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Rehman H, Ang TFA, Tao Q, Espenilla AL, Au R, Farrer LA, Zhang X, Qiu WQ. Comparison of Commonly Measured Plasma and Cerebrospinal Fluid Proteins and Their Significance for the Characterization of Cognitive Impairment Status. J Alzheimers Dis 2024; 97:621-633. [PMID: 38143358 DOI: 10.3233/jad-230837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
BACKGROUND Although cerebrospinal fluid (CSF) amyloid-β42 peptide (Aβ42) and phosphorylated tau (p-tau) and blood p-tau are valuable for differential diagnosis of Alzheimer's disease (AD) from cognitively normal (CN) there is a lack of validated biomarkers for mild cognitive impairment (MCI). OBJECTIVE This study sought to determine how plasma and CSF protein markers compared in the characterization of MCI and AD status. METHODS This cohort study included Alzheimer's Disease Neuroimaging Initiative (ADNI) participants who had baseline levels of 75 proteins measured commonly in plasma and CSF (257 total, 46 CN, 143 MCI, and 68 AD). Logistic regression, least absolute shrinkage and selection operator (LASSO) and Random Forest (RF) methods were used to identify the protein candidates for the disease classification. RESULTS We observed that six plasma proteins panel (APOE, AMBP, C3, IL16, IGFBP2, APOD) outperformed the seven CSF proteins panel (VEGFA, HGF, PRL, FABP3, FGF4, CD40, RETN) as well as AD markers (CSF p-tau and Aβ42) to distinguish the MCI from AD [area under the curve (AUC) = 0.75 (plasma proteins), AUC = 0.60 (CSF proteins) and AUC = 0.56 (CSF p-tau and Aβ42)]. Also, these six plasma proteins performed better than the CSF proteins and were in line with CSF p-tau and Aβ42 in differentiating CN versus MCI subjects [AUC = 0.89 (plasma proteins), AUC = 0.85 (CSF proteins) and AUC = 0.89 (CSF p-tau and Aβ42)]. These results were adjusted for age, sex, education, and APOEϵ4 genotype. CONCLUSIONS This study suggests that the combination of 6 plasma proteins can serve as an effective marker for differentiating MCI from AD and CN.
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Affiliation(s)
- Habbiburr Rehman
- Department of Medicine (Biomedical Genetics), Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Ting Fang Alvin Ang
- Department of Anatomy & Neurobiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Qiushan Tao
- Department of Pharmacology & Experimental Therapeutics, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Arielle Lauren Espenilla
- Department of Biostatistics and Boston University School of Public Health, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Rhoda Au
- Department of Medicine (Biomedical Genetics), Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Anatomy & Neurobiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Framingham Heart Study, Boston University School of Medicine, Framingham, MA, USA
- Alzheimer's Disease Research Center, Boston University School of Medicine, Boston, MA, USA
| | - Lindsay A Farrer
- Department of Medicine (Biomedical Genetics), Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Ophthalmology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Biostatistics and Boston University School of Public Health, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Framingham Heart Study, Boston University School of Medicine, Framingham, MA, USA
- Alzheimer's Disease Research Center, Boston University School of Medicine, Boston, MA, USA
| | - Xiaoling Zhang
- Department of Medicine (Biomedical Genetics), Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Biostatistics and Boston University School of Public Health, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Framingham Heart Study, Boston University School of Medicine, Framingham, MA, USA
- Alzheimer's Disease Research Center, Boston University School of Medicine, Boston, MA, USA
| | - Wei Qiao Qiu
- Department of Anatomy & Neurobiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Pharmacology & Experimental Therapeutics, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Alzheimer's Disease Research Center, Boston University School of Medicine, Boston, MA, USA
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2
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Montoliu-Gaya L, Alosco ML, Yhang E, Tripodis Y, Sconzo D, Ally M, Grötschel L, Ashton NJ, Lantero-Rodriguez J, Sauer M, Gomes B, Nilsson J, Brinkmalm G, Sugarman MA, Aparicio HJ, Martin B, Palmisano JN, Steinberg EG, Simkin I, Turk KW, Budson AE, Au R, Farrer L, Jun GR, Kowall NW, Stern RA, Goldstein LE, Qiu WQ, Mez J, Huber BR, Alvarez VE, McKee AC, Zetterberg H, Gobom J, Stein TD, Blennow K. Optimal blood tau species for the detection of Alzheimer's disease neuropathology: an immunoprecipitation mass spectrometry and autopsy study. Acta Neuropathol 2023; 147:5. [PMID: 38159140 PMCID: PMC10757700 DOI: 10.1007/s00401-023-02660-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 01/03/2024]
Abstract
Plasma-to-autopsy studies are essential for validation of blood biomarkers and understanding their relation to Alzheimer's disease (AD) pathology. Few such studies have been done on phosphorylated tau (p-tau) and those that exist have made limited or no comparison of the different p-tau variants. This study is the first to use immunoprecipitation mass spectrometry (IP-MS) to compare the accuracy of eight different plasma tau species in predicting autopsy-confirmed AD. The sample included 123 participants (AD = 69, non-AD = 54) from the Boston University Alzheimer's disease Research Center who had an available ante-mortem plasma sample and donated their brain. Plasma samples proximate to death were analyzed by targeted IP-MS for six different tryptic phosphorylated (p-tau-181, 199, 202, 205, 217, 231), and two non-phosphorylated tau (195-205, 212-221) peptides. NIA-Reagan Institute criteria were used for the neuropathological diagnosis of AD. Binary logistic regressions tested the association between each plasma peptide and autopsy-confirmed AD status. Area under the receiver operating curve (AUC) statistics were generated using predicted probabilities from the logistic regression models. Odds Ratio (OR) was used to study associations between the different plasma tau species and CERAD and Braak classifications. All tau species were increased in AD compared to non-AD, but p-tau217, p-tau205 and p-tau231 showed the highest fold-changes. Plasma p-tau217 (AUC = 89.8), p-tau231 (AUC = 83.4), and p-tau205 (AUC = 81.3) all had excellent accuracy in discriminating AD from non-AD brain donors, even among those with CDR < 1). Furthermore, p-tau217, p-tau205 and p-tau231 showed the highest ORs with both CERAD (ORp-tau217 = 15.29, ORp-tau205 = 5.05 and ORp-tau231 = 3.86) and Braak staging (ORp-tau217 = 14.29, ORp-tau205 = 5.27 and ORp-tau231 = 4.02) but presented increased levels at different amyloid and tau stages determined by neuropathological examination. Our findings support plasma p-tau217 as the most promising p-tau species for detecting AD brain pathology. Plasma p-tau231 and p-tau205 may additionally function as markers for different stages of the disease.
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Affiliation(s)
- Laia Montoliu-Gaya
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.
| | - Michael L Alosco
- Boston University Alzheimer's Disease Research Center and CTE Center, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Neurology, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
| | - Eukyung Yhang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, 02118, USA
| | - Yorghos Tripodis
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, 02118, USA
| | - Daniel Sconzo
- Boston University Alzheimer's Disease Research Center and CTE Center, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
| | | | - Lana Grötschel
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
- Department of Old Age Psychiatry, Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London & Maudsley NHS Foundation, London, UK
| | - Juan Lantero-Rodriguez
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Mathias Sauer
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Bárbara Gomes
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Johanna Nilsson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Gunnar Brinkmalm
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Michael A Sugarman
- Department of Neurology, Medical University of South Carolina, Charleston, SC, 29425, USA
| | - Hugo J Aparicio
- Boston University Alzheimer's Disease Research Center and CTE Center, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Neurology, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
| | - Brett Martin
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, 02118, USA
| | - Joseph N Palmisano
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, 02118, USA
| | - Eric G Steinberg
- Boston University Alzheimer's Disease Research Center and CTE Center, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Neurology, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
| | - Irene Simkin
- Department of Medicine, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
| | - Katherine W Turk
- Boston University Alzheimer's Disease Research Center and CTE Center, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Neurology, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- VA Boston Healthcare System, U.S. Department of Veteran Affairs, Jamaica Plain, MA, 02130, USA
| | - Andrew E Budson
- Boston University Alzheimer's Disease Research Center and CTE Center, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Neurology, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- VA Boston Healthcare System, U.S. Department of Veteran Affairs, Jamaica Plain, MA, 02130, USA
| | - Rhoda Au
- Boston University Alzheimer's Disease Research Center and CTE Center, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Neurology, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Medicine, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, 02118, USA
| | - Lindsay Farrer
- Boston University Alzheimer's Disease Research Center and CTE Center, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Neurology, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Medicine, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, 02118, USA
| | - Gyungah R Jun
- Boston University Alzheimer's Disease Research Center and CTE Center, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Medicine, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
| | - Neil W Kowall
- Boston University Alzheimer's Disease Research Center and CTE Center, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Neurology, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
| | - Robert A Stern
- Boston University Alzheimer's Disease Research Center and CTE Center, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Neurology, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, 02118, USA
- Department of Neurosurgery, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Lee E Goldstein
- Boston University Alzheimer's Disease Research Center and CTE Center, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Neurology, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Psychiatry and Ophthalmology, Boston University School of Medicine, Boston, MA, 02118, USA
- Department of Biomedical, Electrical and Computer Engineering, Boston University College of Engineering, Boston, MA, 02215, USA
| | - Wei Qiao Qiu
- Boston University Alzheimer's Disease Research Center and CTE Center, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Neurology, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Pharmacology and Experimental Therapeutics, Boston University, Chobanian an Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Psychiatry, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
| | - Jesse Mez
- Boston University Alzheimer's Disease Research Center and CTE Center, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Neurology, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
| | - Bertrand Russell Huber
- Boston University Alzheimer's Disease Research Center and CTE Center, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Neurology, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- VA Boston Healthcare System, U.S. Department of Veteran Affairs, Jamaica Plain, MA, 02130, USA
| | - Victor E Alvarez
- Boston University Alzheimer's Disease Research Center and CTE Center, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Neurology, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- VA Boston Healthcare System, U.S. Department of Veteran Affairs, Jamaica Plain, MA, 02130, USA
- VA Bedford Healthcare System, U.S. Department of Veteran Affairs, Bedford, MA, 01730, USA
| | - Ann C McKee
- Boston University Alzheimer's Disease Research Center and CTE Center, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Neurology, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- VA Boston Healthcare System, U.S. Department of Veteran Affairs, Jamaica Plain, MA, 02130, USA
- Department of Psychiatry and Ophthalmology, Boston University School of Medicine, Boston, MA, 02118, USA
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, Queen Square Institute of Neurology, University College London, London, UK
- UK Dementia Research Institute, University College London, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
- UW Department of Medicine, School of Medicine and Public Health, Madison, WI, USA
| | - Johan Gobom
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Thor D Stein
- Boston University Alzheimer's Disease Research Center and CTE Center, Boston University, Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, 02118, USA
- Department of Psychiatry and Ophthalmology, Boston University School of Medicine, Boston, MA, 02118, USA
- Department of Neurodegenerative Disease, Queen Square Institute of Neurology, University College London, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
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Groechel RC, Alosco ML, Dixon D, Tripodis Y, Mez J, Goldstein L, Budson AE, Qiu WQ, Killiany RJ. Associations between white matter integrity of the cingulum bundle, surrounding gray matter regions, and cognition across the dementia continuum. J Comp Neurol 2023; 531:2162-2171. [PMID: 38010204 PMCID: PMC10841586 DOI: 10.1002/cne.25564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 10/19/2023] [Accepted: 10/21/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Previous Alzheimer's disease and related dementias (AD/ADRD) research studies have illustrated the significance of studying alterations in white matter (WM). Fewer studies have examined how WM integrity, measured with diffusion tensor imaging (DTI), is associated with volume of gray matter (GM) regions and measures of cognitive function in aged participants spanning the dementia continuum. METHODS Magnetic resonance imaging and cognitive data were collected from 241 Boston University Alzheimer's Disease Research Center participants who spanned from cognitively normal controls to amnestic mild cognitive impairment to having dementia. Primary DTI tracts of interest were the cingulum ventral (CV) and cingulum dorsal (CD) pathways. GM regions of interest (ROIs) were in the medial temporal lobe (MTL), prefrontal cortex, and retrosplenial cortex. Analyses of covariance models were used to assess differences in WM integrity across groups (control, amnestic mild cognitive impairment, and dementia). Multiple linear regression models were used to assess associations between WM integrity and GM volume, and with measures of memory and executive function. RESULTS Differences in WM integrity were shown in both cingulum pathways in participants across the dementia continuum. Associations between WM integrity of both cingulum pathways and volume of selected GM ROIs were widespread. Functionally significant associations were found between WM of the CV pathway and memory, independent of MTL GM volume. DISCUSSION Differences in WM integrity of the cingulum bundle and surrounding GM ROI are likely related to the progression of AD/ADRD. Such differences should continue to be studied, particularly in association with memory performance.
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Affiliation(s)
- Renée C. Groechel
- Department of Anatomy & Neurobiology, Boston University Chobanian & Avedisian School of Medicine
- National Institute of Neurological Disorders & Stroke Intramural Research Program
| | - Michael L. Alosco
- Boston University Alzheimer’s Disease Research Center
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine
- Boston University Chronic Traumatic Encephalopathy Center
| | - Diane Dixon
- Boston University Alzheimer’s Disease Research Center
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health
| | - Yorghos Tripodis
- Boston University Alzheimer’s Disease Research Center
- Department of Biostatistics, Boston University School of Public Health
| | - Jesse Mez
- Boston University Alzheimer’s Disease Research Center
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine
- Boston University Chronic Traumatic Encephalopathy Center
| | - Lee Goldstein
- Boston University Alzheimer’s Disease Research Center
- Department of Radiology, Boston University Chobanian & Avedisian School of Medicine
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine
| | - Andrew E. Budson
- Boston University Alzheimer’s Disease Research Center
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine
- Neurology Service, VA Boston Healthcare System
| | - Wei Qiao Qiu
- Boston University Alzheimer’s Disease Research Center
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine
| | - Ronald J. Killiany
- Department of Anatomy & Neurobiology, Boston University Chobanian & Avedisian School of Medicine
- Boston University Alzheimer’s Disease Research Center
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine
- Department of Radiology, Boston University Chobanian & Avedisian School of Medicine
- Department of Environmental Health, Boston University School of Public Health
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Groechel RC, Tripodis Y, Alosco ML, Mez J, Qiao Qiu W, Goldstein L, Budson AE, Kowall NW, Shaw LM, Weiner M, Jack CR, Killiany RJ. Biomarkers of Alzheimer's disease in Black and/or African American Alzheimer's Disease Neuroimaging Initiative (ADNI) participants. Neurobiol Aging 2023; 131:144-152. [PMID: 37639768 PMCID: PMC10528881 DOI: 10.1016/j.neurobiolaging.2023.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/03/2023] [Accepted: 07/18/2023] [Indexed: 08/31/2023]
Abstract
Majority of dementia research is conducted in non-Hispanic White participants despite a greater prevalence of dementia in other racial groups. To obtain a better understanding of biomarker presentation of Alzheimer's disease (AD) in the non-Hispanic White population, this study exclusively examined AD biomarker abnormalities in 85 Black and/or African American participants within the Alzheimer's Disease Neuroimaging Initiative (ADNI). Participants were classified by the ADNI into 3 clinical groups: cognitively normal, mild cognitive impairment, or dementia. Data examined included demographics, apolipoprotein E (APOE) ε4, cerebrospinal fluid (CSF) Aβ1-42, CSF total tau (t-tau), CSF phosphorylated tau (p-tau), 3T magnetic resonance imaging (MRI), and measures of cognition and function. Analyses of variance and covariance showed lower cortical thickness in 5 of 7 selected MRI regions, lower hippocampal volume, greater volume of white matter hyperintensities, lower measures of cognition and function, lower measures of CSF Aβ1-42, and greater measures of CSF t-tau and p-tau between clinical groups. Our findings confirmed greater AD biomarker abnormalities between clinical groups in this sample.
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Affiliation(s)
- Renée C Groechel
- Department of Anatomy and Neurobiology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA.
| | - Yorghos Tripodis
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA; Boston University Alzheimer's Disease Research Center, Boston, MA, USA
| | - Michael L Alosco
- Boston University Alzheimer's Disease Research Center, Boston, MA, USA; Department of Neurology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Jesse Mez
- Boston University Alzheimer's Disease Research Center, Boston, MA, USA; Department of Neurology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Wei Qiao Qiu
- Boston University Alzheimer's Disease Research Center, Boston, MA, USA; Department of Psychiatry, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Lee Goldstein
- Boston University Alzheimer's Disease Research Center, Boston, MA, USA; Department of Neurology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Andrew E Budson
- Boston University Alzheimer's Disease Research Center, Boston, MA, USA; Department of Neurology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Neil W Kowall
- Boston University Alzheimer's Disease Research Center, Boston, MA, USA; Department of Neurology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Leslie M Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA, USA
| | - Michael Weiner
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | | | - Ronald J Killiany
- Department of Anatomy and Neurobiology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA; Boston University Alzheimer's Disease Research Center, Boston, MA, USA; Department of Neurology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
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Chen J, Doyle MF, Fang Y, Mez J, Crane PK, Scollard P, Satizabal CL, Alosco ML, Qiu WQ, Murabito JM, Lunetta KL. Peripheral inflammatory biomarkers are associated with cognitive function and dementia: Framingham Heart Study Offspring cohort. Aging Cell 2023; 22:e13955. [PMID: 37584418 PMCID: PMC10577533 DOI: 10.1111/acel.13955] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 07/19/2023] [Accepted: 07/19/2023] [Indexed: 08/17/2023] Open
Abstract
Inflammatory protein biomarkers induced by immune responses have been associated with cognitive decline and the pathogenesis of Alzheimer's disease (AD). Here, we investigate associations between a panel of inflammatory biomarkers and cognitive function and incident dementia outcomes in the well-characterized Framingham Heart Study Offspring cohort. Participants aged ≥40 years and dementia-free at Exam 7 who had a stored plasma sample were selected for profiling using the OLINK proteomics inflammation panel. Cross-sectional associations of the biomarkers with cognitive domain scores (N = 708, 53% female, 22% apolipoprotein E (APOE) ε4 carriers, 15% APOE ε2 carriers, mean age 61) and incident all-cause and AD dementia during up to 20 years of follow-up were tested. APOE genotype-stratified analyses were performed to explore effect modification. Higher levels of 12 and 3 proteins were associated with worse executive function and language domain factor scores, respectively. Several proteins were associated with more than one cognitive domain, including IL10, LIF-R, TWEAK, CCL19, IL-17C, MCP-4, and TGF-alpha. Stratified analyses suggested differential effects between APOE ε2 and ε4 carriers: most ε4 carrier associations were with executive function and memory domains, whereas most ε2 associations were with the visuospatial domain. Higher levels of TNFB and CDCP1 were associated with higher risks of incident all-cause and AD dementia. Our study found that TWEAK concentration was associated both with cognitive function and risks for AD dementia. The association of these inflammatory biomarkers with cognitive function and incident dementia may contribute to the discovery of therapeutic interventions for the prevention and treatment of cognitive decline.
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Affiliation(s)
- Jiachen Chen
- Boston University School of Public HealthDepartment of BiostatisticsBostonMassachusettsUSA
| | - Margaret F. Doyle
- Department of Pathology and Laboratory MedicineLarner College of Medicine, University of VermontBurlingtonVermontUSA
| | - Yuan Fang
- Boston University School of Public HealthDepartment of BiostatisticsBostonMassachusettsUSA
| | - Jesse Mez
- Boston University Chobanian & Avedisian School of Medicine, Boston University Alzheimer's Disease Research Center and CTE CenterBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Framingham Heart Study, National Heart, Lung, and Blood Institute and Boston University Chobanian & Avedisian School of MedicineFraminghamMassachusettsUSA
| | - Paul K. Crane
- Division of General Internal Medicine, Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Phoebe Scollard
- Division of General Internal Medicine, Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | | | - Claudia L. Satizabal
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- University of Texas Health Science Center at San Antonio, Glenn Biggs Institute for Alzheimer's and Neurodegenerative DiseasesSan AntonioTexasUSA
| | - Michael L. Alosco
- Boston University Chobanian & Avedisian School of Medicine, Boston University Alzheimer's Disease Research Center and CTE CenterBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Wei Qiao Qiu
- Boston University Chobanian & Avedisian School of Medicine, Boston University Alzheimer's Disease Research Center and CTE CenterBostonMassachusettsUSA
- Department of PsychiatryBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Boston University Chobanian & Avedisian School of MedicineDepartment of Pharmacology & Experimental TherapeuticsBostonMassachusettsUSA
| | - Joanne M. Murabito
- Framingham Heart Study, National Heart, Lung, and Blood Institute and Boston University Chobanian & Avedisian School of MedicineFraminghamMassachusettsUSA
- Department of Medicine, Section of General Internal MedicineBoston University Chobanian & Avedisian School of Medicine and Boston Medical CenterBostonMassachusettsUSA
| | - Kathryn L. Lunetta
- Boston University School of Public HealthDepartment of BiostatisticsBostonMassachusettsUSA
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Ally M, Sugarman MA, Zetterberg H, Blennow K, Ashton NJ, Karikari TK, Aparicio HJ, Frank B, Tripodis Y, Martin B, Palmisano JN, Steinberg EG, Simkin I, Farrer LA, Jun GR, Turk KW, Budson AE, O'Connor MK, Au R, Goldstein LE, Kowall NW, Killiany R, Stern RA, Stein TD, McKee AC, Qiu WQ, Mez J, Alosco ML. Cross-sectional and longitudinal evaluation of plasma glial fibrillary acidic protein to detect and predict clinical syndromes of Alzheimer's disease. Alzheimers Dement (Amst) 2023; 15:e12492. [PMID: 37885919 PMCID: PMC10599277 DOI: 10.1002/dad2.12492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/15/2023] [Accepted: 09/26/2023] [Indexed: 10/28/2023]
Abstract
Introduction This study examined plasma glial fibrillary acidic protein (GFAP) as a biomarker of cognitive impairment due to Alzheimer's disease (AD) with and against plasma neurofilament light chain (NfL), and phosphorylated tau (p-tau)181+231. Methods Plasma samples were analyzed using Simoa platform for 567 participants spanning the AD continuum. Cognitive diagnosis, neuropsychological testing, and dementia severity were examined for cross-sectional and longitudinal outcomes. Results Plasma GFAP discriminated AD dementia from normal cognition (adjusted mean difference = 0.90 standard deviation [SD]) and mild cognitive impairment (adjusted mean difference = 0.72 SD), and demonstrated superior discrimination compared to alternative plasma biomarkers. Higher GFAP was associated with worse dementia severity and worse performance on 11 of 12 neuropsychological tests. Longitudinally, GFAP predicted decline in memory, but did not predict conversion to mild cognitive impairment or dementia. Discussion Plasma GFAP was associated with clinical outcomes related to suspected AD and could be of assistance in a plasma biomarker panel to detect in vivo AD.
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Affiliation(s)
- Madeline Ally
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of PsychologyUniversity of ArizonaTucsonArizonaUSA
| | - Michael A. Sugarman
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Henrik Zetterberg
- Department of Neurodegenerative DiseaseUCL Institute of NeurologyLondonUK
- UK Dementia Research Institute at UCL, UCL Institute of NeurologyUniversity College LondonLondonUK
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and PhysiologyThe Sahlgrenska Academy at the University of GothenburgGothenburgSweden
| | - Kaj Blennow
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and PhysiologyThe Sahlgrenska Academy at the University of GothenburgGothenburgSweden
| | - Nicholas J. Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and PhysiologyThe Sahlgrenska Academy at the University of GothenburgGothenburgSweden
- Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology, and NeuroscienceKing's College LondonLondonUK
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and MaudsleyNHS FoundationLondonUK
- Centre for Age‐Related MedicineStavanger University HospitalStavangerNorway
| | - Thomas K. Karikari
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and PhysiologyThe Sahlgrenska Academy at the University of GothenburgGothenburgSweden
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Hugo J. Aparicio
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Brandon Frank
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- US Department of Veterans AffairsVA Boston Healthcare SystemJamaica PlainMassachusettsUSA
| | - Yorghos Tripodis
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of BiostatisticsBoston University School of Public HealthBostonMassachusettsUSA
| | - Brett Martin
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Biostatistics and Epidemiology Data Analytics CenterBoston University School of Public HealthBostonMassachusettsUSA
| | - Joseph N. Palmisano
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Biostatistics and Epidemiology Data Analytics CenterBoston University School of Public HealthBostonMassachusettsUSA
| | - Eric G. Steinberg
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Irene Simkin
- Department of MedicineBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Lindsay A. Farrer
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of BiostatisticsBoston University School of Public HealthBostonMassachusettsUSA
- Department of MedicineBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- The Framingham Heart StudyFraminghamMassachusettsUSA
- Department of EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA
- Department of OphthalmologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Gyungah R. Jun
- Department of MedicineBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Katherine W. Turk
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- US Department of Veterans AffairsVA Boston Healthcare SystemJamaica PlainMassachusettsUSA
| | - Andrew E. Budson
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- US Department of Veterans AffairsVA Boston Healthcare SystemJamaica PlainMassachusettsUSA
| | - Maureen K. O'Connor
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeuropsychologyEdith Nourse Rogers Memorial Veterans HospitalBedfordMassachusettsUSA
| | - Rhoda Au
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- The Framingham Heart StudyFraminghamMassachusettsUSA
- Department of EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA
- Department of Anatomy and NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Lee E. Goldstein
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Biostatistics and Epidemiology Data Analytics CenterBoston University School of Public HealthBostonMassachusettsUSA
- Department of OphthalmologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of Biomedical, Electrical, and Computer EngineeringBoston University College of EngineeringBostonMassachusettsUSA
| | - Neil W. Kowall
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- US Department of Veterans AffairsVA Boston Healthcare SystemJamaica PlainMassachusettsUSA
- Department of Pathology and Laboratory MedicineBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Ronald Killiany
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of Anatomy and NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Center for Biomedical ImagingBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Robert A. Stern
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of Anatomy and NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurosurgeryBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Thor D. Stein
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- US Department of Veterans AffairsVA Boston Healthcare SystemJamaica PlainMassachusettsUSA
- Department of Pathology and Laboratory MedicineBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- US Department of Veterans AffairsVA Bedford Healthcare SystemBedfordMassachusettsUSA
| | - Ann C. McKee
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- US Department of Veterans AffairsVA Boston Healthcare SystemJamaica PlainMassachusettsUSA
- Department of Pathology and Laboratory MedicineBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- US Department of Veterans AffairsVA Bedford Healthcare SystemBedfordMassachusettsUSA
| | - Wei Qiao Qiu
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of PsychiatryBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of Pharmacology and Experimental TherapeuticsBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Jesse Mez
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Michael L. Alosco
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
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7
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Huang J, Wang Y, Stein TD, Ang TFA, Zhu Y, Tao Q, Lunetta KL, Mez J, Au R, Farrer LA, Qiu WQ, Zhang X. The impact of blood MCP-1 levels on Alzheimer's disease with genetic variation of UNC5C and NAV3 loci. Res Sq 2023:rs.3.rs-3376348. [PMID: 37841863 PMCID: PMC10571626 DOI: 10.21203/rs.3.rs-3376348/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Background Previous study shows that monocyte chemoattractant protein-1 (MCP-1), which is implicated in the peripheral proinflammatory cascade and blood-brain barrier (BBB) disruption, modulates the genetic risks of AD in established AD loci. Methods In this study, we hypothesized that blood MCP-1 impacts the AD risk of genetic variants beyond known AD loci. We thus performed a genome-wide association study (GWAS) using the logistic regression via generalized estimating equations (GEE) and the Cox proportional-hazards models to examine the interactive effects between single nucleotide polymorphisms (SNPs) and blood MCP-1 level on AD in three cohorts: the Framingham Heart Study (FHS), Alzheimer's Disease Neuroimaging Initiative (ADNI) and Religious Orders Study/Memory and Aging Project (ROSMAP). Results We identified SNPs in two genes, neuron navigator 3 (NAV3, also named Unc-53 Homolog 3, rs696468) (p < 7.55×10- 9) and Unc-5 Netrin Receptor C (UNC5C rs72659964) (p < 1.07×10- 8) that showed an association between increasing levels of blood MCP-1 and AD. Elevating blood MCP-1 concentrations increased AD risk and AD pathology in genotypes of NAV3 (rs696468-CC) and UNC5C (rs72659964-AT + TT), but did not influence the other counterpart genotypes of these variants. Conclusions NAV3 and UNC5C are homologs and may increase AD risk through dysregulating the functions of neurite outgrowth and guidance. Overall, the association of risk alleles of NAV3 and UNC5C with AD is enhanced by peripheral MCP-1 level, suggesting that lowering the level of blood MCP-1 may reduce the risk of developing AD for people with these genotypes.
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Affiliation(s)
- Jinghan Huang
- Boston University Chobanian & Avedisian School of Medicine
| | - Yixuan Wang
- Boston University Chobanian & Avedisian School of Medicine
| | - Thor D Stein
- Boston University Chobanian & Avedisian School of Medicine
| | | | - Yibo Zhu
- Boston University Chobanian & Avedisian School of Medicine
| | - Qiushan Tao
- Boston University Chobanian & Avedisian School of Medicine
| | | | - Jesse Mez
- Boston University Chobanian & Avedisian School of Medicine
| | - Rhoda Au
- Boston University Chobanian & Avedisian School of Medicine
| | | | - Wei Qiao Qiu
- Boston University Chobanian & Avedisian School of Medicine
| | - Xiaoling Zhang
- Boston University Chobanian & Avedisian School of Medicine
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8
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Fang Y, Doyle MF, Chen J, Mez J, Satizabal CL, Alosco ML, Qiu WQ, Lunetta KL, Murabito JM. Correction for: Circulating immune cell phenotypes are associated with age, sex, CMV, and smoking status in the Framingham Heart Study offspring participants. Aging (Albany NY) 2023; 15:7855-7856. [PMID: 37580144 PMCID: PMC10457073 DOI: 10.18632/aging.204988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 07/31/2023] [Indexed: 08/16/2023]
Affiliation(s)
- Yuan Fang
- Boston University School of Public Health, Department of Biostatistics, Boston, MA 02118, USA
| | - Margaret F. Doyle
- University of Vermont, Larner College of Medicine, Department of Pathology and Laboratory Medicine, Burlington, VT 05405, USA
| | - Jiachen Chen
- Boston University School of Public Health, Department of Biostatistics, Boston, MA 02118, USA
| | - Jesse Mez
- Boston University Chobanian and Avedisian School of Medicine, Boston University Alzheimer’s Disease Research Center and CTE Center, Boston, MA 02118, USA
- Boston University Chobanian and Avedisian School of Medicine, Department of Neurology, Boston, MA 02118, USA
- Framingham Heart Study, National Heart, Lung, and Blood Institute and Boston University Chobanian and Avedisian School of Medicine, Framingham, MA 01702, USA
| | - Claudia L. Satizabal
- Boston University Chobanian and Avedisian School of Medicine, Department of Neurology, Boston, MA 02118, USA
- Framingham Heart Study, National Heart, Lung, and Blood Institute and Boston University Chobanian and Avedisian School of Medicine, Framingham, MA 01702, USA
- University of Texas Health Science Center at San Antonio, Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, San Antonio, TX 78229, USA
| | - Michael L. Alosco
- Boston University Chobanian and Avedisian School of Medicine, Boston University Alzheimer’s Disease Research Center and CTE Center, Boston, MA 02118, USA
- Boston University Chobanian and Avedisian School of Medicine, Department of Neurology, Boston, MA 02118, USA
| | - Wei Qiao Qiu
- Boston University Chobanian and Avedisian School of Medicine, Boston University Alzheimer’s Disease Research Center and CTE Center, Boston, MA 02118, USA
- Boston University Chobanian and Avedisian School of Medicine, Department of Psychiatry, Boston, MA 02118, USA
- Boston University Chobanian and Avedisian School of Medicine, Department of Pharmacology and Experimental Therapeutics, Boston, MA 02118, USA
| | - Kathryn L. Lunetta
- Boston University School of Public Health, Department of Biostatistics, Boston, MA 02118, USA
| | - Joanne M. Murabito
- Framingham Heart Study, National Heart, Lung, and Blood Institute and Boston University Chobanian and Avedisian School of Medicine, Framingham, MA 01702, USA
- Boston University Chobanian and Avedisian School of Medicine, Department of Medicine, Boston, MA 02118, USA
- Boston Medical Center, Department of Adult Primary Care, Boston, MA 02119, USA
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9
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Zhang Z, Gan Q, Han J, Tao Q, Qiu WQ, Madri JA. CD31 as a probable responding and gate-keeping protein of the blood-brain barrier and the risk of Alzheimer's disease. J Cereb Blood Flow Metab 2023; 43:1027-1041. [PMID: 37051650 PMCID: PMC10291450 DOI: 10.1177/0271678x231170041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 03/17/2023] [Accepted: 03/24/2023] [Indexed: 04/14/2023]
Abstract
Several studies have shown that an abnormal vascular-immunity link could increase Alzheimer's disease (AD) risk; however, the mechanism is unclear. CD31, also named platelet endothelial cell adhesion molecule (PECAM), is a surface membrane protein of both endothelial and immune cells and plays important roles in the interaction between the vascular and immune systems. In this review, we focus on research regarding CD31 biological actions in the pathological process that may contribute to AD based on the following rationales. First, endothelial, leukocyte and soluble forms of CD31 play multi-roles in regulating transendothelial migration, increasing blood-brain barrier (BBB) permeability and resulting in neuroinflammation. Second, CD31 expressed by endothelial and immune cells dynamically modulates numbers of signaling pathways, including Src family kinases, selected G proteins, and β-catenin which in turn affect cell-matrix and cell-cell attachment, activation, permeability, survival, and ultimately neuronal cell injury. In endothelia and immune cells, these diverse CD31-mediated pathways act as a critical regulator in the immunity-endothelia-brain axis, thereby mediating AD pathogenesis in ApoE4 carriers, which is the major genetic risk factor for AD. This evidence suggests a novel mechanism and potential drug target for CD31 in the background of genetic vulnerabilities and peripheral inflammation for AD development and progression.
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Affiliation(s)
- Zhengrong Zhang
- Departments of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Qini Gan
- Departments of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Jingyan Han
- Whitaker Cardiovascular Research Institute, Boston University School of Medicine, Boston, MA, USA
| | - Qiushan Tao
- Departments of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Wei Qiao Qiu
- Departments of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
- Psychiatry, Boston University School of Medicine, Boston, MA, USA
- The Alzheimer’s Disease Research Center, Boston University School of Medicine, Boston, MA, USA
| | - Joseph A Madri
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
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10
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Kloske CM, Barnum CJ, Batista AF, Bradshaw EM, Brickman AM, Bu G, Dennison J, Gearon MD, Goate AM, Haass C, Heneka MT, Hu WT, Huggins LKL, Jones NS, Koldamova R, Lemere CA, Liddelow SA, Marcora E, Marsh SE, Nielsen HM, Petersen KK, Petersen M, Piña-Escudero SD, Qiu WQ, Quiroz YT, Reiman E, Sexton C, Tansey MG, Tcw J, Teunissen CE, Tijms BM, van der Kant R, Wallings R, Weninger SC, Wharton W, Wilcock DM, Wishard TJ, Worley SL, Zetterberg H, Carrillo MC. APOE and immunity: Research highlights. Alzheimers Dement 2023; 19:2677-2696. [PMID: 36975090 DOI: 10.1002/alz.13020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 03/29/2023]
Abstract
INTRODUCTION At the Alzheimer's Association's APOE and Immunity virtual conference, held in October 2021, leading neuroscience experts shared recent research advances on and inspiring insights into the various roles that both the apolipoprotein E gene (APOE) and facets of immunity play in neurodegenerative diseases, including Alzheimer's disease and other dementias. METHODS The meeting brought together more than 1200 registered attendees from 62 different countries, representing the realms of academia and industry. RESULTS During the 4-day meeting, presenters illuminated aspects of the cross-talk between APOE and immunity, with a focus on the roles of microglia, triggering receptor expressed on myeloid cells 2 (TREM2), and components of inflammation (e.g., tumor necrosis factor α [TNFα]). DISCUSSION This manuscript emphasizes the importance of diversity in current and future research and presents an integrated view of innate immune functions in Alzheimer's disease as well as related promising directions in drug development.
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Affiliation(s)
| | | | - Andre F Batista
- Department of Neurology, Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Departments of Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Elizabeth M Bradshaw
- Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, G.H. Sergievsky Center, and Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Guojun Bu
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
| | - Jessica Dennison
- Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mary D Gearon
- Department of Physiology, University of Kentucky, Lexington, Kentucky, USA
| | - Alison M Goate
- Department of Genetics & Genomic Sciences, Ronald M. Loeb Center for Alzheimer's disease, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Christian Haass
- Metabolic Biochemistry, Biomedical Center (BMC), Faculty of Medicine, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany 3 Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Michael T Heneka
- Luxembourg Centre for Systems Biomedicine (LCSB) University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - William T Hu
- Department of Neurology, Rutgers-Robert Wood Johnson Medical School and Center for Healthy Aging, Rutgers Institute for Health, Health Care Policy, and Aging Research, New Brunswick, New Jersey, USA
| | - Lenique K L Huggins
- Department of Biology, Duke University, Durham, North Carolina, USA
- Yale School of Medicine, New Haven, Connecticut, USA
| | - Nahdia S Jones
- Interdisciplinary Program in Neuroscience, Georgetown University, Washington, District of Columbia, USA
| | - Radosveta Koldamova
- EOH, School of Public Health University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Cynthia A Lemere
- Department of Neurology, Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Departments of Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Shane A Liddelow
- Neuroscience Institute and Departments of Neuroscience & Physiology and of Ophthalmology, NYU Grossman School of Medicine, New York, New York, USA
| | - Edoardo Marcora
- Ronald M. Loeb Center for Alzheimer's disease, Dept. of Genetics & Genomic Sciences, Dept. of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Samuel E Marsh
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Henrietta M Nielsen
- Department of Biochemistry and Biophysics, Stockholm University, Stockholm, Sweden
| | - Kellen K Petersen
- The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Melissa Petersen
- Department of Family Medicine, Institute of Translational Research, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Stefanie D Piña-Escudero
- Global Brain Health Institute, Department of Neurology, University of California, San Francisco, California, USA
| | - Wei Qiao Qiu
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Yakeel T Quiroz
- Departments of Psychiatry and Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Eric Reiman
- Banner Alzheimer's Institute, Phoenix, Arizona, USA
- Banner Research, Phoenix, Arizona, USA
| | | | - Malú Gámez Tansey
- Department of Neuroscience and Center for Translational Research in Neurodegenerative Disease, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Julia Tcw
- Department of Pharmacology & Experimental Therapeutics, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Clinical Chemistry department, Amsterdam Neuroscience, Program Neurodegeneration, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Betty M Tijms
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Rik van der Kant
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research (CNCR), VU University Amsterdam, Amsterdam, The Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Rebecca Wallings
- CTRND, Department of Neuroscience, University of Florida, Florida, USA
| | | | | | - Donna M Wilcock
- Sanders-Brown Center on Aging and Department of Physiology, University of Kentucky, Lexington, Kentucky, USA
| | - Tyler James Wishard
- Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA
| | - Susan L Worley
- Independent science writer, Bryn Mawr, Pennsylvania, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
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11
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Huang J, Stein TD, Wang Y, Ang TFA, Tao Q, Lunetta KL, Massaro J, Akhter-Khan SC, Mez J, Au R, Farrer LA, Zhang X, Qiu WQ. Blood levels of MCP-1 modulate the genetic risks of Alzheimer's disease mediated by HLA-DRB1 and APOE for Alzheimer's disease. Alzheimers Dement 2023; 19:1925-1937. [PMID: 36396603 PMCID: PMC10182187 DOI: 10.1002/alz.12851] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/13/2022] [Accepted: 10/05/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION C-Reactive protein (CRP) and monocyte chemoattractant protein-1 (MCP-1) are both implicated in the peripheral proinflammatory cascade and blood-brain barrier (BBB) disruption. Since the blood CRP level increases Alzheimer's disease (AD) risk depending on the apolipoprotein E (APOE) genotype, we hypothesized that the blood MCP-1 level exerts different effects on the AD risk depending on the genotypes. METHODS Using multiple regression analyses, data from the Framingham Heart Study (n = 2884) and Alzheimer's Disease Neuroimaging Initiative study (n = 231) were analyzed. RESULTS An elevated blood MCP-1 level was associated with AD risk in major histocompatibility complex, Class II, DR beta 1 (HLA-DRB1) rs9271192-AC/CC (hazard ratio [HR] = 3.07, 95% confidence interval [CI] = 1.50-6.28, p = 0.002) and in APOE ε4 carriers (HR = 3.22, 95% CI = 1.59-6.53, p = 0.001). In contrast, among HLA-DRB1 rs9271192-AA and APOE ε4 noncarriers, blood MCP-1 levels were not associated with these phenotypes. DISCUSSION Since HLA-DRB1 and APOE are expressed in the BBB, blood MCP-1 released in the peripheral inflammatory cascade may function as a mediator of the effects of HLA-DRB1 rs9271192-AC/CC and APOE ε4 genotypes on AD pathogenesis in the brain via the BBB pathways.
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Affiliation(s)
- Jinghan Huang
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
| | - Thor D. Stein
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA
- Alzheimer’s Disease Research Center, Boston University School of Medicine, Boston, MA, USA
- VA Boston Healthcare System, Boston, MA, USA
| | - Yixuan Wang
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
| | - Ting Fang Alvin Ang
- Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Qiushan Tao
- Department of Pharmacology & Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Kathryn L. Lunetta
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Joseph Massaro
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Framingham Heart Study, Boston University School of Medicine, Framingham, MA, USA
| | - Samia C. Akhter-Khan
- Framingham Heart Study, Boston University School of Medicine, Framingham, MA, USA
- Department of Health Service & Population Research, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Jesse Mez
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Framingham Heart Study, Boston University School of Medicine, Framingham, MA, USA
- Alzheimer’s Disease Research Center, Boston University School of Medicine, Boston, MA, USA
| | - Rhoda Au
- Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Framingham Heart Study, Boston University School of Medicine, Framingham, MA, USA
- Alzheimer’s Disease Research Center, Boston University School of Medicine, Boston, MA, USA
| | - Lindsay A. Farrer
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Ophthalmology, Boston University School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Framingham Heart Study, Boston University School of Medicine, Framingham, MA, USA
- Alzheimer’s Disease Research Center, Boston University School of Medicine, Boston, MA, USA
| | - Xiaoling Zhang
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Wei Qiao Qiu
- Department of Pharmacology & Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
- Alzheimer’s Disease Research Center, Boston University School of Medicine, Boston, MA, USA
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Fang Y, Doyle MF, Chen J, Mez J, Satizabal CL, Alosco ML, Qiu WQ, Lunetta KL, Murabito JM. Circulating immune cell phenotypes are associated with age, sex, CMV, and smoking status in the Framingham Heart Study offspring participants. Aging (Albany NY) 2023; 15:3939-3966. [PMID: 37116193 PMCID: PMC10258017 DOI: 10.18632/aging.204686] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/17/2023] [Indexed: 04/30/2023]
Abstract
Understanding the composition of circulating immune cells with aging and the underlying biologic mechanisms driving aging may provide molecular targets to slow the aging process and reduce age-related disease. Utilizing cryopreserved cells from 996 Framingham Heart Study (FHS) Offspring Cohort participants aged 40 and older (mean 62 years, 48% female), we report on 116 immune cell phenotypes including monocytes, T-, B-, and NK cells and their subtypes, across age groups, sex, cytomegalovirus (CMV) exposure groups, smoking and other cardiovascular risk factors. The major cellular differences with CMV exposure were higher Granzyme B+ cells, effector cells, and effector-memory re-expressing CD45RA (TEMRA) cells for both CD4+ and CD8+. Older age was associated with lower CD3+ T cells, lower naïve cells and naïve/memory ratios for CD4+ and CD8+. We identified many immune cell differences by sex, with males showing lower naïve cells and higher effector and effector memory cells. Current smokers showed lower pro-inflammatory CD8 cells, higher CD8 regulatory type cells and altered B cell subsets. No significant associations were seen with BMI and other cardiovascular risk factors. Our cross-sectional observations of immune cell phenotypes provide a reference to further the understanding of the complexity of immune cells in blood, an easily accessible tissue.
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Affiliation(s)
- Yuan Fang
- Boston University School of Public Health, Department of Biostatistics, Boston, MA 02118, USA
| | - Margaret F. Doyle
- University of Vermont, Larner College of Medicine, Department of Pathology and Laboratory Medicine, Burlington, VT 05405, USA
| | - Jiachen Chen
- Boston University School of Public Health, Department of Biostatistics, Boston, MA 02118, USA
| | - Jesse Mez
- Boston University Chobanian and Avedisian School of Medicine, Boston University Alzheimer’s Disease Research Center and CTE Center, Boston, MA 02118, USA
- Boston University Chobanian and Avedisian School of Medicine, Department of Neurology, Boston, MA 02118, USA
- Framingham Heart Study, National Heart, Lung, and Blood Institute and Boston University Chobanian and Avedisian School of Medicine, Framingham, MA 01702, USA
| | - Claudia L. Satizabal
- Boston University Chobanian and Avedisian School of Medicine, Department of Neurology, Boston, MA 02118, USA
- Framingham Heart Study, National Heart, Lung, and Blood Institute and Boston University Chobanian and Avedisian School of Medicine, Framingham, MA 01702, USA
- University of Texas Health Science Center at San Antonio, Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, San Antonio, TX 78229, USA
| | - Michael L. Alosco
- Boston University Chobanian and Avedisian School of Medicine, Boston University Alzheimer’s Disease Research Center and CTE Center, Boston, MA 02118, USA
- Boston University Chobanian and Avedisian School of Medicine, Department of Neurology, Boston, MA 02118, USA
| | - Wei Qiao Qiu
- Boston University Chobanian and Avedisian School of Medicine, Boston University Alzheimer’s Disease Research Center and CTE Center, Boston, MA 02118, USA
- Boston University Chobanian and Avedisian School of Medicine, Department of Psychiatry, Boston, MA 02118, USA
- Boston University Chobanian and Avedisian School of Medicine, Department of Pharmacology and Experimental Therapeutics, Boston, MA 02118, USA
| | - Kathryn L. Lunetta
- Boston University School of Public Health, Department of Biostatistics, Boston, MA 02118, USA
| | - Joanne M. Murabito
- Framingham Heart Study, National Heart, Lung, and Blood Institute and Boston University Chobanian and Avedisian School of Medicine, Framingham, MA 01702, USA
- Boston University Chobanian and Avedisian School of Medicine, Department of Medicine, Boston, MA 02118, USA
- Boston Medical Center, Department of Adult Primary Care, Boston, MA 02119, USA
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13
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Bei J, Miranda-Morales EG, Gan Q, Qiu Y, Husseinzadeh S, Liew JY, Chang Q, Krishnan B, Gaitas A, Yuan S, Felicella M, Qiu WQ, Fang X, Gong B. Circulating exosomes from Alzheimer's disease suppress VE-cadherin expression and induce barrier dysfunction in recipient brain microvascular endothelial cell. bioRxiv 2023:2023.04.03.535441. [PMID: 37066187 PMCID: PMC10103966 DOI: 10.1101/2023.04.03.535441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Background Blood-brain barrier (BBB) breakdown is a component of the progression and pathology of Alzheimer's disease (AD). BBB dysfunction is primarily caused by reduced or disorganized tight junction or adherens junction proteins of brain microvascular endothelial cell (BMEC). While there is growing evidence of tight junction disruption in BMECs in AD, the functional role of adherens junctions during BBB dysfunction in AD remains unknown. Exosomes secreted from senescent cells have unique characteristics and contribute to modulating the phenotype of recipient cells. However, it remains unknown if and how these exosomes cause BMEC dysfunction in AD. Objectives This study aimed to investigate the potential roles of AD circulating exosomes and their RNA cargos in brain endothelial dysfunction in AD. Methods We isolated exosomes from sera of five cases of AD compared with age- and sex-matched cognitively normal controls using size-exclusion chromatography technology. We validated the qualities and particle sizes of isolated exosomes with nanoparticle tracking analysis and atomic force microscopy. We measured the biomechanical natures of the endothelial barrier of BMECs, the lateral binding forces between live BMECs, using fluidic force miscopy. We visualized the paracellular expressions of the key adherens junction protein VE-cadherin in BMEC cultures and a 3D BBB model that employs primary human BMECs and pericytes with immunostaining and evaluated them using confocal microscopy. We also examined the VE-cadherin signal in brain tissues from five cases of AD and five age- and sex-matched cognitively normal controls. Results We found that circulating exosomes from AD patients suppress the paracellular expression levels of VE-cadherin and impair the barrier function of recipient BMECs. Immunostaining analysis showed that AD circulating exosomes damage VE-cadherin integrity in a 3D model of microvascular tubule formation. We found that circulating exosomes in AD weaken the BBB depending on the RNA cargos. In parallel, we observed that microvascular VE-cadherin expression is diminished in AD brains compared to normal controls. Conclusion Using in vitro and ex vivo models, our study illustrates that circulating exosomes from AD patients play a significant role in mediating the damage effect on adherens junction of recipient BMEC of the BBB in an exosomal RNA-dependent manner. This suggests a novel mechanism of peripheral senescent exosomes for AD risk.
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Groechel RC, Tripodis Y, Alosco ML, Mez J, Qiu WQ, Mercier G, Goldstein L, Budson AE, Kowall N, Killiany RJ. Annualized changes in rate of amyloid deposition and neurodegeneration are greater in participants who become amyloid positive than those who remain amyloid negative. Neurobiol Aging 2023; 127:33-42. [PMID: 37043881 DOI: 10.1016/j.neurobiolaging.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 03/01/2023] [Accepted: 03/06/2023] [Indexed: 03/12/2023]
Abstract
This study longitudinally examined participants in the Alzheimer's Disease Neuroimaging Initiative (ADNI) who underwent a conversion in amyloid-beta (Aβ) status in comparison to a group of ADNI participants who did not show a change in amyloid status over the same follow-up period. Participants included 136 ADNI dementia-free participants with 2 florbetapir positron emission tomography (PET) scans. Of these participants, 68 showed amyloid conversion as measured on florbetapir PET, and the other 68 did not. Amyloid converters and non-converters were chosen to have representative demographic data (age, education, sex, diagnostic status, and race). The amyloid converter group showed increased prevalence of APOE ε4 (p < 0.001), greater annualized percent volume loss in selected magnetic resonance imaging (MRI) regions (p < 0.05), lower cerebrospinal fluid Aβ1-42 (p < 0.001), and greater amyloid retention (as measured by standard uptake value ratios) on florbetapir PET scans (p < 0.001) in comparison to the non-converter group. These results provide compelling evidence that important neuropathological changes are occurring alongside amyloid conversion.
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15
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Na H, Yang JB, Zhang Z, Gan Q, Tian H, Rajab IM, Potempa LA, Tao Q, Qiu WQ. Peripheral apolipoprotein E proteins and their binding to LRP1 antagonize Alzheimer’s disease pathogenesis in the brain during peripheral chronic inflammation. Neurobiol Aging 2023; 127:54-69. [PMID: 37060729 DOI: 10.1016/j.neurobiolaging.2023.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 12/15/2022] [Accepted: 02/28/2023] [Indexed: 03/09/2023]
Abstract
C-reactive protein (CRP) impacts apolipoprotein E4 (ApoE4) allele to increase Alzheimer's disease (AD) risk. However, it is unclear how the ApoE protein and its binding to LRP1 are involved. We found that ApoE2 carriers had the highest but ApoE4 carriers had the lowest concentrations of blood ApoE in both humans and mice; blood ApoE concentration was negatively associated with AD risk. Elevation of peripheral monomeric CRP (mCRP) reduced the expression of ApoE in ApoE2 mice, while it decreased ApoE-LRP1 binding in the brains of ApoE4 mice that was characterized by Proximity Ligation Assay. Both serum ApoE and brain ApoE-LRP1 binding were positively associated with the expression of pericytes that disappeared after mCRP treatment, and negatively associated with brain tauopathy and neuroinflammation in the presence of mCRP. In ApoE-/- mice, mCRP reduced the brain expression levels of synaptophysin and PSD95 and the positive relationship between ApoE-LRP1 binding and synaptophysin or PSD95 expression disappeared. Our study suggests that blood ApoE protects against AD pathogenesis by binding to LRP1 during peripheral chronic inflammation.
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Affiliation(s)
- Hana Na
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Jack B Yang
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Zhengrong Zhang
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Qini Gan
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Hua Tian
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA; Department of Pharmacology, Qiqihar Medical University, Qiqihar, Heilongjiang, China
| | | | | | - Qiushan Tao
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Wei Qiao Qiu
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA; Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
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16
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Wang Y, Huang J, Ang TFA, Zhu Y, Tao Q, Mez J, Alosco M, Denis GV, Belkina A, Gurnani A, Ross M, Gong B, Han J, Lunetta KL, Stein TD, Au R, Farrer LA, Zhang X, Qiu WQ. Circulating Endothelial Progenitor Cells Reduce the Risk of Alzheimer's Disease. medRxiv 2023:2023.01.16.23284571. [PMID: 36711847 PMCID: PMC9882408 DOI: 10.1101/2023.01.16.23284571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Cerebrovascular damage coexists with Alzheimer's disease (AD) pathology and increases AD risk. However, it is unclear whether endothelial progenitor cells reduce AD risk via cerebrovascular repair. By using the Framingham Heart Study (FHS) offspring cohort, which includes data on different progenitor cells, the incidence of AD dementia, peripheral and cerebrovascular pathologies, and genetic data (n = 1,566), we found that elevated numbers of circulating endothelial progenitor cells with CD34+CD133+ co-expressions had a dose-dependent association with decreased AD risk (HR = 0.67, 95% CI: 0.46-0.96, p = 0.03) after adjusting for age, sex, years of education, and APOE ε4. With stratification, this relationship was only significant among those individuals who had vascular pathologies, especially hypertension (HTN) and cerebral microbleeds (CMB), but not among those individuals who had neither peripheral nor central vascular pathologies. We applied a genome-wide association study (GWAS) and found that the number of CD34+CD133+ cells impacted AD risk depending on the homozygous genotypes of two genes: KIRREL3 rs580382 CC carriers (HR = 0.31, 95% CI: 0.17-0.57, p<0.001), KIRREL3 rs4144611 TT carriers (HR = 0.29, 95% CI: 0.15-0.57, p<0.001), and EXOC6B rs61619102 CC carriers (HR = 0.49, 95% CI: 0.31-0.75, p<0.001) after adjusting for confounders. In contrast, the relationship did not exist in their counterpart genotypes, e.g. KIRREL3 TT/CT or GG/GT carriers and EXOC6B GG/GC carriers. Our findings suggest that circulating CD34+CD133+ endothelial progenitor cells can be therapeutic in reducing AD risk in the presence of cerebrovascular pathology, especially in KIRREL3 and EXOC6B genotype carriers.
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Bei J, Miranda-Morales EG, Gan Q, Qiu Y, Husseinzadeh S, Liew JY, Chang Q, Krishnan B, Gaitas A, Yuan S, Felicella M, Qiu WQ, Fang X, Gong B. Circulating Exosomes from Alzheimer's Disease Suppress Vascular Endothelial-Cadherin Expression and Induce Barrier Dysfunction in Recipient Brain Microvascular Endothelial Cell. J Alzheimers Dis 2023; 95:869-885. [PMID: 37661885 DOI: 10.3233/jad-230347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
BACKGROUND Blood-brain barrier (BBB) breakdown is a crucial aspect of Alzheimer's disease (AD) progression. Dysfunction in BBB is primarily caused by impaired tight junction and adherens junction proteins in brain microvascular endothelial cells (BMECs). The role of adherens junctions in AD-related BBB dysfunction remains unclear. Exosomes from senescent cells have unique characteristics and contribute to modulating the phenotype of recipient cells. However, it remains unknown if and how these exosomes cause BMEC dysfunction in AD. OBJECTIVE This study aimed to investigate the impact of AD circulating exosomes on brain endothelial dysfunction. METHODS Exosomes were isolated from sera of AD patients and age- and sex-matched cognitively normal controls using size-exclusion chromatography. The study measured the biomechanical nature of BMECs' endothelial barrier, the lateral binding forces between live BMECs. Paracellular expressions of the key adherens junction protein vascular endothelial (VE)-cadherin were visualized in BMEC cultures and a 3D BBB model using human BMECs and pericytes. VE-cadherin signals were also examined in brain tissues from AD patients and normal controls. RESULTS Circulating exosomes from AD patients reduced VE-cadherin expression levels and impaired barrier function in recipient BMECs. Immunostaining analysis demonstrated that AD exosomes damaged VE-cadherin integrity in a 3D microvascular tubule formation model. The study found that AD exosomes weakened BBB integrity depending on their RNA content. Additionally, diminished microvascular VE-cadherin expression was observed in AD brains compared to controls. CONCLUSION These findings highlight the significant role of circulating exosomes from AD patients in damaging adherens junctions of recipient BMECs, dependent on exosomal RNA.
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Affiliation(s)
- Jiani Bei
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
| | - Ernesto G Miranda-Morales
- Department of Neurology, Mitchell Center for Neurodegenerative Diseases, University of Texas Medical Branch, Galveston, TX, USA
| | - Qini Gan
- Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA
| | - Yuan Qiu
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
| | - Sorosh Husseinzadeh
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
| | - Jia Yi Liew
- Department of Neurobiology, University of Texas Medical Branch, Galveston, TX, USA
| | - Qing Chang
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
| | - Balaji Krishnan
- Department of Neurology, Mitchell Center for Neurodegenerative Diseases, University of Texas Medical Branch, Galveston, TX, USA
| | - Angelo Gaitas
- The Estelle and Daniel Maggin Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Subo Yuan
- Department of Neurobiology, University of Texas Medical Branch, Galveston, TX, USA
| | - Michelle Felicella
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
| | - Wei Qiao Qiu
- Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA
| | - Xiang Fang
- Department of Neurology, Mitchell Center for Neurodegenerative Diseases, University of Texas Medical Branch, Galveston, TX, USA
| | - Bin Gong
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
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Zhang X, Tong T, Chang A, Ang TFA, Tao Q, Auerbach S, Devine S, Qiu WQ, Mez J, Massaro J, Lunetta KL, Au R, Farrer LA. Midlife lipid and glucose levels are associated with Alzheimer's disease. Alzheimers Dement 2023; 19:181-193. [PMID: 35319157 PMCID: PMC10078665 DOI: 10.1002/alz.12641] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 01/31/2023]
Abstract
INTRODUCTION It is unknown whether vascular and metabolic diseases assessed in early adulthood are associated with Alzheimer's disease (AD) later in life. METHODS Association of AD with lipid fractions, glucose, blood pressure, body mass index (BMI), and smoking obtained prospectively from 4932 Framingham Heart Study (FHS) participants across nine quadrennial examinations was evaluated using Cox proportional hazard and Kaplan-Meier models. Age-, sex-, and education-adjusted models were tested for each factor measured at each exam and within three adult age groups (early = 35-50, middle = 51-60, and late = 61-70). RESULTS A 15 mg/dL increase in high density lipoprotein (HDL) cholesterol was associated with decreased AD risk during early (15.4%, P = 0.041) and middle (17.9%, P = 0.014) adulthood. A 15 mg/dL increase in glucose measured during middle adulthood was associated with 14.5% increased AD risk (P = 0.00029). These findings remained significant after adjusting for treatment. DISCUSSION Our findings suggest that careful management of cholesterol and glucose beginning in early adulthood can lower AD risk.
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Affiliation(s)
- Xiaoling Zhang
- Department of Medicine (Biomedical Genetics)Boston University School of MedicineBostonMassachusettsUSA
- Department of BiostatisticsBoston University School of Public HealthBostonMassachusettsUSA
| | - Tong Tong
- Department of Medicine (Biomedical Genetics)Boston University School of MedicineBostonMassachusettsUSA
| | - Andrew Chang
- Department of Physiology & BiophysicsBoston University School of MedicineBostonMassachusettsUSA
| | - Ting Fang Alvin Ang
- Department of Anatomy & NeurobiologyBoston University School of MedicineBostonMassachusettsUSA
- Framingham Heart StudyBoston University School of MedicineFraminghamMassachusettsUSA
| | - Qiushan Tao
- Department of Pharmacology & Experimental TherapeuticsBoston University School of MedicineBostonMassachusettsUSA
| | - Sanford Auerbach
- Department of NeurologyBoston University School of MedicineBostonMassachusettsUSA
| | - Sherral Devine
- Department of Anatomy & NeurobiologyBoston University School of MedicineBostonMassachusettsUSA
- Framingham Heart StudyBoston University School of MedicineFraminghamMassachusettsUSA
| | - Wei Qiao Qiu
- Department of Pharmacology & Experimental TherapeuticsBoston University School of MedicineBostonMassachusettsUSA
- Department of PsychiatryBoston University School of MedicineBostonMassachusettsUSA
- Alzheimer's Disease Research CenterBoston University School of MedicineBostonMassachusettsUSA
| | - Jesse Mez
- Framingham Heart StudyBoston University School of MedicineFraminghamMassachusettsUSA
- Department of NeurologyBoston University School of MedicineBostonMassachusettsUSA
- Alzheimer's Disease Research CenterBoston University School of MedicineBostonMassachusettsUSA
| | - Joseph Massaro
- Department of BiostatisticsBoston University School of Public HealthBostonMassachusettsUSA
- Framingham Heart StudyBoston University School of MedicineFraminghamMassachusettsUSA
| | - Kathryn L. Lunetta
- Department of BiostatisticsBoston University School of Public HealthBostonMassachusettsUSA
| | - Rhoda Au
- Department of Anatomy & NeurobiologyBoston University School of MedicineBostonMassachusettsUSA
- Framingham Heart StudyBoston University School of MedicineFraminghamMassachusettsUSA
- Department of NeurologyBoston University School of MedicineBostonMassachusettsUSA
- Alzheimer's Disease Research CenterBoston University School of MedicineBostonMassachusettsUSA
- Department of EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA
| | - Lindsay A. Farrer
- Department of Medicine (Biomedical Genetics)Boston University School of MedicineBostonMassachusettsUSA
- Department of BiostatisticsBoston University School of Public HealthBostonMassachusettsUSA
- Framingham Heart StudyBoston University School of MedicineFraminghamMassachusettsUSA
- Department of NeurologyBoston University School of MedicineBostonMassachusettsUSA
- Alzheimer's Disease Research CenterBoston University School of MedicineBostonMassachusettsUSA
- Department of EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA
- Department of OphthalmologyBoston University School of MedicineBostonMassachusettsUSA
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Huang J, Tao Q, Ang TFA, Farrell J, Zhu C, Wang Y, Stein TD, Lunetta KL, Massaro J, Mez J, Au R, Farrer LA, Qiu WQ, Zhang X. The impact of increasing levels of blood C-reactive protein on the inflammatory loci SPI1 and CD33 in Alzheimer's disease. Transl Psychiatry 2022; 12:523. [PMID: 36550123 PMCID: PMC9780312 DOI: 10.1038/s41398-022-02281-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 11/19/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Apolipoprotein ε4 (APOE ε4) is the most significant genetic risk factor for late-onset Alzheimer's disease (AD). Elevated blood C-reactive protein (CRP) further increases the risk of AD for people carrying the APOE ε4 allele. We hypothesized that CRP, as a key inflammatory element, could modulate the impact of other genetic variants on AD risk. We selected ten single nucleotide polymorphisms (SNPs) in reported AD risk loci encoding proteins related to inflammation. We then tested the interaction effects between these SNPs and blood CRP levels on AD incidence using the Cox proportional hazards model in UK Biobank (n = 279,176 white participants with 803 incident AD cases). The five top SNPs were tested for their interaction with different CRP cutoffs for AD incidence in the Framingham Heart Study (FHS) Generation 2 cohort (n = 3009, incident AD = 156). We found that for higher concentrations of serum CRP, the AD risk increased for SNP genotypes in 3 AD-associated genes (SPI1, CD33, and CLU). Using the Cox model in stratified genotype analysis, the hazard ratios (HRs) for the association between a higher CRP level (≥10 vs. <10 mg/L) and the risk of incident AD were 1.94 (95% CI: 1.33-2.84, p < 0.001) for the SPI1 rs1057233-AA genotype, 1.75 (95% CI: 1.20-2.55, p = 0.004) for the CD33 rs3865444-CC genotype, and 1.76 (95% CI: 1.25-2.48, p = 0.001) for the CLU rs9331896-C genotype. In contrast, these associations were not observed in the other genotypes of these genes. Finally, two SNPs were validated in 321 Alzheimer's Disease Neuroimaging (ADNI) Mild Cognitive Impairment (MCI) patients. We observed that the SPI1 and CD33 genotype effects were enhanced by elevated CRP levels for the risk of MCI to AD conversion. Furthermore, the SPI1 genotype was associated with CSF AD biomarkers, including t-Tau and p-Tau, in the ADNI cohort when the blood CRP level was increased (p < 0.01). Our findings suggest that elevated blood CRP, as a peripheral inflammatory biomarker, is an important moderator of the genetic effects of SPI1 and CD33 in addition to APOE ε4 on AD risk. Monitoring peripheral CRP levels may be helpful for precise intervention and prevention of AD for these genotype carriers.
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Affiliation(s)
- Jinghan Huang
- Departments of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
| | - Qiushan Tao
- Departments of Pharmacology & Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Ting Fang Alvin Ang
- Departments of Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - John Farrell
- Departments of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
| | - Congcong Zhu
- Departments of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
| | - Yixuan Wang
- Departments of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
| | - Thor D Stein
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA
- Alzheimer's Disease Research Center, Boston University School of Medicine, Boston, MA, USA
- VA Boston Healthcare System, Boston, MA, USA
- VA Bedford Healthcare System, Bedford, MA, USA
| | - Kathryn L Lunetta
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Framingham Heart Study, Boston University School of Medicine, Framingham, MA, USA
| | - Joseph Massaro
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Framingham Heart Study, Boston University School of Medicine, Framingham, MA, USA
| | - Jesse Mez
- Alzheimer's Disease Research Center, Boston University School of Medicine, Boston, MA, USA
- Framingham Heart Study, Boston University School of Medicine, Framingham, MA, USA
- Departments of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Rhoda Au
- Departments of Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Alzheimer's Disease Research Center, Boston University School of Medicine, Boston, MA, USA
- Framingham Heart Study, Boston University School of Medicine, Framingham, MA, USA
- Departments of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Lindsay A Farrer
- Departments of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Alzheimer's Disease Research Center, Boston University School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Framingham Heart Study, Boston University School of Medicine, Framingham, MA, USA
- Departments of Neurology, Boston University School of Medicine, Boston, MA, USA
- Departments of Ophthalmology, Boston University School of Medicine, Boston, MA, USA
| | - Wei Qiao Qiu
- Departments of Pharmacology & Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA.
- Alzheimer's Disease Research Center, Boston University School of Medicine, Boston, MA, USA.
- Departments of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
| | - Xiaoling Zhang
- Departments of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA.
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
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20
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Qiu WQ, Tao Q, Akhter-Khan SC. Author Response: Impact of C-Reactive Protein on Cognition and Alzheimer Disease Biomarkers in Homozygous APOE ɛ4 Carriers. Neurology 2022; 99:919. [PMID: 36376087 DOI: 10.1212/wnl.0000000000201509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023] Open
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21
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Tao Q, Akhter-Khan SC, Ang TFA, DeCarli C, Alosco ML, Mez J, Killiany R, Devine S, Rokach A, Itchapurapu IS, Zhang X, Lunetta KL, Steffens DC, Farrer LA, Greve DN, Au R, Qiu WQ. Different loneliness types, cognitive function, and brain structure in midlife: Findings from the Framingham Heart Study. EClinicalMedicine 2022; 53:101643. [PMID: 36105871 PMCID: PMC9465265 DOI: 10.1016/j.eclinm.2022.101643] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 11/29/2022] Open
Abstract
Background It remains unclear whether persistent loneliness is related to brain structures that are associated with cognitive decline and development of Alzheimer's disease (AD). This study aimed to investigate the relationships between different loneliness types, cognitive functioning, and regional brain volumes. Methods Loneliness was measured longitudinally, using the item from the Center for Epidemiologic Studies Depression Scale in the Framingham Heart Study, Generation 3, with participants' average age of 46·3 ± 8·6 years. Robust regression models tested the association between different loneliness types with longitudinal neuropsychological performance (n = 2,609) and regional magnetic resonance imaging brain data (n = 1,829) (2002-2019). Results were stratified for sex, depression, and Apolipoprotein E4 (ApoE4). Findings Persistent loneliness, but not transient loneliness, was strongly associated with cognitive decline, especially memory and executive function. Persistent loneliness was negatively associated with temporal lobe volume (β = -0.18, 95%CI [-0.32, -0.04], P = 0·01). Among women, persistent loneliness was associated with smaller frontal lobe (β = -0.19, 95%CI [-0.38, -0.01], P = 0·04), temporal lobe (β = -0.20, 95%CI [-0.37, -0.03], P = 0·02), and hippocampus volumes (β = -0.23, 95%CI [-0.40, -0.06], P = 0·007), and larger lateral ventricle volume (β = 0.15, 95%CI [0.02, 0.28], P = 0·03). The higher cumulative loneliness scores across three exams, the smaller parietal, temporal, and hippocampus volumes and larger lateral ventricle were evident, especially in the presence of ApoE4. Interpretation Persistent loneliness in midlife was associated with atrophy in brain regions responsible for memory and executive dysfunction. Interventions to reduce the chronicity of loneliness may mitigate the risk of age-related cognitive decline and AD. Funding US National Institute on Aging.
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Affiliation(s)
- Qiushan Tao
- Department of Pharmacology & Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
- Framingham Heart Study, Boston University School of Medicine, USA
| | - Samia C. Akhter-Khan
- Department of Health Service & Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Ting Fang Alvin Ang
- Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Slone Epidemiology Center, Boston University School of Medicine, USA
| | - Charles DeCarli
- Alzheimer's Disease Center, University of California Davis Medical Center, CA, USA
| | - Michael L. Alosco
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Alzheimer's Diesease and Chronic Traumatic Encephalopathy Research Centers, Boston University, Boston, MA, USA
| | - Jesse Mez
- Framingham Heart Study, Boston University School of Medicine, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Alzheimer's Diesease and Chronic Traumatic Encephalopathy Research Centers, Boston University, Boston, MA, USA
| | - Ronald Killiany
- Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Sherral Devine
- Framingham Heart Study, Boston University School of Medicine, USA
- Department of Psychiatry, Boston University School of Medicine, USA
| | - Ami Rokach
- Department of Psychology, York University, Toronto, Canada
| | - Indira Swetha Itchapurapu
- Department of Pharmacology & Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Xiaoling Zhang
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Medicine, USA
| | | | - David C. Steffens
- Department of Psychiatry, University of Connecticut School of Medicine, USA
| | - Lindsay A. Farrer
- Framingham Heart Study, Boston University School of Medicine, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Medicine, USA
| | - Douglas N. Greve
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard University School of Medicine, USA
| | - Rhoda Au
- Framingham Heart Study, Boston University School of Medicine, USA
- Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Slone Epidemiology Center, Boston University School of Medicine, USA
| | - Wei Qiao Qiu
- Department of Pharmacology & Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
- Alzheimer's Diesease and Chronic Traumatic Encephalopathy Research Centers, Boston University, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, USA
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22
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Morrison MS, Aparicio HJ, Blennow K, Zetterberg H, Ashton NJ, Karikari TK, Tripodis Y, Martin B, Palmisano JN, Sugarman MA, Frank B, Steinberg EG, Turk KW, Budson AE, Au R, Goldstein LE, Jun GR, Kowall NW, Killiany R, Qiu WQ, Stern RA, Mez J, McKee AC, Stein TD, Alosco ML. Ante-mortem plasma phosphorylated tau (181) predicts Alzheimer's disease neuropathology and regional tau at autopsy. Brain 2022; 145:3546-3557. [PMID: 35554506 PMCID: PMC10233293 DOI: 10.1093/brain/awac175] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/07/2022] [Accepted: 05/02/2022] [Indexed: 11/14/2022] Open
Abstract
Blood-based biomarkers such as tau phosphorylated at threonine 181 (phosphorylated-tau181) represent an accessible, cost-effective and scalable approach for the in vivo detection of Alzheimer's disease pathophysiology. Plasma-pathological correlation studies are needed to validate plasma phosphorylated-tau181 as an accurate and reliable biomarker of Alzheimer's disease neuropathological changes. This plasma-to-autopsy correlation study included participants from the Boston University Alzheimer's Disease Research Center who had a plasma sample analysed for phosphorylated-tau181 between 2008 and 2018 and donated their brain for neuropathological examination. Plasma phosphorelated-tau181 was measured with single molecule array technology. Of 103 participants, 62 (60.2%) had autopsy-confirmed Alzheimer's disease. Average time between blood draw and death was 5.6 years (standard deviation = 3.1 years). Multivariable analyses showed higher plasma phosphorylated-tau181 concentrations were associated with increased odds for having autopsy-confirmed Alzheimer's disease [AUC = 0.82, OR = 1.07, 95% CI = 1.03-1.11, P < 0.01; phosphorylated-tau standardized (z-transformed): OR = 2.98, 95% CI = 1.50-5.93, P < 0.01]. Higher plasma phosphorylated-tau181 levels were associated with increased odds for having a higher Braak stage (OR = 1.06, 95% CI = 1.02-1.09, P < 0.01) and more severe phosphorylated-tau across six cortical and subcortical brain regions (ORs = 1.03-1.06, P < 0.05). The association between plasma phosphorylated-tau181 and Alzheimer's disease was strongest in those who were demented at time of blood draw (OR = 1.25, 95%CI = 1.02-1.53), but an effect existed among the non-demented (OR = 1.05, 95% CI = 1.01-1.10). There was higher discrimination accuracy for Alzheimer's disease when blood draw occurred in years closer to death; however, higher plasma phosphorylated-tau181 levels were associated with Alzheimer's disease even when blood draw occurred >5 years from death. Ante-mortem plasma phosphorylated-tau181 concentrations were associated with Alzheimer's disease neuropathology and accurately differentiated brain donors with and without autopsy-confirmed Alzheimer's disease. These findings support plasma phosphorylated-tau181 as a scalable biomarker for the detection of Alzheimer's disease.
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Affiliation(s)
- Madeline S Morrison
- Boston University Alzheimer’s Disease Research Center and CTE Center, Boston University School of Medicine, Boston, MA 02118, USA
| | - Hugo J Aparicio
- Boston University Alzheimer’s Disease Research Center and CTE Center, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA 02118, USA
- Framingham Heart Study, Boston University School of Medicine, Boston, MA 02118, USA
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 413 45 Mölndal, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, 413 90 Gothenburg, Sweden
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 413 45 Mölndal, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, 413 90 Gothenburg, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
- UK Dementia Research Institute at UCL, London WC1N 3BG, UK
| | - Nicholas J Ashton
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 413 45 Mölndal, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, 413 90 Gothenburg, Sweden
| | - Thomas K Karikari
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 413 45 Mölndal, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, 413 90 Gothenburg, Sweden
| | - Yorghos Tripodis
- Boston University Alzheimer’s Disease Research Center and CTE Center, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
| | - Brett Martin
- Boston University Alzheimer’s Disease Research Center and CTE Center, Boston University School of Medicine, Boston, MA 02118, USA
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA 02118, USA
| | - Joseph N Palmisano
- Boston University Alzheimer’s Disease Research Center and CTE Center, Boston University School of Medicine, Boston, MA 02118, USA
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA 02118, USA
| | - Michael A Sugarman
- Department of Neurology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Brandon Frank
- Boston University Alzheimer’s Disease Research Center and CTE Center, Boston University School of Medicine, Boston, MA 02118, USA
| | - Eric G Steinberg
- Boston University Alzheimer’s Disease Research Center and CTE Center, Boston University School of Medicine, Boston, MA 02118, USA
| | - Katherine W Turk
- Boston University Alzheimer’s Disease Research Center and CTE Center, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA 02118, USA
- VA Boston Healthcare System, U.S. Department of Veteran Affairs, Jamaica Plain, MA 02130, USA
| | - Andrew E Budson
- Boston University Alzheimer’s Disease Research Center and CTE Center, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA 02118, USA
- VA Boston Healthcare System, U.S. Department of Veteran Affairs, Jamaica Plain, MA 02130, USA
| | - Rhoda Au
- Boston University Alzheimer’s Disease Research Center and CTE Center, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA 02118, USA
- Framingham Heart Study, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
| | - Lee E Goldstein
- Boston University Alzheimer’s Disease Research Center and CTE Center, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Ophthalmology, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Biomedical Engineering, Boston University College of Engineering, Boston, MA 02215, USA
- Department of Electrical and Computer Engineering, Boston University College of Engineering, Boston, MA 02215, USA
| | - Gyungah R Jun
- Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA
| | - Neil W Kowall
- Boston University Alzheimer’s Disease Research Center and CTE Center, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA 02118, USA
- VA Boston Healthcare System, U.S. Department of Veteran Affairs, Jamaica Plain, MA 02130, USA
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA 02118, USA
| | - Ronald Killiany
- Boston University Alzheimer’s Disease Research Center and CTE Center, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA
- Center for Biomedical Imaging, Boston University School of Medicine, Boston, MA 02118, USA
| | - Wei Qiao Qiu
- Boston University Alzheimer’s Disease Research Center and CTE Center, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA 02118, USA
| | - Robert A Stern
- Boston University Alzheimer’s Disease Research Center and CTE Center, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Neurosurgery, Boston University School of Medicine, Boston, MA 02118, USA
| | - Jesse Mez
- Boston University Alzheimer’s Disease Research Center and CTE Center, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA 02118, USA
- Framingham Heart Study, Boston University School of Medicine, Boston, MA 02118, USA
| | - Ann C McKee
- Boston University Alzheimer’s Disease Research Center and CTE Center, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA 02118, USA
- VA Boston Healthcare System, U.S. Department of Veteran Affairs, Jamaica Plain, MA 02130, USA
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA 02118, USA
- VA Bedford Healthcare System, U.S. Department of Veteran Affairs, Bedford, MA 01730, USA
| | - Thor D Stein
- Boston University Alzheimer’s Disease Research Center and CTE Center, Boston University School of Medicine, Boston, MA 02118, USA
- VA Boston Healthcare System, U.S. Department of Veteran Affairs, Jamaica Plain, MA 02130, USA
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA 02118, USA
- VA Bedford Healthcare System, U.S. Department of Veteran Affairs, Bedford, MA 01730, USA
| | - Michael L Alosco
- Boston University Alzheimer’s Disease Research Center and CTE Center, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA 02118, USA
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23
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Fang Y, Doyle MF, Chen J, Alosco ML, Mez J, Satizabal CL, Qiu WQ, Murabito JM, Lunetta KL. Association between inflammatory biomarkers and cognitive aging. PLoS One 2022; 17:e0274350. [PMID: 36083988 PMCID: PMC9462682 DOI: 10.1371/journal.pone.0274350] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/25/2022] [Indexed: 11/18/2022] Open
Abstract
Inflammatory cytokines and chemokines related to the innate and adaptive immune system have been linked to neuroinflammation in Alzheimer's Disease, dementia, and cognitive disorders. We examined the association of 11 plasma proteins (CD14, CD163, CD5L, CD56, CD40L, CXCL16, SDF1, DPP4, SGP130, sRAGE, and MPO) related to immune and inflammatory responses with measures of cognitive function, brain MRI and dementia risk. We identified Framingham Heart Study Offspring participants who underwent neuropsychological testing (n = 2358) or brain MRI (n = 2100) within five years of the seventh examination where a blood sample for quantifying the protein biomarkers was obtained; and who were followed for 10 years for incident all-cause dementia (n = 1616). We investigated the association of inflammatory biomarkers with neuropsychological test performance and brain MRI volumes using linear mixed effect models accounting for family relationships. We further used Cox proportional hazards models to examine the association with incident dementia. False discovery rate p-values were used to account for multiple testing. Participants included in the neuropsychological test and MRI samples were on average 61 years old and 54% female. Participants from the incident dementia sample (average 68 years old at baseline) included 124 participants with incident dementia. In addition to CD14, which has an established association, we found significant associations between higher levels of CD40L and myeloperoxidase (MPO) with executive dysfunction. Higher CD5L levels were significantly associated with smaller total brain volumes (TCBV), whereas higher levels of sRAGE were associated with larger TCBV. Associations persisted after adjustment for APOE ε4 carrier status and additional cardiovascular risk factors. None of the studied inflammatory biomarkers were significantly associated with risk of incident all-cause dementia. Higher circulating levels of soluble CD40L and MPO, markers of immune cell activation, were associated with poorer performance on neuropsychological tests, while higher CD5L, a key regulator of inflammation, was associated with smaller total brain volumes. Higher circulating soluble RAGE, a decoy receptor for the proinflammatory RAGE/AGE pathway, was associated with larger total brain volume. If confirmed in other studies, this data indicates the involvement of an activated immune system in abnormal brain aging.
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Affiliation(s)
- Yuan Fang
- Department of Biostatistics, School of Public Health, Boston University, Boston, Massachusetts, United States of America
- * E-mail:
| | - Margaret F. Doyle
- Department of Pathology and Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont, United States of America
| | - Jiachen Chen
- Department of Biostatistics, School of Public Health, Boston University, Boston, Massachusetts, United States of America
| | - Michael L. Alosco
- Boston University Alzheimer’s Disease Research Center and CTE Center, School of Medicine, Boston University, Boston, Massachusetts, United States of America
- Department of Neurology, School of Medicine, Boston University, Boston, Massachusetts, United States of America
| | - Jesse Mez
- Boston University Alzheimer’s Disease Research Center and CTE Center, School of Medicine, Boston University, Boston, Massachusetts, United States of America
- Department of Neurology, School of Medicine, Boston University, Boston, Massachusetts, United States of America
- Framingham Heart Study, National Heart, Lung, and Blood Institute and Boston University School of Medicine, Framingham, Massachusetts, United States of America
| | - Claudia L. Satizabal
- Department of Neurology, School of Medicine, Boston University, Boston, Massachusetts, United States of America
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
| | - Wei Qiao Qiu
- Boston University Alzheimer’s Disease Research Center and CTE Center, School of Medicine, Boston University, Boston, Massachusetts, United States of America
- Department of Psychiatry, School of Medicine, Boston University, Boston, Massachusetts, United States of America
- Department of Pharmacology & Experimental Therapeutics, School of Medicine, Boston University, Boston, Massachusetts, United States of America
| | - Joanne M. Murabito
- Framingham Heart Study, National Heart, Lung, and Blood Institute and Boston University School of Medicine, Framingham, Massachusetts, United States of America
- Department of Medicine, Section of General Internal Medicine, School of Medicine, Boston University, Boston, Massachusetts, United States of America
- Boston Medical Center, Boston University, Boston, Massachusetts, United States of America
| | - Kathryn L. Lunetta
- Department of Biostatistics, School of Public Health, Boston University, Boston, Massachusetts, United States of America
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24
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Potempa LA, Qiu WQ, Stefanski A, Rajab IM. Relevance of lipoproteins, membranes, and extracellular vesicles in understanding C-reactive protein biochemical structure and biological activities. Front Cardiovasc Med 2022; 9:979461. [PMID: 36158829 PMCID: PMC9493015 DOI: 10.3389/fcvm.2022.979461] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
Early purification protocols for C-reactive protein (CRP) often involved co-isolation of lipoproteins, primarily very low-density lipoproteins (VLDLs). The interaction with lipid particles was initially attributed to CRP’s calcium-dependent binding affinity for its primary ligand—phosphocholine—the predominant hydrophilic head group expressed on phospholipids of most lipoprotein particles. Later, CRP was shown to additionally express binding affinity for apolipoprotein B (apo B), a predominant apolipoprotein of both VLDL and LDL particles. Apo B interaction with CRP was shown to be mediated by a cationic peptide sequence in apo B. Optimal apo B binding required CRP to be surface immobilized or aggregated, treatments now known to structurally change CRP from its serum soluble pentamer isoform (i.e., pCRP) into its poorly soluble, modified, monomeric isoform (i.e., mCRP). Other cationic ligands have been described for CRP which affect complement activation, histone bioactivities, and interactions with membranes. mCRP, but not pCRP, binds cholesterol and activates signaling pathways that activate pro-inflammatory bioactivities long associated with CRP as a biomarker. Hence, a key step to express CRP’s biofunctions is its conversion into its mCRP isoform. Conversion occurs when (1) pCRP binds to a membrane surface expressed ligand (often phosphocholine); (2) biochemical forces associated with binding cause relaxation/partial dissociation of secondary and tertiary structures into a swollen membrane bound intermediate (described as mCRPm or pCRP*); (3) further structural relaxation which leads to total, irreversible dissociation of the pentamer into mCRP and expression of a cholesterol/multi-ligand binding sequence that extends into the subunit core; (4) reduction of the CRP subunit intrachain disulfide bond which enhances CRP’s binding accessibility for various ligands and activates acute phase proinflammatory responses. Taken together, the biofunctions of CRP involve both lipid and protein interactions and a conformational rearrangement of higher order structure that affects its role as a mediator of inflammatory responses.
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Affiliation(s)
- Lawrence A. Potempa
- College of Science, Health and Pharmacy, Roosevelt University Schaumburg, Schaumburg, IL, United States
- *Correspondence: Lawrence A. Potempa,
| | - Wei Qiao Qiu
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, United States
- Alzheimer’s Disease Center, Boston University School of Medicine, Boston, MA, United States
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States
| | - Ashley Stefanski
- College of Science, Health and Pharmacy, Roosevelt University Schaumburg, Schaumburg, IL, United States
| | - Ibraheem M. Rajab
- College of Science, Health and Pharmacy, Roosevelt University Schaumburg, Schaumburg, IL, United States
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25
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Frank B, Ally M, Tripodis Y, Puzo C, Labriolo C, Hurley L, Martin B, Palmisano J, Chan L, Steinberg E, Turk K, Budson A, O’Connor M, Au R, Qiu WQ, Goldstein L, Kukull W, Kowall N, Killiany R, Stern R, Stein T, McKee A, Mez J, Alosco M. Trajectories of Cognitive Decline in Brain Donors With Autopsy-Confirmed Alzheimer Disease and Cerebrovascular Disease. Neurology 2022; 98:e2454-e2464. [PMID: 35444054 PMCID: PMC9231841 DOI: 10.1212/wnl.0000000000200304] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/16/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Cerebrovascular disease (CBVD) is frequently comorbid with autopsy-confirmed Alzheimer disease (AD), but its contribution to the clinical presentation of AD remains unclear. We leveraged the National Alzheimer's Coordinating Center (NACC) uniform and neuropathology datasets to compare the cognitive and functional trajectories of AD+/CBVD+ and AD+/CBVD- brain donors. METHODS The sample included NACC brain donors with autopsy-confirmed AD (Braak stage ≥3, Consortium to Establish a Registry for Alzheimer's Disease score ≥2) and complete Uniform Data Set (UDS) evaluations between 2005 and 2019, with the most recent UDS evaluation within 2 years of autopsy. CBVD was defined as moderate to severe arteriosclerosis or atherosclerosis. We used propensity score weighting to isolate the effects of comorbid AD and CBVD. This method improved the balance of covariates between the AD+/CBVD+ and AD+/CBVD- groups. Longitudinal mixed-effects models were assessed with robust bayesian estimation. UDS neuropsychological test and the Clinical Dementia Rating Scale Sum of Boxes (CDR-SB) scores were primary outcomes. RESULTS Of 2,423 brain donors, 1,476 were classified as AD+/CBVD+. Compared with AD+/CVBD- donors, the AD+/CBVD+ group had accelerated decline (i.e., group × time effects) on measures of processing speed (β = -0.93, 95% CI -1.35, -0.51, Bayes factor [BF] 130.75), working memory (β = 0.05, 95% CI 0.02, 0.07, BF 3.59), verbal fluency (β = 0.10, 95% CI 0.04, 0.15, BF 1.28), naming (β = 0.09, 95% CI 0.03, 0.16, BF = 0.69), and CDR-SB (β = -0.08, 95% CI -0.12, -0.05, BF 18.11). Effects ranged from weak (BFs <3.0) to strong (BFs <150). We also found worse performance in the AD+/CBVD+ group across time on naming (β = -1.04, 95% CI -1.83, -0.25, BF 2.52) and verbal fluency (β = -0.73, 95% CI -1.30, -0.15, BF 1.34) and more impaired CDR-SB scores (β = 0.45, 95% CI 0.01, 0.89, BF 0.33). DISCUSSION In brain donors with autopsy-confirmed AD, comorbid CBVD was associated with an accelerated functional and cognitive decline, particularly on neuropsychological tests of attention, psychomotor speed, and working memory. CBVD magnified effects of AD neuropathology on semantic-related neuropsychological tasks. Findings support a prominent additive and more subtle synergistic effect for comorbid CBVD neuropathology in AD.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Michael Alosco
- From the Boston University Alzheimer's Disease Center and CTE Center (B.F., M. Ally, Y.T., C.P., C.L., B.M., J.P., L.C., E.S., K.T., A.B., M.O., R.A., W.Q.Q., L.G., N.K., R.K., R.S., T.S., A.M., J.M., M. Alosco), Boston University School of Medicine; Veteran Affairs Bedford Healthcare System (B.F., M.O., T.S., A.M.), Bedford; Department of Biostatistics (Y.T.), Boston University School of Public Health, MA; Yale School of Public Health (L.H.), New Haven, CT; Biostatistics and Epidemiology Data Analytics Center (B.M., J.P.), Boston University School of Public Health; Department of Neurology (K.T., A.B., R.A., N.K., R.S., A.M., J.M., M. Alosco), Boston University School of Medicine; Veterans Affairs Boston Healthcare System (K.T., A.B., N.K., T.S., A.M); Department of Anatomy & Neurobiology (R.A., R.K., R.S.), Boston University School of Medicine; MA; Framingham Heart Study (R.A.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology (R.A.), Boston University School of Public Health; Department of Psychiatry (W.Q.Q.), Boston University School of Medicine; Department of Pharmacology & Experimental Therapeutics (W.Q.Q.), Boston University School of Medicine; Department of Pathology and Laboratory Medicine (L.G.), Boston University School of Medicine; Departments of Psychiatry and Ophthalmology (L.G.), Boston University School of Medicine; Departments of Biomedical, Electrical & Computer Engineering (L.G.), Boston University College of Engineering, MA; National Alzheimer's Coordinating Center (W.K.), Department of Epidemiology, University of Washington, Seattle; Center for Biomedical Imaging (R.K.), and Boston University School of Medicine; Department of Neurosurgery (R.S.), Boston University School of Medicine, MA.
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Zheng C, Fillmore NR, Ramos-Cejudo J, Brophy M, Osorio R, Gurney ME, Qiu WQ, Au R, Perry G, Dubreuil M, Chen SG, Qi X, Davis PB, Do N, Xu R. Potential long-term effect of tumor necrosis factor inhibitors on dementia risk: A propensity score matched retrospective cohort study in US veterans. Alzheimers Dement 2022; 18:1248-1259. [PMID: 34569707 PMCID: PMC8957621 DOI: 10.1002/alz.12465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/31/2021] [Accepted: 08/03/2021] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Tumor necrosis factor (TNF) inhibitors are widely used to treat rheumatoid arthritis (RA) and their potential to retard Alzheimer's disease (AD) progression has been reported. However, their long-term effects on the dementia/AD risk remain unknown. METHODS A propensity scored matched retrospective cohort study was conducted among 40,207 patients with RA within the US Veterans Affairs health-care system from 2000 to 2020. RESULTS A total of 2510 patients with RA prescribed TNF inhibitors were 1:2 matched to control patients. TNF inhibitor use was associated with reduced dementia risk (hazard ratio [HR]: 0.64, 95% confidence interval [CI]: 0.52-0.80), which was consistent as the study period increased from 5 to 20 years after RA diagnosis. TNF inhibitor use also showed a long-term effect in reducing the risk of AD (HR: 0.57, 95% CI: 0.39-0.83) during the 20 years of follow-up. CONCLUSION TNF inhibitor use is associated with lower long-term risk of dementia/AD among US veterans with RA.
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Affiliation(s)
- Chunlei Zheng
- Center for Artificial Intelligence in Drug Discovery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- VA Boston Cooperative Studies Program, MAVERIC, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Nathanael R. Fillmore
- VA Boston Cooperative Studies Program, MAVERIC, VA Boston Healthcare System, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Jaime Ramos-Cejudo
- VA Boston Cooperative Studies Program, MAVERIC, VA Boston Healthcare System, Boston, Massachusetts, USA
- Division of Brain Aging, Department of Psychiatry, New York University School of Medicine, New York City, New York, USA
| | - Mary Brophy
- VA Boston Cooperative Studies Program, MAVERIC, VA Boston Healthcare System, Boston, Massachusetts, USA
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Ricardo Osorio
- Department of Psychiatry, Healthy Brain Aging and Sleep Center, NYU Langone Medical Center, New York City, New York, USA
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York City, New York, USA
| | | | - Wei Qiao Qiu
- Department of Pharmacology and Experimental Therapeutics, Boston University Medical Campus, Boston, Massachusetts, USA
- Alzheimer’s Disease Center, Boston University Medical Campus, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Medical Campus, Boston, Massachusetts, USA
| | - Rhoda Au
- Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, Massachusetts, USA
- Boston University Alzheimer’s Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - George Perry
- College of Sciences, The University of Texas at San Antonio, San Antonio, Texas, USA
| | - Maureen Dubreuil
- VA Boston Cooperative Studies Program, MAVERIC, VA Boston Healthcare System, Boston, Massachusetts, USA
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Shu G Chen
- Department of Pathology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Xin Qi
- Department of Physiology & Biophysics, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Pamela B Davis
- Center for Clinical Investigation, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Nhan Do
- VA Boston Cooperative Studies Program, MAVERIC, VA Boston Healthcare System, Boston, Massachusetts, USA
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Rong Xu
- Center for Artificial Intelligence in Drug Discovery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
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27
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Fang Y, Doyle MF, Alosco ML, Mez J, Satizabal CL, Qiu WQ, Lunetta KL, Murabito JM. Cross-Sectional Association Between Blood Cell Phenotypes, Cognitive Function, and Brain Imaging Measures in the Community-Based Framingham Heart Study. J Alzheimers Dis 2022; 87:1291-1305. [PMID: 35431244 PMCID: PMC9969805 DOI: 10.3233/jad-215533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Peripheral inflammation is associated with increased risk for dementia. Neutrophil to lymphocyte ratio (NLR), red cell distribution width (RDW), and mean platelet volume (MPV), are easily measured circulating blood cell phenotypes reflecting chronic peripheral inflammation, but their association with dementia status is unclear. OBJECTIVE We sought to investigate the cross-sectional association of these inflammatory measures with neuropsychological (NP) test performance, and brain magnetic resonance imaging (MRI) measures in the Framingham Heart Study (FHS) Offspring, Third-generation, and Omni cohorts. METHODS We identified FHS participants who attended an exam that included a complete blood cell count (CBC) and underwent NP testing (n = 3,396) or brain MRI (n = 2,770) within five years of blood draw. We investigated the association between NLR, RDW, and MPV and NP test performance and structural MRI-derived volumetric measurements using linear mixed effect models accounting for family relationships and adjusting for potential confounders. RESULTS Participants were on average 60 years old, 53% female, and about 80% attended some college. Higher NLR was significantly associated with poorer performance on visual memory, and visuospatial abilities, as well as with larger white matter hyperintensity volume. We also observed associations for higher RDW with poorer executive function and smaller total cerebral brain volume. CONCLUSION Chronic peripheral inflammation as measured by NLR and RDW was associated with worse cognitive function, reduced brain volume, and greater microvascular disease in FHS participants. If confirmed in other samples, CBC may provide informative and cost-effective biomarkers of abnormal brain aging in the community.
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Affiliation(s)
- Yuan Fang
- Boston University School of Public Health, Department of Biostatistics, Boston, MA, USA
| | - Margaret F. Doyle
- University of Vermont, Larner College of Medicine, Department of Pathology and Laboratory Medicine, Burlington, VT
| | - Michael L. Alosco
- Boston University School of Medicine, Boston University Alzheimer’s Disease Research Center and CTE Center, Boston, MA, USA.,Boston University School of Medicine, Department of Neurology, Boston, MA, USA
| | - Jesse Mez
- Boston University School of Medicine, Boston University Alzheimer’s Disease Research Center and CTE Center, Boston, MA, USA.,Boston University School of Medicine, Department of Neurology, Boston, MA, USA.,Framingham Heart Study, National Heart, Lung, and Blood Institute and Boston University School of Medicine, Framingham, MA, USA
| | - Claudia L. Satizabal
- Boston University School of Medicine, Department of Neurology, Boston, MA, USA.,University of Texas Health Science Center at San Antonio, Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, San Antonio, USA
| | - Wei Qiao Qiu
- Boston University School of Medicine, Boston University Alzheimer’s Disease Research Center and CTE Center, Boston, MA, USA.,Boston University School of Medicine, Department of Psychiatry, Boston, MA, USA.,Boston University School of Medicine, Department of Pharmacology & Experimental Therapeutics, Boston, MA, USA
| | - Kathryn L. Lunetta
- Boston University School of Public Health, Department of Biostatistics, Boston, MA, USA
| | - Joanne M. Murabito
- Framingham Heart Study, National Heart, Lung, and Blood Institute and Boston University School of Medicine, Framingham, MA, USA.,Boston University School of Medicine, Department of Medicine, Section of General Internal Medicine, Boston, MA, USA
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28
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Gan Q, Wong A, Zhang Z, Na H, Tian H, Tao Q, Rajab IM, Potempa LA, Qiu WQ. Monomeric C‐reactive protein induces the cellular pathology of Alzheimer's disease. A&D Transl Res & Clin Interv 2022; 8:e12319. [PMID: 35846159 PMCID: PMC9270638 DOI: 10.1002/trc2.12319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 05/17/2022] [Accepted: 06/01/2022] [Indexed: 11/19/2022]
Abstract
Introduction Human study shows that elevated C‐reactive protein (CRP) in blood impacts apolipoprotein E (APOE) ε4, but not APOE ε3 or APOE ε2, genotype to increase the risk of Alzheimer's disease (AD). However, whether CRP is directly involved in cellular AD pathogenesis and in which type of neuronal cells of APOE ε4 carriers are unknown. Methods We aimed to use different primary neuronal cells and investigate if CRP induces cellular AD pathology depending on APOE genotypes. Here the different primary neuronal cells from the different APOE genotype knock‐in mice cortex were isolated and used. Results Monomeric CRP (mCRP) increased amyloid beta production and, in parallel, induced tau phosphorylation in addition to their related proteins in the primary neurons in a pattern of APOE ε4 > APOE ε3 > APOE ε2 in a dose‐ and time‐dependent manner. Consistently, mCRP induced the staining of other neurodegenerative biomarkers, including Fluoro‐Jade B stain (FjB), TUNEL and Cleaved Caspase‐3, in primary neurons in a similar pattern of APOE ε4 > APOE ε3 > APOE ε2. In contrast, pentameric CRP (pCRP) had a tendency to induce cellular AD pathology but did not reach statistical significance. On the other hand, it is intriguing that regardless of APOE genotype, mCRP did not influence the expressions of Iba‐1 and CD68 in primary microglia or the expression of glial fibrillary acidic protein in primary astrocytes, and additionally mCRP did not affect the secretions of interleukin (IL)‐1α, IL‐1β, and tumor necrosis factor α from these cells. Discussion This is the first report to demonstrate that mCRP directly induces cellular AD pathogenesis in neurons in an APOE genotype‐dependent pattern, suggesting that mCRP plays a role as a mediator involved in the APOE ε4‐related pathway for AD during chronic inflammation. Highlights Pentameric C‐reactive protein (pCRP) can be dissociated irreversibly to form free subunits or monomeric CRP (mCRP) during and after the acute phase. mCRP increased amyloid beta production in the primary neurons in a pattern of apolipoprotein E (APOE) ε4 > APOE ε3 > APOE ε2 in a dose‐dependent manner. mCRP induced the expression of phosphorylated tau in the primary neurons in a pattern of APOE ε4 > APOE ε3 > APOE ε2 in a dose‐ and time‐dependent manner. mCRP plays an important mediator role in the APOE ε4‐related pathway of Alzheimer's disease risk.
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Affiliation(s)
- Qini Gan
- Department of Pharmacology and Experimental Therapeutics Boston University School of Medicine Boston Massachusetts USA
| | - Alfred Wong
- Department of Pharmacology and Experimental Therapeutics Boston University School of Medicine Boston Massachusetts USA
| | - Zhengrong Zhang
- Department of Pharmacology and Experimental Therapeutics Boston University School of Medicine Boston Massachusetts USA
| | - Hana Na
- Department of Pharmacology and Experimental Therapeutics Boston University School of Medicine Boston Massachusetts USA
| | - Hua Tian
- Department of Pharmacology and Experimental Therapeutics Boston University School of Medicine Boston Massachusetts USA
- Department of Pharmacology Xiaman Medical College Xiaman People's Republic of China
| | - Qiushan Tao
- Department of Pharmacology and Experimental Therapeutics Boston University School of Medicine Boston Massachusetts USA
| | - Ibraheem M. Rajab
- Roosevelt University College of Science Health and Pharmacy Schaumburg Illinois USA
| | - Lawrence A. Potempa
- Roosevelt University College of Science Health and Pharmacy Schaumburg Illinois USA
| | - Wei Qiao Qiu
- Department of Pharmacology and Experimental Therapeutics Boston University School of Medicine Boston Massachusetts USA
- Alzheimer's Disease Center Boston University School of Medicine Boston Massachusetts USA
- Department of Psychiatry Boston University School of Medicine Boston Massachusetts USA
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29
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Frank B, Ally M, Brekke B, Zetterberg H, Blennow K, Sugarman MA, Ashton NJ, Karikari TK, Tripodis Y, Martin B, Palmisano JN, Steinberg EG, Simkina I, Turk KW, Budson AE, O'Connor MK, Au R, Goldstein LE, Jun GR, Kowall NW, Stein TD, McKee AC, Killiany R, Qiu WQ, Stern RA, Mez J, Alosco ML. Plasma p-tau 181 shows stronger network association to Alzheimer's disease dementia than neurofilament light and total tau. Alzheimers Dement 2021; 18:1523-1536. [PMID: 34854549 DOI: 10.1002/alz.12508] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 07/07/2021] [Accepted: 09/22/2021] [Indexed: 01/29/2023]
Abstract
INTRODUCTION We examined the ability of plasma hyperphosphorylated tau (p-tau)181 to detect cognitive impairment due to Alzheimer's disease (AD) independently and in combination with plasma total tau (t-tau) and neurofilament light (NfL). METHODS Plasma samples were analyzed using the Simoa platform for 235 participants with normal cognition (NC), 181 with mild cognitive impairment due to AD (MCI), and 153 with AD dementia. Statistical approaches included multinomial regression and Gaussian graphical models (GGMs) to assess a network of plasma biomarkers, neuropsychological tests, and demographic variables. RESULTS Plasma p-tau181 discriminated AD dementia from NC, but not MCI, and correlated with dementia severity and worse neuropsychological test performance. Plasma NfL similarly discriminated diagnostic groups. Unlike plasma NfL or t-tau, p-tau181 had a direct association with cognitive diagnosis in a bootstrapped GGM. DISCUSSION These results support plasma p-tau181 for the detection of AD dementia and the use of blood-based biomarkers for optimal disease detection.
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Affiliation(s)
- Brandon Frank
- Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA.,U.S. Department of Veteran Affairs, VA Bedford Healthcare System, Bedford, Massachusetts, USA
| | - Madeline Ally
- Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Bailee Brekke
- Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Henrik Zetterberg
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.,UK Dementia Research Institute at UCL, London, UK.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Michael A Sugarman
- Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA.,U.S. Department of Veteran Affairs, VA Bedford Healthcare System, Bedford, Massachusetts, USA
| | - Nicholas J Ashton
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Thomas K Karikari
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Yorghos Tripodis
- Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Brett Martin
- Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Joseph N Palmisano
- Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Eric G Steinberg
- Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Irene Simkina
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Katherine W Turk
- Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA.,U.S. Department of Veteran Affairs, VA Boston Healthcare System, Jamaica Plain, Massachusetts, USA
| | - Andrew E Budson
- Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA.,U.S. Department of Veteran Affairs, VA Boston Healthcare System, Jamaica Plain, Massachusetts, USA
| | - Maureen K O'Connor
- Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA.,U.S. Department of Veteran Affairs, VA Bedford Healthcare System, Bedford, Massachusetts, USA
| | - Rhoda Au
- Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, Massachusetts, USA.,Framingham Heart Study, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Lee E Goldstein
- Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.,Departments of Psychiatry and Ophthalmology, Boston University School of Medicine, Boston, Massachusetts, USA.,Departments of Biomedical, Electrical & Computer Engineering, Boston University College of Engineering, Boston, Massachusetts, USA
| | - Gyungah R Jun
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Neil W Kowall
- Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.,U.S. Department of Veteran Affairs, VA Boston Healthcare System, Jamaica Plain, Massachusetts, USA
| | - Thor D Stein
- Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA.,U.S. Department of Veteran Affairs, VA Bedford Healthcare System, Bedford, Massachusetts, USA.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.,U.S. Department of Veteran Affairs, VA Boston Healthcare System, Jamaica Plain, Massachusetts, USA
| | - Ann C McKee
- Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA.,U.S. Department of Veteran Affairs, VA Bedford Healthcare System, Bedford, Massachusetts, USA.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.,U.S. Department of Veteran Affairs, VA Boston Healthcare System, Jamaica Plain, Massachusetts, USA
| | - Ronald Killiany
- Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, Massachusetts, USA.,Center for Biomedical Imaging, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Wei Qiao Qiu
- Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Pharmacology & Experimental Therapeutics, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Robert A Stern
- Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurosurgery, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Jesse Mez
- Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA.,Framingham Heart Study, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Michael L Alosco
- Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
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Zhang Z, Na H, Gan Q, Tao Q, Alekseyev Y, Hu J, Yan Z, Yang JB, Tian H, Zhu S, Li Q, Rajab IM, Blusztajn JK, Wolozin B, Emili A, Zhang X, Stein T, Potempa LA, Qiu WQ. Monomeric C-reactive protein via endothelial CD31 for neurovascular inflammation in an ApoE genotype-dependent pattern: A risk factor for Alzheimer's disease? Aging Cell 2021; 20:e13501. [PMID: 34687487 PMCID: PMC8590103 DOI: 10.1111/acel.13501] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/25/2021] [Accepted: 10/11/2021] [Indexed: 11/29/2022] Open
Abstract
In chronic peripheral inflammation, endothelia in brain capillary beds could play a role for the apolipoprotein E4 (ApoE4)‐mediated risk for Alzheimer's disease (AD) risk. Using human brain tissues, here we demonstrate that the interactions of endothelial CD31 with monomeric C‐reactive protein (mCRP) versus ApoE were linked with shortened neurovasculature for AD pathology and cognition. Using ApoE knock‐in mice, we discovered that intraperitoneal injection of mCRP, via binding to CD31 on endothelial surface and increased CD31 phosphorylation (pCD31), leading to cerebrovascular damage and the extravasation of T lymphocytes into the ApoE4 brain. While mCRP was bound to endothelial CD31 in a dose‐ and time‐dependent manner, knockdown of CD31 significantly decreased mCRP binding and altered the expressions of vascular‐inflammatory factors including vWF, NF‐κB and p‐eNOS. RNAseq revealed endothelial pathways related to oxidative phosphorylation and AD pathogenesis were enhanced, but endothelial pathways involving in epigenetics and vasculogenesis were inhibited in ApoE4. This is the first report providing some evidence on the ApoE4‐mCRP‐CD31 pathway for the cross talk between peripheral inflammation and cerebrovasculature leading to AD risk.
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Affiliation(s)
- Zhengrong Zhang
- Department of Pharmacology and Experimental Therapeutics Boston University School of Medicine Boston Massachusetts USA
| | - Hana Na
- Department of Pharmacology and Experimental Therapeutics Boston University School of Medicine Boston Massachusetts USA
| | - Qini Gan
- Department of Pharmacology and Experimental Therapeutics Boston University School of Medicine Boston Massachusetts USA
| | - Qiushan Tao
- Department of Pharmacology and Experimental Therapeutics Boston University School of Medicine Boston Massachusetts USA
| | - Yuriy Alekseyev
- Microarray and Sequencing Core Facility Boston University School of Medicine Boston Massachusetts USA
| | - Junming Hu
- Department of Medicine Boston University School of Medicine Boston Massachusetts USA
| | - Zili Yan
- Department of Pharmacology and Experimental Therapeutics Boston University School of Medicine Boston Massachusetts USA
| | - Jack B. Yang
- Department of Pharmacology and Experimental Therapeutics Boston University School of Medicine Boston Massachusetts USA
| | - Hua Tian
- Department of Pharmacology and Experimental Therapeutics Boston University School of Medicine Boston Massachusetts USA
- Department of Pharmacology Xiaman Medical College Xiaman China
| | - Shenyu Zhu
- Department of Pharmacology and Experimental Therapeutics Boston University School of Medicine Boston Massachusetts USA
| | - Qiang Li
- Department of Pharmacology and Experimental Therapeutics Boston University School of Medicine Boston Massachusetts USA
- Nursing School Qiqihar Medical University Qiqihar China
| | | | - Jan Krizysztof Blusztajn
- Department of Pathology and Laboratory Medicine Boston University School of Medicine Boston Massachusetts USA
| | - Benjamin Wolozin
- Department of Pharmacology and Experimental Therapeutics Boston University School of Medicine Boston Massachusetts USA
| | - Andrew Emili
- Department of Biochemistry Boston University School of Medicine Boston Massachusetts USA
| | - Xiaoling Zhang
- Department of Medicine Boston University School of Medicine Boston Massachusetts USA
| | - Thor Stein
- Department of Pathology and Laboratory Medicine Boston University School of Medicine Boston Massachusetts USA
- Alzheimer’s Disease Center Boston University School of Medicine Boston Massachusetts USA
- VA Boston Healthcare System Boston Massachusetts USA
- Department of Veterans Affairs Medical Center Bedford Massachusetts USA
| | | | - Wei Qiao Qiu
- Department of Pharmacology and Experimental Therapeutics Boston University School of Medicine Boston Massachusetts USA
- Alzheimer’s Disease Center Boston University School of Medicine Boston Massachusetts USA
- Department of Psychiatry Boston University School of Medicine Boston Massachusetts USA
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Zhao MJ, Mao AY, Yuan SS, Wang K, Dong P, Du S, Meng YL, Qiu WQ. [Research progress on building of disease control and prevention system of the international experience]. Zhonghua Yu Fang Yi Xue Za Zhi 2021; 55:1263-1269. [PMID: 34706515 DOI: 10.3760/cma.j.cn112150-20201117-01379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Through literature search in regular database and official websites of relevant countries, this paper combs and summarizes the main characteristics of disease prevention and control systems in five countries, the United States, Germany, South Korea, Australia and Japan, and the European Union at key levels including legal construction, organizational structure, financing, personnel construction and international cooperation, in order to provide decision support for the construction of disease prevention and control system in China in the future.
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Affiliation(s)
- M J Zhao
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - A Y Mao
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - S S Yuan
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - K Wang
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - P Dong
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - S Du
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - Y L Meng
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - W Q Qiu
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
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Yuan SS, Wang F, Qiu WQ. [Policy analysis of disease control and prevention system in China from the perspective of policy instruments from 2000 to 2020]. Zhonghua Yu Fang Yi Xue Za Zhi 2021; 55:1181-1185. [PMID: 34706501 DOI: 10.3760/cma.j.cn112150-20201116-01371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: To analyze the related polities about disease control and prevention system in China from 2000 to 2020, and to provide implication for the policy formulation of disease control and prevention system in the future. Methods: Policy documents were searched in the official websites of relevant government departments including the State Council, National Health Commission, National Development and Reform Commission, Ministry of Human Resources and Social Security, and Ministry of Finance by using the keywords related to disease control and prevention from 2000 to 2020. Thematic framework and content analysis were performed to analyze the eligible policy documents based on the theory of policy instruments. Results: A total of 37 policy documents were included in this study. The application of single policy instrument was common (81.1%), of which the capacity building instrument was the most frequently used (32.4%), followed by mandate instrument (21.6%) and inducement instrument (13.5%), while system-changing instrument (8.1%) and symbolic and hortatory instrument were less used (5.4%). The main policy themes were personnel system (15.2%) and system construction (15.2%), followed by personnel development (13.0%) and information construction (2.2%). Conclusion: In the policy formulation process, the government should strengthen the comprehensive application of multiple policy instruments. Particularly about the inducement instrument and symbolic and hortatory instrument to further stimulate the internal motivation of disease control and prevention system and institutions in China.
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Affiliation(s)
- S S Yuan
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - F Wang
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - W Q Qiu
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
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Yuan SS, Qiu WQ, Wang F, Zhao J. [Changes of the number of disease control and prevention staffs at provincial level in China from 2002 to 2018: an interrupted time series analysis]. Zhonghua Yu Fang Yi Xue Za Zhi 2021; 55:1192-1195. [PMID: 34706503 DOI: 10.3760/cma.j.cn112150-20201116-01373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: To analyze the change of the number of staff at the provincial center for disease control and prevention (CDC) in China before and after the new health care reform. Methods: The data was from publicly reported health statistics yearbooks from 2002 to 2018. Descriptive analysis and interrupted time series analysis (ITS) were conducted in Stata/SE 15. Results: The decreasing trend of total number and average number of CDC staff per ten thousand people further exacerbated in the eastern and central areas after the new health care reform, while the total number of CDC staff in the western area changed from a decreasing trend to an increasing tend and the decreasing trend of average number of CDC staff per ten thousand people slowed down. After controlling the provincial and time fixed effects, the ITS analysis showed that before the reform, the number of CDC staff in central area showed a decreasing trend (P=0.012). After the reform, no statistically significant changes were observed in the number of CDC staff in the eastern, central and western areas increased instantaneously (P>0.05), and the decreasing trend (slope) of the number of CDC staff in the eastern and central areas further increased. The number of CDC staff in the western area changed to an increasing trend (P>0.05). Conclusion: After the new health care reform, the total number and average number of CDC staff at the provincial level have not improved, therefore targeted reform strategies are needed to reverse the continuous reduction of CDC staff and reflect regional differences in the future.
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Affiliation(s)
- S S Yuan
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - W Q Qiu
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - F Wang
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - J Zhao
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
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Akhter-Khan SC, Tao Q, Ang TFA, Itchapurapu IS, Alosco ML, Mez J, Piers RJ, Steffens DC, Au R, Qiu WQ. Associations of loneliness with risk of Alzheimer's disease dementia in the Framingham Heart Study. Alzheimers Dement 2021; 17:1619-1627. [PMID: 33760348 PMCID: PMC8460688 DOI: 10.1002/alz.12327] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 12/22/2022]
Abstract
INTRODUCTION The relationship between persistent loneliness and Alzheimer's disease (AD) is unclear. We examined the relationship between different types of mid-life loneliness and the development of dementia and AD. METHODS Loneliness was assessed in cognitively normal adults using one item from the Center for Epidemiologic Studies Depression Scale. We defined loneliness as no loneliness, transient loneliness, incident loneliness,or persistent loneliness, and applied Cox regression models and Kaplan-Meier plots with dementia and AD as outcomes (n = 2880). RESULTS After adjusting for demographics, social network, physical health, and apolipoprotein E ε4, persistent loneliness was associated with higher (hazard ratio [HR], 1.91; 95% confidence interval [CI] 1.25-2.90; P < .01), and transient loneliness with lower (HR, 0.34; 95% CI 0.14-0.84; P < .05), risk of dementia onset, compared to no loneliness. Results were similar for AD risk. DISCUSSION Persistent loneliness in mid-life is an independent risk factor for dementia and AD, whereas recovery from loneliness suggests resilience to dementia risk.
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Affiliation(s)
- Samia C. Akhter-Khan
- Department of Psychology, Humboldt University of Berlin, Unter den Linden 6, 10117 Berlin, Germany
| | - Qiushan Tao
- Framingham Heart Study, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
- Department of Pharmacology & Experimental Therapeutics, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
| | - Ting Fang Alvin Ang
- Department of Anatomy & Neurobiology, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
- Department of Epidemiology, Boston University School of Public Health, 715 Albany St, Boston, MA 02118, USA
- Slone Epidemiology Center, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
| | - Indira Swetha Itchapurapu
- Department of Pharmacology & Experimental Therapeutics, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
| | - Michael L. Alosco
- Department of Neurology, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
- Alzheimer’s Disease and CTE Centers, Boston University, 72 E Concord St, Boston, MA 02118, USA
| | - Jesse Mez
- Framingham Heart Study, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
- Department of Neurology, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
- Alzheimer’s Disease and CTE Centers, Boston University, 72 E Concord St, Boston, MA 02118, USA
| | - Ryan J. Piers
- Framingham Heart Study, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
| | - David C. Steffens
- Department of Psychiatry, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT 06030, USA
| | - Rhoda Au
- Framingham Heart Study, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
- Department of Anatomy & Neurobiology, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
- Department of Epidemiology, Boston University School of Public Health, 715 Albany St, Boston, MA 02118, USA
- Slone Epidemiology Center, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
- Department of Neurology, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
- Alzheimer’s Disease and CTE Centers, Boston University, 72 E Concord St, Boston, MA 02118, USA
| | - Wei Qiao Qiu
- Framingham Heart Study, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
- Department of Pharmacology & Experimental Therapeutics, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
- Alzheimer’s Disease and CTE Centers, Boston University, 72 E Concord St, Boston, MA 02118, USA
- Department of Psychiatry, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
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Tao Q, Alvin Ang TF, Akhter-Khan SC, Itchapurapu IS, Killiany R, Zhang X, Budson AE, Turk KW, Goldstein L, Mez J, Alosco ML, Qiu WQ. Impact of C-Reactive Protein on Cognition and Alzheimer Disease Biomarkers in Homozygous APOE ɛ4 Carriers. Neurology 2021; 97:e1243-e1252. [PMID: 34266923 PMCID: PMC8480484 DOI: 10.1212/wnl.0000000000012512] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 06/28/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Previous research has shown that elevated blood C-reactive protein (CRP) is associated with increased Alzheimer disease (AD) risk only in APOE ε4 allele carriers; the objective of this study was to examine the interactive effects of plasma CRP and APOE genotype on cognition and AD biomarkers. METHODS Data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) study were analyzed, including APOE genotype; plasma CRP concentrations; diagnostic status (i.e., mild cognitive impairment and dementia due to AD); Mini-Mental State Examination (MMSE) and Clinical Dementia Rating Dementia Staging Instrument scores; CSF concentrations of β-amyloid peptide (Aβ42), total tau (t-Tau) and phosphorylated tau (p-Tau); and amyloid (AV45) PET imaging. Multivariable regression analyses tested the associations between plasma CRP and APOE on cognitive and biomarker outcomes. RESULTS Among 566 ADNI participants, 274 (48.4%) had no, 222 (39.2%) had 1, and 70 (12.4%) had 2 APOE ε4 alleles. Among only participants who had 2 APOE ε4 alleles, elevated CRP was associated with lower MMSE score at baseline (β [95% confidence interval] -0.52 [-1.01, -0.12]) and 12-month follow-up (β -1.09 [-1.88, -0.17]) after adjustment for sex, age, and education. The interaction of 2 APOE ε4 alleles and elevated plasma CRP was associated with increased CSF levels of t-Tau (β = 11.21, SE 3.37, p < 0.001) and p-Tau (β = +2.74, SE 1.14, p < 0.01). Among those who had no APOE ε4 alleles, elevated CRP was associated with decreased CSF t-Tau and p-Tau. These effects were stronger at the 12-month follow-up. DISCUSSION CRP released during peripheral inflammation could be a mediator in APOE ε4-related AD neurodegeneration and serve as a drug target for AD.
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Affiliation(s)
- Qiushan Tao
- From the Department of Pharmacology and Experimental Therapeutics (Q.T., I.S.I., W.Q.Q.), Framingham Heart Study (Q.T., T.F.A.A.), Department of Anatomy and Neurobiology (T.F.A.A., R.K.), Slone Epidemiology Center (T.F.A.A.), Department of Medicine (X.Z.), Department of Neurology (A.E.B., K.W.T., J.M., M.L.A.), Department of Psychiatry (W.Q.Q.), and Alzheimer's Disease and CTE Centers (A.E.B., K.W.T., L.G., J.M., M.L.A., W.Q.Q.), Boston University School of Medicine, MA; Department of Psychology (S.C.A.-K.), Humboldt University of Berlin, Germany; Department of Health Service and Population Research (S.C.A.-K.), King's College London, UK; and Veterans Affairs Boston Healthcare System (A.E.B., K.W.T.), MA
| | - Ting Fang Alvin Ang
- From the Department of Pharmacology and Experimental Therapeutics (Q.T., I.S.I., W.Q.Q.), Framingham Heart Study (Q.T., T.F.A.A.), Department of Anatomy and Neurobiology (T.F.A.A., R.K.), Slone Epidemiology Center (T.F.A.A.), Department of Medicine (X.Z.), Department of Neurology (A.E.B., K.W.T., J.M., M.L.A.), Department of Psychiatry (W.Q.Q.), and Alzheimer's Disease and CTE Centers (A.E.B., K.W.T., L.G., J.M., M.L.A., W.Q.Q.), Boston University School of Medicine, MA; Department of Psychology (S.C.A.-K.), Humboldt University of Berlin, Germany; Department of Health Service and Population Research (S.C.A.-K.), King's College London, UK; and Veterans Affairs Boston Healthcare System (A.E.B., K.W.T.), MA
| | - Samia C Akhter-Khan
- From the Department of Pharmacology and Experimental Therapeutics (Q.T., I.S.I., W.Q.Q.), Framingham Heart Study (Q.T., T.F.A.A.), Department of Anatomy and Neurobiology (T.F.A.A., R.K.), Slone Epidemiology Center (T.F.A.A.), Department of Medicine (X.Z.), Department of Neurology (A.E.B., K.W.T., J.M., M.L.A.), Department of Psychiatry (W.Q.Q.), and Alzheimer's Disease and CTE Centers (A.E.B., K.W.T., L.G., J.M., M.L.A., W.Q.Q.), Boston University School of Medicine, MA; Department of Psychology (S.C.A.-K.), Humboldt University of Berlin, Germany; Department of Health Service and Population Research (S.C.A.-K.), King's College London, UK; and Veterans Affairs Boston Healthcare System (A.E.B., K.W.T.), MA
| | - Indira Swetha Itchapurapu
- From the Department of Pharmacology and Experimental Therapeutics (Q.T., I.S.I., W.Q.Q.), Framingham Heart Study (Q.T., T.F.A.A.), Department of Anatomy and Neurobiology (T.F.A.A., R.K.), Slone Epidemiology Center (T.F.A.A.), Department of Medicine (X.Z.), Department of Neurology (A.E.B., K.W.T., J.M., M.L.A.), Department of Psychiatry (W.Q.Q.), and Alzheimer's Disease and CTE Centers (A.E.B., K.W.T., L.G., J.M., M.L.A., W.Q.Q.), Boston University School of Medicine, MA; Department of Psychology (S.C.A.-K.), Humboldt University of Berlin, Germany; Department of Health Service and Population Research (S.C.A.-K.), King's College London, UK; and Veterans Affairs Boston Healthcare System (A.E.B., K.W.T.), MA
| | - Ronald Killiany
- From the Department of Pharmacology and Experimental Therapeutics (Q.T., I.S.I., W.Q.Q.), Framingham Heart Study (Q.T., T.F.A.A.), Department of Anatomy and Neurobiology (T.F.A.A., R.K.), Slone Epidemiology Center (T.F.A.A.), Department of Medicine (X.Z.), Department of Neurology (A.E.B., K.W.T., J.M., M.L.A.), Department of Psychiatry (W.Q.Q.), and Alzheimer's Disease and CTE Centers (A.E.B., K.W.T., L.G., J.M., M.L.A., W.Q.Q.), Boston University School of Medicine, MA; Department of Psychology (S.C.A.-K.), Humboldt University of Berlin, Germany; Department of Health Service and Population Research (S.C.A.-K.), King's College London, UK; and Veterans Affairs Boston Healthcare System (A.E.B., K.W.T.), MA
| | - Xiaoling Zhang
- From the Department of Pharmacology and Experimental Therapeutics (Q.T., I.S.I., W.Q.Q.), Framingham Heart Study (Q.T., T.F.A.A.), Department of Anatomy and Neurobiology (T.F.A.A., R.K.), Slone Epidemiology Center (T.F.A.A.), Department of Medicine (X.Z.), Department of Neurology (A.E.B., K.W.T., J.M., M.L.A.), Department of Psychiatry (W.Q.Q.), and Alzheimer's Disease and CTE Centers (A.E.B., K.W.T., L.G., J.M., M.L.A., W.Q.Q.), Boston University School of Medicine, MA; Department of Psychology (S.C.A.-K.), Humboldt University of Berlin, Germany; Department of Health Service and Population Research (S.C.A.-K.), King's College London, UK; and Veterans Affairs Boston Healthcare System (A.E.B., K.W.T.), MA
| | - Andrew E Budson
- From the Department of Pharmacology and Experimental Therapeutics (Q.T., I.S.I., W.Q.Q.), Framingham Heart Study (Q.T., T.F.A.A.), Department of Anatomy and Neurobiology (T.F.A.A., R.K.), Slone Epidemiology Center (T.F.A.A.), Department of Medicine (X.Z.), Department of Neurology (A.E.B., K.W.T., J.M., M.L.A.), Department of Psychiatry (W.Q.Q.), and Alzheimer's Disease and CTE Centers (A.E.B., K.W.T., L.G., J.M., M.L.A., W.Q.Q.), Boston University School of Medicine, MA; Department of Psychology (S.C.A.-K.), Humboldt University of Berlin, Germany; Department of Health Service and Population Research (S.C.A.-K.), King's College London, UK; and Veterans Affairs Boston Healthcare System (A.E.B., K.W.T.), MA
| | - Katherine W Turk
- From the Department of Pharmacology and Experimental Therapeutics (Q.T., I.S.I., W.Q.Q.), Framingham Heart Study (Q.T., T.F.A.A.), Department of Anatomy and Neurobiology (T.F.A.A., R.K.), Slone Epidemiology Center (T.F.A.A.), Department of Medicine (X.Z.), Department of Neurology (A.E.B., K.W.T., J.M., M.L.A.), Department of Psychiatry (W.Q.Q.), and Alzheimer's Disease and CTE Centers (A.E.B., K.W.T., L.G., J.M., M.L.A., W.Q.Q.), Boston University School of Medicine, MA; Department of Psychology (S.C.A.-K.), Humboldt University of Berlin, Germany; Department of Health Service and Population Research (S.C.A.-K.), King's College London, UK; and Veterans Affairs Boston Healthcare System (A.E.B., K.W.T.), MA
| | - Lee Goldstein
- From the Department of Pharmacology and Experimental Therapeutics (Q.T., I.S.I., W.Q.Q.), Framingham Heart Study (Q.T., T.F.A.A.), Department of Anatomy and Neurobiology (T.F.A.A., R.K.), Slone Epidemiology Center (T.F.A.A.), Department of Medicine (X.Z.), Department of Neurology (A.E.B., K.W.T., J.M., M.L.A.), Department of Psychiatry (W.Q.Q.), and Alzheimer's Disease and CTE Centers (A.E.B., K.W.T., L.G., J.M., M.L.A., W.Q.Q.), Boston University School of Medicine, MA; Department of Psychology (S.C.A.-K.), Humboldt University of Berlin, Germany; Department of Health Service and Population Research (S.C.A.-K.), King's College London, UK; and Veterans Affairs Boston Healthcare System (A.E.B., K.W.T.), MA
| | - Jesse Mez
- From the Department of Pharmacology and Experimental Therapeutics (Q.T., I.S.I., W.Q.Q.), Framingham Heart Study (Q.T., T.F.A.A.), Department of Anatomy and Neurobiology (T.F.A.A., R.K.), Slone Epidemiology Center (T.F.A.A.), Department of Medicine (X.Z.), Department of Neurology (A.E.B., K.W.T., J.M., M.L.A.), Department of Psychiatry (W.Q.Q.), and Alzheimer's Disease and CTE Centers (A.E.B., K.W.T., L.G., J.M., M.L.A., W.Q.Q.), Boston University School of Medicine, MA; Department of Psychology (S.C.A.-K.), Humboldt University of Berlin, Germany; Department of Health Service and Population Research (S.C.A.-K.), King's College London, UK; and Veterans Affairs Boston Healthcare System (A.E.B., K.W.T.), MA
| | - Michael L Alosco
- From the Department of Pharmacology and Experimental Therapeutics (Q.T., I.S.I., W.Q.Q.), Framingham Heart Study (Q.T., T.F.A.A.), Department of Anatomy and Neurobiology (T.F.A.A., R.K.), Slone Epidemiology Center (T.F.A.A.), Department of Medicine (X.Z.), Department of Neurology (A.E.B., K.W.T., J.M., M.L.A.), Department of Psychiatry (W.Q.Q.), and Alzheimer's Disease and CTE Centers (A.E.B., K.W.T., L.G., J.M., M.L.A., W.Q.Q.), Boston University School of Medicine, MA; Department of Psychology (S.C.A.-K.), Humboldt University of Berlin, Germany; Department of Health Service and Population Research (S.C.A.-K.), King's College London, UK; and Veterans Affairs Boston Healthcare System (A.E.B., K.W.T.), MA
| | - Wei Qiao Qiu
- From the Department of Pharmacology and Experimental Therapeutics (Q.T., I.S.I., W.Q.Q.), Framingham Heart Study (Q.T., T.F.A.A.), Department of Anatomy and Neurobiology (T.F.A.A., R.K.), Slone Epidemiology Center (T.F.A.A.), Department of Medicine (X.Z.), Department of Neurology (A.E.B., K.W.T., J.M., M.L.A.), Department of Psychiatry (W.Q.Q.), and Alzheimer's Disease and CTE Centers (A.E.B., K.W.T., L.G., J.M., M.L.A., W.Q.Q.), Boston University School of Medicine, MA; Department of Psychology (S.C.A.-K.), Humboldt University of Berlin, Germany; Department of Health Service and Population Research (S.C.A.-K.), King's College London, UK; and Veterans Affairs Boston Healthcare System (A.E.B., K.W.T.), MA.
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McGurk SR, Otto MW, Fulford D, Cutler Z, Mulcahy LP, Talluri SS, Qiu WQ, Gan Q, Tran I, Turner L, DeTore NR, Zawacki SA, Khare C, Pillai A, Mueser KT. A randomized controlled trial of exercise on augmenting the effects of cognitive remediation in persons with severe mental illness. J Psychiatr Res 2021; 139:38-46. [PMID: 34022474 DOI: 10.1016/j.jpsychires.2021.04.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/06/2021] [Accepted: 04/25/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Preliminary evidence suggests that aerobic exercise may augment the effects of cognitive remediation on improving cognitive functioning in severe mental illness. It has also been hypothesized that increases in cognitive functioning associated with adding exercise are mediated by increases in brain derived neurotrophic factor (BDNF). However, rigorous controlled trials are lacking. METHODS A randomized controlled trial was conducted to explore whether adding a 30-h aerobic exercise program over 10 weeks to an equally intensive cognitive remediation program (CR + E) improved cognitive functioning more than cognitive remediation alone (CR-Only). Thirty-four participants with schizophrenia or bipolar disorder were randomly assigned to CR + E or CR-Only, and cognitive functioning was assessed at baseline and post-treatment. Total and mature BDNF were measured in blood serum at baseline, Week-5 pre- and post-exercise, and Week-10 pre- and post-exercise. RESULTS Participants in both conditions had high levels of engagement in the interventions and improved significantly in cognitive functioning, but did not differ in amount of cognitive change. The groups also did not differ in changes in BDNF from pre-to post-exercise at Weeks 5 or 10, nor in resting BDNF levels. Exploratory analyses indicated that higher body mass index (BMI) significantly predicted attenuated improvement in cognitive functioning for both groups. DISCUSSION Exercise did not augment the effects of cognitive remediation in persons with severe mental illness, possibly because the cognitive remediation program resulted in strong gains in cognitive functioning. Moderate aerobic exercise does not appear to reliably increase BDNF levels in persons with severe mental illness. CLINICALTRIALS. GOV IDENTIFIER NCT02326389.
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Affiliation(s)
- Susan R McGurk
- Center for Psychiatric Rehabilitation, Boston University, United States; Department of Occupational Therapy and Psychological and Brain Sciences, Boston University, United States
| | - Michael W Otto
- Department Psychological and Brain Sciences, Boston University, United States
| | - Daniel Fulford
- Department of Occupational Therapy and Psychological and Brain Sciences, Boston University, United States
| | - Zachary Cutler
- Center for Psychiatric Rehabilitation, Boston University, United States
| | - Leonard P Mulcahy
- Center for Psychiatric Rehabilitation, Boston University, United States
| | - Sai Snigdha Talluri
- Chicago Health Disparities Program, Department of Psychology, Illinois Institute of Technology, United States
| | - Wei Qiao Qiu
- Department of Psychiatry, Boston University School of Medicine, United States; Pharmacology & Experimental Therapeutics, Boston University School of Medicine, United States
| | - Qini Gan
- Pharmacology & Experimental Therapeutics, Boston University School of Medicine, United States
| | - Ivy Tran
- Department of Psychology, Hofstra University, United States
| | - Laura Turner
- Franciscan Children's Hospital, Boston, MA, United States
| | - Nicole R DeTore
- Department of Psychiatry, Massachusetts General Hospital, United States; Department of Psychiatry, Harvard Medical School, United States
| | | | - Chitra Khare
- Department of Occupational Therapy and Psychological and Brain Sciences, Boston University, United States
| | - Anilkumar Pillai
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, United States
| | - Kim T Mueser
- Center for Psychiatric Rehabilitation, Boston University, United States; Department of Occupational Therapy and Psychological and Brain Sciences, Boston University, United States.
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Piers RJ, Liu Y, Ang TFA, Tao Q, Au R, Qiu WQ. Association Between Elevated Depressive Symptoms and Cognitive Function Moderated by APOE4 Status: Framingham Offspring Study. J Alzheimers Dis 2021; 80:1269-1279. [PMID: 33646152 DOI: 10.3233/jad-200998] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Depression and Apolipoprotein E4 (APOE4) are associated with decreased cognitive function and differences in brain structure. OBJECTIVE This study investigated whether APOE4 status moderates the association between elevated depressive symptoms, cognitive function, and brain structure. METHODS Stroke- and dementia-free participants (n = 1,968) underwent neuropsychological evaluation, brain MRI, and depression screening. Linear and logistic regression was used to examine all associations. Secondary analyses were performed using interaction terms to assess effect modification by APOE4 status. RESULTS Elevated depressive symptoms were associated with lower cognitive performance in several domains. In stratified analyses, elevated depressive symptoms were associated with poorer visual short- and long-term memory performance for APOE4 + participants. Elevated depressive symptoms were not associated with any brain structure in this study sample. CONCLUSION Elevated depressive symptoms impact cognitive function in non-demented individuals. Having the APOE4 allele may exacerbate the deleterious effects of elevated depressive symptoms on visual memory performance. Screening for elevated depressive symptoms in both research studies and clinical practice may be warranted to avoid false positive identification of neurodegeneration, particularly among those who are APOE4 + .
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Affiliation(s)
- Ryan J Piers
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Yulin Liu
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA.,Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Ting F A Ang
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA.,Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA.,Slone Epidemiology Center, Boston University School of Medicine, Boston, MA, USA
| | - Qiushan Tao
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Rhoda Au
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA.,Department of Neurology, Boston University School of Medicine, Boston, MA, USA.,Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA.,Slone Epidemiology Center, Boston University School of Medicine, Boston, MA, USA.,Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.,Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA
| | - Wei Qiao Qiu
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA.,Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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38
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Na H, Tian H, Zhang Z, Li Q, Yang JB, Mcparland L, Gan Q, Qiu WQ. Oral Amylin Treatment Reduces the Pathological Cascade of Alzheimer's Disease in a Mouse Model. Am J Alzheimers Dis Other Demen 2021; 36:15333175211012867. [PMID: 34137273 PMCID: PMC10623958 DOI: 10.1177/15333175211012867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 03/24/2021] [Accepted: 04/04/2021] [Indexed: 11/16/2022]
Abstract
Intraperitoneal injection of amylin or its analog reduces Alzheimer's disease (AD) pathology in the brains. However, self-injecting amylin analogs is difficult for patients due to cognitive deficits. This work aims to study the effects of amylin on the brain could be achieved by oral delivery as some study reported that amylin receptor may be present in the gastrointestinal tract. A 6-week course of oral amylin treatment reduced components of AD pathology, including the levels of amyloid-β, phosphorylated tau, and ionized calcium binding adaptor molecule 1. The treatment reduced active forms of cyclin-dependent kinase 5. Oral amylin treatment led to improvements in social deficit in AD mouse. Using immunofluorescence, we observed the amylin receptor complexed with the calcitonin receptor and receptor activity-modifying proteins in the enteric neurons. The study suggests the potential of the oral delivery of amylin analogs for the treatment of AD and other neurodegenerative diseases through enteric neurons.
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Affiliation(s)
- Hana Na
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Hua Tian
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
- Department of Pharmacology, Qiqihar Medical University, Qiqihar, Heilongjiang, China
| | - Zhengrong Zhang
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Qiang Li
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
- Nursing School, Qiqihar Medical University, Qiqihar, Heilongjiang, China
| | - Jack B. Yang
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Liam Mcparland
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Qini Gan
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Wei Qiao Qiu
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
- Alzheimer’s Disease Center, Boston University School of Medicine, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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39
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Na H, Gan Q, Mcparland L, Yang JB, Yao H, Tian H, Zhang Z, Qiu WQ. Characterization of the effects of calcitonin gene-related peptide receptor antagonist for Alzheimer's disease. Neuropharmacology 2020; 168:108017. [PMID: 32113968 DOI: 10.1016/j.neuropharm.2020.108017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 02/19/2020] [Accepted: 02/21/2020] [Indexed: 10/25/2022]
Abstract
Calcitonin gene-related peptide (cGRP) receptor antagonists effectively treat migraine through reducing neuroinflammation, vasoconstriction and possibly neruogenesis. Since neuroinflammation is also involved in the pathogenesis of Alzheimer's diseases (AD), we hypothesized and tested if a cGRP receptor antagonist, BIBN 4096 BS (BIBN), has effects on AD pathology. Using an AD mouse model, 5XFAD, with different ages, here we report that the BIBN treatment significantly increased the brain expression of PSD95, a postsynaptic protein, in both young and old AD mice. In parallel, BIBN improved learning and memory in the behavior test in the young, but not old, AD mice. The BIBN treatment reduced α-synuclein aggregation in both young and old AD mice. BIBN significantly decreased neuroinflammatory markers of ionized calcium binding adapter molecules-1 (Iba-1) and the p38 MAPK and NFκB signaling pathways in young, but not old, AD mice. The treatment also reduced the accumulation of amyloid-β (Aβ), and decreased tau phosphorylation through the pathway of CDK5/p25 in young mice only. Our study provides the evidence and suggests that the cGRP antagonists might be a therapeutic target to attenuate the pathological cascade and delay cognitive decline of AD in humans.
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Affiliation(s)
- Hana Na
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Qini Gan
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Liam Mcparland
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Jack B Yang
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Hongbo Yao
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA; Department of Histology and Embriology, Qiqihaer Medical University, China
| | - Hua Tian
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA; Department of Histology and Embriology, Qiqihaer Medical University, China
| | - Zhengrong Zhang
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Wei Qiao Qiu
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA; Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
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40
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Mao AY, Shi JF, Qiu WQ, Liu CC, Dong P, Huang HY, Wang K, Wang DB, Liu GX, Liao XZ, Bai YN, Sun XJ, Ren JS, Yang L, Wei DH, Song BB, Lei HK, Liu YQ, Zhang YZ, Ren SY, Zhou JY, Wang JL, Gong JY, Yu LZ, Liu YY, Zhu L, Guo LW, Wang YQ, He YT, Lou PA, Cai B, Sun XH, Wu SL, Qi X, Zhang K, Li N, Dai M, Chen WQ. [Analysis on the consciousness of the cancer early detection and its influencing factors among urban residents in China from 2015 to 2017]. Zhonghua Yu Fang Yi Xue Za Zhi 2020; 54:54-61. [PMID: 31914570 DOI: 10.3760/cma.j.issn.0253-9624.2020.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To understand the consciousness of the cancer early detection among urban residents and identify the influencing factors from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. Self-designed questionnaires were used to collect population, socioeconomic indicators, self-cancer risk assessment, regular participation in physical examination and other information. The multivariate logistic regression model was used to identify the factors of people who had not regularly participated in the regular physical examination in the past five years. Results: The self-assessment results of 32 357 residents showed that there were 27.54% (8 882) of total study population with self-reported cancer risk, 45.48% (14 671) without cancer risk and 26.98% (8 704) with unclear judgement on their own cancer risk. Among population with cancer risk, 79.84% (7 091) considered physical examination accounted. In the past five years, there were 21 105 (65.43%) residents participated in regular physical examination and 11 148 (34.56%) participated in non-scheduled one, respectively. The multivariate logistic regression analysis showed that compared with unmarried and western region residents, divorced, middle and eastern region residents had a stronger consciousness to participate in the regular physical examination (P<0.05). Compare with residents with annual household income less than 20 000 CNY in 2014, cancer risk assessment/screening intervention population, and self-assessment with cancer risk, residents with annual household income between 20 000 CNY and 59 000 CNY in 2014, occupational population, community residents, cancer patients, self-reported cancer-free risk, and self-assessment with unclear judgement of cancer risk were less likely to participate in the regular physical examination (all P values <0.05). Conclusion: From 2015 to 2017, the Chinese urban residents had a acceptable consciousness of the cancer early detection. The marital status, annual household income, population group and self-assessment of cancer risk were related to the consciousness of the cancer early detection of people who had not participated in the regular physical examination in the past five years.
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Affiliation(s)
- A Y Mao
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - J F Shi
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - W Q Qiu
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - C C Liu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - P Dong
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - H Y Huang
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - K Wang
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - D B Wang
- Health Management College, Anhui Medical University, Hefei 230032, China
| | - G X Liu
- School of Public Health, Harbin Medical University, Harbin 150081, China
| | - X Z Liao
- The Department of Cancer Prevention and Control, Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - Y N Bai
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X J Sun
- School of Health Care Management, Shandong University, Jinan 250012, China
| | - J S Ren
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L Yang
- School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - D H Wei
- Department of Medical Examination for Cancer Prevention, Anhui Provincial Cancer Hospital, Hefei 230032, China
| | - B B Song
- The Department of Cancer Prevention and Control, Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
| | - H K Lei
- Department of Cancer Research and Control, Chongqing University Cancer Hospital/Chongqing Cancer Institute/Chongqing Cancer Hospital, Chongqing 400030, China
| | - Y Q Liu
- Department of Cancer Epidemiology, Gansu Provincial Cancer Hospital, Lanzhou 730050, China
| | - Y Z Zhang
- Department of Epidemiology, Shanxi Provincial Center Hospital, Taiyuan 030013, China
| | - S Y Ren
- Institute for Chronic and Non-communicable Disease Prevention and Control, Yunnan Center for Disease Prevention and Control,Kunming 650118, China
| | - J Y Zhou
- Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - J L Wang
- The Department of Cancer Prevention and Control, Shandong Tumor Hospital, Jinan 250117, China
| | - J Y Gong
- The Department of Cancer Prevention and Control, Shandong Tumor Hospital, Jinan 250117, China
| | - L Z Yu
- Institute for Chronic and Non-communicable Disease Prevention and Control, Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, China
| | - Y Y Liu
- The Department of Cancer Prevention and Control, Liaoning Cancer Hospital & Institute, Shenyang 110042, China
| | - L Zhu
- Cancer Research Institute, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - L W Guo
- Office for Cancer Control and Research, Henan Cancer Hospital/The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - Y Q Wang
- Department of Cancer Prevention, Cancer Hospital of University of Chinese Academy of Sciences/Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Y T He
- The Department of Cancer Prevention and Control, Cancer Institute, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - P A Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
| | - B Cai
- Department of Health Education and Chronic Disease Control, Nantong Center for Disease Control and Prevention, Nantong 226000, China
| | - X H Sun
- Endocrine Department, Ningbo NO.2 Hospital, Ningbo 315010,China
| | - S L Wu
- Department of Cardiovascular Diseases, Kailuan General Hospital, Tangshan 063000, China
| | - X Qi
- Office of Cancer Screening, Tangshan People's Hospital, Tangshan 063001, China
| | - K Zhang
- Department of Medical Examination for Cancer Prevention, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - N Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Dai
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - W Q Chen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Wang K, Liu CC, Mao AY, Shi JF, Dong P, Huang HY, Wang DB, Liu GX, Liao XZ, Bai YN, Sun XJ, Ren JS, Yang L, Wei DH, Song BB, Lei HK, Liu YQ, Zhang YZ, Ren SY, Zhou JY, Wang JL, Gong JY, Yu LZ, Liu YY, Zhu L, Guo LW, Wang YQ, He YT, Lou PA, Cai B, Sun XH, Wu SL, Qi X, Zhang K, Li N, Chen WQ, Qiu WQ, Dai M. [Analysis on the demand, access and related factors of cancer prevention and treatment knowledge among urban residents in China from 2015 to 2017]. Zhonghua Yu Fang Yi Xue Za Zhi 2020; 54:84-91. [PMID: 31914574 DOI: 10.3760/cma.j.issn.0253-9624.2020.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the demand and access to the cancer prevention and treatment knowledge and related factors among urban residents in China from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of general demographic characteristics, the demand and access to cancer prevention and treatment knowledge, and the influencing factors of the attitude. The Chi-square test was used to analyze the difference of the demand of the cancer prevention knowledge among different groups and the corresponding factors of the cancer prevention and treatment knowledge were analyzed by using the logistic regression model. Results: The proportion of residents who need the cancer prevention and treatment knowledge was 79.5%. The demand rate of the inducement, symptom and diagnosis methods of cancer in the occupational population was highest, about 66.8%, 71.0% and 20.8%, respectively. The demand rate of treatment methods and cost in current cancer patients was the highest, about the 45.9% and 21.9%, respectively. The top three sources to acquire the cancer prevention and treatment knowledge were "broadcast or television" (69.5%), "books, newspapers, posters or brochures" (44.7%) and "family and friends" (33.8%). The multivariate analysis showed that compared with public institution personnel/civil servants, unmarried/cohabiting/divorced/widowed and others, annual household income less than 20 000 CNY, from the eastern region, people without cancer diagnosis and people with self-assessment of cancer risk, the demand rate of cancer prevention and treatment knowledge was higher in enterprise personnel/workers, married, annual household income between 60 000 CNY and 150 000 CNY, from the central region, people with cancer and people with unclear cancer risk (all P values <0.05). Conclusion: There was a high demand for the cancer prevention and treatment knowledge among urban residents in China from 2015 to 2017. The main access to the knowledge is from the radio or television. The occupation, marital status, annual household income, residential region, health status and risk of disease were the main factors of the demand of the cancer prevention and treatment knowledge.
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Affiliation(s)
- K Wang
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - C C Liu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - A Y Mao
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - J F Shi
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - P Dong
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - H Y Huang
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - D B Wang
- Health Management College, Anhui Medical University, Hefei 230032, China
| | - G X Liu
- School of Public Health, Harbin Medical University, Harbin 150081, China
| | - X Z Liao
- The Department of Cancer Prevention and Control, Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - Y N Bai
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X J Sun
- School of Health Care Management, Shandong University, Jinan 250012, China
| | - J S Ren
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L Yang
- School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - D H Wei
- Department of Medical Examination for Cancer Prevention, Anhui Provincial Cancer Hospital, Hefei 230032, China
| | - B B Song
- The Department of Cancer Prevention and Control, Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
| | - H K Lei
- Department of Cancer Research and Control, Chongqing University Cancer Hospital/Chongqing Cancer Institute/Chongqing Cancer Hospital, Chongqing 400030, China
| | - Y Q Liu
- Department of Cancer Epidemiology, Gansu Provincial Cancer Hospital, Lanzhou 730050, China
| | - Y Z Zhang
- Department of Epidemiology, Shanxi Provincial Center Hospital, Taiyuan 030013, China
| | - S Y Ren
- Institute for Chronic and Non-communicable Disease Prevention and Control, Yunnan Center for Disease Prevention and Control, Kunming 650118, China
| | - J Y Zhou
- Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - J L Wang
- The Department of Cancer Prevention and Control, Shandong Tumor Hospital, Jinan 250117, China
| | - J Y Gong
- The Department of Cancer Prevention and Control, Shandong Tumor Hospital, Jinan 250117, China
| | - L Z Yu
- Institute for Chronic and Non-communicable Disease Prevention and Control, Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, China
| | - Y Y Liu
- The Department of Cancer Prevention and Control, Liaoning Cancer Hospital & Institute, Shenyang 110042, China
| | - L Zhu
- Cancer Research Institute, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - L W Guo
- Office for Cancer Control and Research, Henan Cancer Hospital/The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou 450008, China
| | - Y Q Wang
- Department of Cancer Prevention, Cancer Hospital of University of Chinese Academy of Sciences/Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Y T He
- The Department of Cancer Prevention and Control, Cancer Institute, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - P A Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou221006, China
| | - B Cai
- Department of Health Education and Chronic Disease Control, Nantong Center for Disease Control and Prevention, Nantong 226000, China
| | - X H Sun
- Endocrine Department, Ningbo NO.2 Hospital, Ningbo 315010, China
| | - S L Wu
- Department of Cardiovascular Diseases, Kailuan General Hospital, Tangshan 063000, China
| | - X Qi
- Office of Cancer Screening, Tangshan People's Hospital, Tangshan 063001, China
| | - K Zhang
- Department of Medical Examination for Cancer Prevention, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - N Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - W Q Chen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - W Q Qiu
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - M Dai
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Liu CC, Shi CL, Shi JF, Mao AY, Huang HY, Dong P, Bai FZ, Chen YS, Wang DB, Liu GX, Liao XZ, Bai YN, Sun XJ, Ren JS, Yang L, Wei DH, Song BB, Lei HK, Liu YQ, Zhang YZ, Ren SY, Zhou JY, Wang JL, Gong JY, Yu LZ, Liu YY, Zhu L, Guo LW, Wang YQ, He YT, Lou PA, Cai B, Sun XH, Wu SL, Qi X, Zhang K, Li N, Xu WH, Qiu WQ, Dai M, Chen WQ. [Study on the health literacy and related factors of the cancer prevention consciousness among urban residents in China from 2015 to 2017]. Zhonghua Yu Fang Yi Xue Za Zhi 2020; 54:47-53. [PMID: 31914569 DOI: 10.3760/cma.j.issn.0253-9624.2020.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To understand the health literacy and relevant factors of cancer prevention consciousness in Chinese urban residents from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of demographic characteristics and cancer prevention consciousness focusing on nine common risk factors, including smoking, alcohol, fiber food, food in hot temperature or pickled food, chewing betel nut, helicobacter pylori, moldy food, hepatitis B infection, estrogen, and exercise. The logistic regression model was adopted to identify the influencing factors. Results: The overall health literacy of the cancer prevention consciousness was 77.4% (24 980 participants), with 77.4% (12 018 participants), 79.9% (6 406 participants), 77.2% (1 766 participants) and 74.5% (4 709 participants) in each group (P<0.001). The correct response rates for nine risk factors ranged from 55.2% to 93.0%. The multivariate logistic regression analysis showed that compared with community residents, people with primary school level education or below, and the number of people living together in the family <3, the cancer risk assessment/screening intervention population, cancer patients, those with junior high school level educationor above and the number of people living in the family ≥3 had better health literacy of the cancer prevention consciousness (all P values <0.05). Compared with females, 39 years old and below, government-affiliated institutions or civil servants, from the eastern region, males, older than 40 years, company or enterprise employees, and from the middle or western region had worse health literacy of the cancer prevention consciousness (all P values <0.05). Conclusion: The health literacy of the cancer prevention consciousness in Chinese urban residents should be improved. The cancer screening intervention, gender, age, education, occupation, the number of people co-living in the family, and residential region were associated with the health literacy of the cancer prevention consciousness.
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Affiliation(s)
- C C Liu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - C L Shi
- Department of Disease Control and Prevention, Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
| | - J F Shi
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - A Y Mao
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - H Y Huang
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - P Dong
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - F Z Bai
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y S Chen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - D B Wang
- Health Management College, Anhui Medical University, Hefei 230032, China
| | - G X Liu
- School of Public Health, Harbin Medical University, Harbin 150081, China
| | - X Z Liao
- The Department of Cancer Prevention and Control, Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - Y N Bai
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X J Sun
- Scholl of Health Care Management, Shandong University, Jinan 250012, China
| | - J S Ren
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L Yang
- School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - D H Wei
- Department of Medical Examination for Cancer Prevention, Anhui Provincial Cancer Hospital, Hefei 230032, China
| | - B B Song
- The department of Cancer Prevention and Control, Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
| | - H K Lei
- Department of Cancer Research and Control, Chongqing University Cancer Hospital/Chongqing Cancer Institute/Chongqing Cancer Hospital, Chongqing 400030, China
| | - Y Q Liu
- Department of Cancer Epidemiology, Gansu Provincial Cancer Hospital, Lanzhou 730050, China
| | - Y Z Zhang
- Department of Epidemiology, Shanxi Provincial Center Hospital, Taiyuan 030013, China
| | - S Y Ren
- Institute for Chronic and Non-communicable Disease Prevention and Control, Yunnan Center for Disease Prevention and Control, Kunming 650118, China
| | - J Y Zhou
- Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - J L Wang
- The Department of Cancer Prevention and Control, Shandong Tumor Hospital, Jinan 250117, China
| | - J Y Gong
- The Department of Cancer Prevention and Control, Shandong Tumor Hospital, Jinan 250117, China
| | - L Z Yu
- Institute for Chronic and Non-communicable Disease Prevention and Control, Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, China
| | - Y Y Liu
- The Department of Cancer Prevention and Control, Liaoning Cancer Hospital/Institute, Shenyang 110042, China
| | - L Zhu
- Cancer Research Institute, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - L W Guo
- Office for Cancer Control and Research, Henan Cancer Hospital/The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - Y Q Wang
- Department of Cancer Prevention, Cancer hospital of University of Chinese Academy of Sciences/Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Y T He
- The Department of Cancer Prevention and Control, Cancer Institute, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - P A Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou221006, China
| | - B Cai
- Department of Health Education and Chronic Disease Control, Nantong Center for Disease Control and Prevention, Nantong 226000, China
| | - X H Sun
- Endocrine Department, Ningbo NO.2 Hospital, Ningbo 315010, China
| | - S L Wu
- Department of Cardiovascular Diseases, Kailuan General Hospital, Tangshan 063000, China
| | - X Qi
- Office of Cancer Screening, Tangshan People's Hospital, Tangshan 063001, China
| | - K Zhang
- Department of Medical Examination for Cancer Prevention, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - N Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - W H Xu
- Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai 200032, China
| | - W Q Qiu
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - M Dai
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - W Q Chen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Dong P, Shi JF, Qiu WQ, Liu CC, Wang K, Huang HY, Wang DB, Liu GX, Liao XZ, Bai YN, Sun XJ, Ren JS, Yang L, Wei DH, Song BB, Lei HK, Liu YQ, Zhang YZ, Ren SY, Zhou JY, Wang JL, Gong JY, Yu LZ, Liu YY, Zhu L, Guo LW, Wang YQ, He YT, Lou PA, Cai B, Sun XH, Wu SL, Qi X, Zhang K, Li N, Dai M, Chen WQ, Mao AY, He J. [Analysis on the health literacy of the cancer prevention and treatment and its related factors among urban residents in China from 2015 to 2017]. Zhonghua Yu Fang Yi Xue Za Zhi 2020; 54:76-83. [PMID: 31914573 DOI: 10.3760/cma.j.issn.0253-9624.2020.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To understand the health literacy of the cancer prevention and treatment among urban residents of China, and explore the related factors. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China (CanSPUC) from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The health literacy of the cancer prevention, early discovery, early diagnosis, early treatment and the demands of cancer prevention and treatment knowledge was analyzed. The level of health literacy among different groups were calculated and compared. The binary logistic regression model was used to analyze the influencing factors of the health literacy of the cancer prevention and treatment. Results: The level of health literacy of the cancer prevention and treatment was 56.97% among all study population; in each group it was 55.01% for community residents, 59.08% for cancer risk assessment/screening population, 61.99% for cancer patients and 57.31% for occupational population, respectively (P<0.001). The level of health literacy of the cancer prevention and treatment of residents aged 50 to 69 years old, other occupational groups, unmarried, the central and western region residents and the group with unclear self-assessment of cancer risk was significantly lower than that of residents younger than 40 years old, personnel of public institutions/civil servants, married, the eastern region residents and the group whose self-assessment without cancer risk (P<0.05) . The level of health literacy of cancer prevention and treatment of females, people who went to high school or over, cancer risk assessment/screening population, cancer patients and occupational population was significantly higher than that of males, people who had an education level of primary school or below and community residents (P<0.05) . Conclusion: The health literacy of the cancer prevention and treatment of urban residents in China was relatively high, but there was still room for improvement. Gender, age, educational level, occupation, region, marital status, self-assessment of cancer risk, and type of respondents were the key influencing factors of the health literacy of the cancer prevention and treatment. Male, 50-69 years old, lower educational level, central and western regions, unclear cancer risk self-assessment, and without specific environmental exposure to cancer prevention and treatment knowledge or related risk factors were the characteristics of the key intervention group of the health literacy of the cancer prevention and treatment.
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Affiliation(s)
- P Dong
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - J F Shi
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - W Q Qiu
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - C C Liu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - K Wang
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - H Y Huang
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - D B Wang
- Health Management College, Anhui Medical University, Hefei 230032, China
| | - G X Liu
- School of Public Health, Harbin Medical University, Harbin 150081, China
| | - X Z Liao
- The Department of Cancer Prevention and Control, Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - Y N Bai
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X J Sun
- School of Health Care Management, Shandong University, Jinan 250012, China
| | - J S Ren
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L Yang
- School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - D H Wei
- Department of Medical Examination for Cancer Prevention, Anhui Provincial Cancer Hospital, Hefei 230032, China
| | - B B Song
- The Department of Cancer Prevention and Control, Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
| | - H K Lei
- Department of Cancer Research and Control, Chongqing University Cancer Hospital/Chongqing Cancer Institute/Chongqing Cancer Hospital, Chongqing 400030, China
| | - Y Q Liu
- Department of Cancer Epidemiology, Gansu Provincial Cancer Hospital, Lanzhou 730050, China
| | - Y Z Zhang
- Department of Epidemiology, Shanxi Provincial Center Hospital, Taiyuan 030013, China
| | - S Y Ren
- Institute for Chronic and Non-communicable Disease Prevention and Control, Yunnan Center for Disease Prevention and Control, Kunming 650118, China
| | - J Y Zhou
- Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - J L Wang
- The Department of Cancer Prevention and Control, Shandong Tumor Hospital, Jinan 250117, China
| | - J Y Gong
- The Department of Cancer Prevention and Control, Shandong Tumor Hospital, Jinan 250117, China
| | - L Z Yu
- Institute for Chronic and Non-communicable Disease Prevention and Control, Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, China
| | - Y Y Liu
- The Department of Cancer Prevention and Control, Liaoning Cancer Hospital & Institute, Shenyang 110042, China
| | - L Zhu
- Cancer Research Institute, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - L W Guo
- Office for Cancer Control and Research, Henan Cancer Hospital/The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - Y Q Wang
- Department of Cancer Prevention, Cancer hospital of University of Chinese Academy of Sciences/Zhejiang cancer hospital, Hangzhou 310022, China
| | - Y T He
- The Department of Cancer Prevention and Control, Cancer Institute, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - P A Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
| | - B Cai
- Department of Health Education and Chronic Disease Control, Nantong Center for Disease Control and Prevention, Nantong 226000, China
| | - X H Sun
- Endocrine Department, Ningbo NO.2 Hospital, Ningbo 315010, China
| | - S L Wu
- Department of Cardiovascular Diseases, Kailuan General Hospital, Tangshan 063000, China
| | - X Qi
- Office of Cancer Screening, Tangshan People's Hospital, Tangshan 063001, China
| | - K Zhang
- Department of Medical Examination for Cancer Prevention, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - N Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Dai
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - W Q Chen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - A Y Mao
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - J He
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Li HC, Wang K, Yuan YN, Mao AY, Liu CC, Liu S, Yang L, Huang HY, Dong P, Wang DB, Liu GX, Liao XZ, Bai YN, Sun XJ, Ren JS, Yang L, Wei DH, Song BB, Lei HK, Liu YQ, Zhang YZ, Ren SY, Zhou JY, Wang JL, Gong JY, Yu LZ, Liu YY, Zhu L, Guo LW, Wang YQ, He YT, Lou PA, Cai B, Sun XH, Wu SL, Qi X, Zhang K, Li N, Dai M, Chen WQ, Wang N, Qiu WQ, Shi JF. [Analysis on the consciousness of the early cancer treatment and its influencing factors among urban residents in China from 2015 to 2017]. Zhonghua Yu Fang Yi Xue Za Zhi 2020; 54:69-75. [PMID: 31914572 DOI: 10.3760/cma.j.issn.0253-9624.2020.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To understand the consciousness of the cancer early treatment and its demographic and socioeconomic factors. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China (CanSPUC) from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The questionnaire collected personal information, the consciousness of the cancer early treatment and relevant factors. The Chi square test was used to compare the difference between the consciousness of the cancer early treatment and relevant factors among the four groups. The logistic regression model was used to analyze the influencing factors related to the consciousness of the cancer early treatment. Results: With the assumption of being diagnosed as precancer or cancer, 89.97% of community residents, 91.84% of cancer risk assessment/screening population, 93.00% of cancer patients and 91.52% of occupational population would accept active treatments (P<0.001). If the immediate family members were diagnosed as precancer or cancer, people who would encourage their family members to receive early treatment in the four groups accounted for 91.96%, 91.94%, 92.44% and 91.55%, respectively (P<0.001). The company employees, annual household income with 40 000 yuan and more and other three groups had a relatively better consciousness of the cancer early treatment (P<0.05). Male, widowed, unemployed and from the central and western regions had a relatively worse consciousness of the cancer early treatment (P<0.05). Conclusion: Residents in urban China participants had a good consciousness of the cancer early treatment. The marital status, occupation, annual household income and residential regions were major factors related to the consciousness of the cancer early treatment.
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Affiliation(s)
- H C Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - K Wang
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - Y N Yuan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - A Y Mao
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - C C Liu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - S Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - L Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - H Y Huang
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - P Dong
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - D B Wang
- Health Management College, Anhui Medical University, Hefei 230032, China
| | - G X Liu
- School of Public Health, Harbin Medical University, Harbin 150081, China
| | - X Z Liao
- The Department of Cancer Prevention and Control, Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - Y N Bai
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X J Sun
- School of Health Care Management, Shandong University, Jinan 250012, China
| | - J S Ren
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L Yang
- School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - D H Wei
- Department of Medical Examination for Cancer Prevention, Anhui Provincial Cancer Hospital, Hefei 230032, China
| | - B B Song
- The Department of Cancer Prevention and Control, Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
| | - H K Lei
- Department of Cancer Research and Control, Chongqing University Cancer Hospital/Chongqing Cancer Institute/Chongqing Cancer Hospital, Chongqing 400030, China
| | - Y Q Liu
- Department of Cancer Epidemiology, Gansu Provincial Cancer Hospital, Lanzhou 730050, China
| | - Y Z Zhang
- Department of Epidemiology, Shanxi Provincial Center Hospital, Taiyuan 030013, China
| | - S Y Ren
- Institute for Chronic and Non-communicable Disease Prevention and Control, Yunnan Center for Disease Prevention and Control, Kunming 650118, China
| | - J Y Zhou
- Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - J L Wang
- The Department of Cancer Prevention and Control, Shandong Tumor Hospital, Jinan 250117, China
| | - J Y Gong
- The Department of Cancer Prevention and Control, Shandong Tumor Hospital, Jinan 250117, China
| | - L Z Yu
- Institute for Chronic and Non-communicable Disease Prevention and Control, Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, China
| | - Y Y Liu
- The Department of Cancer Prevention and Control, Liaoning Cancer Hospital & Institute, Shenyang 110042, China
| | - L Zhu
- Cancer Research Institute, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - L W Guo
- Office for Cancer Control and Research, Henan Cancer Hospital/The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - Y Q Wang
- Department of Cancer Prevention, Cancer hospital of University of Chinese Academy of Sciences/Zhejiang cancer hospital, Hangzhou 310022, China
| | - Y T He
- The Department of Cancer Prevention and Control, Cancer Institute, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - P A Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
| | - B Cai
- Department of Health Education and Chronic Disease Control, Nantong Center for Disease Control and Prevention, Nantong 226000, China
| | - X H Sun
- Endocrine Department, Ningbo NO.2 Hospital, Ningbo 315010, China
| | - S L Wu
- Department of Cardiovascular Diseases, Kailuan General Hospital, Tangshan 063000, China
| | - X Qi
- Officeof Cancer Screening, Tangshan People's Hospital, Tangshan 063001, China
| | - K Zhang
- Department of Medical Examination for Cancer Prevention, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - N Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Dai
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - W Q Chen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - N Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - W Q Qiu
- Department of Public Health Strategy Research, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China
| | - J F Shi
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Zhu H, Tao Q, Ang TFA, Massaro J, Gan Q, Salim S, Zhu RY, Kolachalama VB, Zhang X, Devine S, Auerbach SH, DeCarli C, Au R, Qiu WQ. Association of Plasma Amylin Concentration With Alzheimer Disease and Brain Structure in Older Adults. JAMA Netw Open 2019; 2:e199826. [PMID: 31433485 PMCID: PMC6707010 DOI: 10.1001/jamanetworkopen.2019.9826] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
IMPORTANCE Preclinical studies suggest that amylin has a U-shaped dose-response association with risk of Alzheimer disease (AD). The association of plasma amylin with AD in humans is unknown. OBJECTIVES To measure amylin concentration in plasma by using enzyme-linked immunosorbent assay and to study the association between plasma amylin, incidence of AD, and brain structure in humans. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from the Framingham Heart Study offspring cohort from 1998 to 2015. Using a Monte Carlo approach, participants were divided into 3 plasma amylin concentration groups: (1) low (<75 pmol/L), (2) high (75-2800 pmol/L), and (3) extremely high (≥2800 pmol/L). Data analyses were conducted October 5, 2017, to December 18, 2018. EXPOSURES Baseline plasma amylin concentrations at examination 7. MAIN OUTCOMES AND MEASURES Incidence of dementia or AD and brain volumetric measures from structural magnetic resonance imaging data. RESULTS From the Framingham Heart Study offspring cohort, 3061 participants (mean [SD] age at baseline, 61.0 [9.5] years; 1653 [54.0%] women) who had plasma amylin measurements, dementia incidence, and brain volume measurements on record were included in this study. The distribution of plasma amylin concentrations was highly skewed (median [interquartile range], 7.5 [4.6-18.9] pmol/L; mean [SD], 302.3 [1941.0] pmol/L; range, 0.03-44 623.7 pmol/L). Compared with the low plasma amylin concentration group, the high plasma amylin concentration group had a lower rate of AD incidence (2.3% vs 5.6%; P = .04), but the extremely high plasma amylin concentration group had a higher rate of AD incidence (14.3%; P < .001). After adjusting for age, sex, education, body mass index, diabetes, cardiovascular disease, high-density lipoprotein level, and APOE4, high plasma amylin was not associated with decreased AD risk (hazard ratio, 0.42 [95% CI, 0.16-1.14]; P = .09) but was positively associated with volume of gray matter in the temporal lobe (β = 0.17 [SE, 0.05]; P < .001). In contrast, extremely high plasma amylin concentration was associated with a higher AD risk (hazard ratio, 2.51 [95% CI, 1.38-4.57]; P = .003) but not associated with temporal lobe volume (β = 0.02 [SE, 0.07]; P = .82). CONCLUSIONS AND RELEVANCE This study found that plasma amylin concentration was associated with AD incidence and brain structure with a U-shaped pattern. These findings are consistent with preclinical findings that suggest amylin is a neuropeptide that is physiological; however, at extremely high concentrations, it may lead to amylin aggregation and therefore may be a risk factor for AD.
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Affiliation(s)
- Haihao Zhu
- Department of Pharmacology & Experimental Therapeutics, Boston University School of Medicine, Boston, Massachusetts
| | - Qiushan Tao
- Department of Pharmacology & Experimental Therapeutics, Boston University School of Medicine, Boston, Massachusetts
| | - Ting Fang Alvin Ang
- Department of Epidemiology, School of Public Health, Boston University School of Medicine, Boston, Massachusetts
- Framingham Heart Study, Boston University School of Medicine, Boston, Massachusetts
| | - Joseph Massaro
- Department of Epidemiology, School of Public Health, Boston University School of Medicine, Boston, Massachusetts
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
| | - Qini Gan
- Department of Pharmacology & Experimental Therapeutics, Boston University School of Medicine, Boston, Massachusetts
| | - Saraf Salim
- Department of Pharmacology & Experimental Therapeutics, Boston University School of Medicine, Boston, Massachusetts
| | - Rui-ying Zhu
- Department of Pharmacology & Experimental Therapeutics, Boston University School of Medicine, Boston, Massachusetts
| | | | - Xiaoling Zhang
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Sheral Devine
- Department of Epidemiology, School of Public Health, Boston University School of Medicine, Boston, Massachusetts
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
| | - Sanford H. Auerbach
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
| | - Charles DeCarli
- Alzheimer’s Disease Center, University of California Davis Medical Center, Sacramento
| | - Rhoda Au
- Department of Epidemiology, School of Public Health, Boston University School of Medicine, Boston, Massachusetts
- Framingham Heart Study, Boston University School of Medicine, Boston, Massachusetts
- Alzheimer’s Disease Center, Boston University School of Medicine, Boston, Massachusetts
- Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, Massachusetts
| | - Wei Qiao Qiu
- Department of Pharmacology & Experimental Therapeutics, Boston University School of Medicine, Boston, Massachusetts
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
- Alzheimer’s Disease Center, Boston University School of Medicine, Boston, Massachusetts
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46
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Scott TM, Bhadelia RA, Qiu WQ, Folstein MF, Rosenberg IH. Small Vessel Cerebrovascular Pathology Identified by Magnetic Resonance Imaging Is Prevalent in Alzheimer's Disease and Mild Cognitive Impairment: A Potential Target for Intervention. J Alzheimers Dis 2019; 65:293-302. [PMID: 30040728 DOI: 10.3233/jad-180366] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is evidence that Alzheimer's disease (AD) has significant cerebrovascular etiopathogenesis. Understanding potentially modifiable risk factors for vascular disease can help design long-term intervention strategies for controlling or preventing cognitive dysfunction attributable to cerebrovascular disease. OBJECTIVE To evaluate the presence and severity of markers of cerebrovascular pathology, its relationship to diagnostic categories of dementia, including AD, and association with the metabolic biomarker homocysteine. METHODS In a cross-sectional observational study, 340 community-dwelling elders received a clinical evaluation including brain MRI and neuropsychological tests. Dementia and mild cognitive impairment (MCI) were diagnosed by consensus committee. Fasting total plasma homocysteine was measured. Statistical analyses were adjusted for demographics and cerebrovascular risk factors. RESULTS Nearly 25% of those diagnosed with AD had small vessel infarcts (SVI). Periventricular white matter hyperintensity (pvWMHI) was prevalent in participants with AD (61%) or MCI (amnesic 61% and non-amnesic 54%, respectively). Participants with SVI and/or pvWMHI also had greater brain atrophy. Homocysteine concentrations were higher in individuals with cerebrovascular findings than in those without. In individuals with cerebrovascular disease, homocysteine was inversely related to executive function (p = 0.022) and directly related to degree of brain atrophy (p = 0.009). CONCLUSIONS We demonstrated a significant prevalence of small vessel markers of cerebrovascular pathology in individuals diagnosed with AD, with a significant concurrence between cerebrovascular disease and brain and ventricular atrophy. While current research on AD has focused on amyloid-βpeptide deposition, tau-pathology, and microglial activation and inflammation, greater attention to the cerebrovascular contribution to this neurodegenerative disease presents an additional target for therapeutic prevention and intervention.
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Affiliation(s)
- Tammy M Scott
- Friedman School of Nutrition Science and Policy, Boston, MA, USA.,Tufts University School of Medicine, Boston, MA, USA
| | | | - Wei Qiao Qiu
- Boston University School of Medicine, Boston, MA, USA
| | | | - Irwin H Rosenberg
- Friedman School of Nutrition Science and Policy, Boston, MA, USA.,Tufts University School of Medicine, Boston, MA, USA.,USDA Jean Mayer Human Nutrition Research Center on Aging, Boston, MA, USA
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47
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Gan Q, Yao H, Na H, Ballance H, Tao Q, Leung L, Tian H, Zhu H, Wolozin B, Qiu WQ. Effects of Amylin Against Amyloid-β-Induced Tauopathy and Synapse Loss in Primary Neurons. J Alzheimers Dis 2019; 70:1025-1040. [PMID: 31306122 PMCID: PMC6833957 DOI: 10.3233/jad-190161] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Recent studies demonstrate that peripheral amylin treatment reduces pathology in mouse models of Alzheimer's disease (AD). However, soluble and aggregated amylin are distinct species; while amylin is a physiological neuropeptide, amylin aggregation is a pathological factor for diabetes. We thus hypothesized that because of their similarity in secondary structures, amylin antagonizes amyloid-β peptide (Aβ)-induced AD pathology in neurons with a dose-dependent pattern. To test the hypothesis, we conducted both in vitro and in vivo experiments with different doses of amylin and with its analog, pramlintide. Here we report that a high concentration of either Aβ or amylin alone induced tau phosphorylation (pTau) in primary neurons. Interestingly, with a low concentration, amylin had direct effects to reverse the Aβ-induced pTau, as well as damaged neuronal synapses and neurite disorganization. However, when the concentration was high (10.24 μM), amylin lost the effects against the Aβ-induced cellular AD pathology and, together with Aβ, worsened tauopathy in neurons. In the 5XFAD AD mouse model, daily peripheral amylin treatment with a low dose (200 μg/kg) more effectively reduced amyloid burden, and increased synapse, but with a high dose (800 μg/kg), it more effectively reduced tauopathy. Correspondingly, amylin treatment improved learning and memory in these mice. It demonstrates that amylin has a dose-dependent U-shape effect against AD pathogenesis. Within a physiological range, amylin is a neuroprotective hormone against AD in neurons; but when both Aβ and amylin concentrations are elevated, imbalance of Aβ and amylin may contribute to brain AD pathogenesis.
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Affiliation(s)
- Qini Gan
- Department of Pharmacology and Experimental Therapeutics, Boston, MA, USA
| | - Hongbo Yao
- Department of Pharmacology and Experimental Therapeutics, Boston, MA, USA
- Department of Histology and Embriology, Qiqihaer Medical University, China
| | - Hana Na
- Department of Pharmacology and Experimental Therapeutics, Boston, MA, USA
| | - Heather Ballance
- Department of Pharmacology and Experimental Therapeutics, Boston, MA, USA
| | - Qiushan Tao
- Department of Pharmacology and Experimental Therapeutics, Boston, MA, USA
| | - Lorene Leung
- Department of Pharmacology and Experimental Therapeutics, Boston, MA, USA
| | - Hua Tian
- Department of Pharmacology and Experimental Therapeutics, Boston, MA, USA
- Department of Histology and Embriology, Qiqihaer Medical University, China
| | - Haihao Zhu
- Department of Pharmacology and Experimental Therapeutics, Boston, MA, USA
| | - Benjamin Wolozin
- Department of Pharmacology and Experimental Therapeutics, Boston, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Wei Qiao Qiu
- Department of Pharmacology and Experimental Therapeutics, Boston, MA, USA
- Alzheimer’s Disease Center, Boston University School of Medicine, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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48
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Tao Q, Ang TFA, DeCarli C, Auerbach SH, Devine S, Stein TD, Zhang X, Massaro J, Au R, Qiu WQ. Association of Chronic Low-grade Inflammation With Risk of Alzheimer Disease in ApoE4 Carriers. JAMA Netw Open 2018; 1:e183597. [PMID: 30646251 PMCID: PMC6324596 DOI: 10.1001/jamanetworkopen.2018.3597] [Citation(s) in RCA: 130] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 08/21/2018] [Indexed: 12/31/2022] Open
Abstract
Importance The association between peripheral inflammatory biomarkers and Alzheimer disease (AD) is not consistent in the literature. It is possible that chronic inflammation, rather than 1 episode of inflammation, interacts with genetic vulnerability to increase the risk for AD. Objective To study the interaction between the apolipoprotein E (ApoE) genotype and chronic low-grade inflammation and its association with the incidence of AD. Design, Setting, and Participants In this cohort study, data from 2656 members of the Framingham Heart Study offspring cohort (Generation 2; August 13, 1971-November 27, 2017) were evaluated, including longitudinal measures of serum C-reactive protein (CRP), diagnoses of incident dementia including AD, and brain volume. Chronic low-grade inflammation was defined as having CRP at a high cutoff level at a minimum of 2 time points. Statistical analysis was performed from December 1, 1979, to December 31, 2015. Main Outcomes and Measures Development of AD and brain volumes. Results Of the 3130 eligible participants, 2656 (84.9%; 1227 men and 1429 women; mean [SD] age at last CRP measurement, 61.6 [9.5] years) with both ApoE status and longitudinal CRP measurements were included in this study analysis. Median (interquartile range) CRP levels increased with mean (SD) age (43.3 [9.6] years, 0.95 mg/L [0.40-2.35 mg/L] vs 59.1 [9.6] years, 2.04 mg/L [0.93-4.75 mg/L] vs 61.6 [9.5] years, 2.21 mg/L [1.05-5.12 mg/L]; P < .001), but less so among those with ApoE4 alleles, followed by ApoE3 then ApoE2 genotypes. During the 17 years of follow-up, 194 individuals (7.3%) developed dementia, 152 (78.4%) of whom had AD. ApoE4 coupled with chronic low-grade inflammation, defined as a CRP level of 8 mg/L or higher, was associated with an increased risk of AD, especially in the absence of cardiovascular diseases (hazard ratio, 6.63; 95% CI, 1.80-24.50; P = .005), as well as an increased risk of earlier disease onset compared with ApoE4 carriers without chronic inflammation (hazard ratio, 3.52; 95% CI, 1.27-9.75; P = .009). This phenomenon was not observed among ApoE3 and ApoE2 carriers with chronic low-grade inflammation. Finally, a subset of 1761 individuals (66.3%) underwent brain magnetic resonance imaging, and the interaction between ApoE4 and chronic low-grade inflammation was associated with brain atrophy in the temporal lobe (β = -0.88, SE = 0.22; P < .001) and hippocampus (β = -0.04, SE = 0.01; P = .005), after adjusting for confounders. Conclusions and Relevance In this study, peripheral chronic low-grade inflammation in participants with ApoE4 was associated with shortened latency for onset of AD. Rigorously treating chronic systemic inflammation based on genetic risk could be effective for the prevention and intervention of AD.
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Affiliation(s)
- Qiushan Tao
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, Massachusetts
| | - Ting Fang Alvin Ang
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Charles DeCarli
- Alzheimer’s Disease Center, University of California Davis Medical Center, Sacramento
| | - Sanford H. Auerbach
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
| | - Sheral Devine
- Framingham Heart Study, Boston University School of Medicine, Boston, Massachusetts
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
| | - Thor D. Stein
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts
- Department of Pathology, Veterans Affairs Boston Healthcare System, Boston, Massachusetts
- Alzheimer’s Disease Center, Boston University School of Medicine, Boston, Massachusetts
| | - Xiaoling Zhang
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Joseph Massaro
- Framingham Heart Study, Boston University School of Medicine, Boston, Massachusetts
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Rhoda Au
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
- Framingham Heart Study, Boston University School of Medicine, Boston, Massachusetts
- Alzheimer’s Disease Center, Boston University School of Medicine, Boston, Massachusetts
| | - Wei Qiao Qiu
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, Massachusetts
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
- Alzheimer’s Disease Center, Boston University School of Medicine, Boston, Massachusetts
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49
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Sun ZX, Shi JF, Lan L, Mao AY, Huang HY, Lei HK, Qiu WQ, Dong P, Zhu J, Wang DB, Liu GX, Bai YN, Sun XJ, Liao XZ, Ren JS, Guo LW, Zhou Q, Yang L, Song BB, Du LB, Zhu L, Gong JY, Liu YQ, Ren Y, Mai L, Qin MF, Zhang YZ, Zhou JY, Sun XH, Wu SL, Qi X, Lou PA, Cai B, Zhang K, He J, Dai M. [Constituent and workload of service providers engaged in cancer screening: findings and suggestions from a multi-center survey in China]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:295-301. [PMID: 29609242 DOI: 10.3760/cma.j.issn.0254-6450.2018.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To understand the constituent and workload of service providers engaged in cancer screening in China and provide evidence for the assessment of the sustainability of national cancer screening project. Methods: Using either questionnaire or online approach, the survey was conducted in 16 provinces, where Cancer Screening Program in Urban China (CanSPUC) was conducted, from 2014 to 2015. The medical institutes surveyed included hospitals [71.1% were class Ⅲ(A) hospitals], centers for disease control and prevention (CDCs) and community centers where cancer screening was undertaken during 2013-2015. The questionnaire survey was conducted among the staffs responsible for the overall coordination, management and implementation of the screening project to collect the information about the allocation, workload and compensation of the service providers from different specialties. Results: A total of 4 626 staffs were surveyed in this study, their average age was (37.7±9.5) years, and males accounted for 31.0%. Human resources allocated differed with province. The number of senior staff ranged from 6 (Chongqing) to 43 (Beijing) among the 8 comparable provinces. Among the staffs surveyed, 2 192 were from hospitals, 431 were from CDCs and 1 990 were from community centers, and the staffs who complained heavy workload accounted for 19.9%, 24.6% and 34.1% respectively (P<0.001). Among 227 staffs for overall coordination, 376 management staffs and 3 908 staffs for implementation, those who complained heavy workload accounted for 23.6%, 22.3% and 28.2% respectively (P<0.001). A total of 3 244 staffs (73.8%) got compensations for heavy workload. The compensation types were manly labor fee linked with workload (67.5%) and labor fee regardless workload (26.6%). Conclusion: The province specific differences in human resources allocation indicated the differences in screening project's organizing pattern and capability. It is suggested to conduct routine cancer screening (using specialized staffs), reduce the workload of the first line and community staffs and increase the compensation for the service providers for the sustainability of cancer screening project in China.
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Affiliation(s)
- Z X Sun
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - J F Shi
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L Lan
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - A Y Mao
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - H Y Huang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - H K Lei
- Chongqing Cancer Institute, Chongqing 400030, China
| | - W Q Qiu
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - P Dong
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - J Zhu
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - D B Wang
- Anhui Medical University, Hefei 230032, China
| | - G X Liu
- Harbin Medical University, Harbin 150056, China
| | - Y N Bai
- Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou 730000, China
| | - X J Sun
- Center for Health Management and Policy Research, Shandong University, Jinan 250012, China
| | - X Z Liao
- Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - J S Ren
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L W Guo
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - Q Zhou
- Chongqing Cancer Institute, Chongqing 400030, China
| | - L Yang
- Guangxi Medical University, Nanning 530021, China
| | - B B Song
- Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
| | - L B Du
- Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - L Zhu
- Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - J Y Gong
- Shandong Tumor Hospital, Jinan 250117, China
| | - Y Q Liu
- Gansu Provincial Cancer Hospital, Lanzhou 730050, China
| | - Y Ren
- Tieling Central Hospital, Tieling 112000, China
| | - L Mai
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - M F Qin
- Yunnan Cancer Hospital, Kunming 650018, China
| | - Y Z Zhang
- Shanxi Provincial Cancer Hospital, Taiyuan 030013, China
| | - J Y Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - X H Sun
- Ningbo No.2 Hospital, Ningbo 315010, China
| | - S L Wu
- Kailuan General Hospital, Tangshan 063000, China
| | - X Qi
- Tangshan People's Hospital, Tangshan 063001, China
| | - P A Lou
- Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
| | - B Cai
- Nantong Tumor Hospital, Nantong 226000, China
| | - K Zhang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J He
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Dai
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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50
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Mao AY, Shi JF, Qiu WQ, Dong P, Sun ZX, Huang HY, Sun XJ, Liu GX, Wang DB, Bai YN, Liao XZ, Ren JS, Guo LW, Lan L, Zhou Q, Zhou JY, Yang L, Wang JL, Qin MF, Zhang YZ, Song BB, Xing XJ, Zhu L, Mai L, Du LB, Liu YQ, Lou PA, Cai B, Sun XH, Wu SL, Qi X, Zhang K, He J, Dai M. [Willingness of potential service suppliers to provide cancer screening in urban China]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:150-156. [PMID: 29495197 DOI: 10.3760/cma.j.issn.0254-6450.2018.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: Based on the investment for potential suppliers of cancer screening services, we assessed the reasons that affecting their participation motivation related to the long-term sustainability of cancer screening in China. Methods: Hospitals that had never been involved in any national level cancer screening project were selected by using the convenient sampling method within the 16 project cities of Cancer Screening Program in Urban China (CanSPUC) with 1 or 2 hospitals for each city. All the managers from the institutional/department level and professional staff working and providing screening services in these hospitals, were interviewed by paper-based questionnaire. SAS 9.4 was used for logical verification and data analysis. Results: A total of 31 hospitals (18 hospitals at the third level and, 13 hospitals at the second level) and 2 201 staff (508 hospital and clinic unit managers, 1 693 professional staff) completed the interview. All the hospitals guaranteed their potential capacity in service providing. 92.5% hospital managers showed strong willingness in providing cancer screening services, while 68.3% of them declared that the project fund-raising function was the responsibility of the government. For professional staff, their prospect gains from providing screening service would include development on professional skills (72.4%) and material rewards (46.8%). Their main worries would include extra work for CanSPUC might interfere their routine work (42.1%) plus inadequate compensation (41.8%). Medians of the prospect compensation for extra work ran between 20 to 90 Chinese Yuan per screening item respectively. For all the screening items, workers from the third-level hospitals expected their compensation to be twice as much of those working at the second level hospitals. Conclusion: Professional capacity building and feasible material incentive seemed to be the two key factors that influenced the sustainability and development of the programs.
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Affiliation(s)
- A Y Mao
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - J F Shi
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - W Q Qiu
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - P Dong
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
| | - Z X Sun
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - H Y Huang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - X J Sun
- School of Health Care Management, Shandong University, Jinan 250012, China
| | - G X Liu
- Harbin Medical University, Harbin 150081, China
| | - D B Wang
- Anhui Medical University, Hefei 230032, China
| | - Y N Bai
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X Z Liao
- Hunan Provincial Cancer Hospital, Changsha 410006, China
| | - J S Ren
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L W Guo
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - L Lan
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - Q Zhou
- Chongqing Cancer Institute, Chongqing 400030, China
| | - J Y Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - L Yang
- Guangxi Medical University, Nanning 530021, China
| | - J L Wang
- Shandong Tumor Hospital, Jinan 250117, China
| | - M F Qin
- Yunnan Cancer Hospital, Kunming 650118, China
| | - Y Z Zhang
- Shanxi Provincial Cancer Hospital, Taiyuan 030013, China
| | - B B Song
- Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China
| | - X J Xing
- Liaoning Cancer Hospital and Institute, Shenyang 110042, China
| | - L Zhu
- Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - L Mai
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - L B Du
- Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Y Q Liu
- Gansu Provincial Cancer Hospital, Lanzhou 730050, China
| | - P A Lou
- Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China
| | - B Cai
- Nantong Tumor Hospital, Nantong 226000, China
| | - X H Sun
- Ningbo No.2 Hospital, Ningbo 315010, China
| | - S L Wu
- Kailuan General Hospital, Tangshan 063000, China
| | - X Qi
- Tangshan People's Hospital, Tangshan 063001, China
| | - K Zhang
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J He
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Dai
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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