Dataset Information

Apolipoprotein E ?-4 as a genetic determinant of Alzheimer's disease heterogeneity.

ABSTRACT: Alzheimer's disease (AD) displays a high degree of heterogeneity in terms of its etiology, presentation, prognosis, and treatment response. This can partly be explained by high-penetrance mutations in the amyloid precursor protein, presenilin 1 and presenilin 2 genes causing amyloid beta aggregation, which is a major pathogenic mechanism in the development of early-onset AD in a small subgroup of patients. Late-onset AD is considered a polygenic disorder in which cumulative risk resulting from interaction with modifiable environmental risk factors may be responsible for the majority of cases. The ?-4 allele of the apolipoprotein E (APOE) gene has emerged as the most significant genetic risk factor for late-onset AD, influencing nearly every pathogenic domain affected in AD. It is a major risk factor for cerebral amyloid angiopathy, recognized as a common pathological finding in an AD subtype associated with white matter dysfunction. The APOE ?-4 allele is also a known risk factor for ischemic stroke, which can result in vascular dementia or contribute to subcortical vascular dysfunction. In this review, we evaluate the clinical relevance of APOE genotyping in relation to cholesterol metabolism and available evidence on risk reduction strategies applicable to AD.

SUBMITTER: Kotze MJ

PROVIDER: S-EPMC7337157 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Apolipoprotein E ε-4 as a genetic determinant of Alzheimer's disease heterogeneity.

Kotze M J MJ Lückhoff H K HK Brand T T Pretorius J J van Rensburg S J SJ

Degenerative neurological and neuromuscular disease 20150612

Alzheimer's disease (AD) displays a high degree of heterogeneity in terms of its etiology, presentation, prognosis, and treatment response. This can partly be explained by high-penetrance mutations in the amyloid precursor protein, presenilin 1 and presenilin 2 genes causing amyloid beta aggregation, which is a major pathogenic mechanism in the development of early-onset AD in a small subgroup of patients. Late-onset AD is considered a polygenic disorder in which cumulative risk resulting from i ...[more]

PMID: 32669910

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Project description:BackgroundAlzheimer's disease (AD) exhibits heterogeneity in cognitive impairment, atrophy, and pathological accumulation, suggesting the potential existence of subtypes. AD is under substantial genetic influence, thus identifying systematic variation in genetic risk may provide insights into disease origins.ObjectiveWe investigated genetic heterogeneity in AD risk through a multi-step analysis.MethodsWe performed principal component analysis (PCA) on AD-associated variants in the UK Biobank (AD cases=2,739, controls=5,478) to assess the presence of structured genetic heterogeneity. Subsequently, a biclustering algorithm searched for distinct disease-specific genetic signatures among subsets of cases. Replication tests were conducted using the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset (AD cases=500, controls=470). We categorized a separate set of ADNI individuals with mild cognitive impairment (MCI; n=399) into genetic subtypes and examined cognitive, amyloid, and tau trajectories.ResultsPCA revealed three distinct clusters ("constellations") within AD-associated variants containing a mixture of cases and controls, reflecting disease-relevant structure. We found two disease-specific biclusters among AD cases. Pathway analysis linked bicluster-associated variants to neuron morphogenesis and outgrowth, including genes related to cellular components and development-modulating factors. Both disease-relevant and disease-specific structure replicated in ADNI. Individuals with genetic signatures resembling bicluster 2 exhibited increased CSF p-tau and cognitive decline over time.ConclusionsThis study unveils a hierarchical structure of AD genetic risk. Disease-relevant constellations may represent differential biological vulnerability that is itself not sufficient to increase risk. Biclusters may represent distinct AD genetic subtypes. This structure replicates in an independent dataset and relates to differential pathological accumulation and cognitive decline over time.

Project description:Despite evident success in clarifying many important features of Alzheimer's disease (AD) the efficient methods of its prevention and treatment are not yet available. The reasons are likely to be the fact that AD is a multifactorial and heterogeneous health disorder with multiple alternative pathways of disease development and progression. The availability of genetic data on individuals participated in longitudinal studies of aging health and longevity, as well as on participants of cross-sectional case-control studies allow for investigating genetic and non-genetic connections with AD and to link the results of these analyses with research findings obtained in clinical, experimental, and molecular biological studies of this health disorder. The objective of this paper is to perform GWAS of AD in several study populations and investigate possible roles of detected genetic factors in developing AD hallmarks and in other health disorders. The data collected in the Framingham Heart Study (FHS), Cardiovascular Health Study (CHS), Health and Retirement Study (HRS) and Late Onset Alzheimer's Disease Family Study (LOADFS) were used in these analyses. The logistic regression and Cox's regression were used as statistical models in GWAS. The results of analyses confirmed strong associations of genetic variants from well-known genes APOE, TOMM40, PVRL2 (NECTIN2), and APOC1 with AD. Possible roles of these genes in pathological mechanisms resulting in development of hallmarks of AD are described. Many genes whose connection with AD was detected in other studies showed nominally significant associations with this health disorder in our study. The evidence on genetic connections between AD and vulnerability to infection, as well as between AD and other health disorders, such as cancer and type 2 diabetes, were investigated. The progress in uncovering hidden heterogeneity in AD would be substantially facilitated if common mechanisms involved in development of AD, its hallmarks, and AD related chronic conditions were investigated in their mutual connection.

Dataset Information

Apolipoprotein E ?-4 as a genetic determinant of Alzheimer's disease heterogeneity.

Publications

Apolipoprotein E ε-4 as a genetic determinant of Alzheimer's disease heterogeneity.

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