Genetic factors in Alzheimer's disease

Identification of diagnostic biomarkers in Alzheimer's disease by integrated bioinformatic analysis and machine learning strategies

Background

Alzheimer's disease (AD) is the most prevalent form of dementia, and is becoming one of the most burdening and lethal diseases. More useful biomarkers for diagnosing AD and reflecting the disease progression are in need and of significance.

Methods

The integrated bioinformatic analysis combined with machine-learning strategies was applied for exploring crucial functional pathways and identifying diagnostic biomarkers of AD. Four datasets (GSE5281, GSE131617, GSE48350, and GSE84422) with samples of AD frontal cortex are integrated as experimental datasets, and another two datasets (GSE33000 and GSE44772) with samples of AD frontal cortex were used to perform validation analyses. Functional Correlation enrichment analyses were conducted based on Gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and the Reactome database to reveal AD-associated biological functions and key pathways. Four models were employed to screen the potential diagnostic biomarkers, including one bioinformatic analysis of Weighted gene co-expression network analysis (WGCNA)and three machine-learning algorithms: Least absolute shrinkage and selection operator (LASSO), support vector machine-recursive feature elimination (SVM-RFE) and random forest (RF) analysis. The correlation analysis was performed to explore the correlation between the identified biomarkers with CDR scores and Braak staging.

Results

The pathways of the immune response and oxidative stress were identified as playing a crucial role during AD. Thioredoxin interacting protein (TXNIP), early growth response 1 (EGR1), and insulin-like growth factor binding protein 5 (IGFBP5) were screened as diagnostic markers of AD. The diagnostic efficacy of TXNIP, EGR1, and IGFBP5 was validated with corresponding AUCs of 0.857, 0.888, and 0.856 in dataset GSE33000, 0.867, 0.909, and 0.841 in dataset GSE44770. And the AUCs of the combination of these three biomarkers as a diagnostic tool for AD were 0.954 and 0.938 in the two verification datasets.

Conclusion

The pathways of immune response and oxidative stress can play a crucial role in the pathogenesis of AD. TXNIP, EGR1, and IGFBP5 are useful biomarkers for diagnosing AD and their mRNA level may reflect the development of the disease by correlation with the CDR scores and Breaking staging.

Recent Advances in Multi-target Anti-Alzheimer Disease Compounds (2013 Up to the Present)

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Since the last century, when scientists proposed the lock-and-key model, the discovery of drugs has focused on the development of drugs acting on single target. However, single-target drug therapies are not effective to complex diseases with multi-factorial pathogenesis. Moreover, the combination of single-target drugs readily causes drug resistance and side effects. In recent years, multi-target drugs have increasingly been represented among FDA-approved drugs. Alzheimer’s Disease (AD) is a complex and multi-factorial disease for which the precise molecular mechanisms are still not fully understood. In recent years, rational multi-target drug design methods, which combine the pharmacophores of multiple drugs, have been increasingly applied in the development of anti-AD drugs. In this review, we give a brief description of the pathogenesis of AD and provide detailed discussions about the recent development of chemical structures of anti-AD agents (2013 up to present) that have multiple targets, such as amyloid-β peptide, Tau protein, cholinesterases, monoamine oxidase, β-site amyloid-precursor protein-cleaving enzyme 1, free radicals, metal ions (Fe2+, Cu2+, Zn2+) and so on. In this paper, we also added some novel targets or possible pathogenesis which have been reported in recent years for AD therapy. We hope that these findings may provide new perspectives for the pharmacological treatment of AD.

Alzheimer's disease: A hypothesis on pathogenesis

Alzheimer's disease (AD) is the major cause of dementia. It is a systemic disorder whose major manifestations are in the brain. AD cases can be categorized into two groups on the basis of the age of onset-before or after about age 60. The majority of cases, 90-95 percent, are in the late onset category. Early onset cases are largely, if not all, familial (FAD). These are caused by mutations in the genes for the amyloid precursor protein (APP), presenilin 1 (PS1), and presenilin 2 (PS2). In contrast late onset cases are mainly sporadic. The disorder is characterized by intraneuronal fibrillary tangles, plaques, and cell loss. The brain lesions in both early and late-onset AD are the same, and in the same distribution pattern, as those seen in individuals with Down's syndrome (DS) and in smaller numbers in normal older individuals. Extensive studies of AD have yet to result in a generally accepted hypothesis on the pathogenesis of the disorder. Major emphasis has been placed on the role of amyloid, the neurotoxin formed by the action of free radicals on preamyloid. The observation that AD lesions are frequently present in normal older individuals prompted the hypothesis that AD is the result of faster than normal aging of the neurons associated with it. This hypothesis provides plausible explanations for FAD and AD. FAD is associated with mutations in APP, PS1, and PS2. These substances, along with their normal counterparts, undergo proteolytic processing in the endoplasmic reticulum (ER). The mutated compounds, aside from increasing the ratio of βA42 to βA40, may down-regulate the calcium buffering activity of the ER in a manner akin to one or more of the many compounds known to do so. Decreases in the ER calcium pool would cause compensatory increases in other calcium pools, particularly in mitochondria. Increases in mitochondrial calcium levels are associated with enhanced formation of superoxide radical formation, and hence of the rate of aging. SAD may be caused by nuclear and/or mitochondrial DNA mutations beginning early in life that enhance mitochondrial superoxide radical formation in the neurons associated with the disorder. The above explanations for FAD and AD are suggestive of measures to prevent and for treatment.