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Grasset L, Bouteloup V, Cacciamani F, Pellegrin I, Planche V, Chêne G, Dufouil C. Associations Between Blood-Based Biomarkers and Cognitive and Functional Trajectories Among Participants of the MEMENTO Cohort. Neurology 2024; 102:e209307. [PMID: 38626384 DOI: 10.1212/wnl.0000000000209307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Elevated levels of Alzheimer disease (AD) blood-based biomarkers are associated with accelerated cognitive decline. However, their distinct relationships with specific cognitive and functional domains require further investigation. We aimed at estimating the associations between AD blood-based biomarkers and the trajectories of distinct cognitive and functional domains over a 5-year follow-up period. METHODS We conducted a clinic-based prospective study using data from the MEMENTO study, a nationwide French cohort. We selected dementia-free individuals at baseline aged 60 years or older. Baseline measurements of β-amyloid (Aβ) 40 and 42, phosphorylated tau (p-tau181), and neurofilament light chain (NfL) concentrations were obtained using the Simoa HD-X analyzer. Mini-Mental State Examination (MMSE), Free and Cued Selective Reminding Test (FCSRT), animal fluency, Trail Making Tests A and B, Short Physical Performance Battery (SPPB), and Instrumental Activities of Daily Living were administered annually for up to 5 years. We used linear mixed models, adjusted for potential confounders, to model AD biomarkers' relation with cognitive and functional decline. RESULTS A total of 1,938 participants were included in this study, with a mean (SD) baseline age of 72.8 (6.6) years, and 62% were women. Higher baseline p-tau181 and NfL were associated with significantly faster decline in most cognitive, physical, and functional outcomes (+1 SD p-tau181: βMMSE = -0.055, 95% CI -0.067 to -0.043, βFCSRT = -0.034, 95% CI -0.043 to -0.025, βfluency = -0.029, 95% CI -0.038 to -0.020, βSPPB = -0.040, 95% CI -0.057 to -0.022, and β4IADL = -0.115, 95% CI 0.091-0.140. +1 SD NfL: βMMSE = -0.039, 95% CI -0.053 to -0.025, βFCSRT = -0.022, 95% CI -0.032 to -0.012, βfluency = -0.014, 95% CI -0.024 to -0.004, and β4IADL = 0.077, 95% CI 0.048-0.105). A multiplicative association of p-tau181 and NfL with worsening cognitive and functional trajectories was evidenced. Lower Aβ42/40 ratio was only associated with slightly faster cognitive decline in FCSRT and semantic fluency (+1 SD: β = 0.011, 95% CI 0.002-0.020, and β = 0.011, 95% CI 0.003-0.020, respectively). These associations were not modified by APOE ε4, sex, nor education level. DISCUSSION In a memory clinic sample, p-tau181 and NfL, both independently and jointly, are linked to more pronounced cognitive, physical and functional declines. Blood-based biomarker measurement in AD research may provide useful insights regarding biological processes underlying cognitive, physical, and functional declines in at-risk individuals.
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Affiliation(s)
- Leslie Grasset
- From the UMR 1219 (L.G., V.B., F.C., G.C., C.D.), Bordeaux Population Health Center, University of Bordeaux, Inserm; CIC 1401-EC (L.G., V.B., F.C., G.C., C.D.), Inserm, University of Bordeaux, CHU de Bordeaux; Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), Pole de sante publique; ARAMISLab (F.C.), Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière; Qairnel SAS (F.C.), Paris; Laboratory of Immunology and Immunogenetics (I.P.), Resources Biological Center (CRB), CHU Bordeaux; Univ. Bordeaux (I.P.), CNRS, ImmunoConcEpT, UMR 5164; and Univ. Bordeaux (V.P.), CNRS UMR 5293, Institut des Maladies Neurodégénératives, Centre Mémoire de Ressources et de Recherches, Pôle de Neurosciences Cliniques, CHU de Bordeaux, France
| | - Vincent Bouteloup
- From the UMR 1219 (L.G., V.B., F.C., G.C., C.D.), Bordeaux Population Health Center, University of Bordeaux, Inserm; CIC 1401-EC (L.G., V.B., F.C., G.C., C.D.), Inserm, University of Bordeaux, CHU de Bordeaux; Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), Pole de sante publique; ARAMISLab (F.C.), Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière; Qairnel SAS (F.C.), Paris; Laboratory of Immunology and Immunogenetics (I.P.), Resources Biological Center (CRB), CHU Bordeaux; Univ. Bordeaux (I.P.), CNRS, ImmunoConcEpT, UMR 5164; and Univ. Bordeaux (V.P.), CNRS UMR 5293, Institut des Maladies Neurodégénératives, Centre Mémoire de Ressources et de Recherches, Pôle de Neurosciences Cliniques, CHU de Bordeaux, France
| | - Federica Cacciamani
- From the UMR 1219 (L.G., V.B., F.C., G.C., C.D.), Bordeaux Population Health Center, University of Bordeaux, Inserm; CIC 1401-EC (L.G., V.B., F.C., G.C., C.D.), Inserm, University of Bordeaux, CHU de Bordeaux; Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), Pole de sante publique; ARAMISLab (F.C.), Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière; Qairnel SAS (F.C.), Paris; Laboratory of Immunology and Immunogenetics (I.P.), Resources Biological Center (CRB), CHU Bordeaux; Univ. Bordeaux (I.P.), CNRS, ImmunoConcEpT, UMR 5164; and Univ. Bordeaux (V.P.), CNRS UMR 5293, Institut des Maladies Neurodégénératives, Centre Mémoire de Ressources et de Recherches, Pôle de Neurosciences Cliniques, CHU de Bordeaux, France
| | - Isabelle Pellegrin
- From the UMR 1219 (L.G., V.B., F.C., G.C., C.D.), Bordeaux Population Health Center, University of Bordeaux, Inserm; CIC 1401-EC (L.G., V.B., F.C., G.C., C.D.), Inserm, University of Bordeaux, CHU de Bordeaux; Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), Pole de sante publique; ARAMISLab (F.C.), Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière; Qairnel SAS (F.C.), Paris; Laboratory of Immunology and Immunogenetics (I.P.), Resources Biological Center (CRB), CHU Bordeaux; Univ. Bordeaux (I.P.), CNRS, ImmunoConcEpT, UMR 5164; and Univ. Bordeaux (V.P.), CNRS UMR 5293, Institut des Maladies Neurodégénératives, Centre Mémoire de Ressources et de Recherches, Pôle de Neurosciences Cliniques, CHU de Bordeaux, France
| | - Vincent Planche
- From the UMR 1219 (L.G., V.B., F.C., G.C., C.D.), Bordeaux Population Health Center, University of Bordeaux, Inserm; CIC 1401-EC (L.G., V.B., F.C., G.C., C.D.), Inserm, University of Bordeaux, CHU de Bordeaux; Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), Pole de sante publique; ARAMISLab (F.C.), Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière; Qairnel SAS (F.C.), Paris; Laboratory of Immunology and Immunogenetics (I.P.), Resources Biological Center (CRB), CHU Bordeaux; Univ. Bordeaux (I.P.), CNRS, ImmunoConcEpT, UMR 5164; and Univ. Bordeaux (V.P.), CNRS UMR 5293, Institut des Maladies Neurodégénératives, Centre Mémoire de Ressources et de Recherches, Pôle de Neurosciences Cliniques, CHU de Bordeaux, France
| | - Geneviève Chêne
- From the UMR 1219 (L.G., V.B., F.C., G.C., C.D.), Bordeaux Population Health Center, University of Bordeaux, Inserm; CIC 1401-EC (L.G., V.B., F.C., G.C., C.D.), Inserm, University of Bordeaux, CHU de Bordeaux; Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), Pole de sante publique; ARAMISLab (F.C.), Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière; Qairnel SAS (F.C.), Paris; Laboratory of Immunology and Immunogenetics (I.P.), Resources Biological Center (CRB), CHU Bordeaux; Univ. Bordeaux (I.P.), CNRS, ImmunoConcEpT, UMR 5164; and Univ. Bordeaux (V.P.), CNRS UMR 5293, Institut des Maladies Neurodégénératives, Centre Mémoire de Ressources et de Recherches, Pôle de Neurosciences Cliniques, CHU de Bordeaux, France
| | - Carole Dufouil
- From the UMR 1219 (L.G., V.B., F.C., G.C., C.D.), Bordeaux Population Health Center, University of Bordeaux, Inserm; CIC 1401-EC (L.G., V.B., F.C., G.C., C.D.), Inserm, University of Bordeaux, CHU de Bordeaux; Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), Pole de sante publique; ARAMISLab (F.C.), Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière; Qairnel SAS (F.C.), Paris; Laboratory of Immunology and Immunogenetics (I.P.), Resources Biological Center (CRB), CHU Bordeaux; Univ. Bordeaux (I.P.), CNRS, ImmunoConcEpT, UMR 5164; and Univ. Bordeaux (V.P.), CNRS UMR 5293, Institut des Maladies Neurodégénératives, Centre Mémoire de Ressources et de Recherches, Pôle de Neurosciences Cliniques, CHU de Bordeaux, France
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Slee MG, Rainey‐Smith SR, Villemagne VL, Doecke JD, Sohrabi HR, Taddei K, Ames D, Dore V, Maruff P, Laws SM, Masters CL, Rowe CC, Martins RN, Erickson KI, Brown BM. Physical activity and brain amyloid beta: A longitudinal analysis of cognitively unimpaired older adults. Alzheimers Dement 2024; 20:1350-1359. [PMID: 37984813 PMCID: PMC10917015 DOI: 10.1002/alz.13556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/13/2023] [Accepted: 10/23/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION The current study evaluated the relationship between habitual physical activity (PA) levels and brain amyloid beta (Aβ) over 15 years in a cohort of cognitively unimpaired older adults. METHODS PA and Aβ measures were collected over multiple timepoints from 731 cognitively unimpaired older adults participating in the Australian Imaging, Biomarkers and Lifestyle (AIBL) Study of Aging. Regression modeling examined cross-sectional and longitudinal relationships between PA and brain Aβ. Moderation analyses examined apolipoprotein E (APOE) ε4 carriage impact on the PA-Aβ relationship. RESULTS PA was not associated with brain Aβ at baseline (β = -0.001, p = 0.72) or over time (β = -0.26, p = 0.24). APOE ε4 status did not moderate the PA-Aβ relationship over time (β = 0.12, p = 0.73). Brain Aβ levels did not predict PA trajectory (β = -54.26, p = 0.59). DISCUSSION Our study did not identify a relationship between habitual PA and brain Aβ levels. HIGHLIGHTS Physical activity levels did not predict brain amyloid beta (Aβ) levels over time in cognitively unimpaired older adults (≥60 years of age). Apolipoprotein E (APOE) ε4 carrier status did not moderate the physical activity-brain Aβ relationship over time. Physical activity trajectories were not impacted by brain Aβ levels.
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Affiliation(s)
- Michael G. Slee
- Centre for Healthy AgeingHealthy Futures InstituteMurdoch UniversityMurdochWestern AustraliaAustralia
| | - Stephanie R. Rainey‐Smith
- Centre for Healthy AgeingHealthy Futures InstituteMurdoch UniversityMurdochWestern AustraliaAustralia
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- Australian Alzheimer's Research FoundationNedlandsWestern AustraliaAustralia
- School of Psychological ScienceUniversity of Western AustraliaCrawleyWestern AustraliaAustralia
| | - Victor L. Villemagne
- Department of Molecular Imaging & TherapyAustin HealthHeidelbergVictoriaAustralia
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
- Centre for Precision HealthEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - James D. Doecke
- The Australian e‐Health Research CentreCSIROHerstonQueenslandAustralia
| | - Hamid R. Sohrabi
- Centre for Healthy AgeingHealthy Futures InstituteMurdoch UniversityMurdochWestern AustraliaAustralia
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- Australian Alzheimer's Research FoundationNedlandsWestern AustraliaAustralia
- Department of Biomedical SciencesMacquarie UniversitySydneyNew South WalesAustralia
| | - Kevin Taddei
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- Australian Alzheimer's Research FoundationNedlandsWestern AustraliaAustralia
| | - David Ames
- The Florey Institute of Neuroscience and Mental HealthUniversity of MelbourneParkvilleVictoriaAustralia
- National Ageing Research InstituteParkvilleVictoriaAustralia
- Academic Unit for Psychiatry of Old AgeUniversity of MelbourneCarltonVictoriaAustralia
| | - Vincent Dore
- Department of Molecular Imaging & TherapyAustin HealthHeidelbergVictoriaAustralia
| | - Paul Maruff
- The Florey Institute of Neuroscience and Mental HealthUniversity of MelbourneParkvilleVictoriaAustralia
- Cogstate LtdMelbourneVictoriaAustralia
| | - Simon M. Laws
- Centre for Precision HealthEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- Collaborative Genomics and Translation GroupSchool of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- Curtin Medical SchoolCurtin UniversityBentleyWestern AustraliaAustralia
| | - Colin L. Masters
- The Florey Institute of Neuroscience and Mental HealthUniversity of MelbourneParkvilleVictoriaAustralia
| | - Christopher C. Rowe
- Department of Molecular Imaging & TherapyAustin HealthHeidelbergVictoriaAustralia
- The Florey Institute of Neuroscience and Mental HealthUniversity of MelbourneParkvilleVictoriaAustralia
| | - Ralph N. Martins
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- Australian Alzheimer's Research FoundationNedlandsWestern AustraliaAustralia
- Department of Biomedical SciencesMacquarie UniversitySydneyNew South WalesAustralia
| | - Kirk I. Erickson
- Department of PsychologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Belinda M. Brown
- Centre for Healthy AgeingHealthy Futures InstituteMurdoch UniversityMurdochWestern AustraliaAustralia
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- Australian Alzheimer's Research FoundationNedlandsWestern AustraliaAustralia
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Shin YJ, Evitts KM, Jin S, Howard C, Sharp-Milgrom M, Schwarze-Taufiq T, Kinoshita C, Young JE, Zheng Y. Amyloid beta peptides (Aβ) from Alzheimer's disease neuronal secretome induce endothelial activation in a human cerebral microvessel model. Neurobiol Dis 2023; 181:106125. [PMID: 37062307 DOI: 10.1016/j.nbd.2023.106125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/19/2023] [Accepted: 04/12/2023] [Indexed: 04/18/2023] Open
Abstract
In Alzheimer's disease (AD), secretion and deposition of amyloid beta peptides (Aβ) have been associated with blood-brain barrier dysfunction. However, the role of Aβ in endothelial cell (EC) dysfunction remains elusive. Here we investigated AD mediated EC activation by studying the effect of Aβ secreted from human induced pluripotent stem cell-derived cortical neurons (hiPSC-CN) harboring a familial AD mutation (Swe+/+) on human brain microvascular endothelial cells (HBMECs) in 2D and 3D perfusable microvessels. We demonstrated that increased Aβ levels in Swe+/+ conditioned media (CM) led to stress fiber formation and upregulation of genes associated with endothelial inflammation and immune-adhesion. Perfusion of Aβ-rich Swe+/+ CM induced acute formation of von Willebrand factor (VWF) fibers in the vessel lumen, which was attenuated by reducing Aβ levels in CM. Our findings suggest that Aβ peptides can trigger rapid inflammatory and thrombogenic responses within cerebral microvessels, which may exacerbate AD pathology.
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Affiliation(s)
- Yu Jung Shin
- Department of Bioengineering, University of Washington, Seattle, WA 98109, United States of America; Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA 98109, United States of America
| | - Kira M Evitts
- Department of Bioengineering, University of Washington, Seattle, WA 98109, United States of America; Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA 98109, United States of America
| | - Solhee Jin
- Department of Bioengineering, University of Washington, Seattle, WA 98109, United States of America
| | - Caitlin Howard
- Department of Bioengineering, University of Washington, Seattle, WA 98109, United States of America; Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA 98109, United States of America
| | - Margaret Sharp-Milgrom
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA 98109, United States of America
| | - Tiara Schwarze-Taufiq
- Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA 98109, United States of America; Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA 98109, United States of America
| | - Chizuru Kinoshita
- Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA 98109, United States of America; Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA 98109, United States of America
| | - Jessica E Young
- Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA 98109, United States of America; Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA 98109, United States of America.
| | - Ying Zheng
- Department of Bioengineering, University of Washington, Seattle, WA 98109, United States of America; Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA 98109, United States of America.
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Skapetze L, Owino S, Lo EH, Arai K, Merrow M, Harrington M. Rhythms in barriers and fluids: Circadian clock regulation in the aging neurovascular unit. Neurobiol Dis 2023; 181:106120. [PMID: 37044366 DOI: 10.1016/j.nbd.2023.106120] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/27/2023] [Accepted: 04/07/2023] [Indexed: 04/14/2023] Open
Abstract
The neurovascular unit is where two very distinct physiological systems meet: The central nervous system (CNS) and the blood. The permeability of the barriers separating these systems is regulated by time, including both the 24 h circadian clock and the longer processes of aging. An endogenous circadian rhythm regulates the transport of molecules across the blood-brain barrier and the circulation of the cerebrospinal fluid and the glymphatic system. These fluid dynamics change with time of day, and with age, and especially in the context of neurodegeneration. Factors may differ depending on brain region, as can be highlighted by consideration of circadian regulation of the neurovascular niche in white matter. As an example of a potential target for clinical applications, we highlight chaperone-mediated autophagy as one mechanism at the intersection of circadian dysregulation, aging and neurodegenerative disease. In this review we emphasize key areas for future research.
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Affiliation(s)
- Lea Skapetze
- Institute of Medical Psychology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Sharon Owino
- Neuroscience Program, Smith College, Northampton, MA 01060, United States of America
| | - Eng H Lo
- Neuroprotection Research Laboratories, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ken Arai
- Neuroprotection Research Laboratories, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Martha Merrow
- Institute of Medical Psychology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Mary Harrington
- Neuroscience Program, Smith College, Northampton, MA 01060, United States of America.
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Saunders TS, Pozzolo FE, Heslegrave A, King D, McGeachan RI, Spires-Jones MP, Harris SE, Ritchie C, Muniz-Terrera G, Deary IJ, Cox SR, Zetterberg H, Spires-Jones TL. Predictive blood biomarkers and brain changes associated with age-related cognitive decline. Brain Commun 2023; 5:fcad113. [PMID: 37180996 PMCID: PMC10167767 DOI: 10.1093/braincomms/fcad113] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 12/28/2022] [Accepted: 04/05/2023] [Indexed: 04/08/2023] Open
Abstract
Growing evidence supports the use of plasma levels of tau phosphorylated at threonine 181, amyloid-β, neurofilament light and glial fibrillary acidic protein as promising biomarkers for Alzheimer's disease. While these blood biomarkers are promising for distinguishing people with Alzheimer's disease from healthy controls, their predictive validity for age-related cognitive decline without dementia remains unclear. Further, while tau phosphorylated at threonine 181 is a promising biomarker, the distribution of this phospho-epitope of tau in the brain is unknown. Here, we tested whether plasma levels of tau phosphorylated at threonine 181, amyloid-β, neurofilament light and fibrillary acidic protein predict cognitive decline between ages 72 and 82 in 195 participants in the Lothian birth cohorts 1936 study of cognitive ageing. We further examined post-mortem brain samples from temporal cortex to determine the distribution of tau phosphorylated at threonine 181 in the brain. Several forms of tau phosphorylated at threonine 181 have been shown to contribute to synapse degeneration in Alzheimer's disease, which correlates closely with cognitive decline in this form of dementia, but to date, there have not been investigations of whether tau phosphorylated at threonine 181 is found in synapses in Alzheimer's disease or healthy ageing brain. It was also previously unclear whether tau phosphorylated at threonine 181 accumulated in dystrophic neurites around plaques, which could contribute to tau leakage to the periphery due to impaired membrane integrity in dystrophies. Brain homogenate and biochemically enriched synaptic fractions were examined with western blot to examine tau phosphorylated at threonine 181 levels between groups (n = 10-12 per group), and synaptic and astrocytic localization of tau phosphorylated at threonine 181 were examined using array tomography (n = 6-15 per group), and localization of tau phosphorylated at threonine 181 in plaque-associated dystrophic neurites with associated gliosis were examined with standard immunofluorescence (n = 8-9 per group). Elevated baseline plasma tau phosphorylated at threonine 181, neurofilament light and fibrillary acidic protein predicted steeper general cognitive decline during ageing. Further, increasing tau phosphorylated at threonine 181 over time predicted general cognitive decline in females only. Change in plasma tau phosphorylated at threonine 181 remained a significant predictor of g factor decline when taking into account Alzheimer's disease polygenic risk score, indicating that the increase of blood tau phosphorylated at threonine 181 in this cohort was not only due to incipient Alzheimer's disease. Tau phosphorylated at threonine 181 was observed in synapses and astrocytes in both healthy ageing and Alzheimer's disease brain. We observed that a significantly higher proportion of synapses contain tau phosphorylated at threonine 181 in Alzheimer's disease relative to aged controls. Aged controls with pre-morbid lifetime cognitive resilience had significantly more tau phosphorylated at threonine 181 in fibrillary acidic protein-positive astrocytes than those with pre-morbid lifetime cognitive decline. Further, tau phosphorylated at threonine 181 was found in dystrophic neurites around plaques and in some neurofibrillary tangles. The presence of tau phosphorylated at threonine 181 in plaque-associated dystrophies may be a source of leakage of tau out of neurons that eventually enters the blood. Together, these data indicate that plasma tau phosphorylated at threonine 181, neurofilament light and fibrillary acidic protein may be useful biomarkers of age-related cognitive decline, and that efficient clearance of tau phosphorylated at threonine 181 by astrocytes may promote cognitive resilience.
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Affiliation(s)
- Tyler S Saunders
- UK Dementia Research Institute and Centre for Discovery Brain Sciences at the University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Edinburgh Dementia Prevention & Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - Francesca E Pozzolo
- UK Dementia Research Institute and Centre for Discovery Brain Sciences at the University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Amanda Heslegrave
- United Kingdom UK Dementia Research Institute at University College London, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Declan King
- UK Dementia Research Institute and Centre for Discovery Brain Sciences at the University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Robert I McGeachan
- UK Dementia Research Institute and Centre for Discovery Brain Sciences at the University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Maxwell P Spires-Jones
- UK Dementia Research Institute and Centre for Discovery Brain Sciences at the University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Sarah E Harris
- Lothian Birth Cohort studies, Department of Psychology, University of Edinburgh, Edinburgh, EH8 9AD, UK
| | - Craig Ritchie
- Edinburgh Dementia Prevention & Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - Graciela Muniz-Terrera
- Edinburgh Dementia Prevention & Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK
- Department of Social Medicine, Ohio University, Athens, Ohio 45701, USA
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago 3485, Chile
| | - Ian J Deary
- Lothian Birth Cohort studies, Department of Psychology, University of Edinburgh, Edinburgh, EH8 9AD, UK
| | - Simon R Cox
- Lothian Birth Cohort studies, Department of Psychology, University of Edinburgh, Edinburgh, EH8 9AD, UK
| | - Henrik Zetterberg
- United Kingdom UK Dementia Research Institute at University College London, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, S-431 80 Molndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, S-431 80 Molndal, Sweden
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
| | - Tara L Spires-Jones
- UK Dementia Research Institute and Centre for Discovery Brain Sciences at the University of Edinburgh, Edinburgh, EH8 9JZ, UK
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Winston CN, Langford O, Levin N, Raman R, Yarasheski K, West T, Abdel-Latif S, Donohue M, Nakamura A, Toba K, Masters CL, Doecke J, Sperling RA, Aisen PS, Rissman RA. Evaluation of Blood-Based Plasma Biomarkers as Potential Markers of Amyloid Burden in Preclinical Alzheimer's Disease. J Alzheimers Dis 2023; 92:95-107. [PMID: 36710683 DOI: 10.3233/jad-221118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Participant eligibility for the A4 Study was determined by amyloid PET imaging. Given the disadvantages of amyloid PET imaging in accessibility and cost, blood-based biomarkers may serve as a sufficient biomarker and more cost-effective screening tool for patient enrollment into preclinical AD trials. OBJECTIVE To determine if a blood-based screening test can adequately identify amyloid burden in participants screened into a preclinical AD trial. METHODS In this cross-sectional study, 224 participants from the A4 Study received an amyloid PET scan (18Florbetapir) within 90 days of blood sample collection. Blood samples from all study participants were processed within 2 h after phlebotomy. Plasma amyloid measures were quantified by Shimazdu and C2 N Diagnostics using mass spectrometry-based platforms. A corresponding subset of blood samples (n = 100) was processed within 24 h after phlebotomy and analyzed by C2 N. RESULTS Plasma Aβ42/Aβ40 demonstrated the highest association for Aβ accumulation in the brain with an AUC 0.76 (95%CI = 0.69, 0.82) at C2 N and 0.80 (95%CI = 0.75, 0.86) at Shimadzu. Blood samples processed to plasma within 2 h after phlebotomy provided a better prediction of amyloid PET status than blood samples processed within 24 h (AUC 0.80 versus 0.64; p < 0.001). Age, sex, and APOE ɛ4 carrier status did not the diagnostic performance of plasma Aβ42/Aβ40 to predict amyloid PET positivity in A4 Study participants. CONCLUSION Plasma Aβ42/Aβ40 may serve as a potential biomarker for predicting elevated amyloid in the brain. Utilizing blood testing over PET imaging may improve screening efficiency into clinical trials.
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Affiliation(s)
- Charisse N Winston
- Department of Neurosciences, University of California San Diego, La Jolla, CA, USA
| | - Oliver Langford
- Alzheimer's Therapeutic Research Institute, Keck School of Medicine University of Southern California, San Diego, CA, USA
| | - Natalie Levin
- Department of Neurosciences, University of California San Diego, La Jolla, CA, USA
| | - Rema Raman
- Alzheimer's Therapeutic Research Institute, Keck School of Medicine University of Southern California, San Diego, CA, USA
| | | | - Tim West
- C2N Diagnostics, St. Louis, MO, USA
| | - Sara Abdel-Latif
- Alzheimer's Therapeutic Research Institute, Keck School of Medicine University of Southern California, San Diego, CA, USA
| | - Michael Donohue
- Alzheimer's Therapeutic Research Institute, Keck School of Medicine University of Southern California, San Diego, CA, USA
| | - Akinori Nakamura
- Department of Biomarker Research, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Kenji Toba
- National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.,Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Colin L Masters
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - James Doecke
- The Commonwealth Scientific and Industrial Research Organization, Brisbane, QLD, Australia
| | | | - Paul S Aisen
- Alzheimer's Therapeutic Research Institute, Keck School of Medicine University of Southern California, San Diego, CA, USA
| | - Robert A Rissman
- Department of Neurosciences, University of California San Diego, La Jolla, CA, USA.,Department of Neurosciences, University of California San Diego and VA San Diego Healthcare System, La Jolla, CA, USA
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7
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Emery DC, Davies M, Cerajewska TL, Taylor J, Hazell M, Paterson A, Allen-Birt SJ, West NX. High resolution 16S rRNA gene Next Generation Sequencing study of brain areas associated with Alzheimer's and Parkinson's disease. Front Aging Neurosci 2022; 14:1026260. [PMID: 36570533 PMCID: PMC9780557 DOI: 10.3389/fnagi.2022.1026260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/02/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction Alzheimer's (AD) and Parkinson's disease (PD) are neurodegenerative conditions characterized by incremental deposition of β-amyloid (Aβ) and α-synuclein in AD and PD brain, respectively, in relatively conserved patterns. Both are associated with neuroinflammation, with a proposed microbial component for disease initiation and/or progression. Notably, Aβ and α-synuclein have been shown to possess antimicrobial properties. There is evidence for bacterial presence within the brain, including the oral pathobiont Porphyromonas gingivalis, with cognitive impairment and brain pathology being linked to periodontal (gum) disease and gut dysbiosis. Methods Here, we use high resolution 16S rRNA PCR-based Next Generation Sequencing (16SNGS) to characterize bacterial composition in brain areas associated with the early, intermediate and late-stage of the diseases. Results and discussion This study reveals the widespread presence of bacteria in areas of the brain associated with AD and PD pathology, with distinctly different bacterial profiles in blood and brain. Brain area profiles were overall somewhat similar, predominantly oral, with some bacteria subgingival and oronasal in origin, and relatively comparable profiles in AD and PD brain. However, brain areas associated with early disease development, such as the locus coeruleus, were substantially different in bacterial DNA content compared to areas affected later in disease etiology.
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Affiliation(s)
| | | | | | | | - Mae Hazell
- Translational Health Sciences, Learning and Research, Bristol Medical School, Southmead Hospital, Bristol, United Kingdom
| | - Alex Paterson
- School of Biological Sciences, University of Bristol Genomics Facility, Bristol, United Kingdom
| | - Shelley J. Allen-Birt
- Translational Health Sciences, Learning and Research, Bristol Medical School, Southmead Hospital, Bristol, United Kingdom
| | - Nicola X. West
- Bristol Dental School, Bristol, United Kingdom,*Correspondence: Nicola X. West,
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8
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Egiazarian MA, Strømstad S, Sakshaug T, Nunez-Nescolarde AB, Bethge N, Bjørås M, Scheffler K. Age- and sex-dependent effects of DNA glycosylase Neil3 on amyloid pathology, adult neurogenesis, and memory in a mouse model of Alzheimer's disease. Free Radic Biol Med 2022; 193:685-693. [PMID: 36395955 DOI: 10.1016/j.freeradbiomed.2022.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 10/21/2022] [Accepted: 11/12/2022] [Indexed: 11/16/2022]
Abstract
Oxidative stress generating DNA damage has been shown to be a key characteristic in Alzheimer's disease (AD). However, how it affects the pathogenesis of AD is not yet fully understood. Neil3 is a DNA glycosylase initiating repair of oxidative DNA base lesions and with a distinct expression pattern in proliferating cells. In brain, its function has been linked to hippocampal-dependent memory and to induction of neurogenesis after stroke and in prion disease. Here, we generated a novel AD mouse model deficient for Neil3 to study the impact of impaired oxidative base lesion repair on the pathogenesis of AD. Our results demonstrate an age-dependent decrease in amyloid-β (Aβ) plaque deposition in female Neil3-deficient AD mice, whereas no significant difference was observed in male mice. Furthermore, male but not female Neil3-deficient AD mice show reduced neural stem cell proliferation in the adult hippocampus and impaired working memory compared to controls. These effects seem to be independent of DNA repair as both sexes show increased level of oxidative base lesions in the hippocampus upon loss of Neil3. Thus, our findings suggest an age- and sex-dependent role of Neil3 in the progression of AD by altering cerebral Aβ accumulation and promoting adult hippocampal neurogenesis to maintain cognitive function.
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Affiliation(s)
- Milena A Egiazarian
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Silje Strømstad
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Teri Sakshaug
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Ana B Nunez-Nescolarde
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Nicole Bethge
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Magnar Bjørås
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Microbiology, Oslo University Hospital HF, Rikshospitalet and University of Oslo, Oslo, Norway
| | - Katja Scheffler
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Neurology and Clinical Neurophysiology, University Hospital Trondheim, Trondheim, Norway.
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9
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Connor JP, Quinn SD, Schaefer C. Sticker-and-spacer model for amyloid beta condensation and fibrillation. Front Mol Neurosci 2022; 15:962526. [PMID: 36311031 PMCID: PMC9611774 DOI: 10.3389/fnmol.2022.962526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 09/14/2022] [Indexed: 11/17/2022] Open
Abstract
A major pathogenic hallmark of Alzheimer's disease is the presence of neurotoxic plaques composed of amyloid beta (Aβ) peptides in patients' brains. The pathway of plaque formation remains elusive, though some clues appear to lie in the dominant presence of Aβ1 − 42 in these plaques despite Aβ1−40 making up approximately 90% of the Aβ pool. We hypothesize that this asymmetry is driven by the hydrophobicity of the two extra amino acids that are incorporated in Aβ1−42. To investigate this hypothesis at the level of single molecules, we have developed a molecular “sticker-and-spacer lattice model” of unfolded Aβ. The model protein has a single sticker that may reversibly dimerise and elongate into semi-flexible linear chains. The growth is hampered by excluded-volume interactions that are encoded by the hydrophilic spacers but are rendered cooperative by the attractive interactions of hydrophobic spacers. For sufficiently strong hydrophobicity, the chains undergo liquid-liquid phase-separation (LLPS) into condensates that facilitate the nucleation of fibers. We find that a small fraction of Aβ1−40 in a mixture of Aβ1−40 and Aβ1−42 shifts the critical concentration for LLPS to lower values. This study provides theoretical support for the hypothesis that LLPS condensates act as a precursor for aggregation and provides an explanation for the Aβ1−42-enrichment of aggregates in terms of hydrophobic interactions.
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Affiliation(s)
- Jack P. Connor
- Department of Biology, University of York, York, United Kingdom
- School of Physics, Engineering and Technology, University of York, York, United Kingdom
- Astbury Centre for Structural Molecular Biology, School of Molecular and Cellular Biology, University of Leeds, Leeds, United Kingdom
- *Correspondence: Jack P. Connor
| | - Steven D. Quinn
- School of Physics, Engineering and Technology, University of York, York, United Kingdom
- York Biomedical Research Institute, University of York, York, United Kingdom
| | - Charley Schaefer
- School of Physics, Engineering and Technology, University of York, York, United Kingdom
- Charley Schaefer
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10
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Xiao Z, Wu W, Ma X, Liang X, Lu J, Zheng L, Ding S, Lei Q, Luo J, Chen K, Ding D, Zhao Q. Plasma Aβ42/Aβ40 and p-tau 181 Predict Long-Term Clinical Progression in a Cohort with Amnestic Mild Cognitive Impairment. Clin Chem 2022; 68:1552-1563. [PMID: 36208187 DOI: 10.1093/clinchem/hvac149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Previous studies reported the value of blood-based biomarkers in predicting Alzheimer disease (AD) progression among individuals with different disease stages. However, evidence regarding the value of these markers in those with amnestic mild cognitive impairment (aMCI) is insufficient. METHODS A cohort with 251 aMCI individuals were followed for up to 8 years. Baseline blood biomarkers were measured on a single-molecule array platform. Multipoint clinical diagnosis and domain-specific cognitive functions were assessed to investigate the longitudinal relationship between blood biomarkers and clinical AD progression. RESULTS Individuals with low Aβ42/Aβ40 and high p-tau181 at baseline demonstrated the highest AD risk (hazard ratio = 4.83, 95% CI 2.37-9.86), and the most dramatic decline across cognitive domains. Aβ42/Aβ40 and p-tau181, combined with basic characteristics performed the best in predicting AD conversion (AUC = 0.825, 95% CI 0.771-0.878). CONCLUSIONS Combining Aβ42/Aβ40 and p-tau181 may be a feasible indicator for AD progression in clinical practice, and a potential composite marker in clinical trials.
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Affiliation(s)
- Zhenxu Xiao
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Wanqing Wu
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaoxi Ma
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaoniu Liang
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Jiaying Lu
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Li Zheng
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Saineng Ding
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Qiqi Lei
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Jianfeng Luo
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Keliang Chen
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Ding Ding
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Qianhua Zhao
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China.,MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
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11
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Blood-Based Biomarkers for Alzheimer's Disease Diagnosis and Progression: An Overview. Cells 2022; 11:cells11081367. [PMID: 35456047 PMCID: PMC9044750 DOI: 10.3390/cells11081367] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/12/2022] [Accepted: 04/15/2022] [Indexed: 01/10/2023] Open
Abstract
Alzheimer’s Disease (AD) is a progressive neurodegenerative disease characterized by amyloid-β (Aβ) plaque deposition and neurofibrillary tangle accumulation in the brain. Although several studies have been conducted to unravel the complex and interconnected pathophysiology of AD, clinical trial failure rates have been high, and no disease-modifying therapies are presently available. Fluid biomarker discovery for AD is a rapidly expanding field of research aimed at anticipating disease diagnosis and following disease progression over time. Currently, Aβ1–42, phosphorylated tau, and total tau levels in the cerebrospinal fluid are the best-studied fluid biomarkers for AD, but the need for novel, cheap, less-invasive, easily detectable, and more-accessible markers has recently led to the search for new blood-based molecules. However, despite considerable research activity, a comprehensive and up-to-date overview of the main blood-based biomarker candidates is still lacking. In this narrative review, we discuss the role of proteins, lipids, metabolites, oxidative-stress-related molecules, and cytokines as possible disease biomarkers. Furthermore, we highlight the potential of the emerging miRNAs and long non-coding RNAs (lncRNAs) as diagnostic tools, and we briefly present the role of vitamins and gut-microbiome-related molecules as novel candidates for AD detection and monitoring, thus offering new insights into the diagnosis and progression of this devastating disease.
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12
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Li TR, Yang Q, Hu X, Han Y. Biomarkers and Tools for Predicting Alzheimer's Disease in the Preclinical Stage. Curr Neuropharmacol 2022; 20:713-737. [PMID: 34030620 PMCID: PMC9878962 DOI: 10.2174/1570159x19666210524153901] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 04/27/2021] [Accepted: 05/08/2021] [Indexed: 11/22/2022] Open
Abstract
Alzheimer's disease (AD) is the only leading cause of death for which no disease-modifying therapy is currently available. Over the past decade, a string of disappointing clinical trial results has forced us to shift our focus to the preclinical stage of AD, which represents the most promising therapeutic window. However, the accurate diagnosis of preclinical AD requires the presence of brain β- amyloid deposition determined by cerebrospinal fluid or amyloid-positron emission tomography, significantly limiting routine screening and diagnosis in non-tertiary hospital settings. Thus, an easily accessible marker or tool with high sensitivity and specificity is highly needed. Recently, it has been discovered that individuals in the late stage of preclinical AD may not be truly "asymptomatic" in that they may have already developed subtle or subjective cognitive decline. In addition, advances in bloodderived biomarker studies have also allowed the detection of pathologic changes in preclinical AD. Exosomes, as cell-to-cell communication messengers, can reflect the functional changes of their source cell. Methodological advances have made it possible to extract brain-derived exosomes from peripheral blood, making exosomes an emerging biomarker carrier and liquid biopsy tool for preclinical AD. The eye and its associated structures have rich sensory-motor innervation. In this regard, studies have indicated that they may also provide reliable markers. Here, our report covers the current state of knowledge of neuropsychological and eye tests as screening tools for preclinical AD and assesses the value of blood and brain-derived exosomes as carriers of biomarkers in conjunction with the current diagnostic paradigm.
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Affiliation(s)
- Tao-Ran Li
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
| | - Qin Yang
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
| | - Xiaochen Hu
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, 50924, Germany
| | - Ying Han
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China;,Center of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing, 100053, China;,National Clinical Research Center for Geriatric Disorders, Beijing, 100053, China;,School of Biomedical Engineering, Hainan University, Haikou, 570228, China;,Address correspondence to this author at the Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China; Tel: +86 13621011941; E-mail:
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13
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Sheng C, Yang K, He B, Du W, Cai Y, Han Y. Combination of gut microbiota and plasma amyloid-β as a potential index for identifying preclinical Alzheimer's disease: a cross-sectional analysis from the SILCODE study. Alzheimers Res Ther 2022; 14:35. [PMID: 35164860 PMCID: PMC8843023 DOI: 10.1186/s13195-022-00977-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/06/2022] [Indexed: 12/15/2022]
Abstract
Background Plasma amyloid-β (Aβ) may facilitate identification of individuals with brain amyloidosis. Gut microbial dysbiosis in Alzheimer’s disease (AD) is increasingly being recognized. However, knowledge about alterations of gut microbiota in preclinical AD, as well as whether the combination of plasma Aβ and gut microbiota could identify preclinical AD, remains largely unknown. Methods This study recruited 34 Aβ-negative cognitively normal (CN−) participants, 32 Aβ-positive cognitively normal (CN+) participants, and 22 patients with cognitive impairment (CI), including 11 patients with mild cognitive impairment (MCI) and 11 AD dementia patients. All participants underwent neuropsychological assessments and fecal microbiota analysis through 16S ribosomal RNA (rRNA) Illumina Miseq sequencing technique. Meso Scale Discovery (MSD) kits were used to quantify the plasma Aβ40, Aβ42, and Aβ42/Aβ40 in CN− and CN+ participants. Using Spearman’s correlation analysis, the associations of global standard uptake value rate (SUVR) with altered gut microbiota and plasma Aβ markers were separately evaluated. Furthermore, the discriminative power of the combination of gut microbiota and plasma Aβ markers for identifying CN+ individuals was investigated. Results Compared with the CN− group, the CN+ group showed significantly reduced plasma Aβ42 (p = 0.011) and Aβ42/Aβ40 (p = 0.003). The relative abundance of phylum Bacteroidetes was significantly enriched, whereas phylum Firmicutes and class Deltaproteobacteria were significantly decreased in CN+ individuals in comparison with that in CN− individuals. Particularly, the relative abundance of phylum Firmicutes and its corresponding SCFA-producing bacteria exhibited a progressive decline tendency from CN− to CN+ and CI. Besides, the global brain Aβ burden was negatively associated with the plasma Aβ42/Aβ40 (r = −0.298, p = 0.015), family Desulfovibrionaceae (r = −0.331, p = 0.007), genus Bilophila (r = −0.247, p = 0.046), and genus Faecalibacterium (r = −0.291, p = 0.018) for all CN participants. Finally, the combination of plasma Aβ markers, altered gut microbiota, and cognitive performance reached a relatively good discriminative power in identifying individuals with CN+ from CN− (AUC = 0.869, 95% CI 0.782 ~ 0.955). Conclusions This study provided the evidence that the gut microbial composition was altered in preclinical AD. The combination of plasma Aβ and gut microbiota may serve as a non-invasive, cost-effective diagnostic tool for early AD screening. Targeting the gut microbiota may be a novel therapeutic strategy for AD. Trial registration This study has been registered in ClinicalTrials.gov (NCT03370744, https://www.clinicaltrials.gov) in November 15, 2017. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-00977-x.
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Affiliation(s)
- Can Sheng
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
| | - Kun Yang
- Evidence-Based Medicine Center, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China.,Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Beiqi He
- Key Laboratory of Biomedical Engineering of Hainan Province, School of Biomedical Engineering, Hainan University, Haikou, 570228, China
| | - Wenying Du
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
| | - Yanning Cai
- Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China.,Key Laboratory for Neurodegenerative Diseases of the Ministry of Education, Beijing, 100053, China.,Department of Biobank, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
| | - Ying Han
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China. .,Key Laboratory of Biomedical Engineering of Hainan Province, School of Biomedical Engineering, Hainan University, Haikou, 570228, China. .,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, 100053, China. .,National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China.
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14
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Tatulian SA. Challenges and hopes for Alzheimer's disease. Drug Discov Today 2022; 27:1027-1043. [PMID: 35121174 DOI: 10.1016/j.drudis.2022.01.016] [Citation(s) in RCA: 83] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 09/01/2021] [Accepted: 01/27/2022] [Indexed: 12/11/2022]
Abstract
Recent drug development efforts targeting Alzheimer's disease (AD) have failed to produce effective disease-modifying agents for many reasons, including the substantial presymptomatic neuronal damage that is caused by the accumulation of the amyloid β (Aβ) peptide and tau protein abnormalities, deleterious adverse effects of drug candidates, and inadequate design of clinical trials. New molecular targets, biomarkers, and diagnostic techniques, as well as alternative nonpharmacological approaches, are sorely needed to detect and treat early pathological events. This article analyzes the successes and debacles of pharmaceutical endeavors to date, and highlights new technologies that may lead to the more effective diagnosis and treatment of the pathologies that underlie AD. The use of focused ultrasound, deep brain stimulation, stem cell therapy, and gene therapy, in parallel with pharmaceuticals and judicious lifestyle adjustments, holds promise for the deceleration, prevention, or cure of AD and other neurodegenerative disorders.
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Affiliation(s)
- Suren A Tatulian
- Department of Physics, College of Sciences, and Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32816, USA.
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15
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Teunissen CE, Verberk IMW, Thijssen EH, Vermunt L, Hansson O, Zetterberg H, van der Flier WM, Mielke MM, Del Campo M. Blood-based biomarkers for Alzheimer's disease: towards clinical implementation. Lancet Neurol 2021; 21:66-77. [PMID: 34838239 DOI: 10.1016/s1474-4422(21)00361-6] [Citation(s) in RCA: 333] [Impact Index Per Article: 111.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 12/13/2022]
Abstract
For many years, blood-based biomarkers for Alzheimer's disease seemed unattainable, but recent results have shown that they could become a reality. Convincing data generated with new high-sensitivity assays have emerged with remarkable consistency across different cohorts, but also independent of the precise analytical method used. Concentrations in blood of amyloid and phosphorylated tau proteins associate with the corresponding concentrations in CSF and with amyloid-PET or tau-PET scans. Moreover, other blood-based biomarkers of neurodegeneration, such as neurofilament light chain and glial fibrillary acidic protein, appear to provide information on disease progression and potential for monitoring treatment effects. Now the question emerges of when and how we can bring these biomarkers to clinical practice. This step would pave the way for blood-based biomarkers to support the diagnosis of, and development of treatments for, Alzheimer's disease and other dementias.
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Affiliation(s)
- Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands.
| | - Inge M W Verberk
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Elisabeth H Thijssen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Lisa Vermunt
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Sölvegatan, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL, London, UK; Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK; Hong Kong Center for Neurodegenerative Diseases, Hong Kong Special Administrative Region, China
| | - Wiesje M van der Flier
- Alzheimer Center, Department of Neurology, and Department of Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Michelle M Mielke
- Department of Quantitative Health Sciences, and Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Marta Del Campo
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands; Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain
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16
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Verberk IMW, Misdorp EO, Koelewijn J, Ball AJ, Blennow K, Dage JL, Fandos N, Hansson O, Hirtz C, Janelidze S, Kang S, Kirmess K, Kindermans J, Lee R, Meyer MR, Shan D, Shaw LM, Waligorska T, West T, Zetterberg H, Edelmayer RM, Teunissen CE. Characterization of pre-analytical sample handling effects on a panel of Alzheimer's disease-related blood-based biomarkers: Results from the Standardization of Alzheimer's Blood Biomarkers (SABB) working group. Alzheimers Dement 2021; 18:1484-1497. [PMID: 34845818 PMCID: PMC9148379 DOI: 10.1002/alz.12510] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 09/10/2021] [Accepted: 09/15/2021] [Indexed: 12/11/2022]
Abstract
Introduction Pre‐analytical sample handling might affect the results of Alzheimer's disease blood‐based biomarkers. We empirically tested variations of common blood collection and handling procedures. Methods We created sample sets that address the effect of blood collection tube type, and of ethylene diamine tetraacetic acid plasma delayed centrifugation, centrifugation temperature, aliquot volume, delayed storage, and freeze–thawing. We measured amyloid beta (Aβ)42 and 40 peptides with six assays, and Aβ oligomerization‐tendency (OAβ), amyloid precursor protein (APP)699‐711, glial fibrillary acidic protein (GFAP), neurofilament light (NfL), total tau (t‐tau), and phosphorylated tau181. Results Collection tube type resulted in different values of all assessed markers. Delayed plasma centrifugation and storage affected Aβ and t‐tau; t‐tau was additionally affected by centrifugation temperature. The other markers were resistant to handling variations. Discussion We constructed a standardized operating procedure for plasma handling, to facilitate introduction of blood‐based biomarkers into the research and clinical settings.
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Affiliation(s)
- Inge M W Verberk
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Els O Misdorp
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Jannet Koelewijn
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Andrew J Ball
- Quanterix Corporation, Billerica, Massachusetts, USA
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, The Salhgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | | | | | - Oskar Hansson
- Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Christophe Hirtz
- IRMB-LBPC/PPC, INM, Univ Montpellier, CHU Montpellier, INSERM CNRS, Montpellier, France
| | | | | | | | - Jana Kindermans
- IRMB-LBPC/PPC, INM, Univ Montpellier, CHU Montpellier, INSERM CNRS, Montpellier, France
| | - Ryan Lee
- PeopleBio, Seongnam, South Korea
| | | | - Dandan Shan
- Quanterix Corporation, Billerica, Massachusetts, USA
| | - Leslie M Shaw
- Department of Pathology & Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Teresa Waligorska
- Department of Pathology & Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Tim West
- C2N Diagnostics, St. Louis, Missouri, USA
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, The Salhgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,UK Dementia Research Institute at UCL, London, UK.,Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | | | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
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17
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Matuszyk MM, Garwood CJ, Ferraiuolo L, Simpson JE, Staniforth RA, Wharton SB. Biological and methodological complexities of beta-amyloid peptide: Implications for Alzheimer's disease research. J Neurochem 2021; 160:434-453. [PMID: 34767256 DOI: 10.1111/jnc.15538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/29/2021] [Accepted: 11/09/2021] [Indexed: 01/01/2023]
Abstract
Although controversial, the amyloid cascade hypothesis remains central to the Alzheimer's disease (AD) field and posits amyloid-beta (Aβ) as the central factor initiating disease onset. In recent years, there has been an increase in emphasis on studying the role of low molecular weight aggregates, such as oligomers, which are suggested to be more neurotoxic than fibrillary Aβ. Other Aβ isoforms, such as truncated Aβ, have also been implicated in disease. However, developing a clear understanding of AD pathogenesis has been hampered by the complexity of Aβ biochemistry in vitro and in vivo. This review explores factors contributing to the lack of consistency in experimental approaches taken to model Aβ aggregation and toxicity and provides an overview of the different techniques available to analyse Aβ, such as electron and atomic force microscopy, nuclear magnetic resonance spectroscopy, dye-based assays, size exclusion chromatography, mass spectrometry and SDS-PAGE. The review also explores how different types of Aβ can influence Aβ aggregation and toxicity, leading to variation in experimental outcomes, further highlighting the need for standardisation in Aβ preparations and methods used in current research.
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Affiliation(s)
- Martyna M Matuszyk
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
| | - Claire J Garwood
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
| | - Laura Ferraiuolo
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
| | - Julie E Simpson
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
| | | | - Stephen B Wharton
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
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18
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Souto JJ, Silva GM, Almeida NL, Shoshina II, Santos NA, Fernandes TP. Age-related episodic memory decline and the role of amyloid-β: a systematic review. Dement Neuropsychol 2021; 15:299-313. [PMID: 34630918 PMCID: PMC8485646 DOI: 10.1590/1980-57642021dn15-030002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 02/22/2021] [Indexed: 12/25/2022] Open
Abstract
Aging has been associated with the functional decline of episodic memory (EM). Unanswered questions are whether the decline of EM occurs even during healthy aging and whether this decline is related to amyloid-β (Aβ) deposition in the hippocampus. Objective The main purpose of this study was to investigate data on the relationship between the age-related EM decline and Aβ deposition. Methods We searched the Cochrane, MEDLINE, Scopus, and Web of Science databases and reference lists of retrieved articles that were published in the past 10 years. The initial literature search identified 517 studies. After screening the title, abstract, key words, and reference lists, 56 studies met the inclusion criteria. Results The overall results revealed that increases in Aβ are related to lower hippocampal volume and worse performance on EM tests. The results of this systematic review revealed that high levels of Aβ may be related to EM deficits and the progression to Alzheimer's disease. Conclusions We discussed the strengths and pitfalls of various tests and techniques used for investigating EM and Aβ deposition, methodological issues, and potential directions for future research.
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Affiliation(s)
- Jandirlly Julianna Souto
- Department of Psychology, Universidade Federal da Paraíba - João Pessoa, PB, Brazil.,Perception, Neuroscience and Behaviour Laboratory, Universidade Federal da Paraíba - João Pessoa, Brazil
| | - Gabriella Medeiros Silva
- Department of Psychology, Universidade Federal da Paraíba - João Pessoa, PB, Brazil.,Perception, Neuroscience and Behaviour Laboratory, Universidade Federal da Paraíba - João Pessoa, Brazil
| | - Natalia Leandro Almeida
- Department of Psychology, Universidade Federal da Paraíba - João Pessoa, PB, Brazil.,Perception, Neuroscience and Behaviour Laboratory, Universidade Federal da Paraíba - João Pessoa, Brazil
| | | | - Natanael Antonio Santos
- Department of Psychology, Universidade Federal da Paraíba - João Pessoa, PB, Brazil.,Perception, Neuroscience and Behaviour Laboratory, Universidade Federal da Paraíba - João Pessoa, Brazil
| | - Thiago Paiva Fernandes
- Department of Psychology, Universidade Federal da Paraíba - João Pessoa, PB, Brazil.,Perception, Neuroscience and Behaviour Laboratory, Universidade Federal da Paraíba - João Pessoa, Brazil
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19
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Korecka M, Shaw LM. Mass spectrometry-based methods for robust measurement of Alzheimer's disease biomarkers in biological fluids. J Neurochem 2021; 159:211-233. [PMID: 34244999 PMCID: PMC9057379 DOI: 10.1111/jnc.15465] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/11/2021] [Accepted: 07/06/2021] [Indexed: 11/29/2022]
Abstract
Alzheimer's disease (AD) is the most common form of dementia affecting 60%-70% of people afflicted with this disease. Accurate antemortem diagnosis is urgently needed for early detection of AD to enable reliable estimation of prognosis, intervention, and monitoring of the disease. The National Institute on Aging/Alzheimer's Association sponsored the 'Research Framework: towards a biological definition of AD', which recommends using different biomarkers in living persons for a biomarker-based definition of AD regardless of clinical status. Fluid biomarkers represent one of key groups of them. Since cerebrospinal fluid (CSF) is in direct contact with brain and many proteins present in the brain can be detected in CSF, this fluid has been regarded as the best biofluid in which to measure AD biomarkers. Recently, technological advancements in protein detection made possible the effective study of plasma AD biomarkers despite their significantly lower concentrations versus to that in CSF. This and other challenges that face plasma-based biomarker measurements can be overcome by using mass spectrometry. In this review, we discuss AD biomarkers which can be reliably measured in CSF and plasma using targeted mass spectrometry coupled to liquid chromatography (LC/MS/MS). We describe progress in LC/MS/MS methods' development, emphasize the challenges, and summarize major findings. We also highlight the role of mass spectrometry and progress made in the process of global standardization of the measurement of Aβ42/Aβ40. Finally, we briefly describe exploratory proteomics which seek to identify new biomarkers that can contribute to detection of co-pathological processes that are common in sporadic AD.
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Affiliation(s)
- Magdalena Korecka
- Department of Pathology and Laboratory Medicine Perlman School of Medicine University of Pennsylvania Philadelphia PA USA
| | - Leslie M. Shaw
- Department of Pathology and Laboratory Medicine Perlman School of Medicine University of Pennsylvania Philadelphia PA USA
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20
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Cianflone A, Coppola L, Mirabelli P, Salvatore M. Predictive Accuracy of Blood-Derived Biomarkers for Amyloid-β Brain Deposition Along with the Alzheimer's Disease Continuum: A Systematic Review. J Alzheimers Dis 2021; 84:393-407. [PMID: 34542072 DOI: 10.3233/jad-210496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND An amyloid-β (Aβ) positron emission tomography (Aβ-PET) scan of the human brain could lead to an early diagnosis of Alzheimer's disease (AD) and estimate disease progression. However, Aβ-PET imaging is expensive, invasive, and rarely applicable to cognitively normal subjects at risk for dementia. The identification of blood biomarkers predictive of Aβ brain deposition could help the identification of subjects at risk for dementia and could be helpful for the prognosis of AD progression. OBJECTIVE This study aimed to analyze the prognostic accuracy of blood biomarkers in predicting Aβ-PET status along with progression toward AD. METHODS In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched bibliographic databases from 2010 to 2020. The quality of the included studies was assessed by the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. RESULTS A total of 8 studies were retrieved. The prognostic accuracy of Aβ-PET status was calculated by obtaining ROCs for the following biomarkers: free, total, and bound Aβ42 and Aβ40; Aβ42/40 ratio; neurofilaments (NFL); total tau (T-tau); and phosphorylated-tau181 (P-tau181). Higher and lower plasma baseline levels of P-tau181 and the Aβ42/40 ratio, respectively, showed consistently good prognostication of Aβ-PET brain accumulation. Only P-tau181 was shown to predict AD progression. CONCLUSION In conclusion, the Aβ42/40 ratio and plasma P-tau181 were shown to predict Aβ-PET status. Plasma P-tau181 could also be a preclinical biomarker for AD progression.
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21
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Xiao Z, Wu X, Wu W, Yi J, Liang X, Ding S, Zheng L, Luo J, Gu H, Zhao Q, Xu H, Ding D. Plasma biomarker profiles and the correlation with cognitive function across the clinical spectrum of Alzheimer's disease. Alzheimers Res Ther 2021; 13:123. [PMID: 34225797 PMCID: PMC8259165 DOI: 10.1186/s13195-021-00864-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 06/20/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Plasma biomarkers showed a promising value in the disease diagnosis and management of Alzheimer's disease (AD). However, profiles of the biomarkers and the associations with cognition across a spectrum of cognitive stages have seldom been reported. METHODS We recruited 320 individuals with cognitive impairment and 131 cognitively normal participants from a memory clinic and a community cohort. Participants were classified into 6 groups based on their Clinical Dementia Rating (CDR) scores and clinical diagnosis, including AD, amnestic mild cognitive impairment (aMCI), and normal cognition (NC). A battery of neuropsychological tests was used to assess the global and domain-specific cognition. Plasma Aβ1-40, Aβ1-42, Aβ1-42/Aβ1-40, total tau (t-tau), neurofilament protein light chain (NfL), and phosphorylated tau at threonine 181 (p-tau181) were quantified using the single-molecule array (Simoa) platform. RESULTS All the plasma markers (Aβ1-40, Aβ1-42, Aβ1-42/Aβ1-40, t-tau, NfL, p-tau181) showed certain discrepancies among NC, aMCI, and AD groups. The p-tau181 level showed a continuous escalating trend as the CDR scores increased from 0 (NC group) to 3 (severe AD). Compared with other biomarkers, p-tau181 had correlations with broader cognitive domains, covering global cognition (r = -0.536, P < 0.0001), memory (r = -0.481, P < 0.0001), attention (r = -0.437, P < 0.0001), visuospatial function (r = -0.385, P < 0.0001), and language (r = -0.177, P = 0.0003). Among participants with CDR ≥ 1, higher p-tau181 was correlated with worse global cognition (r = -0.301, P < 0.001). CONCLUSIONS Plasma p-tau181 had correlations with broader cognitive domains, suggesting its potential as a promising clinical-relevant blood-based biomarker.
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Affiliation(s)
- Zhenxu Xiao
- Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Rd, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xue Wu
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Wanqing Wu
- Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Rd, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jingwei Yi
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoniu Liang
- Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Rd, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Saineng Ding
- Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Rd, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Li Zheng
- Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Rd, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jianfeng Luo
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Hongchen Gu
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Qianhua Zhao
- Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Rd, Shanghai, China.
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.
| | - Hong Xu
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
| | - Ding Ding
- Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Rd, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
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22
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Lipid Peroxidation Assessment in Preclinical Alzheimer Disease Diagnosis. Antioxidants (Basel) 2021; 10:antiox10071043. [PMID: 34209667 PMCID: PMC8300760 DOI: 10.3390/antiox10071043] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Alzheimer disease (AD) is an increasingly common neurodegenerative disease, especially in countries with aging populations. Its diagnosis is complex and is usually carried out in advanced stages of the disease. In addition, lipids and oxidative stress have been related to AD since the earliest stages. A diagnosis in the initial or preclinical stages of the disease could help in a more effective action of the treatments. METHODS Isoprostanoid biomarkers were determined in plasma samples from preclinical AD participants (n = 12) and healthy controls (n = 31) by chromatography and mass spectrometry (UPLC-MS/MS). Participants were accurately classified according to cerebrospinal fluid (CSF) biomarkers and neuropsychological examination. RESULTS Isoprostanoid levels did not show differences between groups. However, some of them correlated with CSF biomarkers (t-tau, p-tau) and with cognitive decline. In addition, a panel including 10 biomarkers showed an area under curve (AUC) of 0.96 (0.903-1) and a validation AUC of 0.90 in preclinical AD prediction. CONCLUSIONS Plasma isoprostanoids could be useful biomarkers in preclinical diagnosis for AD. However, these results would require a further validation with an external cohort.
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23
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Fowler C, Rainey-Smith SR, Bird S, Bomke J, Bourgeat P, Brown BM, Burnham SC, Bush AI, Chadunow C, Collins S, Doecke J, Doré V, Ellis KA, Evered L, Fazlollahi A, Fripp J, Gardener SL, Gibson S, Grenfell R, Harrison E, Head R, Jin L, Kamer A, Lamb F, Lautenschlager NT, Laws SM, Li QX, Lim L, Lim YY, Louey A, Macaulay SL, Mackintosh L, Martins RN, Maruff P, Masters CL, McBride S, Milicic L, Peretti M, Pertile K, Porter T, Radler M, Rembach A, Robertson J, Rodrigues M, Rowe CC, Rumble R, Salvado O, Savage G, Silbert B, Soh M, Sohrabi HR, Taddei K, Taddei T, Thai C, Trounson B, Tyrrell R, Vacher M, Varghese S, Villemagne VL, Weinborn M, Woodward M, Xia Y, Ames D. Fifteen Years of the Australian Imaging, Biomarkers and Lifestyle (AIBL) Study: Progress and Observations from 2,359 Older Adults Spanning the Spectrum from Cognitive Normality to Alzheimer's Disease. J Alzheimers Dis Rep 2021; 5:443-468. [PMID: 34368630 PMCID: PMC8293663 DOI: 10.3233/adr-210005] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background: The Australian Imaging, Biomarkers and Lifestyle (AIBL) Study commenced in 2006 as a prospective study of 1,112 individuals (768 cognitively normal (CN), 133 with mild cognitive impairment (MCI), and 211 with Alzheimer’s disease dementia (AD)) as an ‘Inception cohort’ who underwent detailed ssessments every 18 months. Over the past decade, an additional 1247 subjects have been added as an ‘Enrichment cohort’ (as of 10 April 2019). Objective: Here we provide an overview of these Inception and Enrichment cohorts of more than 8,500 person-years of investigation. Methods: Participants underwent reassessment every 18 months including comprehensive cognitive testing, neuroimaging (magnetic resonance imaging, MRI; positron emission tomography, PET), biofluid biomarkers and lifestyle evaluations. Results: AIBL has made major contributions to the understanding of the natural history of AD, with cognitive and biological definitions of its three major stages: preclinical, prodromal and clinical. Early deployment of Aβ-amyloid and tau molecular PET imaging and the development of more sensitive and specific blood tests have facilitated the assessment of genetic and environmental factors which affect age at onset and rates of progression. Conclusion: This fifteen-year study provides a large database of highly characterized individuals with longitudinal cognitive, imaging and lifestyle data and biofluid collections, to aid in the development of interventions to delay onset, prevent or treat AD. Harmonization with similar large longitudinal cohort studies is underway to further these aims.
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Affiliation(s)
- Christopher Fowler
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Stephanie R Rainey-Smith
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia.,Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA, Australia.,School of Psychological Science, University of Western Australia, Crawley, WA, Australia
| | - Sabine Bird
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia
| | - Julia Bomke
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Pierrick Bourgeat
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Belinda M Brown
- Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia.,Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA, Australia
| | - Samantha C Burnham
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Ashley I Bush
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Carolyn Chadunow
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Steven Collins
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - James Doecke
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia.,Cooperative Research Council for Mental Health, Melbourne, VIC, Australia
| | - Vincent Doré
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia.,Department of Molecular Imaging and Therapy, Austin Health, Heidelberg, VIC, Australia
| | - Kathryn A Ellis
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia.,University of Melbourne Academic Unit for Psychiatry of Old Age, Parkville, VIC, Australia.,Melbourne School of Psychological Sciences, Melbourne, VIC, Australia
| | - Lis Evered
- Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital Melbourne, Victoria Parade, Fitzroy, VIC, Australia
| | - Amir Fazlollahi
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Jurgen Fripp
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Samantha L Gardener
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia
| | - Simon Gibson
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Robert Grenfell
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Elise Harrison
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Richard Head
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Liang Jin
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Adrian Kamer
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Fiona Lamb
- Department of Molecular Imaging and Therapy, Austin Health, Heidelberg, VIC, Australia
| | | | - Simon M Laws
- Collaborative Genomics and Translation Group, Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Bentley, WA, Australia
| | - Qiao-Xin Li
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Lucy Lim
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia
| | - Yen Ying Lim
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia.,Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Andrea Louey
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - S Lance Macaulay
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Lucy Mackintosh
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Ralph N Martins
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia.,Department of Biomedical Sciences, Macquarie University, North Ryde, NSW, Australia
| | | | - Colin L Masters
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Simon McBride
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Lidija Milicic
- Collaborative Genomics and Translation Group, Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Madeline Peretti
- Collaborative Genomics and Translation Group, Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Kelly Pertile
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Tenielle Porter
- Collaborative Genomics and Translation Group, Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Bentley, WA, Australia
| | - Morgan Radler
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Alan Rembach
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Joanne Robertson
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Mark Rodrigues
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia
| | - Christopher C Rowe
- Department of Molecular Imaging and Therapy, Austin Health, Heidelberg, VIC, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia
| | - Rebecca Rumble
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | | | - Greg Savage
- Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Brendan Silbert
- Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital Melbourne, Victoria Parade, Fitzroy, VIC, Australia
| | - Magdalene Soh
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia
| | - Hamid R Sohrabi
- Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia.,Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA, Australia.,Department of Biomedical Sciences, Macquarie University, North Ryde, NSW, Australia
| | - Kevin Taddei
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia
| | - Tania Taddei
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia
| | - Christine Thai
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Brett Trounson
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Regan Tyrrell
- Department of Molecular Imaging and Therapy, Austin Health, Heidelberg, VIC, Australia
| | - Michael Vacher
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - Shiji Varghese
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Victor L Villemagne
- Department of Molecular Imaging and Therapy, Austin Health, Heidelberg, VIC, Australia.,Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael Weinborn
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation (Ralph and Patricia Sarich Neuroscience Research Institute), Nedlands, WA, Australia.,School of Psychological Science, University of Western Australia, Crawley, WA, Australia
| | - Michael Woodward
- Department of Geriatric Medicine Austin Hospital, Heidelberg, VIC, Australia
| | - Ying Xia
- Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia
| | - David Ames
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia.,University of Melbourne Academic Unit for Psychiatry of Old Age, Parkville, VIC, Australia.,National Ageing Research Institute (NARI), Parkville, VIC, Australia
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Lim YY, Pase MP, Buckley RF, Yassi N, Bransby L, Fowler C, Laws SM, Masters CL, Maruff P. Visual Memory Deficits in Middle-Aged APOE ɛ4 Homozygotes Detected Using Unsupervised Cognitive Assessments. J Alzheimers Dis 2021; 79:1563-1573. [DOI: 10.3233/jad-201281] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: The apolipoprotein E (APOE) ɛ4 allele is associated with dose-response effects on cognitive dysfunction and dementia risk in older adults. However, its effects on cognition in middle-aged adults remains unclear. Objective: We examined effects of ɛ4 heterozygosity and homozygosity on objective and subjective cognition in middle-aged adults enrolled in the Healthy Brain Project (HBP) and in older adults from the Australian Imaging, Biomarkers and Lifestyle (AIBL) study. Methods: HBP participants (1,000 non-carriers; 450 ɛ4 heterozygotes; 50 ɛ4 homozygotes) completed unsupervised assessments of the Cogstate Brief Battery (CBB), ratings of subjective cognitive function and provided a saliva sample. AIBL cognitively normal participants (650 non-carriers; 204 ɛ4 heterozygotes; 31 ɛ4 homozygotes) completed in-person assessments of the CBB, ratings of subjective cognitive function and provided a blood sample. Results: Greater memory impairment was observed in middle-aged ɛ4 homozygotes compared with ɛ4 heterozygotes and non-carriers. When data from middle-aged (HBP) and older (AIBL) adults were pooled, the effect of ɛ4 homozygosity and memory impairment increased with age. In both middle-aged and older adults, ɛ4 heterozygotes did not differ from non-carriers on any measure of objective or subjective cognition. Conclusion: Memory impairment in ɛ4 homozygotes is evident in adults aged 50-60 years, and this can be detected through unsupervised cognitive assessments. The effect of ɛ4 homozygosity increases with older age. APOE ɛ4 homozygosity has a negative impact on memory as early as midlife, but due to the subtle magnitude of effect, our findings support the necessity of online platforms in large cohorts to assess these complex relationships.
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Affiliation(s)
- Yen Ying Lim
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Matthew P. Pase
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Rachel F. Buckley
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Nawaf Yassi
- Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Lisa Bransby
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Christopher Fowler
- Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
| | - Simon M. Laws
- Collaborative Genomics and Translation Group, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Bentley, Western Australia, Australia
| | - Colin L. Masters
- Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
| | - Paul Maruff
- Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
- Cogstate Ltd., Melbourne, Victoria, Australia
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