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      Sex-specific genetic predictors of Alzheimer’s disease biomarkers

      , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , Alzheimer’s Disease Neuroimaging Initiative (ADNI), The Alzheimer Disease Genetics Consortium (ADGC)
      Acta Neuropathologica
      Springer Science and Business Media LLC

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          Abstract

          <p class="first" id="P3">Cerebrospinal fluid (CSF) levels of amyloid-β 42 (Aβ42) and tau have been evaluated as endophenotypes in Alzheimer’s disease (AD) genetic studies. Although there are sex differences in AD risk, sex differences have not been evaluated in genetic studies of AD endophenotypes. We performed sex-stratified and sex interaction genetic analyses of CSF biomarkers to identify sex-specific associations. Data came from a previous genome-wide association study (GWAS) of CSF Aβ42 and tau (1527 males, 1509 females). We evaluated sex interactions at previous loci, performed sex-stratified GWAS to identify sex-specific associations, and evaluated sex interactions at sex-specific GWAS loci. We then evaluated sex-specific associations between prefrontal cortex (PFC) gene expression at relevant loci and autopsy measures of plaques and tangles using data from the Religious Orders Study and Rush Memory and Aging Project. In Aβ42, we observed sex interactions at one previous and one novel locus: rs316341 within <i>SERPINB1</i> (p=0.04) and rs13115400 near <i>LINC00290</i> (p=0.002). These loci showed stronger associations among females (β=−0.03, p=4.25×10 <sup>−8</sup>; β=0.03, p=3.97×10 <sup>−8</sup>) than males (β=−0.02, p=0. 009; β=0.01, p=0.20). Higher levels of expression of <i>SERPINB1, SERPINB6, and SERPINB9</i> in PFC was associated with higher levels of amyloidosis among females (corrected p-values&lt;0.02) but not males (p&gt;0.38). In total tau, we observed a sex interaction at a previous locus, rs1393060 proximal to <i>GMNC</i> (p=0.004), driven by a stronger association among females (β=0.05, p=4.57×10 <sup>−10</sup>) compared to males (β=0.02, p=0.03). There was also a sex-specific association between rs1393060 and tangle density at autopsy (p <sub>female</sub>=0.047; p <sub>male</sub>=0.96), and higher levels of expression of two genes within this locus were associated with lower tangle density among females ( <i>OSTN</i> p=0.006; <i>CLDN16</i> p=0.002) but not males (p≥0.32). Results suggest a female-specific role for <i>SERPINB1</i> in amyloidosis and for <i>OSTN</i> and <i>CLDN16</i> in tau pathology. Sex-specific genetic analyses may improve understanding of AD’s genetic architecture. </p>

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          Overview and findings from the rush Memory and Aging Project.

          The Memory and Aging Project is a longitudinal, epidemiologic clinical-pathologic cohort study of common chronic conditions of aging with an emphasis on decline in cognitive and motor function and risk of Alzheimer's disease (AD). In this manuscript, we first summarize the study design and methods. Then, we present data on: (1) the relation of motor function to cognition, disability, and death; (2) the relation of risk factors to cognitive and motor outcomes, disability and death; (3) the relation of neuropathologic indices to cognitive outcomes; (4) the relation of risk factors to neuropathologic indices; and (5) additional study findings. The findings are discussed and contextualized.
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            Sex modifies the APOE-related risk of developing Alzheimer disease.

            The APOE4 allele is the strongest genetic risk factor for sporadic Alzheimer disease (AD). Case-control studies suggest the APOE4 link to AD is stronger in women. We examined the APOE4-by-sex interaction in conversion risk (from healthy aging to mild cognitive impairment (MCI)/AD or from MCI to AD) and cerebrospinal fluid (CSF) biomarker levels. Cox proportional hazards analysis was used to compute hazard ratios (HRs) for an APOE-by-sex interaction on conversion in controls (n = 5,496) and MCI patients (n = 2,588). The interaction was also tested in CSF biomarker levels of 980 subjects from the Alzheimer's Disease Neuroimaging Initiative. Among controls, male and female carriers were more likely to convert to MCI/AD, but the effect was stronger in women (HR = 1.81 for women; HR = 1.27 for men; interaction: p = 0.011). The interaction remained significant in a predefined subanalysis restricted to APOE3/3 and APOE3/4 genotypes. Among MCI patients, both male and female APOE4 carriers were more likely to convert to AD (HR = 2.16 for women; HR = 1.64 for men); the interaction was not significant (p = 0.14). In the subanalysis restricted to APOE3/3 and APOE3/4 genotypes, the interaction was significant (p = 0.02; HR = 2.17 for women; HR = 1.51 for men). The APOE4-by-sex interaction on biomarker levels was significant for MCI patients for total tau and the tau-to-Aβ ratio (p = 0.009 and p = 0.02, respectively; more AD-like in women). APOE4 confers greater AD risk in women. Biomarker results suggest that increased APOE-related risk in women may be associated with tau pathology. These findings have important clinical implications and suggest novel research approaches into AD pathogenesis. © 2014 American Neurological Association.
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              Overview and findings from the religious orders study.

              The Religious Orders Study is a longitudinal clinical-pathologic cohort study of aging and Alzheimer's disease (AD). In this manuscript, we summarize the study methods including the study design and describe the clinical evaluation, assessment of risk factors, collection of ante-mortem biological specimens, brain autopsy and collection of selected postmortem data. (1) review the relation of neuropathologic indices to clinical diagnoses and cognition proximate to death; (2) examine the relation of risk factors to clinical outcomes; (3) examine the relation of risk factors to measures of neuropathology; and (4) summarize additional study findings. We then discuss and contextualize the study findings.
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                Author and article information

                Contributors
                (View ORCID Profile)
                Journal
                Acta Neuropathologica
                Acta Neuropathol
                Springer Science and Business Media LLC
                0001-6322
                1432-0533
                December 2018
                July 2 2018
                December 2018
                : 136
                : 6
                : 857-872
                Article
                10.1007/s00401-018-1881-4
                6280657
                29967939
                68b28373-36b4-4380-96b9-181561021ab1
                © 2018

                http://www.springer.com/tdm

                http://www.springer.com/tdm

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