-R., J.F., A.L.), Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona; Fundación CITA-Alzhéimer Fundazioa (P.M.-L., A.I., M.E.-T., A.E., M.C.), San Sebastián; Servicio de Neurología (P.S.-J., E.R.-R., J.L.V.H.), Hospital Universitario Marqués de Valdecilla, Santander; Servicio de Neurología (J.O., D.S.R.) and Unidad de Medicina Experimental (M.C.G.), Hospital General Gregorio Marañón, Madrid; Unidad de Demencias (C.A., J.M.M.), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia; Instituto de Salud Carlos III (M.C.), CIBERNED, Madrid; Fundación CIEN (J.O., M.C.), Fundación Reina Sofía, Madrid; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED (The SIGNAL Study), Spain
| | - Mirian Ecay-Torres
- From the Department of Neurology (D.A., R.B., J.C., M.C.-I., E.M.-R., J.F., A.L.), Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona; Fundación CITA-Alzhéimer Fundazioa (P.M.-L., A.I., M.E.-T., A.E., M.C.), San Sebastián; Servicio de Neurología (P.S.-J., E.R.-R., J.L.V.H.), Hospital Universitario Marqués de Valdecilla, Santander; Servicio de Neurología (J.O., D.S.R.) and Unidad de Medicina Experimental (M.C.G.), Hospital General Gregorio Marañón, Madrid; Unidad de Demencias (C.A., J.M.M.), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia; Instituto de Salud Carlos III (M.C.), CIBERNED, Madrid; Fundación CIEN (J.O., M.C.), Fundación Reina Sofía, Madrid; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED (The SIGNAL Study), Spain
| | - Ainara Estanga
- From the Department of Neurology (D.A., R.B., J.C., M.C.-I., E.M.-R., J.F., A.L.), Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona; Fundación CITA-Alzhéimer Fundazioa (P.M.-L., A.I., M.E.-T., A.E., M.C.), San Sebastián; Servicio de Neurología (P.S.-J., E.R.-R., J.L.V.H.), Hospital Universitario Marqués de Valdecilla, Santander; Servicio de Neurología (J.O., D.S.R.) and Unidad de Medicina Experimental (M.C.G.), Hospital General Gregorio Marañón, Madrid; Unidad de Demencias (C.A., J.M.M.), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia; Instituto de Salud Carlos III (M.C.), CIBERNED, Madrid; Fundación CIEN (J.O., M.C.), Fundación Reina Sofía, Madrid; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED (The SIGNAL Study), Spain
| | - Montserrat Clerigué
- From the Department of Neurology (D.A., R.B., J.C., M.C.-I., E.M.-R., J.F., A.L.), Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona; Fundación CITA-Alzhéimer Fundazioa (P.M.-L., A.I., M.E.-T., A.E., M.C.), San Sebastián; Servicio de Neurología (P.S.-J., E.R.-R., J.L.V.H.), Hospital Universitario Marqués de Valdecilla, Santander; Servicio de Neurología (J.O., D.S.R.) and Unidad de Medicina Experimental (M.C.G.), Hospital General Gregorio Marañón, Madrid; Unidad de Demencias (C.A., J.M.M.), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia; Instituto de Salud Carlos III (M.C.), CIBERNED, Madrid; Fundación CIEN (J.O., M.C.), Fundación Reina Sofía, Madrid; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED (The SIGNAL Study), Spain
| | - Maria Concepción Guisasola
- From the Department of Neurology (D.A., R.B., J.C., M.C.-I., E.M.-R., J.F., A.L.), Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona; Fundación CITA-Alzhéimer Fundazioa (P.M.-L., A.I., M.E.-T., A.E., M.C.), San Sebastián; Servicio de Neurología (P.S.-J., E.R.-R., J.L.V.H.), Hospital Universitario Marqués de Valdecilla, Santander; Servicio de Neurología (J.O., D.S.R.) and Unidad de Medicina Experimental (M.C.G.), Hospital General Gregorio Marañón, Madrid; Unidad de Demencias (C.A., J.M.M.), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia; Instituto de Salud Carlos III (M.C.), CIBERNED, Madrid; Fundación CIEN (J.O., M.C.), Fundación Reina Sofía, Madrid; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED (The SIGNAL Study), Spain
| | - Domingo Sánchez Ruiz
- From the Department of Neurology (D.A., R.B., J.C., M.C.-I., E.M.-R., J.F., A.L.), Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona; Fundación CITA-Alzhéimer Fundazioa (P.M.-L., A.I., M.E.-T., A.E., M.C.), San Sebastián; Servicio de Neurología (P.S.-J., E.R.-R., J.L.V.H.), Hospital Universitario Marqués de Valdecilla, Santander; Servicio de Neurología (J.O., D.S.R.) and Unidad de Medicina Experimental (M.C.G.), Hospital General Gregorio Marañón, Madrid; Unidad de Demencias (C.A., J.M.M.), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia; Instituto de Salud Carlos III (M.C.), CIBERNED, Madrid; Fundación CIEN (J.O., M.C.), Fundación Reina Sofía, Madrid; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED (The SIGNAL Study), Spain
| | - Juan Marín Muñoz
- From the Department of Neurology (D.A., R.B., J.C., M.C.-I., E.M.-R., J.F., A.L.), Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona; Fundación CITA-Alzhéimer Fundazioa (P.M.-L., A.I., M.E.-T., A.E., M.C.), San Sebastián; Servicio de Neurología (P.S.-J., E.R.-R., J.L.V.H.), Hospital Universitario Marqués de Valdecilla, Santander; Servicio de Neurología (J.O., D.S.R.) and Unidad de Medicina Experimental (M.C.G.), Hospital General Gregorio Marañón, Madrid; Unidad de Demencias (C.A., J.M.M.), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia; Instituto de Salud Carlos III (M.C.), CIBERNED, Madrid; Fundación CIEN (J.O., M.C.), Fundación Reina Sofía, Madrid; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED (The SIGNAL Study), Spain
| | - Miguel Calero
- From the Department of Neurology (D.A., R.B., J.C., M.C.-I., E.M.-R., J.F., A.L.), Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona; Fundación CITA-Alzhéimer Fundazioa (P.M.-L., A.I., M.E.-T., A.E., M.C.), San Sebastián; Servicio de Neurología (P.S.-J., E.R.-R., J.L.V.H.), Hospital Universitario Marqués de Valdecilla, Santander; Servicio de Neurología (J.O., D.S.R.) and Unidad de Medicina Experimental (M.C.G.), Hospital General Gregorio Marañón, Madrid; Unidad de Demencias (C.A., J.M.M.), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia; Instituto de Salud Carlos III (M.C.), CIBERNED, Madrid; Fundación CIEN (J.O., M.C.), Fundación Reina Sofía, Madrid; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED (The SIGNAL Study), Spain
| | - Rafael Blesa
- From the Department of Neurology (D.A., R.B., J.C., M.C.-I., E.M.-R., J.F., A.L.), Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona; Fundación CITA-Alzhéimer Fundazioa (P.M.-L., A.I., M.E.-T., A.E., M.C.), San Sebastián; Servicio de Neurología (P.S.-J., E.R.-R., J.L.V.H.), Hospital Universitario Marqués de Valdecilla, Santander; Servicio de Neurología (J.O., D.S.R.) and Unidad de Medicina Experimental (M.C.G.), Hospital General Gregorio Marañón, Madrid; Unidad de Demencias (C.A., J.M.M.), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia; Instituto de Salud Carlos III (M.C.), CIBERNED, Madrid; Fundación CIEN (J.O., M.C.), Fundación Reina Sofía, Madrid; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED (The SIGNAL Study), Spain
| | - Jordi Clarimón
- From the Department of Neurology (D.A., R.B., J.C., M.C.-I., E.M.-R., J.F., A.L.), Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona; Fundación CITA-Alzhéimer Fundazioa (P.M.-L., A.I., M.E.-T., A.E., M.C.), San Sebastián; Servicio de Neurología (P.S.-J., E.R.-R., J.L.V.H.), Hospital Universitario Marqués de Valdecilla, Santander; Servicio de Neurología (J.O., D.S.R.) and Unidad de Medicina Experimental (M.C.G.), Hospital General Gregorio Marañón, Madrid; Unidad de Demencias (C.A., J.M.M.), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia; Instituto de Salud Carlos III (M.C.), CIBERNED, Madrid; Fundación CIEN (J.O., M.C.), Fundación Reina Sofía, Madrid; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED (The SIGNAL Study), Spain
| | - María Carmona-Iragui
- From the Department of Neurology (D.A., R.B., J.C., M.C.-I., E.M.-R., J.F., A.L.), Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona; Fundación CITA-Alzhéimer Fundazioa (P.M.-L., A.I., M.E.-T., A.E., M.C.), San Sebastián; Servicio de Neurología (P.S.-J., E.R.-R., J.L.V.H.), Hospital Universitario Marqués de Valdecilla, Santander; Servicio de Neurología (J.O., D.S.R.) and Unidad de Medicina Experimental (M.C.G.), Hospital General Gregorio Marañón, Madrid; Unidad de Demencias (C.A., J.M.M.), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia; Instituto de Salud Carlos III (M.C.), CIBERNED, Madrid; Fundación CIEN (J.O., M.C.), Fundación Reina Sofía, Madrid; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED (The SIGNAL Study), Spain
| | - Estrella Morenas-Rodríguez
- From the Department of Neurology (D.A., R.B., J.C., M.C.-I., E.M.-R., J.F., A.L.), Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona; Fundación CITA-Alzhéimer Fundazioa (P.M.-L., A.I., M.E.-T., A.E., M.C.), San Sebastián; Servicio de Neurología (P.S.-J., E.R.-R., J.L.V.H.), Hospital Universitario Marqués de Valdecilla, Santander; Servicio de Neurología (J.O., D.S.R.) and Unidad de Medicina Experimental (M.C.G.), Hospital General Gregorio Marañón, Madrid; Unidad de Demencias (C.A., J.M.M.), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia; Instituto de Salud Carlos III (M.C.), CIBERNED, Madrid; Fundación CIEN (J.O., M.C.), Fundación Reina Sofía, Madrid; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED (The SIGNAL Study), Spain
| | - Eloy Rodríguez-Rodríguez
- From the Department of Neurology (D.A., R.B., J.C., M.C.-I., E.M.-R., J.F., A.L.), Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona; Fundación CITA-Alzhéimer Fundazioa (P.M.-L., A.I., M.E.-T., A.E., M.C.), San Sebastián; Servicio de Neurología (P.S.-J., E.R.-R., J.L.V.H.), Hospital Universitario Marqués de Valdecilla, Santander; Servicio de Neurología (J.O., D.S.R.) and Unidad de Medicina Experimental (M.C.G.), Hospital General Gregorio Marañón, Madrid; Unidad de Demencias (C.A., J.M.M.), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia; Instituto de Salud Carlos III (M.C.), CIBERNED, Madrid; Fundación CIEN (J.O., M.C.), Fundación Reina Sofía, Madrid; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED (The SIGNAL Study), Spain
| | - José Luis Vázquez Higuera
- From the Department of Neurology (D.A., R.B., J.C., M.C.-I., E.M.-R., J.F., A.L.), Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona; Fundación CITA-Alzhéimer Fundazioa (P.M.-L., A.I., M.E.-T., A.E., M.C.), San Sebastián; Servicio de Neurología (P.S.-J., E.R.-R., J.L.V.H.), Hospital Universitario Marqués de Valdecilla, Santander; Servicio de Neurología (J.O., D.S.R.) and Unidad de Medicina Experimental (M.C.G.), Hospital General Gregorio Marañón, Madrid; Unidad de Demencias (C.A., J.M.M.), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia; Instituto de Salud Carlos III (M.C.), CIBERNED, Madrid; Fundación CIEN (J.O., M.C.), Fundación Reina Sofía, Madrid; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED (The SIGNAL Study), Spain
| | - Juan Fortea
- From the Department of Neurology (D.A., R.B., J.C., M.C.-I., E.M.-R., J.F., A.L.), Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona; Fundación CITA-Alzhéimer Fundazioa (P.M.-L., A.I., M.E.-T., A.E., M.C.), San Sebastián; Servicio de Neurología (P.S.-J., E.R.-R., J.L.V.H.), Hospital Universitario Marqués de Valdecilla, Santander; Servicio de Neurología (J.O., D.S.R.) and Unidad de Medicina Experimental (M.C.G.), Hospital General Gregorio Marañón, Madrid; Unidad de Demencias (C.A., J.M.M.), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia; Instituto de Salud Carlos III (M.C.), CIBERNED, Madrid; Fundación CIEN (J.O., M.C.), Fundación Reina Sofía, Madrid; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED (The SIGNAL Study), Spain
| | - Alberto Lleó
- From the Department of Neurology (D.A., R.B., J.C., M.C.-I., E.M.-R., J.F., A.L.), Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona; Fundación CITA-Alzhéimer Fundazioa (P.M.-L., A.I., M.E.-T., A.E., M.C.), San Sebastián; Servicio de Neurología (P.S.-J., E.R.-R., J.L.V.H.), Hospital Universitario Marqués de Valdecilla, Santander; Servicio de Neurología (J.O., D.S.R.) and Unidad de Medicina Experimental (M.C.G.), Hospital General Gregorio Marañón, Madrid; Unidad de Demencias (C.A., J.M.M.), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia; Instituto de Salud Carlos III (M.C.), CIBERNED, Madrid; Fundación CIEN (J.O., M.C.), Fundación Reina Sofía, Madrid; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED (The SIGNAL Study), Spain.
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Gispert JD, Rami L, Sánchez-Benavides G, Falcon C, Tucholka A, Rojas S, Molinuevo JL. Nonlinear cerebral atrophy patterns across the Alzheimer's disease continuum: impact of APOE4 genotype. Neurobiol Aging 2015; 36:2687-701. [PMID: 26239178 DOI: 10.1016/j.neurobiolaging.2015.06.027] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 06/26/2015] [Accepted: 06/30/2015] [Indexed: 01/11/2023]
Abstract
The progression of Alzheimer's disease (AD) is characterized by complex trajectories of cerebral atrophy that are affected by interactions with age and apolipoprotein E allele ε4 (APOE4) status. In this article, we report the nonlinear volumetric changes in gray matter across the full biological spectrum of the disease, represented by the AD-cerebrospinal fluid (CSF) index. This index reflects the subject's level of pathology and position along the AD continuum. We also evaluated the associated impact of the APOE4 genotype. The atrophy pattern associated with the AD-CSF index was highly symmetrical and corresponded with the typical AD signature. Medial temporal structures showed different atrophy dynamics along the progression of the disease. The bilateral parahippocampal cortices and a parietotemporal region extending from the middle temporal to the supramarginal gyrus presented an initial increase in volume which later reverted. Similarly, a portion of the precuneus presented a rather linear inverse association with the AD-CSF index whereas some other clusters did not show significant atrophy until index values corresponded to positive CSF tau values. APOE4 carriers showed steeper hippocampal volume reductions with AD progression. Overall, the reported atrophy patterns are in close agreement with those mentioned in previous findings. However, the detected nonlinearities suggest that there may be different pathological processes taking place at specific moments during AD progression and reveal the impact of the APOE4 allele.
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Affiliation(s)
- J D Gispert
- Clinical and Neuroimaging Departments, Barcelonabeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain
| | - L Rami
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | - C Falcon
- Clinical and Neuroimaging Departments, Barcelonabeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain
| | - A Tucholka
- Clinical and Neuroimaging Departments, Barcelonabeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - S Rojas
- Clinical and Neuroimaging Departments, Barcelonabeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain; Department of Morphological Sciences, Anatomy and Embriology Unit, Faculty of Medicine, Autonomous University of Barcelona
| | - J L Molinuevo
- Clinical and Neuroimaging Departments, Barcelonabeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain; Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
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46
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Sweeney MD, Sagare AP, Zlokovic BV. Cerebrospinal fluid biomarkers of neurovascular dysfunction in mild dementia and Alzheimer's disease. J Cereb Blood Flow Metab 2015; 35:1055-68. [PMID: 25899298 PMCID: PMC4640280 DOI: 10.1038/jcbfm.2015.76] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 02/27/2015] [Accepted: 03/08/2015] [Indexed: 02/06/2023]
Abstract
Alzheimer's disease (AD) is the most common form of age-related dementias. In addition to genetics, environment, and lifestyle, growing evidence supports vascular contributions to dementias including dementia because of AD. Alzheimer's disease affects multiple cell types within the neurovascular unit (NVU), including brain vascular cells (endothelial cells, pericytes, and vascular smooth muscle cells), glial cells (astrocytes and microglia), and neurons. Thus, identifying and integrating biomarkers of the NVU cell-specific responses and injury with established AD biomarkers, amyloid-β (Aβ) and tau, has a potential to contribute to better understanding of the disease process in dementias including AD. Here, we discuss the existing literature on cerebrospinal fluid biomarkers of the NVU cell-specific responses during early stages of dementia and AD. We suggest that the clinical usefulness of established AD biomarkers, Aβ and tau, could be further improved by developing an algorithm that will incorporate biomarkers of the NVU cell-specific responses and injury. Such biomarker algorithm could aid in early detection and intervention as well as identify novel treatment targets to delay disease onset, slow progression, and/or prevent AD.
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Affiliation(s)
- Melanie D Sweeney
- Department of Physiology and Biophysics, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Abhay P Sagare
- Department of Physiology and Biophysics, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Berislav V Zlokovic
- Department of Physiology and Biophysics, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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47
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Musiek ES, Holtzman DM. Three dimensions of the amyloid hypothesis: time, space and 'wingmen'. Nat Neurosci 2015; 18:800-6. [PMID: 26007213 PMCID: PMC4445458 DOI: 10.1038/nn.4018] [Citation(s) in RCA: 497] [Impact Index Per Article: 55.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 03/23/2015] [Indexed: 02/07/2023]
Abstract
The amyloid hypothesis, which has been the predominant framework for research in Alzheimer's disease (AD), has been the source of considerable controversy. The amyloid hypothesis postulates that amyloid-β peptide (Aβ) is the causative agent in AD. It is strongly supported by data from rare autosomal dominant forms of AD. However, the evidence that Aβ causes or contributes to age-associated sporadic AD is more complex and less clear, prompting criticism of the hypothesis. We provide an overview of the major arguments for and against the amyloid hypothesis. We conclude that Aβ likely is the key initiator of a complex pathogenic cascade that causes AD. However, we argue that Aβ acts primarily as a trigger of other downstream processes, particularly tau aggregation, which mediate neurodegeneration. Aβ appears to be necessary, but not sufficient, to cause AD. Its major pathogenic effects may occur very early in the disease process.
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Affiliation(s)
- Erik S Musiek
- Department of Neurology, Knight Alzheimer's Disease Research Center, and Hope Center for Neurological Disorders, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - David M Holtzman
- Department of Neurology, Knight Alzheimer's Disease Research Center, and Hope Center for Neurological Disorders, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
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48
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Salomon-Zimri S, Liraz O, Michaelson DM. Behavioral testing affects the phenotypic expression of APOE ε3 and APOE ε4 in targeted replacement mice and reduces the differences between them. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2015; 1:127-35. [PMID: 27239500 PMCID: PMC4876887 DOI: 10.1016/j.dadm.2014.11.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Apolipoprotein E4 (APOE ε4) is the most prevalent genetic risk factor for Alzheimer's disease (AD). Targeted replacement mice that express either APOE ε4 or its AD benign isoform, APOE ε3, are used extensively in behavioral, biochemical, and physiological studies directed at assessing the phenotypic effects of APOE ε4 and at unraveling the mechanisms underlying them. Such experiments often involve pursuing biochemical and behavioral measurements on the same cohort of mice. In view of the possible cross-talk interactions between brain parameters and cognitive performance, we presently investigated the extent to which the phenotypic expression of APOE ε4 and APOE ε4 in targeted replacement mice is affected by behavioral testing. This was performed using young, naïve APOE ε4 and APOE ε3 mice in which the levels of distinct brain parameters are affected by the APOE genotype (e.g., elevated levels of amyloid beta [Aβ] and hyperphosphorylated tau and reduced levels of vesicular glutamate transporter (VGLUT) in hippocampal neurons of APOE ε4 mice). These mice were exposed to a fear-conditioning paradigm, and the resulting effects on the brain parameters were examined. The results obtained revealed that the levels of Aβ, hyperphosphorylated tau, VGluT, and doublecortin of the APOE ε4 and APOE ε3 mice were markedly affected following the exposure of APOE ε4 and APOE ε3 mice to the fear-conditioning paradigm such that the isoform-specific effects of APOE ε4 on these parameters were greatly diminished. The finding that behavioral testing affects the APOE ε3 and APOE ε4 phenotypes and masks the differences between them has important theoretical and practical implications and suggests that the assessment of brain and behavioral parameters should be performed using different cohorts.
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Affiliation(s)
- Shiran Salomon-Zimri
- Department of Neurobiology, The George S. Wise Faculty of Life Sciences, The Sagol School of Neuroscience, Tel-Aviv University, Israel
| | - Ori Liraz
- Department of Neurobiology, The George S. Wise Faculty of Life Sciences, The Sagol School of Neuroscience, Tel-Aviv University, Israel
| | - Daniel M Michaelson
- Department of Neurobiology, The George S. Wise Faculty of Life Sciences, The Sagol School of Neuroscience, Tel-Aviv University, Israel
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Ungar L, Altmann A, Greicius MD. Apolipoprotein E, gender, and Alzheimer's disease: an overlooked, but potent and promising interaction. Brain Imaging Behav 2014; 8:262-73. [PMID: 24293121 DOI: 10.1007/s11682-013-9272-x] [Citation(s) in RCA: 169] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Alzheimer's disease (AD) is an increasingly prevalent, fatal neurodegenerative disease that has proven resistant, thus far, to all attempts to prevent it, forestall it, or slow its progression. The ε4 allele of the Apolipoprotein E gene (APOE4) is a potent genetic risk factor for sporadic and late-onset familial AD. While the link between APOE4 and AD is strong, many expected effects, like increasing the risk of conversion from MCI to AD, have not been widely replicable. One critical, and commonly overlooked, feature of the APOE4 link to AD is that several lines of evidence suggest it is far more pronounced in women than in men. Here we review previous literature on the APOE4 by gender interaction with a particular focus on imaging-related studies.
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Affiliation(s)
- Leo Ungar
- Functional Imaging in Neuropsychiatric Disorders (FIND) Lab, Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA,
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50
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Yi L, Wu T, Luo W, Zhou W, Wu J. A non-invasive, rapid method to genotype late-onset Alzheimer's disease-related apolipoprotein E gene polymorphisms. Neural Regen Res 2014; 9:69-75. [PMID: 25206745 PMCID: PMC4146311 DOI: 10.4103/1673-5374.125332] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2013] [Indexed: 12/21/2022] Open
Abstract
The apolipoprotein E gene ε4 allele is considered a negative factor for neural regeneration in late-onset Alzheimer's disease cases. The aim of this study was to establish a non-invasive, rapid method to genotype apolipoprotein E gene polymorphisms. Genomic DNA from mouth swab specimens was extracted using magnetic nanoparticles, and genotyping was performed by real-time PCR using TaqMan-BHQ probes. Genotyping accuracy was validated by DNA sequencing. Our results demonstrate 100% correlation to DNA sequencing, indicating reliability of our protocol. Thus, the method we have developed for apolipoprotein E genotyping is accurate and reliable, and also suitable for genotyping large samples, which may help determine the role of the apolipoprotein E ε4 allele in neural regeneration in late-onset Alzheimer's disease cases.
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Affiliation(s)
- Li Yi
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, China
| | - Ting Wu
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, China
| | - Wenyuan Luo
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, China
| | - Wen Zhou
- Department of Radiology, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, China
| | - Jun Wu
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, China
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