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Acha B, Corroza J, Sánchez-Ruiz de Gordoa J, Cabello C, Robles M, Méndez-López I, Macías M, Zueco S, Roldan M, Urdánoz-Casado A, Jericó I, Erro ME, Alcolea D, Lleo A, Blanco-Luquin I, Mendioroz M. Association of Blood-Based DNA Methylation Markers With Late-Onset Alzheimer Disease: A Potential Diagnostic Approach. Neurology 2023; 101:e2434-e2447. [PMID: 37827850 PMCID: PMC10752644 DOI: 10.1212/wnl.0000000000207865] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/13/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVES There is an urgent need to identify novel noninvasive biomarkers for Alzheimer disease (AD) diagnosis. Recent advances in blood-based measurements of phosphorylated tau (pTau) species are promising but still insufficient to address clinical needs. Epigenetics has been shown to be helpful to better understand AD pathogenesis. Epigenetic biomarkers have been successfully implemented in other medical disciplines, such as oncology. The objective of this study was to explore the diagnostic accuracy of a blood-based DNA methylation marker panel as a noninvasive tool to identify patients with late-onset Alzheimer compared with age-matched controls. METHODS A case-control study was performed. Blood DNA methylation levels at 46 cytosine-guanine sites (21 genes selected after a comprehensive literature search) were measured by bisulfite pyrosequencing in patients with "probable AD dementia" following National Institute on Aging and the Alzheimer's Association guidelines (2011) and age-matched and sex-matched controls recruited at Neurology Department-University Hospital of Navarre, Spain, selected by convenience sampling. Plasma pTau181 levels were determined by Simoa technology. Multivariable logistic regression analysis was performed to explore the optimal model to discriminate patients with AD from controls. Furthermore, we performed a stratified analysis by sex. RESULTS The final study cohort consisted of 80 patients with AD (age: median [interquartile range] 79 [11] years; 58.8% female) and 100 cognitively healthy controls (age 77 [10] years; 58% female). A panel including DNA methylation levels at NXN, ABCA7, and HOXA3 genes and plasma pTau181 significantly improved (area under the receiver operating characteristic curve 0.93, 95% CI 0.89-0.97) the diagnostic performance of a single pTau181-based model, adjusted for age, sex, and APOE ɛ4 genotype. The sensitivity and specificity of this panel were 83.30% and 90.00%, respectively. After sex-stratified analysis, HOXA3 DNA methylation levels showed consistent association with AD. DISCUSSION These results highlight the potential translational value of blood-based DNA methylation biomarkers for noninvasive diagnosis of AD. REGISTRATION INFORMATION Research Ethics Committee of the University Hospital of Navarre (PI17/02218).
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Affiliation(s)
- Blanca Acha
- From the Navarrabiomed (B.A., J.S.-R.d.G., C.C., M. Robles, I.M.-L., M.M., S.Z., M. Roldan, A.U.-C., I.J., M.E.E., I.B.-L., M.M.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Universidad Pública de Navarra (UPNA); Departments of Neurology (J.C., J.S.-R.d.G., C.C., I.J., M.E.E., M.M.) and Internal Medicine (I.M.-L.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Pamplona; Department of Neurology (D.A., A.L.), Institut d'Investigacions Biomèdiques Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Catalunya; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (D.A., A.L.), CIBERNED, Madrid, Spain
| | - Jon Corroza
- From the Navarrabiomed (B.A., J.S.-R.d.G., C.C., M. Robles, I.M.-L., M.M., S.Z., M. Roldan, A.U.-C., I.J., M.E.E., I.B.-L., M.M.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Universidad Pública de Navarra (UPNA); Departments of Neurology (J.C., J.S.-R.d.G., C.C., I.J., M.E.E., M.M.) and Internal Medicine (I.M.-L.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Pamplona; Department of Neurology (D.A., A.L.), Institut d'Investigacions Biomèdiques Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Catalunya; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (D.A., A.L.), CIBERNED, Madrid, Spain
| | - Javier Sánchez-Ruiz de Gordoa
- From the Navarrabiomed (B.A., J.S.-R.d.G., C.C., M. Robles, I.M.-L., M.M., S.Z., M. Roldan, A.U.-C., I.J., M.E.E., I.B.-L., M.M.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Universidad Pública de Navarra (UPNA); Departments of Neurology (J.C., J.S.-R.d.G., C.C., I.J., M.E.E., M.M.) and Internal Medicine (I.M.-L.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Pamplona; Department of Neurology (D.A., A.L.), Institut d'Investigacions Biomèdiques Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Catalunya; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (D.A., A.L.), CIBERNED, Madrid, Spain
| | - Carolina Cabello
- From the Navarrabiomed (B.A., J.S.-R.d.G., C.C., M. Robles, I.M.-L., M.M., S.Z., M. Roldan, A.U.-C., I.J., M.E.E., I.B.-L., M.M.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Universidad Pública de Navarra (UPNA); Departments of Neurology (J.C., J.S.-R.d.G., C.C., I.J., M.E.E., M.M.) and Internal Medicine (I.M.-L.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Pamplona; Department of Neurology (D.A., A.L.), Institut d'Investigacions Biomèdiques Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Catalunya; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (D.A., A.L.), CIBERNED, Madrid, Spain
| | - Maitane Robles
- From the Navarrabiomed (B.A., J.S.-R.d.G., C.C., M. Robles, I.M.-L., M.M., S.Z., M. Roldan, A.U.-C., I.J., M.E.E., I.B.-L., M.M.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Universidad Pública de Navarra (UPNA); Departments of Neurology (J.C., J.S.-R.d.G., C.C., I.J., M.E.E., M.M.) and Internal Medicine (I.M.-L.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Pamplona; Department of Neurology (D.A., A.L.), Institut d'Investigacions Biomèdiques Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Catalunya; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (D.A., A.L.), CIBERNED, Madrid, Spain
| | - Iván Méndez-López
- From the Navarrabiomed (B.A., J.S.-R.d.G., C.C., M. Robles, I.M.-L., M.M., S.Z., M. Roldan, A.U.-C., I.J., M.E.E., I.B.-L., M.M.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Universidad Pública de Navarra (UPNA); Departments of Neurology (J.C., J.S.-R.d.G., C.C., I.J., M.E.E., M.M.) and Internal Medicine (I.M.-L.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Pamplona; Department of Neurology (D.A., A.L.), Institut d'Investigacions Biomèdiques Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Catalunya; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (D.A., A.L.), CIBERNED, Madrid, Spain
| | - Mónica Macías
- From the Navarrabiomed (B.A., J.S.-R.d.G., C.C., M. Robles, I.M.-L., M.M., S.Z., M. Roldan, A.U.-C., I.J., M.E.E., I.B.-L., M.M.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Universidad Pública de Navarra (UPNA); Departments of Neurology (J.C., J.S.-R.d.G., C.C., I.J., M.E.E., M.M.) and Internal Medicine (I.M.-L.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Pamplona; Department of Neurology (D.A., A.L.), Institut d'Investigacions Biomèdiques Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Catalunya; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (D.A., A.L.), CIBERNED, Madrid, Spain
| | - Sara Zueco
- From the Navarrabiomed (B.A., J.S.-R.d.G., C.C., M. Robles, I.M.-L., M.M., S.Z., M. Roldan, A.U.-C., I.J., M.E.E., I.B.-L., M.M.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Universidad Pública de Navarra (UPNA); Departments of Neurology (J.C., J.S.-R.d.G., C.C., I.J., M.E.E., M.M.) and Internal Medicine (I.M.-L.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Pamplona; Department of Neurology (D.A., A.L.), Institut d'Investigacions Biomèdiques Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Catalunya; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (D.A., A.L.), CIBERNED, Madrid, Spain
| | - Miren Roldan
- From the Navarrabiomed (B.A., J.S.-R.d.G., C.C., M. Robles, I.M.-L., M.M., S.Z., M. Roldan, A.U.-C., I.J., M.E.E., I.B.-L., M.M.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Universidad Pública de Navarra (UPNA); Departments of Neurology (J.C., J.S.-R.d.G., C.C., I.J., M.E.E., M.M.) and Internal Medicine (I.M.-L.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Pamplona; Department of Neurology (D.A., A.L.), Institut d'Investigacions Biomèdiques Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Catalunya; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (D.A., A.L.), CIBERNED, Madrid, Spain
| | - Amaya Urdánoz-Casado
- From the Navarrabiomed (B.A., J.S.-R.d.G., C.C., M. Robles, I.M.-L., M.M., S.Z., M. Roldan, A.U.-C., I.J., M.E.E., I.B.-L., M.M.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Universidad Pública de Navarra (UPNA); Departments of Neurology (J.C., J.S.-R.d.G., C.C., I.J., M.E.E., M.M.) and Internal Medicine (I.M.-L.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Pamplona; Department of Neurology (D.A., A.L.), Institut d'Investigacions Biomèdiques Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Catalunya; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (D.A., A.L.), CIBERNED, Madrid, Spain
| | - Ivonne Jericó
- From the Navarrabiomed (B.A., J.S.-R.d.G., C.C., M. Robles, I.M.-L., M.M., S.Z., M. Roldan, A.U.-C., I.J., M.E.E., I.B.-L., M.M.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Universidad Pública de Navarra (UPNA); Departments of Neurology (J.C., J.S.-R.d.G., C.C., I.J., M.E.E., M.M.) and Internal Medicine (I.M.-L.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Pamplona; Department of Neurology (D.A., A.L.), Institut d'Investigacions Biomèdiques Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Catalunya; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (D.A., A.L.), CIBERNED, Madrid, Spain
| | - Maria Elena Erro
- From the Navarrabiomed (B.A., J.S.-R.d.G., C.C., M. Robles, I.M.-L., M.M., S.Z., M. Roldan, A.U.-C., I.J., M.E.E., I.B.-L., M.M.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Universidad Pública de Navarra (UPNA); Departments of Neurology (J.C., J.S.-R.d.G., C.C., I.J., M.E.E., M.M.) and Internal Medicine (I.M.-L.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Pamplona; Department of Neurology (D.A., A.L.), Institut d'Investigacions Biomèdiques Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Catalunya; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (D.A., A.L.), CIBERNED, Madrid, Spain
| | - Daniel Alcolea
- From the Navarrabiomed (B.A., J.S.-R.d.G., C.C., M. Robles, I.M.-L., M.M., S.Z., M. Roldan, A.U.-C., I.J., M.E.E., I.B.-L., M.M.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Universidad Pública de Navarra (UPNA); Departments of Neurology (J.C., J.S.-R.d.G., C.C., I.J., M.E.E., M.M.) and Internal Medicine (I.M.-L.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Pamplona; Department of Neurology (D.A., A.L.), Institut d'Investigacions Biomèdiques Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Catalunya; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (D.A., A.L.), CIBERNED, Madrid, Spain
| | - Alberto Lleo
- From the Navarrabiomed (B.A., J.S.-R.d.G., C.C., M. Robles, I.M.-L., M.M., S.Z., M. Roldan, A.U.-C., I.J., M.E.E., I.B.-L., M.M.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Universidad Pública de Navarra (UPNA); Departments of Neurology (J.C., J.S.-R.d.G., C.C., I.J., M.E.E., M.M.) and Internal Medicine (I.M.-L.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Pamplona; Department of Neurology (D.A., A.L.), Institut d'Investigacions Biomèdiques Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Catalunya; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (D.A., A.L.), CIBERNED, Madrid, Spain
| | - Idoia Blanco-Luquin
- From the Navarrabiomed (B.A., J.S.-R.d.G., C.C., M. Robles, I.M.-L., M.M., S.Z., M. Roldan, A.U.-C., I.J., M.E.E., I.B.-L., M.M.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Universidad Pública de Navarra (UPNA); Departments of Neurology (J.C., J.S.-R.d.G., C.C., I.J., M.E.E., M.M.) and Internal Medicine (I.M.-L.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Pamplona; Department of Neurology (D.A., A.L.), Institut d'Investigacions Biomèdiques Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Catalunya; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (D.A., A.L.), CIBERNED, Madrid, Spain
| | - Maite Mendioroz
- From the Navarrabiomed (B.A., J.S.-R.d.G., C.C., M. Robles, I.M.-L., M.M., S.Z., M. Roldan, A.U.-C., I.J., M.E.E., I.B.-L., M.M.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Universidad Pública de Navarra (UPNA); Departments of Neurology (J.C., J.S.-R.d.G., C.C., I.J., M.E.E., M.M.) and Internal Medicine (I.M.-L.), Hospital Universitario de Navarra-IdiSNA (Navarra Institute for Health Research), Pamplona; Department of Neurology (D.A., A.L.), Institut d'Investigacions Biomèdiques Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Catalunya; and Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (D.A., A.L.), CIBERNED, Madrid, Spain.
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Kober DL, Stuchell-Brereton MD, Kluender CE, Dean HB, Strickland MR, Steinberg DF, Nelson SS, Baban B, Holtzman DM, Frieden C, Alexander-Brett J, Roberson ED, Song Y, Brett TJ. Functional insights from biophysical study of TREM2 interactions with apoE and Aβ 1-42. Alzheimers Dement 2020; 17:10.1002/alz.12194. [PMID: 33090700 PMCID: PMC8026773 DOI: 10.1002/alz.12194] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 08/12/2020] [Accepted: 08/20/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Triggering receptor expressed on myeloid cells-2 (TREM2) is an immune receptor expressed on microglia that also can become soluble (sTREM2). How TREM2 engages different ligands remains poorly understood. METHODS We used comprehensive biolayer interferometry (BLI) analysis to investigate TREM2 and sTREM2 interactions with apolipoprotein E (apoE) and monomeric amyloid beta (Aβ) (mAβ42). RESULTS TREM2 engagement of apoE was protein mediated with little effect of lipidation, showing slight affinity differences between isoforms (E4 > E3 > E2). Another family member, TREML2, did not bind apoE. Disease-linked TREM2 variants within a "basic patch" minimally impact apoE binding. Instead, TREM2 uses a unique hydrophobic surface to bind apoE, which requires the apoE hinge region. TREM2 and sTREM2 directly bind mAβ42 and potently inhibit Aβ42 polymerization, suggesting a potential role for soluble sTREM2 in preventing AD pathogenesis. DISCUSSION These findings demonstrate that TREM2 has at least two ligand-binding surfaces that might be therapeutic targets and uncovers a potential function for sTREM2 in directly inhibiting Aβ polymerization.
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Affiliation(s)
- Daniel L. Kober
- Molecular Microbiology and Microbial Pathogenesis Program, Washington University School of Medicine, St. Louis, Missouri 63110
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri 63110
| | - Melissa D. Stuchell-Brereton
- Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine, St. Louis, Missouri 63110
| | - Colin E. Kluender
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri 63110
- Biochemistry, Biophysics, and Structural Biology Program, Washington University School of Medicine, St. Louis, Missouri 63110
| | - Hunter B. Dean
- Center for Neurodegeneration and Experimental Therapeutics, Alzheimer’s Disease Center, Departments of Neurology and Neurobiology, University of Alabama at Birmingham, AL 35294
- Department of Biomedical Engineering, University of Alabama at Birmingham, AL 35294
| | - Michael R. Strickland
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri 63110
| | - Deborah F. Steinberg
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri 63110
| | - Samantha S. Nelson
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri 63110
| | - Berevan Baban
- Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine, St. Louis, Missouri 63110
| | - David M. Holtzman
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri 63110
- Charles F. and Joanne Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St. Louis, Missouri 63110
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri 63110
| | - Carl Frieden
- Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine, St. Louis, Missouri 63110
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri 63110
| | - Jennifer Alexander-Brett
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri 63110
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri 63110
| | - Erik D. Roberson
- Center for Neurodegeneration and Experimental Therapeutics, Alzheimer’s Disease Center, Departments of Neurology and Neurobiology, University of Alabama at Birmingham, AL 35294
| | - Yuhua Song
- Department of Biomedical Engineering, University of Alabama at Birmingham, AL 35294
| | - Tom J. Brett
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri 63110
- Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine, St. Louis, Missouri 63110
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri 63110
- Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Missouri 63110
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