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Reus LM, Jansen IE, Tijms BM, Visser PJ, Tesi N, van der Lee SJ, Vermunt L, Peeters CFW, De Groot LA, Hok-A-Hin YS, Chen-Plotkin A, Irwin DJ, Hu WT, Meeter LH, van Swieten JC, Holstege H, Hulsman M, Lemstra AW, Pijnenburg YAL, van der Flier WM, Teunissen CE, Del Campo Milan M. Connecting dementia risk loci to the CSF proteome identifies pathophysiological leads for dementia. Brain 2024:awae090. [PMID: 38527854 DOI: 10.1093/brain/awae090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 01/29/2024] [Accepted: 02/25/2024] [Indexed: 03/27/2024] Open
Abstract
Genome-wide association studies have successfully identified many genetic risk loci for dementia, but exact biological mechanisms through which genetic risk factors contribute to dementia remains unclear. Integrating CSF proteomic data with dementia risk loci could reveal intermediate molecular pathways connecting genetic variance to the development of dementia. We tested to what extent effects of known dementia risk loci can be observed in CSF levels of 665 proteins (proximity extension-based (PEA) immunoassays) in a deeply-phenotyped mixed-memory clinic cohort (n=502, mean age (sd) = 64.1 [8.7] years, 181 female [35.4%]), including patients with Alzheimer's disease (AD, n=213), dementia with Lewy bodies (DLB, n=50) and frontotemporal dementia (FTD, n=93), and controls (n=146). Validation was assessed in independent cohorts (n=99 PEA platform, n=198, MRM-targeted mass spectroscopy and multiplex assay). We performed additional analyses stratified according to diagnostic status (AD, DLB, FTD and controls separately), to explore whether associations between CSF proteins and genetic variants were specific to disease or not. We identified four AD risk loci as protein quantitative trait loci (pQTL): CR1-CR2 (rs3818361, P=1.65e-08), ZCWPW1-PILRB (rs1476679, P=2.73e-32), CTSH-CTSH (rs3784539, P=2.88e-24) and HESX1-RETN (rs186108507, P=8.39e-08), of which the first three pQTLs showed direct replication in the independent cohorts. We identified one AD-specific association between a rare genetic variant of TREM2 and CSF IL6 levels (rs75932628, P = 3.90e-7). DLB risk locus GBA showed positive trans effects on seven inter-related CSF levels in DLB patients only. No pQTLs were identified for frontotemporal dementia, either for the total sample as for analyses performed within FTD only. pQTL variants were involved in the immune system, highlighting the importance of this system in the pathophysiology of dementia. We further identified pQTLs in stratified analyses for AD and DLB, hinting at disease-specific pQTLs in dementia. Dissecting the contribution of risk loci to neurobiological processes aids in understanding disease mechanisms underlying dementia.
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Affiliation(s)
- Lianne M Reus
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
- Center for Neurobehavioral Genetics, University of California Los Angeles, Los Angeles, CA 90095 California, USA
| | - Iris E Jansen
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive research, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Betty M Tijms
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Pieter Jelle Visser
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
- Department of Psychiatry, Maastricht University, 6229 ET Maastricht The Netherlands
| | - Niccoló Tesi
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
- Genomics of Neurodegenerative Diseases and Aging, Department of Human Genetics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, 1081 HZ Amsterdam, The Netherlands
| | - Sven J van der Lee
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
- Genomics of Neurodegenerative Diseases and Aging, Department of Human Genetics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, 1081 HZ Amsterdam, The Netherlands
| | - Lisa Vermunt
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, 1081 HZ Amsterdam, The Netherlands
| | - Carel F W Peeters
- Mathematical & Statistical Methods group (Biometris), Wageningen University & Research, Wageningen, 6708 PB Wageningen, The Netherlands
| | - Lisa A De Groot
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Yanaika S Hok-A-Hin
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, 1081 HZ Amsterdam, The Netherlands
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - David J Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - William T Hu
- Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA
- Rutgers-RWJ Medical School, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901, USA
| | - Lieke H Meeter
- Department of Neurology and Alzheimer Center, Erasmus Medical Center Rotterdam, Rotterdam, 3015 GD, The Netherlands
| | - John C van Swieten
- Department of Neurology and Alzheimer Center, Erasmus Medical Center Rotterdam, Rotterdam, 3015 GD, The Netherlands
| | - Henne Holstege
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
- Genomics of Neurodegenerative Diseases and Aging, Department of Human Genetics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, 1081 HZ Amsterdam, The Netherlands
| | - Marc Hulsman
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
- Genomics of Neurodegenerative Diseases and Aging, Department of Human Genetics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, 1081 HZ Amsterdam, The Netherlands
| | - Afina W Lemstra
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, 1081 HZ Amsterdam, The Netherlands
| | - Marta Del Campo Milan
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, 1081 HZ Amsterdam, The Netherlands
- Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Madrid, 28003 Madrid, Spain
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, 08005 Barcelona, Spain
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Butts B, Huang H, Hu WT, Kehoe PG, Miners JS, Verble DD, Zetterberg H, Zhao L, Trotti LM, Benameur K, Scorr LM, Wharton W. sPDGFRβ and neuroinflammation are associated with AD biomarkers and differ by race: The ASCEND Study. Alzheimers Dement 2024; 20:1175-1189. [PMID: 37933404 PMCID: PMC10916968 DOI: 10.1002/alz.13457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 07/24/2023] [Accepted: 08/08/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION There remains an urgent need to identify preclinical pathophysiological mechanisms of Alzheimer's disease (AD) development in high-risk, racially diverse populations. We explored the relationship between cerebrospinal fluid (CSF) markers of vascular injury and neuroinflammation with AD biomarkers in middle-aged Black/African American (B/AA) and non-Hispanic White (NHW) participants. METHODS Adults (45-65 years) with a parental history of AD were enrolled (n = 82). CSF and blood biomarkers were collected at baseline and year 2. RESULTS CSF total tau (t-tau), phosphorylated tau (p-tau), and amyloid beta (Aβ)40 were elevated at year 2 compared to baseline. CSF soluble platelet-derived growth factor receptor β (sPDGFRβ) levels, a marker of pericyte injury, correlated positively with t-tau, p-tau, Aβ40 markers of vascular injury, and cytokines at baseline and year 2. CSF sPDGFRβ and tau were significantly lower in B/AA than NHW. DISCUSSION Vascular dysfunction and neuroinflammation may precede cognitive decline and disease pathology in the very early preclinical stages of AD, and there are race-related differences in these relationships. HIGHLIGHTS Cerebrospinal fluid (CSF) Alzheimer's disease (AD) biomarkers changed over 2 years in high-risk middle-aged adults. Markers of vascular dysfunction were associated with the CSF biomarkers amyloid beta and tau. AD biomarkers were lower in Black compared to non-Hispanic White individuals. Markers of vascular dysfunction were lower among Black individuals.
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Affiliation(s)
- Brittany Butts
- Emory UniversityNell Hodgson Woodruff School of NursingAtlantaGeorgiaUSA
| | - Hanfeng Huang
- Georgetown University, School of MedicineWashingtonDistrict of ColumbiaUSA
| | - William T. Hu
- Rutgers UniversityInstitute for Health, Health Care Policy, and Aging ResearchNew BrunswickNew JerseyUSA
| | | | | | - Danielle D. Verble
- Emory UniversityNell Hodgson Woodruff School of NursingAtlantaGeorgiaUSA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK; UK Dementia Research Institute at UCL, London, UK; Hong Kong Center for Neurodegenerative Diseases, Clear Water BayHong KongChina
| | - Liping Zhao
- Emory UniversityRollins School of Public HealthAtlantaGeorgiaUSA
| | | | | | | | - Whitney Wharton
- Emory UniversityNell Hodgson Woodruff School of NursingAtlantaGeorgiaUSA
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Kota KJ, Dawson A, Papas J, Sotelo V, Su G, Li M, Lee W, Estervil J, Marquez M, Sarkar S, Lopez LL, Hu WT. Factors associated with attitudes toward research MRI in older Asian Americans. Alzheimers Dement (N Y) 2024; 10:e12449. [PMID: 38356478 PMCID: PMC10865479 DOI: 10.1002/trc2.12449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/14/2023] [Accepted: 12/11/2023] [Indexed: 02/16/2024]
Abstract
INTRODUCTION South Asian (SA) and East Asian (EA) older adults represent the fastest-growing racial/ethnic groups of Americans at risk for dementia. While recruiting older SA adults into a brain health study, we encountered unexpected hesitancy toward structural brain magnetic resonance imaging (MRI) analysis and stigmatizing attitudes related to internal locus of control (LoC) for future dementia risks. We hypothesized that support for MRI-related research was influenced by these attitudes as well as personal MRI experience, perceived MRI safety, and concerns for personal risk for future dementia/stroke. METHODS We developed a brief cross-sectional survey to assess older adults' MRI experiences and perceptions, desire to learn of six incidental findings of increasing impact on health, and attitudes related to dementia (including LoC) and research participation. We recruited a convenience sample of 256 respondents (74% reporting as 50+) from the New Jersey/New York City area to complete the survey (offered in English, Chinese, Korean, and Spanish) and modeled the proportional odds (PO) for favorable attitudes toward research activities. RESULTS Seventy-seven SA and 84 EA respondents were analyzed alongside 95 White, Black, or Hispanic adults. White (PO = 2.54, p = 0.013) and EA (PO = 2.14, p = 0.019) respondents were both more likely than SA respondents to endorse healthy volunteers' participation in research, and the difference between White and SA respondents was mediated by the latter's greater internal LoC for dementia risks. EA respondents had more worries for future dementia/stroke than SA respondents (p = 0.006) but still shared SA respondents' lower wish (measured by proportion of total) to learn of incidental MRI findings. DISCUSSION SA-and EA compared to SA-older adults had low desire to learn of incidental MRI findings but had different attitudes toward future dementia/stroke risks. A culturally appropriate protocol to disclose incidental MRI findings may improve SA and EA participation in brain health research. Highlights Older Asian Americans have limited interest in incidental findings on research MRISouth Asians are most likely to attribute dementia to people's own behaviorsSouth Asians' attitudes mediate lower support for healthy volunteers in researchSouth and East Asians differ in dementia worries and research-related attitudes.
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Affiliation(s)
- Karthik J Kota
- Departments of NeurologyInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
- Departments of MedicineRutgers‐Robert Wood Johnson Medical SchoolInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - Alice Dawson
- Departments of NeurologyInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - Julia Papas
- Departments of NeurologyInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - Victor Sotelo
- Departments of NeurologyInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - Guibin Su
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - Mei‐Ling Li
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - Woowon Lee
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - Jaunis Estervil
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - Melissa Marquez
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - Shromona Sarkar
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - Lisa Lanza Lopez
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
| | - William T. Hu
- Departments of NeurologyInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
- Center for Healthy AgingInstitute for Health, Health Care Policy, and Aging ResearchRutgers Biomedical and Health SciencesNew BrunswickNew JerseyUSA
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Fan JX, Zhang M, Zhao WY, Han Y, Hu WT, Jia HX, Sun XD. [Health economic evaluation of telemedicine diabetic retinopathy examination using a non-mydriatic fundus camera in China]. Zhonghua Yan Ke Za Zhi 2023; 59:919-929. [PMID: 37936360 DOI: 10.3760/cma.j.cn112142-20230204-00038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Objective: To perform a health economic evaluation of telemedicine diabetic retinopathy (DR) examination with a non-mydriatic fundus camera in China and to investigate the optimal examination interval. Methods: Based on 18 peer-reviewed articles related to epidemiology, clinical trial, and health economic evaluation of DR, surveys from 9 ophthalmologists in 3 tertiary hospitals in China, price lists for medical services in each province, and the negotiated price in 2021, a Markov model was conducted to evaluate the cost utility of telemedicine eye examination for diabetes mellitus patients aged 45 and older from the health system perspective. Separate analyses were performed for no examination and for examination intervals of every 1 to 5 years to predict the lifetime health gain, including cumulative days of blindness, cumulative life years, and quality-adjusted life years (QALYs), and costs for unilateral and bilateral direct medication with a 3.5% discount rate. Results: The cumulative days of blindness in the absence of a DR screening were 2 375.00 days, and ranged from 701.00 to 738.00 days for five different DR screening interval programs. The cumulative life years for no screening and five DR screening programs ranged from 27.120 34 to 28.005 00 years, with QALYs ranging from 9.502 96 to 9.875 02. The direct medication costs in the absence of a DR screening program were 72 785.00 yuan for both unilateral and bilateral scenarios. For the five DR screening intervals, the direct medication costs ranged from 52 065.00 to 52 408.00 yuan for unilateral and 79 100.00 to 79 603.00 yuan for bilateral. Comparing the incremental cost-effectiveness ratios between the DR screening intervals and no screening, the 1-to 5-year intervals were dominant in the unilateral scenario (between -56 368.54 and -55 523.75 yuan/QALY). In the bilateral scenario, the ratios ranged from 17 469.07 to 18 325.15 yuan/QALY. Using a willingness-to-pay threshold equal to the per capita GDP (80 976 yuan/QALY), the 1-year DR screening interval had an 85.9% probability of being cost-effective and a 55.2% probability of being dominant in the unilateral scenario. In the bilateral scenario, the 2-year interval held a 61.4% probability of being cost-effective. Conclusions: Analyses on the remote fundus consultation in diabetic patients and health economics based on the Markov model indicate that telemedicine DR examination through a non-mydriatic fundus camera can be effectively employed for diabetes mellitus patients in China. DR examination every two years is recommended for general diabetic patients, and DR examination every year may be chosen in developed areas.
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Affiliation(s)
- J X Fan
- Information Department, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
| | - M Zhang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai 200080, China
| | - W Y Zhao
- Shanghai Phoebus Medical Technology Co., Ltd, Shanghai 200070, China
| | - Y Han
- Health Economics Research Institute, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China
| | - W T Hu
- Shanghai Phoebus Medical Technology Co., Ltd, Shanghai 200070, China
| | - H X Jia
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai 200080, China
| | - X D Sun
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai 200080, China
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van der Ende EL, In ‘t Veld SGJG, Hanskamp I, van der Lee S, Dijkstra JIR, Hok-A-Hin YS, Blujdea ER, van Swieten JC, Irwin DJ, Chen-Plotkin A, Hu WT, Lemstra AW, Pijnenburg YAL, van der Flier WM, del Campo M, Teunissen CE, Vermunt L. CSF proteomics in autosomal dominant Alzheimer's disease highlights parallels with sporadic disease. Brain 2023; 146:4495-4507. [PMID: 37348871 PMCID: PMC10629764 DOI: 10.1093/brain/awad213] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 06/24/2023] Open
Abstract
Autosomal dominant Alzheimer's disease (ADAD) offers a unique opportunity to study pathophysiological changes in a relatively young population with few comorbidities. A comprehensive investigation of proteome changes occurring in ADAD could provide valuable insights into AD-related biological mechanisms and uncover novel biomarkers and therapeutic targets. Furthermore, ADAD might serve as a model for sporadic AD, but in-depth proteome comparisons are lacking. We aimed to identify dysregulated CSF proteins in ADAD and determine the degree of overlap with sporadic AD. We measured 1472 proteins in CSF of PSEN1 or APP mutation carriers (n = 22) and age- and sex-matched controls (n = 20) from the Amsterdam Dementia Cohort using proximity extension-based immunoassays (PEA). We compared protein abundance between groups with two-sided t-tests and identified enriched biological pathways. Using the same protein panels in paired plasma samples, we investigated correlations between CSF proteins and their plasma counterparts. Finally, we compared our results with recently published PEA data from an international cohort of sporadic AD (n = 230) and non-AD dementias (n = 301). All statistical analyses were false discovery rate-corrected. We detected 66 differentially abundant CSF proteins (65 increased, 1 decreased) in ADAD compared to controls (q < 0.05). The most strongly upregulated proteins (fold change >1.8) were related to immunity (CHIT1, ITGB2, SMOC2), cytoskeletal structure (MAPT, NEFL) and tissue remodelling (TMSB10, MMP-10). Significant CSF-plasma correlations were found for the upregulated proteins SMOC2 and LILR1B. Of the 66 differentially expressed proteins, 36 had been measured previously in the sporadic dementias cohort, 34 of which (94%) were also significantly upregulated in sporadic AD, with a strong correlation between the fold changes of these proteins in both cohorts (rs = 0.730, P < 0.001). Twenty-nine of the 36 proteins (81%) were also upregulated among non-AD patients with suspected AD co-pathology. This CSF proteomics study demonstrates substantial biochemical similarities between ADAD and sporadic AD, suggesting involvement of the same biological processes. Besides known AD-related proteins, we identified several relatively novel proteins, such as TMSB10, MMP-10 and SMOC2, which have potential as novel biomarkers. With shared pathophysiological CSF changes, ADAD study findings might be translatable to sporadic AD, which could greatly expedite therapy development.
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Affiliation(s)
- Emma L van der Ende
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Sjors G J G In ‘t Veld
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Iris Hanskamp
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Sven van der Lee
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
- Genomics of Neurodegenerative Diseases and Aging, Human Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Janna I R Dijkstra
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
- Genomics of Neurodegenerative Diseases and Aging, Human Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Yanaika S Hok-A-Hin
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Elena R Blujdea
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - John C van Swieten
- Alzheimer Center and Department of Neurology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - David J Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - William T Hu
- Department of Neurology, Emory University School of Medicine, Atlanta, GA 30307, USA
| | - Afina W Lemstra
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
- Department of Epidemiology and Data Science, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Marta del Campo
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
- Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, 28003 Madrid, Spain
- Barcelonabeta Brain Research Center (BBRC), Pasqual Maragall Foundation, 08005 Barcelona, Spain
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Lisa Vermunt
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
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Giannisis A, Al-Grety A, Carlsson H, Howell JC, Hu WT, Kultima K, Nielsen HM. Correction: Plasma apolipoprotein E levels, isoform composition, and dimer profile in relation to plasma lipids in racially diverse patients with Alzheimer's disease and mild cognitive impairment. Alzheimers Res Ther 2023; 15:160. [PMID: 37759231 PMCID: PMC10523732 DOI: 10.1186/s13195-023-01306-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Affiliation(s)
- Andreas Giannisis
- Department of Biochemistry and Biophysics, Stockholm University, Svante Arrhenius Väg 16B, 114 18, Stockholm, Sweden
| | - Asma Al-Grety
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | - Henrik Carlsson
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | | | - William T Hu
- Department of Neurology, Emory University, Atlanta, GA, USA
- Department of Neurology, Rutgers-Robert Wood Johnson Medical School, and Institute for Health, Health Care Policy, and Aging Research, New Brunswick, NJ, USA
| | - Kim Kultima
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | - Henrietta M Nielsen
- Department of Biochemistry and Biophysics, Stockholm University, Svante Arrhenius Väg 16B, 114 18, Stockholm, Sweden.
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Hu WT, Bergren SM, Dychtwald DK, Ma Y, Dong X. Variations in racial and ethnic groups' trust in researchers associated with willingness to participate in research. Humanit Soc Sci Commun 2023; 10:466. [PMID: 38650745 PMCID: PMC11034911 DOI: 10.1057/s41599-023-01960-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 07/24/2023] [Indexed: 04/25/2024]
Abstract
Low enrollment in U.S. biomedical research by non-White adults has historically been attributed to mistrust, but few studies have simultaneously examined dimensions of trust in three or more racial/ethnic groups. Leveraging the racial/ethnic diversity of New Jersey, we prospectively recruited 293 adults (72% women, 38% older than 54 years of age) between October 2020 and February 2022 to complete two anonymous surveys in English or one of the common languages (e.g., Spanish, Mandarin Chinese). The first consisted of 12 Likert Scale questions related to trust in biomedical researchers (according to safety, equity, transparency), and the second assessed willingness to consider participation in eight common research activities (health-related survey, blood collection, genetic analysis, medication study, etc). Participants self-reported as Hispanic (n=102), Black (n=49), Chinese (n=48), other Asian (n=53), or White (n=41) race/ethnicity. Factor analysis showed three aspects related to trust in researchers: researchers as fiduciaries for research participants, racial/ethnic equity in research, and transparency. Importantly, we observed differences in the relationship between mistrust and willingness to participate. Whereas Chinese respondents' low trust in researchers mediated their low interest in research involving more than health-related surveys, Hispanic respondents' low trust in research equity did not deter high willingness to participate in research involving blood and genetic analysis. We caution that a generic association between trust and research participation should not be broadly assumed, and biomedical researchers should prospectively assess this relationship within each minoritized group to avoid hasty generalization.
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Affiliation(s)
- William T Hu
- Rutgers Institute for Health, Health Care Policy, and Aging Research, USA
| | | | - Dana K Dychtwald
- Rutgers Institute for Health, Health Care Policy, and Aging Research, USA
| | - Yiming Ma
- Rutgers Institute for Health, Health Care Policy, and Aging Research, USA
| | - XinQi Dong
- Rutgers Institute for Health, Health Care Policy, and Aging Research, USA
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Giannisis A, Al-Grety A, Carlsson H, Howell JC, Hu WT, Kultima K, Nielsen HM. Plasma apolipoprotein E levels, isoform composition, and dimer profile in relation to plasma lipids in racially diverse patients with Alzheimer's disease and mild cognitive impairment. Alzheimers Res Ther 2023; 15:119. [PMID: 37400888 PMCID: PMC10316569 DOI: 10.1186/s13195-023-01262-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/14/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND The APOEε4-promoted risk of Alzheimer's disease (AD) is lower in Black/African-Americans (B/AAs), compared to non-Hispanic whites (NHWs). Previous studies reported lower plasma apolipoprotein E (apoE) levels in NHW APOEε4-carriers compared to non-carriers, and low plasma apoE levels were directly associated with an increased risk of AD and all dementia. We further showed that APOEε3/ε3 AD patients exhibited reduced plasma apoE dimers compared to corresponding control subjects. Whether plasma apoE levels and apoE dimer formation differ between races/ethnicities and therefore may help explain AD risk racial disparity remains to be elucidated. METHODS Using mass spectrometry, we determined total plasma apoE and apoE isoform levels in a cohort of B/AAs (n = 58) and NHWs (n = 67) including subjects with normal cognition (B/AA: n = 25, NHW: n = 28), mild cognitive impairment (MCI) (B/AA: n = 24, NHW: n = 24), or AD dementia (B/AA: n = 9, NHW: n = 15). Additionally, we used non-reducing western blot analysis to assess the distribution of plasma apoE into monomers/disulfide-linked dimers. Plasma total apoE, apoE isoform levels, and % apoE monomers/dimers were assessed for correlations with cognition, cerebrospinal fluid (CSF) AD biomarkers, sTREM2, neurofilament light protein (NfL), and plasma lipids. RESULTS Plasma apoE was predominantly monomeric in both racial groups and the monomer/dimer distribution was not affected by disease status, or correlated with CSF AD biomarkers, but associated with plasma lipids. Plasma total apoE levels were not related to disease status and only in the NHW subjects we observed lower plasma apoE levels in the APOEε4/ε4-carriers. Total plasma apoE levels were 13% higher in B/AA compared to NHW APOEε4/ε4 subjects and associated with plasma high-density lipoprotein (HDL) in NHW subjects but with low-density lipoprotein levels (LDL) in the B/AA subjects. Higher plasma apoE4 levels, exclusively in APOEε3/ε4 B/AA subjects, were linked to higher plasma total cholesterol and LDL levels. In the controls, NHWs and B/AAs exhibited opposite associations between plasma apoE and CSF t-tau. CONCLUSIONS The previously reported lower APOEε4-promoted risk of AD in B/AA subjects may be associated with differences in plasma apoE levels and lipoprotein association. Whether differences in plasma apoE levels between races/ethnicities result from altered APOEε4 expression or turnover, needs further elucidation.
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Affiliation(s)
- Andreas Giannisis
- Department of Biochemistry and Biophysics, Stockholm University, Svante Arrhenius Väg 16B, 114 18, Stockholm, Sweden
| | - Asma Al-Grety
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | - Henrik Carlsson
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | | | - William T Hu
- Department of Neurology, Emory University, Atlanta, GA, USA
- Department of Neurology, Rutgers-Robert Wood Johnson Medical School, and Institute for Health, Health Care Policy, and Aging Research, New Brunswick, NJ, USA
| | - Kim Kultima
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | - Henrietta M Nielsen
- Department of Biochemistry and Biophysics, Stockholm University, Svante Arrhenius Väg 16B, 114 18, Stockholm, Sweden.
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Hu WT. Lessons Learned in Time-Is Neurodegeneration Still Something Unpredictable? Neurotherapeutics 2023; 20:911-913. [PMID: 37567934 PMCID: PMC10457255 DOI: 10.1007/s13311-023-01412-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 08/13/2023] Open
Affiliation(s)
- William T Hu
- Department of Neurology, Rutgers-Robert Wood Johnson Medical School, 125 Paterson Street, Suite 6200, New Brunswick, NJ, 08901, USA.
- Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901, USA.
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Abstract
Clinical prediction of underlying pathologic substrates in people with Alzheimer's disease (AD) dementia or related dementia syndromes (ADRD) has limited accuracy. Etiologic biomarkers - including cerebrospinal fluid (CSF) levels of AD proteins and cerebral amyloid PET imaging - have greatly modernized disease-modifying clinical trials in AD, but their integration into medical practice has been slow. Beyond core CSF AD biomarkers (including beta-amyloid 1-42, total tau, and tau phosphorylated at threonine 181), novel biomarkers have been interrogated in single- and multi-centered studies with uneven rigor. Here, we review early expectations for ideal AD/ADRD biomarkers, assess these goals' future applicability, and propose study designs and performance thresholds for meeting these ideals with a focus on CSF biomarkers. We further propose three new characteristics: equity (oversampling of diverse populations in the design and testing of biomarkers), access (reasonable availability to 80% of people at risk for disease, along with pre- and post-biomarker processes), and reliability (thorough evaluation of pre-analytical and analytical factors influencing measurements and performance). Finally, we urge biomarker scientists to balance the desire and evidence for a biomarker to reflect its namesake function, indulge data- as well as theory-driven associations, re-visit the subset of rigorously measured CSF biomarkers in large datasets (such as Alzheimer's disease neuroimaging initiative), and resist the temptation to favor ease over fail-safe in the development phase. This shift from discovery to application, and from suspended disbelief to cogent ingenuity, should allow the AD/ADRD biomarker field to live up to its billing during the next phase of neurodegenerative disease research.
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Affiliation(s)
- William T Hu
- Department of Neurology, Rutgers Biomedical and Health Sciences, Rutgers-Robert Wood Johnson Medical School, 125 Paterson Street, Suite 6200, New Brunswick, NJ, 08901, USA.
- Center for Innovation in Health and Aging Research, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, 08901, USA.
| | - Ashima Nayyar
- Department of Neurology, Rutgers Biomedical and Health Sciences, Rutgers-Robert Wood Johnson Medical School, 125 Paterson Street, Suite 6200, New Brunswick, NJ, 08901, USA
| | - Milota Kaluzova
- Department of Neurology, Rutgers Biomedical and Health Sciences, Rutgers-Robert Wood Johnson Medical School, 125 Paterson Street, Suite 6200, New Brunswick, NJ, 08901, USA
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11
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Kloske CM, Barnum CJ, Batista AF, Bradshaw EM, Brickman AM, Bu G, Dennison J, Gearon MD, Goate AM, Haass C, Heneka MT, Hu WT, Huggins LKL, Jones NS, Koldamova R, Lemere CA, Liddelow SA, Marcora E, Marsh SE, Nielsen HM, Petersen KK, Petersen M, Piña-Escudero SD, Qiu WQ, Quiroz YT, Reiman E, Sexton C, Tansey MG, Tcw J, Teunissen CE, Tijms BM, van der Kant R, Wallings R, Weninger SC, Wharton W, Wilcock DM, Wishard TJ, Worley SL, Zetterberg H, Carrillo MC. APOE and immunity: Research highlights. Alzheimers Dement 2023; 19:2677-2696. [PMID: 36975090 DOI: 10.1002/alz.13020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 03/29/2023]
Abstract
INTRODUCTION At the Alzheimer's Association's APOE and Immunity virtual conference, held in October 2021, leading neuroscience experts shared recent research advances on and inspiring insights into the various roles that both the apolipoprotein E gene (APOE) and facets of immunity play in neurodegenerative diseases, including Alzheimer's disease and other dementias. METHODS The meeting brought together more than 1200 registered attendees from 62 different countries, representing the realms of academia and industry. RESULTS During the 4-day meeting, presenters illuminated aspects of the cross-talk between APOE and immunity, with a focus on the roles of microglia, triggering receptor expressed on myeloid cells 2 (TREM2), and components of inflammation (e.g., tumor necrosis factor α [TNFα]). DISCUSSION This manuscript emphasizes the importance of diversity in current and future research and presents an integrated view of innate immune functions in Alzheimer's disease as well as related promising directions in drug development.
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Affiliation(s)
| | | | - Andre F Batista
- Department of Neurology, Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Departments of Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Elizabeth M Bradshaw
- Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, G.H. Sergievsky Center, and Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Guojun Bu
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
| | - Jessica Dennison
- Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mary D Gearon
- Department of Physiology, University of Kentucky, Lexington, Kentucky, USA
| | - Alison M Goate
- Department of Genetics & Genomic Sciences, Ronald M. Loeb Center for Alzheimer's disease, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Christian Haass
- Metabolic Biochemistry, Biomedical Center (BMC), Faculty of Medicine, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany 3 Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Michael T Heneka
- Luxembourg Centre for Systems Biomedicine (LCSB) University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - William T Hu
- Department of Neurology, Rutgers-Robert Wood Johnson Medical School and Center for Healthy Aging, Rutgers Institute for Health, Health Care Policy, and Aging Research, New Brunswick, New Jersey, USA
| | - Lenique K L Huggins
- Department of Biology, Duke University, Durham, North Carolina, USA
- Yale School of Medicine, New Haven, Connecticut, USA
| | - Nahdia S Jones
- Interdisciplinary Program in Neuroscience, Georgetown University, Washington, District of Columbia, USA
| | - Radosveta Koldamova
- EOH, School of Public Health University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Cynthia A Lemere
- Department of Neurology, Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Departments of Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Shane A Liddelow
- Neuroscience Institute and Departments of Neuroscience & Physiology and of Ophthalmology, NYU Grossman School of Medicine, New York, New York, USA
| | - Edoardo Marcora
- Ronald M. Loeb Center for Alzheimer's disease, Dept. of Genetics & Genomic Sciences, Dept. of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Samuel E Marsh
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Henrietta M Nielsen
- Department of Biochemistry and Biophysics, Stockholm University, Stockholm, Sweden
| | - Kellen K Petersen
- The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Melissa Petersen
- Department of Family Medicine, Institute of Translational Research, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Stefanie D Piña-Escudero
- Global Brain Health Institute, Department of Neurology, University of California, San Francisco, California, USA
| | - Wei Qiao Qiu
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Yakeel T Quiroz
- Departments of Psychiatry and Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Eric Reiman
- Banner Alzheimer's Institute, Phoenix, Arizona, USA
- Banner Research, Phoenix, Arizona, USA
| | | | - Malú Gámez Tansey
- Department of Neuroscience and Center for Translational Research in Neurodegenerative Disease, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Julia Tcw
- Department of Pharmacology & Experimental Therapeutics, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Clinical Chemistry department, Amsterdam Neuroscience, Program Neurodegeneration, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Betty M Tijms
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Rik van der Kant
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research (CNCR), VU University Amsterdam, Amsterdam, The Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Rebecca Wallings
- CTRND, Department of Neuroscience, University of Florida, Florida, USA
| | | | | | - Donna M Wilcock
- Sanders-Brown Center on Aging and Department of Physiology, University of Kentucky, Lexington, Kentucky, USA
| | - Tyler James Wishard
- Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA
| | - Susan L Worley
- Independent science writer, Bryn Mawr, Pennsylvania, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
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12
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Kota K, Dawson A, Papas J, Sotelo V, Su G, Li ML, Lee W, Estervil J, Marquez M, Sarkar S, Lopez LL, Hu WT. Too much information? Asian Americans' preferences for incidental brain MRI findings. medRxiv 2023:2023.04.17.23288629. [PMID: 37162874 PMCID: PMC10168418 DOI: 10.1101/2023.04.17.23288629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
INTRODUCTION South Asian (SA) and East Asian (EA) older adults represent the fastest growing group of Americans at risk for dementia, but their participation in aging and dementia research has been limited. While recruiting healthy SA older adults into a brain health study, we encountered unexpected hesitancy towards structural brain MRI analysis along with some stigmatizing attitudes related to internal locus of control (LoC) for future dementia risks. We hypothesized that support for MRI-related research was influenced by these attitudes as well as one's own MRI experience, perceived MRI safety, and concerns for one's own risks for future dementia/stroke. METHODS We developed a brief cross-sectional survey to assess older adults' MRI experiences and perceptions, desire to learn of six incidental findings of increasing health implications, and attitudes related to dementia as well as research participation. We recruited a convenience sample of 256 respondents (74% reporting as 50+) from the New Jersey/New York City area to complete the survey, and modeled the proportional odds (P.O.) for pro-research attitudes. RESULTS 77 SA and 84 EA respondents were analyzed with 95 non-Asian adults. White (P.O.=2.54, p=0.013) and EA (P.O.=2.14, p=0.019) respondents were both more likely than SA respondents to endorse healthy volunteers' participation in research, and the difference between White and SA respondents was mediated by the latter's greater internal LoC for dementia risks. EA respondents had more worries for future dementia/stroke than SA respondents (p=0.006), but still shared SA respondents' low desire to learn of incidental MRI findings. DISCUSSION SA and EA older adults had different attitudes towards future dementia/stroke risks, but shared a low desire to learn of incidental MRI findings. A culturally-appropriate protocol to disclose incidental MRI findings may improve SA and EA participation in brain health research.
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Affiliation(s)
- Karthik Kota
- Department of Neurology Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
- Department of Medicine, Rutgers-Robert Wood Johnson Medical School, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - Alice Dawson
- Department of Neurology Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - Julia Papas
- Department of Neurology Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - Victor Sotelo
- Department of Neurology Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - Guibin Su
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - Mei-Ling Li
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - Woowon Lee
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - Jaunis Estervil
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - Melissa Marquez
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - Shromona Sarkar
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - Lisa Lanza Lopez
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
| | - William T. Hu
- Department of Neurology Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
- Department of Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901
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Hu WT. In memoriam, Robert C. Bowles, Jr, 1947-2022. Alzheimers Dement 2023. [PMID: 36791285 DOI: 10.1002/alz.12972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- William T Hu
- Rutgers-Robert Wood Johnson Medical School, Rutgers Institute for Health, Health Care Policy, and Aging Research, New Brunswick, New Jersey, USA
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Verma S, Perry K, Razdan R, Howell JC, Dawson AL, Hu WT. CSF IL-8 Associated with Response to Gene Therapy in a Case Series of Spinal Muscular Atrophy. Neurotherapeutics 2023; 20:245-253. [PMID: 36289175 PMCID: PMC9607706 DOI: 10.1007/s13311-022-01305-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 11/27/2022] Open
Abstract
Gene therapies have greatly changed the outlook in spinal muscular atrophy (SMA), and this disorder provides a rare opportunity to study longitudinal biomarker changes correlated with reduced disease burden and improved clinical outcomes. Recent work suggests clinical response to correlate with declining cerebrospinal fluid (CSF) levels of the neurodegenerative marker neurofilament light chain (NfL) in children receiving serial anti-sense oligonucleotide therapy. However, change in CSF NfL levels is no longer a practical biomarker as more children undergo single-dose gene replacement therapy. Here we leverage serial CSF samples (median of 4 per child) collected in 13 children with SMA undergoing anti-sense oligonucleotide therapy to characterize the longitudinal profiles of NfL as well as inflammatory and neuronal proteins. In contrast to neurodegeneration in adults, we found NfL levels to first decrease following initiation of treatment but then increase upon further treatment and improved motor functions. We then examined additional CSF inflammatory and neuronal markers for linear association with motor function during SMA treatment. We identified longitudinal IL-8 levels to inversely correlate with motor functions determined by clinical examination (F(1, 47) = 12.903, p = 0.001) or electromyography in the abductor pollicis brevis muscle (p = 0.064). In keeping with this, lower baseline IL-8 levels were associated with better longitudinal outcomes, even though this difference diminished over 2 years in the younger group. We thus propose CSF IL-8 as a biomarker for baseline function and short-term treatment response in SMA, and a candidate biomarker for future treatment trials in other neurodegenerative disorders.
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Affiliation(s)
- Sumit Verma
- Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, 30324, USA
- Department of Neurology, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, 30324, USA
- Department of Neurosciences, Children's Healthcare of Atlanta, Atlanta, GA, 30324, USA
| | - Kelsey Perry
- Department of Neurology, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, 30324, USA
| | - Raj Razdan
- Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, 30324, USA
| | - J Christina Howell
- Department of Neurology, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, 30324, USA
| | - Alice L Dawson
- Department of Neurology, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, 30324, USA
- Health Care Policy, and Aging Research, Rutgers-Robert Wood Johnson Medical School and Rutgers Institute for Health, New Brunswick, NJ, 08901, USA
- Rutgers-Robert Wood Johnson Medical School, 125 Paterson Street, Suite 6200, New Brunswick, NJ, 08901, USA
| | - William T Hu
- Department of Neurology, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, 30324, USA.
- Health Care Policy, and Aging Research, Rutgers-Robert Wood Johnson Medical School and Rutgers Institute for Health, New Brunswick, NJ, 08901, USA.
- Rutgers-Robert Wood Johnson Medical School, 125 Paterson Street, Suite 6200, New Brunswick, NJ, 08901, USA.
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Butts B, Hu WT, Huang H, Kehoe PG, Miners S, Verble DD, Zetterberg H, Zhao L, Wharton W. Two year cognitive and biomarker change in a racially diverse, middle‐aged, cohort at risk for Alzheimer’s disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.068100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | | | - Patrick G Kehoe
- Translational Health Sciences, Bristol Medical School, University of Bristol Bristol United Kingdom
| | | | | | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
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Smith KM, Jeong L, Hu WT, Wharton W. Incorporating history into disparities research: A model for interdisciplinary collaboration and trust building. Alzheimers Dement 2022. [DOI: 10.1002/alz.062371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Bergren S, Ma Y, Merced M, Guzman J, Wang S, Brogden R, Castaneda MJ, Dong X, Hu WT. Race/ethnicity and the relationship between trust in researchers and hypothetical research participation. Alzheimers Dement 2022. [DOI: 10.1002/alz.069224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Stephanie Bergren
- Rutgers Institute for Health, Health Care Policy, and Aging Research New Brunswick NJ USA
| | - Yiming Ma
- Rutgers Institute for Health, Health Care Policy, and Aging Research New Brunswick NJ USA
| | - Mariam Merced
- Robert Wood Johnson University Hospital New Brunswick NJ USA
| | - Jessica Guzman
- Robert Wood Johnson University Hospital New Brunswick NJ USA
| | - Su Wang
- Cooperman Barnabas Medical Center Livingston NJ USA
| | - Ruth Brogden
- Cooperman Barnabas Medical Center Livingston NJ USA
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Kulshreshtha A, Misiura M, Hu WT, Verble DD, Likos KDS, Wharton W. Association of Mid‐life Discrimination Stress and Coping on Brain Volumes. Alzheimers Dement 2022. [DOI: 10.1002/alz.067672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | - Maria Misiura
- Georgia State University Atlanta GA USA
- Center for Translational Research in Neuroimaging and Data Science Atlanta GA USA
| | - William T. Hu
- Emory University Atlanta GA USA
- Rutgers University New Brunswick NJ USA
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Likos KDS, Swieboda D, Williams M, Dotson VM, Hu WT, Verble DD, Wharton W. Perceived discrimination and cognition in a middle age, racially diverse cohort. Alzheimers Dement 2022. [DOI: 10.1002/alz.067991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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20
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Del Campo M, Peeters CFW, Johnson ECB, Vermunt L, Hok-A-Hin YS, van Nee M, Chen-Plotkin A, Irwin DJ, Hu WT, Lah JJ, Seyfried NT, Dammer EB, Herradon G, Meeter LH, van Swieten J, Alcolea D, Lleó A, Levey AI, Lemstra AW, Pijnenburg YAL, Visser PJ, Tijms BM, van der Flier WM, Teunissen CE. CSF proteome profiling across the Alzheimer's disease spectrum reflects the multifactorial nature of the disease and identifies specific biomarker panels. Nat Aging 2022; 2:1040-1053. [PMID: 37118088 PMCID: PMC10292920 DOI: 10.1038/s43587-022-00300-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 09/28/2022] [Indexed: 04/30/2023]
Abstract
Development of disease-modifying therapies against Alzheimer's disease (AD) requires biomarkers reflecting the diverse pathological pathways specific for AD. We measured 665 proteins in 797 cerebrospinal fluid (CSF) samples from patients with mild cognitive impairment with abnormal amyloid (MCI(Aβ+): n = 50), AD-dementia (n = 230), non-AD dementias (n = 322) and cognitively unimpaired controls (n = 195) using proximity ligation-based immunoassays. Here we identified >100 CSF proteins dysregulated in MCI(Aβ+) or AD compared to controls or non-AD dementias. Proteins dysregulated in MCI(Aβ+) were primarily related to protein catabolism, energy metabolism and oxidative stress, whereas those specifically dysregulated in AD dementia were related to cell remodeling, vascular function and immune system. Classification modeling unveiled biomarker panels discriminating clinical groups with high accuracies (area under the curve (AUC): 0.85-0.99), which were translated into custom multiplex assays and validated in external and independent cohorts (AUC: 0.8-0.99). Overall, this study provides novel pathophysiological leads delineating the multifactorial nature of AD and potential biomarker tools for diagnostic settings or clinical trials.
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Affiliation(s)
- Marta Del Campo
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands.
- Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Spain.
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.
| | - Carel F W Peeters
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
- Mathematical & Statistical Methods group (Biometris), Wageningen University & Research, Wageningen, The Netherlands
| | - Erik C B Johnson
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, GA, USA
| | - Lisa Vermunt
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Yanaika S Hok-A-Hin
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Mirrelijn van Nee
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - David J Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - William T Hu
- Rutgers-RWJ Medical School, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - James J Lah
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, GA, USA
| | - Nicholas T Seyfried
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Eric B Dammer
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Gonzalo Herradon
- Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Spain
| | - Lieke H Meeter
- Department of Neurology and Alzheimer Center, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - John van Swieten
- Department of Neurology and Alzheimer Center, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Daniel Alcolea
- Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau - Hospital de Sant Pau, Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Alberto Lleó
- Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau - Hospital de Sant Pau, Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Allan I Levey
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, GA, USA
| | - Afina W Lemstra
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Pieter J Visser
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Betty M Tijms
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
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21
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Hok-A-Hin YS, Hoozemans JJM, Hu WT, Wouters D, Howell JC, Rábano A, van der Flier WM, Pijnenburg YAL, Teunissen CE, Del Campo M. YKL-40 changes are not detected in post-mortem brain of patients with Alzheimer's disease and frontotemporal lobar degeneration. Alzheimers Res Ther 2022; 14:100. [PMID: 35879733 PMCID: PMC9310415 DOI: 10.1186/s13195-022-01039-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/22/2022] [Indexed: 12/12/2022]
Abstract
Background YKL-40 (Chitinase 3-like I) is increased in CSF of Alzheimer’s disease (AD) and frontotemporal lobar degeneration (FTLD) patients and is therefore considered a potential neuroinflammatory biomarker. Whether changed YKL-40 levels in the CSF reflect dysregulation of YKL-40 in the brain is not completely understood yet. We aimed to extensively analyze YKL-40 levels in the brain of AD and different FTLD pathological subtypes. The direct relationship between YKL-40 levels in post-mortem brain and ante-mortem CSF was examined in a small set of paired brain-CSF samples. Method YKL-40 was analyzed in post-mortem temporal and frontal cortex of non-demented controls and patients with AD and FTLD (including FTLD-Tau and FTLD-TDP) pathology by immunohistochemistry (temporal cortex: 51 controls and 56 AD and frontal cortex: 7 controls and 24 FTLD patients), western blot (frontal cortex: 14 controls, 5 AD and 67 FTLD patients), or ELISA (temporal cortex: 11 controls and 7 AD and frontal cortex: 14 controls, 5 AD and 67 FTLD patients). YKL-40 levels were also measured in paired post-mortem brain and ante-mortem CSF samples from dementia patients (n = 9, time-interval collection: 1.4 years) by ELISA. Results We observed that YKL-40 post-mortem brain levels were similar between AD, FTLD, and controls as shown by immunohistochemistry, western blot, and ELISA. Interestingly, strong YKL-40 immunoreactivity was observed in AD cases with cerebral amyloid angiopathy (CAA; n = 6). In paired CSF-brain samples, YKL-40 concentration was 8-times higher in CSF compared to brain. Conclusion Our data suggest that CSF YKL-40 changes may not reflect YKL-40 changes within AD and FTLD pathological brain areas. The YKL-40 reactivity associated with classical CAA hallmarks indicates a possible relationship between YKL-40, neuroinflammation, and vascular pathology. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-01039-y.
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Affiliation(s)
- Yanaika S Hok-A-Hin
- Neurochemistry Laboratory, Clinical Chemistry department, Amsterdam Neuroscience, VU University Medical Center, Amsterdam UMC, Amsterdam, The Netherlands.
| | - Jeroen J M Hoozemans
- Department of Pathology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam UMC, Amsterdam, The Netherlands
| | - William T Hu
- Department of Neurology, Center for Neurodegenerative Diseases Research, Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, USA
| | - Dorine Wouters
- Neurochemistry Laboratory, Clinical Chemistry department, Amsterdam Neuroscience, VU University Medical Center, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jennifer C Howell
- Department of Neurology, Center for Neurodegenerative Diseases Research, Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, USA
| | - Alberto Rábano
- CIEN Tissue Bank, Alzheimer's Centre Reina Sofía-CIEN Foundation, Madrid, Spain
| | - Wiesje M van der Flier
- Alzheimer Centre Amsterdam, Department of Neurology, Amsterdam Neuroscience, VU University Medical Centers, Amsterdam, The Netherlands.,Department of Epidemiology and Data Science, VU University Medical Centers, Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Centre Amsterdam, Department of Neurology, Amsterdam Neuroscience, VU University Medical Centers, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Clinical Chemistry department, Amsterdam Neuroscience, VU University Medical Center, Amsterdam UMC, Amsterdam, The Netherlands
| | - Marta Del Campo
- Neurochemistry Laboratory, Clinical Chemistry department, Amsterdam Neuroscience, VU University Medical Center, Amsterdam UMC, Amsterdam, The Netherlands.,Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain
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22
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Kalia V, Niedzwiecki MM, Bradner JM, Lau FK, Anderson FL, Bucher ML, Manz KE, Schlotter AP, Fuentes ZC, Pennell KD, Picard M, Walker DI, Hu WT, Jones DP, Miller GW. Cross-species metabolomic analysis of tau- and DDT-related toxicity. PNAS Nexus 2022; 1:pgac050. [PMID: 35707205 PMCID: PMC9186048 DOI: 10.1093/pnasnexus/pgac050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 04/28/2022] [Indexed: 01/29/2023]
Abstract
Exposure to the pesticide dichlorodiphenyltrichloroethane (DDT) has been associated with increased risk of Alzheimer's disease (AD), a disease also associated with hyperphosphorylated tau (p-tau) protein aggregation. We investigated whether exposure to DDT can exacerbate tau protein toxicity in Caenorhabditiselegans using a transgenic strain that expresses human tau protein prone to aggregation by measuring changes in size, swim behavior, respiration, lifespan, learning, and metabolism. In addition, we examined the association between cerebrospinal fluid (CSF) p-tau protein-as a marker of postmortem tau burden-and global metabolism in both a human population study and in C. elegans, using the same p-tau transgenic strain. From the human population study, plasma and CSF-derived metabolic features associated with p-tau levels were related to drug, amino acid, fatty acid, and mitochondrial metabolism pathways. A total of five metabolites overlapped between plasma and C. elegans, and four between CSF and C. elegans. DDT exacerbated the inhibitory effect of p-tau protein on growth and basal respiration. In the presence of p-tau protein, DDT induced more curling and was associated with reduced levels of amino acids but increased levels of uric acid and adenosylselenohomocysteine. Our findings in C. elegans indicate that DDT exposure and p-tau aggregation both inhibit mitochondrial function and DDT exposure can exacerbate the mitochondrial inhibitory effects of p-tau aggregation. Further, biological pathways associated with exposure to DDT and p-tau protein appear to be conserved between species.
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Affiliation(s)
- Vrinda Kalia
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032 USA
| | - Megan M Niedzwiecki
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, 10029 USA
| | - Joshua M Bradner
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032 USA
| | - Fion K Lau
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032 USA
| | - Faith L Anderson
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032 USA
| | - Meghan L Bucher
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032 USA
| | - Katherine E Manz
- School of Engineering, Brown University, Providence, RI, 02912 USA
| | - Alexa Puri Schlotter
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032 USA
| | - Zoe Coates Fuentes
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, 10029 USA
| | - Kurt D Pennell
- School of Engineering, Brown University, Providence, RI, 02912 USA
| | - Martin Picard
- Department of Neurology, Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, 10032 USA
| | - Douglas I Walker
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, 10029 USA
| | - William T Hu
- Department of Neurology, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, 08901 USA
| | - Dean P Jones
- Division of Pulmonary, Allergy and Critical Medicine, Department of Medicine, School of Medicine, Emory University, Atlanta, GA, 30322 USA
| | - Gary W Miller
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032 USA
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23
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Hu WT. Reporting and social construction of race in Alzheimer's disease clinical trials. Alzheimers Dement 2022; 18:865-866. [PMID: 35142032 PMCID: PMC8986596 DOI: 10.1002/alz.12609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 12/10/2021] [Indexed: 11/11/2022]
Affiliation(s)
- William T Hu
- Department of Neurology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.,Center for Healthy Aging, Institute for Health, Health Care Policy, and Aging Research, New Brunswick, New Jersey, USA.,Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, USA
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24
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Hassan A, Mittal SO, Hu WT, Josephs KA, Sorenson EJ, Ahlskog JE. Does limited EMG denervation in early primary lateral sclerosis predict amyotrophic lateral sclerosis? Amyotroph Lateral Scler Frontotemporal Degener 2022; 23:554-561. [PMID: 35170382 DOI: 10.1080/21678421.2022.2039714] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Objective: We assessed whether a cohort of patients with primary lateral sclerosis (PLS) and limited electromyography (EMG) motor unit denervation changes evolve into amyotrophic lateral sclerosis (ALS) with prolonged follow-up. Methods: We initially ascertained all PLS patients diagnosed at Mayo Clinic-Rochester (1990-2016). Of 64 total cases, 43 had normal EMGs ("pure" PLS) during the first 4 years after symptom onset and were the focus of a prior publication, documenting absence of evolution to ALS. The remaining 21 patients had limited motor unit changes on EMG needle examination (denervation and most with fibrillation or fasciculation potentials) but insufficient to raise a strong suspicion of ALS; these 21 patients were followed to determine whether they evolved into ALS. Results: Of these 21 patients, the median follow-up was 7 years' disease duration (range: 4-27 years; IQR 5-8.5). They included 11 females (52%) with median onset-age of 57 years (range: 42-72 years). Two patients (10%) subsequently met revised El Escorial criteria for ALS after 7 and 13 years, respectively. The remainder had stable EMG changes with a persistent PLS phenotype. Among these remaining 19 patients, the PLS course was somewhat more aggressive than our previously reported series of 43 patients devoid of EMG denervation. The paraparetic variant was more common than the hemiparetic and bulbar variants, similar to "pure" PLS. Conclusions: Among PLS patients with definite but limited EMG denervation, 2/21 (10%) later developed ALS. The patients in this series had a more progressive clinical course compared to our previously reported pure PLS cases.
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Affiliation(s)
- Anhar Hassan
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Shivam O Mittal
- Department of Neurology, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates, and
| | - William T Hu
- Department of Neurology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | | | | | - J Eric Ahlskog
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
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25
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Chan AWS, Cho IK, Li CX, Zhang X, Patel S, Rusnak R, Raper J, Bachevalier J, Moran SP, Chi T, Cannon KH, Hunter CE, Martin RC, Xiao H, Yang SH, Gumber S, Herndon JG, Rosen RF, Hu WT, Lah JJ, Levey AI, Smith Y, Walker LC. Cerebral Aβ deposition in an Aβ-precursor protein-transgenic rhesus monkey. Aging Brain 2022; 2:100044. [PMID: 36589695 PMCID: PMC9802652 DOI: 10.1016/j.nbas.2022.100044] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
With the ultimate goal of developing a more representative animal model of Alzheimer's disease (AD), two female amyloid-β-(Aβ) precursor protein-transgenic (APPtg) rhesus monkeys were generated by lentiviral transduction of the APP gene into rhesus oocytes, followed by in vitro fertilization and embryo transfer. The APP-transgene included the AD-associated Swedish K670N/M671L and Indiana V717F mutations (APPSWE/IND) regulated by the human polyubiquitin-C promoter. Overexpression of APP was confirmed in lymphocytes and brain tissue. Upon sacrifice at 10 years of age, one of the monkeys had developed Aβ plaques and cerebral Aβ-amyloid angiopathy in the occipital, parietal, and caudal temporal neocortices. The induction of Aβ deposition more than a decade prior to its usual emergence in the rhesus monkey supports the feasibility of creating a transgenic nonhuman primate model for mechanistic analyses and preclinical testing of treatments for Alzheimer's disease and cerebrovascular amyloidosis.
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Affiliation(s)
- Anthony W S Chan
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA.,Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - In Ki Cho
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - Chun-Xia Li
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - Xiaodong Zhang
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - Sudeep Patel
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - Rebecca Rusnak
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - Jessica Raper
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA.,Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Jocelyne Bachevalier
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA.,Department of Psychology, Emory College, Atlanta, GA 30322, USA
| | - Sean P Moran
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - Tim Chi
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - Katherine H Cannon
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - Carissa E Hunter
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - Ryan C Martin
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - Hailian Xiao
- Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Shang-Hsun Yang
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA.,Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Sanjeev Gumber
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - James G Herndon
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - Rebecca F Rosen
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - William T Hu
- Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - James J Lah
- Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Allan I Levey
- Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Yoland Smith
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA.,Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Lary C Walker
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA.,Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA
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26
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Levey AI, Qiu D, Zhao L, Hu WT, Duong DM, Higginbotham L, Dammer EB, Seyfried NT, Wingo TS, Hales CM, Gámez Tansey M, Goldstein DS, Abrol A, Calhoun VD, Goldstein FC, Hajjar I, Fagan AM, Galasko D, Edland SD, Hanfelt J, Lah JJ, Weinshenker D. A phase II study repurposing atomoxetine for neuroprotection in mild cognitive impairment. Brain 2021; 145:1924-1938. [PMID: 34919634 DOI: 10.1093/brain/awab452] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 11/08/2021] [Accepted: 11/19/2021] [Indexed: 11/12/2022] Open
Abstract
The locus coeruleus (LC) is the initial site of Alzheimer's disease neuropathology, with hyperphosphorylated Tau appearing in early adulthood followed by neurodegeneration in dementia. LC dysfunction contributes to Alzheimer's pathobiology in experimental models, which can be rescued by increasing norepinephrine (NE) transmission. To test NE augmentation as a potential disease-modifying therapy, we performed a biomarker-driven phase II trial of atomoxetine, a clinically-approved NE transporter inhibitor, in subjects with mild cognitive impairment due to Alzheimer's disease. The design was a single-center, 12-month double-blind crossover trial. Thirty-nine participants with mild cognitive impairment (MCI) and biomarker evidence of Alzheimer's disease were randomized to atomoxetine or placebo treatment. Assessments were collected at baseline, 6- (crossover) and 12-months (completer). Target engagement was assessed by CSF and plasma measures of NE and metabolites. Prespecified primary outcomes were CSF levels of IL1α and Thymus-Expressed Chemokine. Secondary/exploratory outcomes included clinical measures, CSF analyses of Aβ42, Tau, and pTau181, mass spectrometry proteomics, and immune-based targeted inflammation-related cytokines, as well as brain imaging with MRI and FDG-PET. Baseline demographic and clinical measures were similar across trial arms. Dropout rates were 5.1% for atomoxetine and 2.7% for placebo, with no significant differences in adverse events. Atomoxetine robustly increased plasma and CSF NE levels. IL-1α and Thymus-Expressed Chemokine were not measurable in most samples. There were no significant treatment effects on cognition and clinical outcomes, as expected given the short trial duration. Atomoxetine was associated with a significant reduction in CSF Tau and pTau181 compared to placebo, but not associated with change in Aβ42. Atomoxetine treatment also significantly altered CSF abundances of protein panels linked to brain pathophysiologies, including synaptic, metabolism, and glial immunity, as well as inflammation-related CDCP1, CD244, TWEAK, and OPG proteins. Treatment was also associated with significantly increased BDNF and reduced triglycerides in plasma. Resting state fMRI showed significantly increased inter-network connectivity due to atomoxetine between the insula and the hippocampus. FDG-PET showed atomoxetine-associated increased uptake in hippocampus, parahippocampal gyrus, middle temporal pole, inferior temporal gyrus, and fusiform gyrus, with carry-over effects six months after treatment. In summary, atomoxetine treatment was safe, well tolerated, and achieved target engagement in prodromal Alzheimer's disease. Atomoxetine significantly reduced CSF Tau and pTau, normalized CSF protein biomarker panels linked to synaptic function, brain metabolism, and glial immunity, and increased brain activity and metabolism in key temporal lobe circuits. Further study of atomoxetine is warranted for repurposing the drug to slow Alzheimer's disease progression.
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Affiliation(s)
- Allan I Levey
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, Georgia, 30322, USA.,Department of Neurology, Emory University, Atlanta, Georgia, 30322, USA
| | - Deqiang Qiu
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, Georgia, 30322, USA.,Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia, 30322, USA
| | - Liping Zhao
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, Georgia, 30322, USA.,Department of Biostatistics, Emory University, Atlanta, Georgia, 30322, USA
| | - William T Hu
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, Georgia, 30322, USA.,Department of Neurology, Emory University, Atlanta, Georgia, 30322, USA
| | - Duc M Duong
- Department of Biochemistry, Emory University, Atlanta, Georgia, 30322, USA
| | - Lenora Higginbotham
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, Georgia, 30322, USA
| | - Eric B Dammer
- Department of Biochemistry, Emory University, Atlanta, Georgia, 30322, USA
| | - Nicholas T Seyfried
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, Georgia, 30322, USA.,Department of Biochemistry, Emory University, Atlanta, Georgia, 30322, USA
| | - Thomas S Wingo
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, Georgia, 30322, USA.,Department of Neurology, Emory University, Atlanta, Georgia, 30322, USA.,Department of Human Genetics, Emory University, Atlanta, Georgia, 30322, USA
| | - Chadwick M Hales
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, Georgia, 30322, USA.,Department of Neurology, Emory University, Atlanta, Georgia, 30322, USA
| | - Malú Gámez Tansey
- Department of Physiology, Emory University, Atlanta, Georgia, 30322, USA
| | | | - Anees Abrol
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, 30303, USA
| | - Vince D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, 30303, USA
| | - Felicia C Goldstein
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, Georgia, 30322, USA.,Department of Neurology, Emory University, Atlanta, Georgia, 30322, USA
| | - Ihab Hajjar
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, Georgia, 30322, USA.,Department of Neurology, Emory University, Atlanta, Georgia, 30322, USA
| | - Anne M Fagan
- Department of Neurology and Knight ADRC, Washington University, St. Louis, MO, 630130, USA
| | - Doug Galasko
- Department of Neurosciences and ADRC, UCSD, San Diego, CA, 92093, USA
| | - Steven D Edland
- Department of Neurosciences and ADRC, UCSD, San Diego, CA, 92093, USA
| | - John Hanfelt
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, Georgia, 30322, USA.,Department of Biostatistics, Emory University, Atlanta, Georgia, 30322, USA
| | - James J Lah
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, Georgia, 30322, USA.,Department of Neurology, Emory University, Atlanta, Georgia, 30322, USA
| | - David Weinshenker
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, Georgia, 30322, USA.,Department of Human Genetics, Emory University, Atlanta, Georgia, 30322, USA
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Misiura M, Igwe K, Howell JC, Tannahill A, Brickman AM, Turner JA, Hu WT. Diversity considerations of white matter hyperintensities and connectivity in normal aging and MCI. Alzheimers Dement 2021. [DOI: 10.1002/alz.054389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Maria Misiura
- Center for Translational Research in Neuroimaging and Data Science Atlanta GA USA
- Emory University Atlanta GA USA
- Georgia State University Atlanta GA USA
| | - Kay Igwe
- Columbia University Taub Institute for Research on Alzheimer's Disease and the Aging Brain New York NY USA
| | - J. Christina Howell
- Emory University Atlanta GA USA
- School of Medicine Emory University Atlanta GA USA
| | | | - Adam M. Brickman
- Columbia University Irving Medical Center New York NY USA
- Columbia University New York NY USA
| | | | - William T. Hu
- Rutgers‐RWJ Medical School New Brunswick NJ USA
- World Young Leaders in Dementia London United Kingdom
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Campo MD, Peeters CF, Johnson EC, Vermunt L, Hok‐A‐Hin YS, van Nee M, Chen‐Plotkin A, Hu WT, Lah JJ, Seyfried NT, Herradon G, Meeter LH, van Swieten JC, Levey AI, Lemstra AW, Pijnenburg YA, Visser PJ, Tijms BM, van der Flier WM, Teunissen CE. CSF protein panels reflecting multiple pathophysiological mechanisms for early and specific diagnosis of Alzheimer’s disease. Alzheimers Dement 2021. [DOI: 10.1002/alz.053710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Marta Del Campo
- Pharmacology Lab Department of Pharmaceutical and Health Sciences University CEU San Pablo Madrid Spain
- Neurochemistry Laboratory Department of Clinical Chemistry Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Carel F.W. Peeters
- Dept. of Epidemiology & Biostatistics VU University Medical Center Amsterdam Amsterdam Netherlands
- Department of Mathematical & Statistical Methods‐Biometris Wageningen University & Research Wageningen Netherlands
| | | | - Lisa Vermunt
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Yanaika S. Hok‐A‐Hin
- Neurochemistry Laboratory Department of Clinical Chemistry Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Mirrelijn van Nee
- Department of Epidemiology & Data Science Amsterdam Public Health Research Institute Amsterdam University Medical Centers, Location VUMC Amsterdam Netherlands
| | - Alice Chen‐Plotkin
- Perelman School of Medicine University of Pennsylvania Philadelphia PA USA
| | | | - James J. Lah
- Emory University School of Medicine Atlanta GA USA
- Emory Goizueta Alzheimer's Disease Research Center Atlanta GA USA
| | - Nicholas T. Seyfried
- Emory University School of Medicine Atlanta GA USA
- Emory Goizueta Alzheimer's Disease Research Center Atlanta GA USA
| | - Gonzalo Herradon
- Departamento de Ciencias Farmacéuticas y de la Salud Facultad de Farmacia Universidad San Pablo‐CEU CEU Universities Madrid Spain
| | | | | | - Allan I. Levey
- Emory University School of Medicine Atlanta GA USA
- Emory Goizueta Alzheimer's Disease Research Center Atlanta GA USA
| | - Afina W. Lemstra
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Yolande A.L. Pijnenburg
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Pieter Jelle Visser
- Alzheimer Center Amsterdam Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Betty M. Tijms
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Department of Neurology Neuroscience Campus Amsterdam VU University Medical Center Amsterdam Netherlands
- Department of Epidemiology and Biostatistics Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Charlotte E. Teunissen
- Neurochemistry Lab Department of Clinical Chemistry Amsterdam Neuroscience Amsterdam UMC Amsterdam Netherlands
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29
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Wharton W, Jeong L, Ni L, Bay AA, Shin R, McCullough L, Silverstein H, Hart AR, Swieboda D, Hu WT, Hackney ME. Adapted Tango to improve blood inflammatory markers in middle‐aged African‐American female caregivers of persons with Alzheimer's disease: A clinical trial. Alzheimers Dement 2021. [DOI: 10.1002/alz.049626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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30
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Misiura M, Igwe KC, Wharton W, Verble DD, Turner JA, Dotson V, Brickman AM, Hu WT. Racial considerations of age and white matter hyperintensities. Alzheimers Dement 2021. [DOI: 10.1002/alz.058540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Maria Misiura
- Georgia State University Atlanta GA USA
- Center for Translational Research in Neuroimaging and Data Science Atlanta GA USA
| | - Kay C Igwe
- Columbia University Medical Center New York NY USA
| | | | | | | | | | - Adam M. Brickman
- Columbia University Medical Center New York NY USA
- Columbia University New York NY USA
- Columbia University Irving Medical Center New York NY USA
| | - William T Hu
- Rutgers‐RWJ Medical School New Brunswick NJ USA
- World Young Leaders in Dementia London United Kingdom
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31
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Butts B, Miners S, Kehoe PG, Hu WT, Huang H, Verble DD, Zetterberg H, Zhao L, Wharton W. Relationship between platelet derived growth factor receptor‐β and Alzheimer’s biomarkers in a racially diverse, high‐risk cohort. Alzheimers Dement 2021. [DOI: 10.1002/alz.057693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | | | | | | | | | | | - Henrik Zetterberg
- Department of Neurodegenerative Disease UCL Institute of Neurology Queen Square London United Kingdom
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32
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Hu WT, Wharton W, Parker MW. Racial differences in biomarkers of Alzheimer’s disease and inflammation. Alzheimers Dement 2021. [DOI: 10.1002/alz.052843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Hu WT, Ozturk T, Kollhoff A, Wharton W, Christina Howell J. Higher CSF sTNFR1-related proteins associate with better prognosis in very early Alzheimer's disease. Nat Commun 2021; 12:4001. [PMID: 34183654 PMCID: PMC8238986 DOI: 10.1038/s41467-021-24220-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 06/08/2021] [Indexed: 02/06/2023] Open
Abstract
Neuroinflammation is associated with Alzheimer's disease, but the application of cerebrospinal fluid measures of inflammatory proteins may be limited by overlapping pathways and relationships between them. In this work, we measure 15 cerebrospinal proteins related to microglial and T-cell functions, and show them to reproducibly form functionally-related groups within and across diagnostic categories in 382 participants from the Alzheimer's Disease Neuro-imaging Initiative as well participants from two independent cohorts. We further show higher levels of proteins related to soluble tumor necrosis factor receptor 1 are associated with reduced risk of conversion to dementia in the multi-centered (p = 0.027) and independent (p = 0.038) cohorts of people with mild cognitive impairment due to predicted Alzheimer's disease, while higher soluble TREM2 levels associated with slower decline in the dementia stage of Alzheimer's disease. These inflammatory proteins thus provide prognostic information independent of established Alzheimer's markers.
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Affiliation(s)
- William T Hu
- Department of Neurology and Center for Neurodegenerative Diseases, School of Medicine, Emory University, Atlanta, GA, USA.
- Rutgers Robert Wood Johnson Medical School and Rutgers Institute for Health, Health Care Policy and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA.
| | - Tugba Ozturk
- Department of Neurology and Center for Neurodegenerative Diseases, School of Medicine, Emory University, Atlanta, GA, USA
| | - Alexander Kollhoff
- Department of Neurology and Center for Neurodegenerative Diseases, School of Medicine, Emory University, Atlanta, GA, USA
| | - Whitney Wharton
- Nell Hodgson School of Nursing, Emory University, Atlanta, GA, USA
| | - J Christina Howell
- Department of Neurology and Center for Neurodegenerative Diseases, School of Medicine, Emory University, Atlanta, GA, USA
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34
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Hassan A, Mittal SO, Hu WT, Josephs KA, Sorenson EJ, Ahlskog JE. Natural History of "Pure" Primary Lateral Sclerosis. Neurology 2021; 96:e2231-e2238. [PMID: 33637635 DOI: 10.1212/wnl.0000000000011771] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/13/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To assess whether primary lateral sclerosis (PLS), classified as pure when the EMG is normal, converts to amyotrophic lateral sclerosis (ALS) after longitudinal follow-up. METHODS Retrospective chart review was performed of patients with pure PLS at Mayo Clinic in Rochester, MN (1990-2016). Inclusion criteria required a normal EMG during the first 4 years of symptoms. RESULTS Forty-three patients had pure PLS (25 female, 58%) with a median onset age of 50 years (range 38-78 years) and median follow-up at 9 years' disease duration (range 4-36 years). The ascending paraparesis phenotype (n = 30, 70%) was most common, followed by hemiparetic onset (n = 9, 21%) and bulbar onset (n = 4, 9%). Among the 30 paraparetic-onset cases, bladder symptoms (n = 18, 60%) and dysarthria (n = 15, 50%) were more common than pseudobulbar affect (n = 9, 30%) and dysphagia (n = 8, 27%). By the last follow-up, 17 of 30 (56%) used a cane and 6 (20%) required a wheelchair. The paraparetic variant, compared with hemiparetic and bulbar onset, had the youngest onset (48 vs 56 vs 60 years, respectively; p = 0.02). Five patients died; 1 patient required a feeding tube; and none required permanent noninvasive ventilation. Two patients developed an idiopathic multisystem neurodegenerative disorder, which surfaced after 19 and 20 years. Two patients developed minor EMG abnormalities. The remainder 39 had persistently normal EMGs. CONCLUSIONS Pure PLS did not convert to ALS after a median of 9 years' disease duration follow-up in our study population. The ascending paraparetic phenotype was most common, with earlier onset and frequent bladder involvement. After years of pure PLS, <5% develop a more pervasive neurodegenerative disorder.
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Affiliation(s)
- Anhar Hassan
- From the Department of Neurology (A.H., K.A.J., E.J.S., J.E.A.), Mayo Clinic, Rochester, MN; Department of Neurology (S.O.M.), Cleveland Clinic Abu Dhabi, United Arab Emirates; and Department of Neurology (W.T.H.), Emory University, Atlanta, GA.
| | - Shivam Om Mittal
- From the Department of Neurology (A.H., K.A.J., E.J.S., J.E.A.), Mayo Clinic, Rochester, MN; Department of Neurology (S.O.M.), Cleveland Clinic Abu Dhabi, United Arab Emirates; and Department of Neurology (W.T.H.), Emory University, Atlanta, GA
| | - William T Hu
- From the Department of Neurology (A.H., K.A.J., E.J.S., J.E.A.), Mayo Clinic, Rochester, MN; Department of Neurology (S.O.M.), Cleveland Clinic Abu Dhabi, United Arab Emirates; and Department of Neurology (W.T.H.), Emory University, Atlanta, GA
| | - Keith A Josephs
- From the Department of Neurology (A.H., K.A.J., E.J.S., J.E.A.), Mayo Clinic, Rochester, MN; Department of Neurology (S.O.M.), Cleveland Clinic Abu Dhabi, United Arab Emirates; and Department of Neurology (W.T.H.), Emory University, Atlanta, GA
| | - Eric J Sorenson
- From the Department of Neurology (A.H., K.A.J., E.J.S., J.E.A.), Mayo Clinic, Rochester, MN; Department of Neurology (S.O.M.), Cleveland Clinic Abu Dhabi, United Arab Emirates; and Department of Neurology (W.T.H.), Emory University, Atlanta, GA
| | - J Eric Ahlskog
- From the Department of Neurology (A.H., K.A.J., E.J.S., J.E.A.), Mayo Clinic, Rochester, MN; Department of Neurology (S.O.M.), Cleveland Clinic Abu Dhabi, United Arab Emirates; and Department of Neurology (W.T.H.), Emory University, Atlanta, GA
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35
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Trotti LM, Bliwise DL, Keating GL, Rye DB, Hu WT. Cerebrospinal Fluid Hypocretin and Nightmares in Dementia Syndromes. Dement Geriatr Cogn Dis Extra 2021; 11:19-25. [PMID: 33790936 PMCID: PMC7989783 DOI: 10.1159/000509585] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 01/08/2023] Open
Abstract
Background/Aims Hypocretin promotes wakefulness and modulates REM sleep. Alterations in the hypocretin system are increasingly implicated in dementia. We evaluated relationships among hypocretin, dementia biomarkers, and sleep symptoms in elderly participants, most of whom had dementia. Methods One-hundred twenty-six adults (mean age 66.2 ± 8.4 years) were recruited from the Emory Cognitive Clinic. Diagnoses were Alzheimer disease (AD; n = 60), frontotemporal dementia (FTD; n = 21), and dementia with Lewy bodies (DLB; n = 20). We also included cognitively normal controls (n = 25). Participants and/or caregivers completed sleep questionnaires and lumbar puncture was performed for cerebrospinal fluid (CSF) assessments. Results Except for sleepiness (worst in DLB) and nocturia (worse in DLB and FTD) sleep symptoms did not differ by diagnosis. CSF hypocretin concentrations were available for 87 participants and normal in 70, intermediate in 16, and low in 1. Hypocretin levels did not differ by diagnosis. Hypocretin levels correlated with CSF total τ levels only in men (r = 0.34; p = 0.02). Lower hypocretin levels were related to frequency of nightmares (203.9 ± 29.8 pg/mL in those with frequent nightmares vs. 240.4 ± 46.1 pg/mL in those without; p = 0.05) and vivid dreams (209.1 ± 28.3 vs. 239.5 ± 47.8 pg/mL; p = 0.014). Cholinesterase inhibitor use was not associated with nightmares or vivid dreaming. Conclusion Hypocretin levels did not distinguish between dementia syndromes. Disturbing dreams in dementia patients may be related to lower hypocretin concentrations in CSF.
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Affiliation(s)
- Lynn Marie Trotti
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA.,Emory Sleep Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Donald L Bliwise
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA.,Emory Sleep Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Glenda L Keating
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - David B Rye
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA.,Emory Sleep Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - William T Hu
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
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Wharton W, Shin R, Hu WT, Jeong L, Bay AA, Hart AR, Ni L, Hackney ME. A pilot clinical trial of adapted tango to improve negative health impacts in middle aged African‐American women caregivers of persons with Alzheimer’s disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.044865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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37
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Hok‐A‐Hin YS, Hu WT, Wouters D, Boonkamp L, Howell JC, Rabano A, Pijnenburg YA, Teunissen CE, Hoozemans JJ, Del Campo M. Localization and protein levels of YKL‐40 in postmortem brain of frontotemporal dementia and Alzheimer’s disease cases. Alzheimers Dement 2020. [DOI: 10.1002/alz.044523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | | | - Dorine Wouters
- VU University Medical Center, Amsterdam UMC Amsterdam Netherlands
| | - Lynn Boonkamp
- VU University Medical Center, Amsterdam UMC Amsterdam Netherlands
| | | | - Alberto Rabano
- Banco de Tejidos, Fundación Centro de Investigación en Enfermedades Neurológicas, Instituto de Salud Carlos III Madrid Spain
| | | | | | | | - Marta Del Campo
- VU University Medical Center, Amsterdam UMC Amsterdam Netherlands
- Pharmacology Lab, Department of Pharmaceutical and Health Sciences University CEU San Pablo Madrid Spain
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38
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Denny A, Streitz M, Stock K, Balls-Berry JE, Barnes LL, Byrd GS, Croff R, Gao S, Glover CM, Hendrie HC, Hu WT, Manly JJ, Moulder KL, Stark S, Thomas SB, Whitmer R, Wong R, Morris JC, Lingler JH. Perspective on the "African American participation in Alzheimer disease research: Effective strategies" workshop, 2018. Alzheimers Dement 2020; 16:1734-1744. [PMID: 33034414 PMCID: PMC7887120 DOI: 10.1002/alz.12160] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/24/2020] [Accepted: 07/07/2020] [Indexed: 12/23/2022]
Abstract
The Washington University School of Medicine Knight Alzheimer Disease Research Center's "African American Participation in Alzheimer Disease Research: Effective Strategies" Workshop convened to address a major limitation of the ongoing scientific progress regarding Alzheimer's disease and related dementias (ADRD): participants in most ADRD research programs overwhelmingly have been limited to non-Hispanic white persons, thus precluding knowledge as to how ADRD may be represented in non-white individuals. Factors that may contribute to successful recruitment and retention of African Americans into ADRD research were discussed and organized into actionable next steps as described within this report.
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Affiliation(s)
- Andrea Denny
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Marissa Streitz
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Kristin Stock
- Washington University in Saint Louis, Saint Louis, Missouri, USA
| | - Joyce E Balls-Berry
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Goldie S Byrd
- Maya Angelou Center for Health Equity, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Raina Croff
- Layton Aging & Alzheimer's Disease Center, Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA
| | - Sujuan Gao
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Crystal M Glover
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Hugh C Hendrie
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | - Jennifer J Manly
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, New York, USA
| | - Krista L Moulder
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Susan Stark
- Department of Occupational Therapy, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Stephen B Thomas
- Maryland Center for Health Equity, University of Maryland College Park, College Park, Maryland, USA
| | - Rachel Whitmer
- Alzheimer's Disease Research Center, UC Davis School of Medicine, Sacramento, California, USA
| | - Roger Wong
- Public Health Sciences Brown School, Washington University in Saint Louis, Saint Louis, Missouri, USA
| | - John C Morris
- Knight Alzheimer Disease Research Center, Harvey A & Dorismae Hacker Friedman Distinguished Professor of Neurology, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Jennifer H Lingler
- School of Nursing and Alzheimer's Disease Research Center, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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39
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Campo MD, Peeters CF, Chen‐Plotkin A, van Der Flier W, Meeter LH, van Swieten JC, Hu WT, Irwin DJ, Pijnenburg YA, Teunissen CE. CSF biomarkers for frontotemporal dementia and its pathological subtypes. Alzheimers Dement 2020. [DOI: 10.1002/alz.045851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Marta Del Campo
- Neurochemistry laboratory Department of Clinical Chemistry VU University Medical Center (VUmc) Amsterdam University Medical Centers (AUMC) Amsterdam Netherlands
- Pharmacology Lab Department of Pharmaceutical and Health Sciences University CEU San Pablo Madrid Spain
| | - Carel F.W. Peeters
- Department of Epidemiology & Biostatistics VU University Medical Center Amsterdam Amsterdam Netherlands
| | | | - Wiesje van Der Flier
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Amsterdam UMC Vrije Universiteit Amsterdam Netherlands Amsterdam Netherlands
| | | | | | | | - David J. Irwin
- Penn FTD Center University of Pennsylvania Philadelphia PA USA
| | - Yolande A.L. Pijnenburg
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam University Medical Center Amsterdam Netherlands
| | - Charlotte E. Teunissen
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Amsterdam UMC Vrije Universiteit Amsterdam Netherlands Amsterdam Netherlands
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40
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Woodruff MC, Ramonell RP, Nguyen DC, Cashman KS, Saini AS, Haddad NS, Ley AM, Kyu S, Howell JC, Ozturk T, Lee S, Suryadevara N, Case JB, Bugrovsky R, Chen W, Estrada J, Morrison-Porter A, Derrico A, Anam FA, Sharma M, Wu HM, Le SN, Jenks SA, Tipton CM, Staitieh B, Daiss JL, Ghosn E, Diamond MS, Carnahan RH, Crowe JE, Hu WT, Lee FEH, Sanz I. Extrafollicular B cell responses correlate with neutralizing antibodies and morbidity in COVID-19. Nat Immunol 2020; 21:1506-1516. [PMID: 33028979 PMCID: PMC7739702 DOI: 10.1038/s41590-020-00814-z] [Citation(s) in RCA: 448] [Impact Index Per Article: 112.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/16/2020] [Indexed: 12/15/2022]
Abstract
A wide spectrum of clinical manifestations has become a hallmark of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) COVID-19 pandemic, although the immunological underpinnings of diverse disease outcomes remain to be defined. We performed detailed characterization of B cell responses through high-dimensional flow cytometry to reveal substantial heterogeneity in both effector and immature populations. More notably, critically ill patients displayed hallmarks of extrafollicular B cell activation and shared B cell repertoire features previously described in autoimmune settings. Extrafollicular activation correlated strongly with large antibody-secreting cell expansion and early production of high concentrations of SARS-CoV-2-specific neutralizing antibodies. Yet, these patients had severe disease with elevated inflammatory biomarkers, multiorgan failure and death. Overall, these findings strongly suggest a pathogenic role for immune activation in subsets of patients with COVID-19. Our study provides further evidence that targeted immunomodulatory therapy may be beneficial in specific patient subpopulations and can be informed by careful immune profiling.
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Affiliation(s)
- Matthew C Woodruff
- Department of Medicine, Division of Rheumatology, Lowance Center for Human Immunology, Emory University, Atlanta, GA, USA
- Emory Autoimmunity Center of Excellence, Emory University, Atlanta, GA, USA
| | - Richard P Ramonell
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, GA, USA
| | - Doan C Nguyen
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, GA, USA
| | - Kevin S Cashman
- Department of Medicine, Division of Rheumatology, Lowance Center for Human Immunology, Emory University, Atlanta, GA, USA
| | - Ankur Singh Saini
- Department of Medicine, Division of Rheumatology, Lowance Center for Human Immunology, Emory University, Atlanta, GA, USA
| | - Natalie S Haddad
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, GA, USA
- MicroB-plex, Atlanta, GA, USA
| | - Ariel M Ley
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, GA, USA
| | - Shuya Kyu
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, GA, USA
| | | | - Tugba Ozturk
- Department of Neurology, Emory University, Atlanta, GA, USA
| | - Saeyun Lee
- Department of Medicine, Division of Rheumatology, Lowance Center for Human Immunology, Emory University, Atlanta, GA, USA
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, GA, USA
| | | | - James Brett Case
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Regina Bugrovsky
- Department of Medicine, Division of Rheumatology, Lowance Center for Human Immunology, Emory University, Atlanta, GA, USA
| | - Weirong Chen
- Department of Medicine, Division of Rheumatology, Lowance Center for Human Immunology, Emory University, Atlanta, GA, USA
| | - Jacob Estrada
- Department of Medicine, Division of Rheumatology, Lowance Center for Human Immunology, Emory University, Atlanta, GA, USA
| | - Andrea Morrison-Porter
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, GA, USA
| | - Andrew Derrico
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, GA, USA
| | - Fabliha A Anam
- Department of Medicine, Division of Rheumatology, Lowance Center for Human Immunology, Emory University, Atlanta, GA, USA
| | - Monika Sharma
- Department of Medicine, Division of Rheumatology, Lowance Center for Human Immunology, Emory University, Atlanta, GA, USA
| | - Henry M Wu
- Department of Medicine, Division of Infectious Diseases, Emory University, Atlanta, GA, USA
| | - Sang N Le
- Department of Medicine, Division of Rheumatology, Lowance Center for Human Immunology, Emory University, Atlanta, GA, USA
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, GA, USA
| | - Scott A Jenks
- Department of Medicine, Division of Rheumatology, Lowance Center for Human Immunology, Emory University, Atlanta, GA, USA
- Emory Autoimmunity Center of Excellence, Emory University, Atlanta, GA, USA
| | - Christopher M Tipton
- Department of Medicine, Division of Rheumatology, Lowance Center for Human Immunology, Emory University, Atlanta, GA, USA
- Emory Autoimmunity Center of Excellence, Emory University, Atlanta, GA, USA
| | - Bashar Staitieh
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, GA, USA
| | | | - Eliver Ghosn
- Department of Medicine, Division of Rheumatology, Lowance Center for Human Immunology, Emory University, Atlanta, GA, USA
| | - Michael S Diamond
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO, USA
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
- Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, St. Louis, MO, USA
| | - Robert H Carnahan
- Vanderbilt Vaccine Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - James E Crowe
- Vanderbilt Vaccine Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - William T Hu
- Department of Neurology, Emory University, Atlanta, GA, USA
| | - F Eun-Hyung Lee
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, GA, USA.
| | - Ignacio Sanz
- Department of Medicine, Division of Rheumatology, Lowance Center for Human Immunology, Emory University, Atlanta, GA, USA.
- Emory Autoimmunity Center of Excellence, Emory University, Atlanta, GA, USA.
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Howell JC, Wharton W, Hodge DA, Warren RC, Hu WT. Trust thyself: How older black and white adults consider Alzheimer’s disease research participation. Alzheimers Dement 2020. [DOI: 10.1002/alz.044858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | | | - David A. Hodge
- National Center for Bioethics in Research and Health Care Tuskegee University Tuskegee AL USA
| | - Reuben C. Warren
- National Center for Bioethics in Research and Health Care Tuskegee University Tuskegee AL USA
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Yilmaz A, Ustun I, Ugur Z, Akyol S, Hu WT, Fiandaca MS, Mapstone M, Federoff H, Maddens M, Graham SF. A Community-Based Study Identifying Metabolic Biomarkers of Mild Cognitive Impairment and Alzheimer's Disease Using Artificial Intelligence and Machine Learning. J Alzheimers Dis 2020; 78:1381-1392. [PMID: 33164929 DOI: 10.3233/jad-200305] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Currently, there is no objective, clinically available tool for the accurate diagnosis of Alzheimer's disease (AD). There is a pressing need for a novel, minimally invasive, cost friendly, and easily accessible tool to diagnose AD, assess disease severity, and prognosticate course. Metabolomics is a promising tool for discovery of new, biologically, and clinically relevant biomarkers for AD detection and classification. OBJECTIVE Utilizing artificial intelligence and machine learning, we aim to assess whether a panel of metabolites as detected in plasma can be used as an objective and clinically feasible tool for the diagnosis of mild cognitive impairment (MCI) and AD. METHODS Using a community-based sample cohort acquired from different sites across the US, we adopted an approach combining Proton Nuclear Magnetic Resonance Spectroscopy (1H NMR), Liquid Chromatography coupled with Mass Spectrometry (LC-MS) and various machine learning statistical approaches to identify a biomarker panel capable of identifying those patients with AD and MCI from healthy controls. RESULTS Of the 212 measured metabolites, 5 were identified as optimal to discriminate between controls, and individuals with MCI or AD. Our models performed with AUC values in the range of 0.72-0.76, with the sensitivity and specificity values ranging from 0.75-0.85 and 0.69-0.81, respectively. Univariate and pathway analysis identified lipid metabolism as the most perturbed biochemical pathway in MCI and AD. CONCLUSION A comprehensive method of acquiring metabolomics data, coupled with machine learning techniques, has identified a strong panel of diagnostic biomarkers capable of identifying individuals with MCI and AD. Further, our data confirm what other groups have reported, that lipid metabolism is significantly perturbed in those individuals suffering with dementia. This work may provide additional insight into AD pathogenesis and encourage more in-depth analysis of the AD lipidome.
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Affiliation(s)
- Ali Yilmaz
- Department of Obstetrics and Gynecology, Department of Internal Medicine, Oakland University-William Beaumont School of Medicine, Rochester, MI, USA.,Metabolomics Division, Beaumont Research Institute, Royal Oak, MI USA
| | - Ilyas Ustun
- Wayne State University, Civil and Environmental Engineering, Detroit, MI, USA
| | - Zafer Ugur
- Metabolomics Division, Beaumont Research Institute, Royal Oak, MI USA
| | - Sumeyya Akyol
- Metabolomics Division, Beaumont Research Institute, Royal Oak, MI USA
| | - William T Hu
- Department of Neurology, Emory University, Atlanta, GA, USA
| | - Massimo S Fiandaca
- Department of Neurology, University of California Irvine, Irvine, CA, USA
| | - Mark Mapstone
- Department of Neurology, University of California Irvine, Irvine, CA, USA
| | - Howard Federoff
- Department of Neurology, University of California Irvine, Irvine, CA, USA
| | - Michael Maddens
- Department of Obstetrics and Gynecology, Department of Internal Medicine, Oakland University-William Beaumont School of Medicine, Rochester, MI, USA
| | - Stewart F Graham
- Department of Obstetrics and Gynecology, Department of Internal Medicine, Oakland University-William Beaumont School of Medicine, Rochester, MI, USA.,Metabolomics Division, Beaumont Research Institute, Royal Oak, MI USA
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43
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Tang JJ, Pan C, Gao YJ, Han YL, Hu WT, Zhang J, Zhou M, Tang JY. [Clinical analysis of 26 children with postoperative residual or recurrent fibrosarcoma]. Zhonghua Er Ke Za Zhi 2020; 58:668-673. [PMID: 32842388 DOI: 10.3760/cma.j.cn112140-20200217-00095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the long-term outcomes and prognostic factors of postoperative residual or recurrent fibrosarcoma in children. Methods: Clinical data of 26 patients continually admitted to Shanghai Children's Medical Center between April 2004 and February 2019 with postoperative residual or recurrent fibrosarcoma were analyzed retrospectively. All patients were treated with Shanghai Children's Medical Center-rhabdomyosarcoma-1999 (SCMC-RS-99) regimen and timely radical tumor resection. Before chemotherapy, according to the surgery and imaging examination, 26 patients were divided into 2 groups: postoperative residual group and postoperative recurrent group. Clinical features and long-term follow-up results of patients were summarized. Kaplan-Meier analysis was used to evaluate the overall survival (OS) and event-free survival (EFS) rates, Log-Rank test and Cox proportional hazards models were used for univariate and multivariate prognostic analysis of factors including age (<3 years or 3-18 years old), gender, primary tumor site, postoperative stage, disease status, ETS variant 6 (ETV6) gene and chemotherapy drugs. Results: Among 26 cases, 13 were male and 13 were female, 17 cases were in postoperative residual group and 9 cases were in postoperative recurrent group. Until the last follow-up at December 31, 2019, the median follow-up time was 73 months (ranged from 10 to 188 months).The 5-year OS and EFS rates were (86±7)% and (77±9)%. Univariate analysis showed that, the 5-year EFS rate of postoperative residual group was significantly higher than that of the postoperative recurrent group ((94±5)% vs.(63±16)%,χ(2)=5.106,P=0.024), the 5-year EFS rate of patients <3 years old was significantly higher than that of patients 3-18 years old ((94±5)% vs. (62±17)%, χ(2)=6.507, P=0.011). Gender (χ(2)=0.445), primary tumor site (χ(2)=0.258), postoperative stage (χ(2)=3.046), ETV6 gene (χ(2)=1.496), and whether doxorubicin-containing drugs in chemotherapy (χ(2)=1.692) did not exhibit significant impact on 5-EFS rate (all P>0.05). Age, postoperative stage and disease status were included in COX proportional risk model for multivariate analysis, which showed that age >3 years old (HR=8.95, 95%CI 0.73-109.50, P=0.086), stage Ⅲ-Ⅳ (HR=16.50, 95%CI 0.84-321.40, P=0.065) and postoperative recurrence (HR=10.60, 95%CI 0.84-134.30, P=0.068) had no significant impact on EFS rate. Conclusion: Children with postoperative residual or postoperative recurrent fibrosarcoma still had good remission rate and long-term survival, especially young children without recurrence have a significant survival advantage.
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Affiliation(s)
- J J Tang
- Department of Hematology and Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China (is working on the Department of Pediatrics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China)
| | - C Pan
- Department of Hematology and Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Y J Gao
- Department of Hematology and Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China Tang
| | - Y L Han
- Department of Hematology and Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - W T Hu
- Department of Hematology and Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - J Zhang
- Department of Hematology and Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - M Zhou
- Department of Hematology and Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - J Y Tang
- Department of Hematology and Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
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44
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Hu WT, Howell JC, Ozturk T, Benameur K, Bassit LC, Ramonell R, Cashman KS, Pirmohammed S, Roback JD, Marconi VC, Yang I, Mac VV, Smith D, Sanz I, Wharton W, Lee FEH, Schinazi RF. Antibody Profiles According to Mild or Severe SARS-CoV-2 Infection, Atlanta, Georgia, USA, 2020. Emerg Infect Dis 2020; 26:2974-2978. [PMID: 32857691 PMCID: PMC7706962 DOI: 10.3201/eid2612.203334] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Among patients with coronavirus disease (COVID-19), IgM levels increased early after symptom onset for those with mild and severe disease, but IgG levels increased early only in those with severe disease. A similar pattern was observed in a separate serosurveillance cohort. Mild COVID-19 should be investigated separately from severe COVID-19.
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45
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Benameur K, Agarwal A, Auld SC, Butters MP, Webster AS, Ozturk T, Howell JC, Bassit LC, Velasquez A, Schinazi RF, Mullins ME, Hu WT. Encephalopathy and Encephalitis Associated with Cerebrospinal Fluid Cytokine Alterations and Coronavirus Disease, Atlanta, Georgia, USA, 2020. Emerg Infect Dis 2020; 26:2016-2021. [PMID: 32487282 PMCID: PMC7454059 DOI: 10.3201/eid2609.202122] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
There are few detailed investigations of neurologic complications in severe acute respiratory syndrome coronavirus 2 infection. We describe 3 patients with laboratory-confirmed coronavirus disease who had encephalopathy and encephalitis develop. Neuroimaging showed nonenhancing unilateral, bilateral, and midline changes not readily attributable to vascular causes. All 3 patients had increased cerebrospinal fluid (CSF) levels of anti-S1 IgM. One patient who died also had increased levels of anti-envelope protein IgM. CSF analysis also showed markedly increased levels of interleukin (IL)-6, IL-8, and IL-10, but severe acute respiratory syndrome coronavirus 2 was not identified in any CSF sample. These changes provide evidence of CSF periinfectious/postinfectious inflammatory changes during coronavirus disease with neurologic complications.
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46
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Ozturk T, Howell JC, Benameur K, Ramonell R, Cashman KS, Pirmohammed S, Bassit LC, Roback JD, Marconi VC, Schinazi RF, Wharton W, Lee FEH, Hu WT. Cross-sectional IgM and IgG profiles in SARS-CoV-2 infection. medRxiv 2020:2020.05.10.20097535. [PMID: 32511499 PMCID: PMC7273267 DOI: 10.1101/2020.05.10.20097535] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background Accurate serological assays can improve the early diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, but few studies have compared performance characteristics between assays in symptomatic and recovered patients. Methods We recruited 32 patients who had 2019 coronavirus disease (COVID-19; 18 hospitalized and actively symptomatic, 14 recovered mild cases), and measured levels of IgM (against the full-length S1 or the highly homologous SARS-CoV E protein) and IgG (against S1 receptor binding domain [RBD]). We performed the same analysis in 103 pre-2020 healthy adult control (HC) participants and 13 participants who had negative molecular testing for SARS-CoV-2. Results Anti-S1-RBD IgG levels were very elevated within days of symptom onset for hospitalized patients (median 2.04 optical density [OD], vs. 0.12 in HC). People who recovered from milder COVID-19 only reached similar IgG levels 28 days after symptom onset. IgM levels were elevated early in both groups (median 1.91 and 2.12 vs. 1.14 OD in HC for anti-S1 IgM, 2.23 and 2.26 vs 1.52 in HC for anti-E IgM), with downward trends in hospitalized cases having longer disease duration. The combination of the two IgM levels showed similar sensitivity for COVID-19 as IgG but greater specificity, and identified 4/10 people (vs. 3/10 by IgG) with prior symptoms and negative molecular testing to have had COVID-19. Conclusions Disease severity and timing both influence levels of IgM and IgG against SARS-CoV-2, with IgG better for early detection of severe cases but IgM more suited for early detection of milder cases.
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Affiliation(s)
| | | | | | - Richard Ramonell
- Department of Medicine - Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine
| | | | | | - Leda C Bassit
- Department of Pediatrics and Center for AIDS Research
| | | | - Vincent C Marconi
- Department of Medicine - Division of Infectious Diseases, Emory University School of Medicine
| | | | - Whitney Wharton
- Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, GA
| | - F Eun-Hyung Lee
- Department of Medicine - Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine
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47
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Hu WT, Wharton W, Ozturk T, Howell JC. Caution on plasma cytokine findings in 2019 novel coronavirus cases. SSRN 2020:3555849. [PMID: 32714107 PMCID: PMC7366808 DOI: 10.2139/ssrn.3555849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 03/19/2020] [Indexed: 11/16/2022]
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48
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Misiura MB, Howell JC, Wu J, Qiu D, Parker MW, Turner JA, Hu WT. Race modifies default mode connectivity in Alzheimer's disease. Transl Neurodegener 2020; 9:8. [PMID: 32099645 PMCID: PMC7029517 DOI: 10.1186/s40035-020-0186-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/04/2020] [Indexed: 12/11/2022] Open
Abstract
Background Older African Americans are more likely to develop Alzheimer's disease (AD) than older Caucasians, and this difference cannot be readily explained by cerebrovascular and socioeconomic factors alone. We previously showed that mild cognitive impairment and AD dementia were associated with attenuated increases in the cerebrospinal fluid (CSF) levels of total and phosphorylated tau in African Americans compared to Caucasians, even though there was no difference in beta-amyloid 1-42 level between the two races. Methods We extended our work by analyzing early functional magnetic resonance imaging (fMRI) biomarkers of the default mode network in older African Americans and Caucasians. We calculated connectivity between nodes of the regions belonging to the various default mode network subsystems and correlated these imaging biomarkers with non-imaging biomarkers implicated in AD (CSF amyloid, total tau, and cognitive performance). Results We found that race modifies the relationship between functional connectivity of default mode network subsystems and cognitive performance, tau, and amyloid levels. Conclusion These findings provide further support that race modifies the AD phenotypes downstream from cerebral amyloid deposition, and identifies key inter-subsystem connections for deep imaging and neuropathologic characterization.
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Affiliation(s)
- Maria B Misiura
- 1Department of Psychology, Georgia State University, Atlanta, GA USA.,2Departments of Neurology, Emory University, 615 Michael Street, Suite 505, Atlanta, GA 30322 USA
| | - J Christina Howell
- 2Departments of Neurology, Emory University, 615 Michael Street, Suite 505, Atlanta, GA 30322 USA
| | - Junjie Wu
- 3Departments of Radiology, Emory University, Atlanta, GA USA
| | - Deqiang Qiu
- 3Departments of Radiology, Emory University, Atlanta, GA USA
| | - Monica W Parker
- 2Departments of Neurology, Emory University, 615 Michael Street, Suite 505, Atlanta, GA 30322 USA
| | - Jessica A Turner
- 1Department of Psychology, Georgia State University, Atlanta, GA USA
| | - William T Hu
- 2Departments of Neurology, Emory University, 615 Michael Street, Suite 505, Atlanta, GA 30322 USA
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49
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Niedzwiecki MM, Walker DI, Howell JC, Watts KD, Jones DP, Miller GW, Hu WT. High-resolution metabolomic profiling of Alzheimer's disease in plasma. Ann Clin Transl Neurol 2019; 7:36-45. [PMID: 31828981 PMCID: PMC6952314 DOI: 10.1002/acn3.50956] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 11/08/2019] [Accepted: 11/09/2019] [Indexed: 12/13/2022] Open
Abstract
Background Alzheimer’s disease (AD) is a complex neurological disorder with contributions from genetic and environmental factors. High‐resolution metabolomics (HRM) has the potential to identify novel endogenous and environmental factors involved in AD. Previous metabolomics studies have identified circulating metabolites linked to AD, but lack of replication and inconsistent diagnostic algorithms have hindered the generalizability of these findings. Here we applied HRM to identify plasma metabolic and environmental factors associated with AD in two study samples, with cerebrospinal fluid (CSF) biomarkers of AD incorporated to achieve high diagnostic accuracy. Methods Liquid chromatography‐mass spectrometry (LC–MS)‐based HRM was used to identify plasma and CSF metabolites associated with AD diagnosis and CSF AD biomarkers in two studies of prevalent AD (Study 1: 43 AD cases, 45 mild cognitive impairment [MCI] cases, 41 controls; Study 2: 50 AD cases, 18 controls). AD‐associated metabolites were identified using a metabolome‐wide association study (MWAS) framework. Results An MWAS meta‐analysis identified three non‐medication AD‐associated metabolites in plasma, including elevated levels of glutamine and an unknown halogenated compound and lower levels of piperine, a dietary alkaloid. The non‐medication metabolites were correlated with CSF AD biomarkers, and glutamine and the unknown halogenated compound were also detected in CSF. Furthermore, in Study 1, the unknown compound and piperine were altered in MCI patients in the same direction as AD dementia. Conclusions In plasma, AD was reproducibly associated with elevated levels of glutamine and a halogen‐containing compound and reduced levels of piperine. These findings provide further evidence that exposures and behavior may modify AD risks.
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Affiliation(s)
- Megan M Niedzwiecki
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia.,Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Douglas I Walker
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia.,Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York.,Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, Georgia
| | | | - Kelly D Watts
- Department of Neurology, Emory University, Atlanta, Georgia
| | - Dean P Jones
- Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, Georgia
| | - Gary W Miller
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia.,Department of Neurology, Emory University, Atlanta, Georgia.,Center for Neurodegenerative Diseases, Emory University, Atlanta, Georgia.,Department of Pharmacology, Emory University, Atlanta, Georgia
| | - William T Hu
- Department of Neurology, Emory University, Atlanta, Georgia.,Center for Neurodegenerative Diseases, Emory University, Atlanta, Georgia.,Alzheimer's Disease Research Center, Emory University, Atlanta, Georgia
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50
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Wharton W, Kollhoff AL, Gangishetti U, Verble DD, Upadhya S, Zetterberg H, Kumar V, Watts KD, Kippels AJ, Gearing M, Howell JC, Parker MW, Hu WT. Interleukin 9 alterations linked to alzheimer disease in african americans. Ann Neurol 2019; 86:407-418. [PMID: 31271450 PMCID: PMC6800153 DOI: 10.1002/ana.25543] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 07/01/2019] [Accepted: 07/01/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Compared to older Caucasians, older African Americans have higher risks of developing Alzheimer disease (AD) and lower cerebrospinal fluid (CSF) tau biomarker levels. It is not known whether tau-related differences begin earlier in life or whether race modifies other AD-related biomarkers such as inflammatory proteins. METHODS We performed multiplex cytokine analysis in a healthy middle-aged cohort with family history of AD (n = 68) and an older cohort (n = 125) with normal cognition (NC), mild cognitive impairment, or AD dementia. After determining baseline interleukin (IL)-9 level and AD-associated IL-9 change to differ according to race, we performed immunohistochemical analysis for proteins mechanistically linked to IL-9 in brains of African Americans and Caucasians (n = 38), and analyzed postmortem IL-9-related gene expression profiles in the publicly available Mount Sinai cohort (26 African Americans and 180 Caucasians). RESULTS Compared to Caucasians with NC, African Americans with NC had lower CSF tau, p-Tau181 , and IL-9 levels in both living cohorts. Conversely, AD was only correlated with increased CSF IL-9 levels in African Americans but not Caucasians. Immunohistochemical analysis revealed perivascular, neuronal, and glial cells immunoreactive to IL-9, and quantitative analysis in independent US cohorts showed AD to correlate with molecular changes (upstream differentiation marker and downstream effector cell marker) of IL-9 upregulation only in African Americans but not Caucasians. INTERPRETATION Baseline and AD-associated IL-9 differences between African Americans and Caucasians point to distinct molecular phenotypes for AD according to ancestry. Genetic and nongenetic factors need to be considered in future AD research involving unique populations. ANN NEUROL 2019;86:407-418.
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Affiliation(s)
- Whitney Wharton
- Department of Neurology, Emory University, Atlanta, GA
- Alzheimer's Disease Research Center, Emory University, Atlanta, GA
| | | | | | | | | | - Henrik Zetterberg
- UK Dementia Research Institute at University College London, London, United Kingdom
| | - Veena Kumar
- Department of Neurology, Emory University, Atlanta, GA
| | - Kelly D Watts
- Department of Neurology, Emory University, Atlanta, GA
| | - Andrea J Kippels
- Department of Neurology, Emory University, Atlanta, GA
- Alzheimer's Disease Research Center, Emory University, Atlanta, GA
| | - Marla Gearing
- Alzheimer's Disease Research Center, Emory University, Atlanta, GA
| | - J Christina Howell
- Department of Neurology, Emory University, Atlanta, GA
- Alzheimer's Disease Research Center, Emory University, Atlanta, GA
| | - Monica W Parker
- Department of Neurology, Emory University, Atlanta, GA
- Alzheimer's Disease Research Center, Emory University, Atlanta, GA
| | - William T Hu
- Department of Neurology, Emory University, Atlanta, GA
- Alzheimer's Disease Research Center, Emory University, Atlanta, GA
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