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Semorinemab Pharmacokinetics and The Effect on Plasma Total Tau Pharmacodynamics in Clinical Studies 临床研究中塞莫瑞尼单抗的药代动力学及其对血浆总 Tau 药效学的影响
IF 6.4 Q2 BUSINESS Pub Date : 2024-07-17 DOI: 10.14283/jpad.2024.146
Vidya Ramakrishnan, B. Bender, J. Langenhorst, M. O. Magnusson, M. Dolton, J. Shim, R. N. Fuji, C. Monteiro, E. Teng, N. Kassir, J. Jin
<h3 data-test="abstract-sub-heading">Background</h3><p>Semorinemab is a monoclonal antibody that targets the N-terminal domain of the tau protein that is in clinical development for the treatment of Alzheimer’s disease.</p><h3 data-test="abstract-sub-heading">Objectives</h3><p>To perform model-based evaluations of the observed pharmacokinetics in serum and the total plasma tau target-engagement dynamics from clinical studies evaluating semorinemab.</p><h3 data-test="abstract-sub-heading">Design</h3><p>The observed semorinemab pharmacokinetics and plasma tau target engagement from phase 1 and 2 clinical studies were modeled using a non-linear mixed effect targetmediated drug disposition model. The model was simulated to understand target engagement at clinical dose levels.</p><h3 data-test="abstract-sub-heading">Settings and Participants</h3><p>The clinical studies testing semorinemab were evaluated in healthy volunteers, subjects with prodromal-to-mild Alzheimer’s disease, and subjects with mild-to-moderate Alzheimer’s disease. The data included a total of 8430 semorinemab serum concentrations and 4772 total tau protein plasma concentrations from 463 subjects treated with a range of single and multiple doses of semorinemab.</p><h3 data-test="abstract-sub-heading">Measurements</h3><p>Serum concentrations of semorinemab and the total plasma tau concentrations were measured after administration of a range of doses of semorinemab to subjects with Alzheimer’s disease. A sensitivity analysis was performed wherein key target-mediated drug disposition model parameters were estimated separately between healthy volunteers, subjects with prodromal-to-mild Alzheimer’s disease, and subjects with mild-to-moderate Alzheimer’s disease.</p><h3 data-test="abstract-sub-heading">Results</h3><p>Serum concentrations of semorinemab were consistent across studies and showed a dose-proportional increase across the evaluated dose range. The pharmacokinetic profile was comparable between healthy volunteers and subjects with Alzheimer’s disease. Total plasma tau concentrations increased in a dose-dependent non-linear manner upon semorinemab administration. The target-mediated drug disposition model adequately described the serum pharmacokinetics and protein dynamics with an estimated antibody-ligand binding strength, K<sub>ss</sub>, of 42.7 nM. The estimated values of clearance and central volume of distribution were 0.109 L/day/70 kg and 2.95 L/70 kg, respectively, and were consistent with typical values for IgG mAbs. In the sensitivity analysis, K<sub>ss</sub> (32 nM) and baseline tau protein (0.30 <i>µ</i>M) were estimated to be lower for healthy volunteers compared to subjects with Alzheimer’s disease but were comparable between subjects with Alzheimer’s disease of different severities (K<sub>ss</sub>: 52–57 nM, baseline tau: 0.44–0.47 <i>µ</i>M). The models suggested that peripheral target engagement was over 90% at the clinical doses in each of the diagnostic subgroup
背景Semorinemab是一种靶向tau蛋白N端结构域的单克隆抗体,目前正处于治疗阿尔茨海默病的临床开发阶段。目的对评估semorinemab的临床研究中观察到的血清中药代动力学和总血浆tau靶向参与动态进行基于模型的评估。设置和参与者在健康志愿者、前驱期至轻度阿尔茨海默病患者以及轻度至中度阿尔茨海默病患者中评估了测试semorinemab的临床研究。这些数据包括463名受试者在服用一系列单剂量或多剂量的舍莫瑞单抗后,血清中舍莫瑞单抗的浓度和血浆中总tau蛋白的浓度,总计分别为8430和4772。进行了一项敏感性分析,分别估算了健康志愿者、前驱期至轻度阿尔茨海默氏症患者和轻度至中度阿尔茨海默氏症患者的关键靶向药物处置模型参数。 结果在各项研究中,塞莫瑞单抗的血清浓度是一致的,并且在评估的剂量范围内呈现剂量比例增长。健康志愿者和阿尔茨海默病患者的药代动力学特征相当。服用semorinemab后,血浆tau总浓度呈剂量依赖性非线性增加。靶向介导的药物处置模型充分描述了血清药代动力学和蛋白质动力学,估计抗体与配体的结合强度(Kss)为42.7 nM。清除率和中心分布容积的估计值分别为 0.109 升/天/70 千克和 2.95 升/70 千克,与 IgG mAbs 的典型值一致。在敏感性分析中,健康志愿者的 Kss(32 nM)和基线 tau 蛋白(0.30 µM)估计值低于阿尔茨海默氏症患者,但与不同严重程度的阿尔茨海默氏症患者相当(Kss:52-57 nM,基线 tau:0.44-0.47 µM)。结论我们的靶向介导药物处置模型充分描述了总 tau 的血清药代动力学和外周非线性剂量增加。该模型证实,这些剂量-反应关系在健康志愿者和患有不同严重程度阿尔茨海默病的受试者群体中是一致的。
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引用次数: 0
Plasma Biomarkers of Alzheimer’s Disease and Neurodegeneration According to Sociodemographic Characteristics and Chronic Health Conditions 根据社会人口特征和慢性健康状况确定阿尔茨海默病和神经退行性变的血浆生物标志物
IF 6.4 Q2 BUSINESS Pub Date : 2024-07-14 DOI: 10.14283/jpad.2024.142
H. T. Zheng, Z. Wu, M. M. Mielke, A. M. Murray, Joanne Ryan

Ultrasensitive assays have been developed which enable biomarkers of Alzheimer’s disease pathology and neurodegeneration to be measured in blood. These biomarkers can aid in diagnosis, and have been used to predict risk of cognitive decline and Alzheimer’s disease. The ease and cost-effectiveness of blood collections means that these biomarkers could be applied more broadly in population-based screening, however it is critical to first understand what other factors could affect blood biomarker levels. The aim of this review was to determine the extent that sociodemographic, lifestyle and health factors have been associated with blood biomarkers of Alzheimer’s disease and neuropathology. Of the 32 studies included in this review, all but one measured biomarker levels in plasma, and age and sex were the most commonly investigated factors. The most consistent significant findings were a positive association between age and neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP), and females had higher GFAP than men. Apolipoprotein ε4 allele carriers had lower Aβ42 and Aβ42/40 ratio. Body mass index was negatively associated with GFAP and NfL, and chronic kidney disease with higher levels of all biomarkers. Too few studies have investigated other chronic health conditions and this requires further investigation. Given the potential for plasma biomarkers to enhance Alzheimer’s disease diagnosis in primary care, it is important to understand how to interpret the biomarkers in light of factors that physiologically impact blood biomarker levels. This information will be critical for the establishment of reference ranges and thus the correct interpretation of these biomarkers in clinical screening.

目前已开发出超灵敏检测方法,可在血液中测量阿尔茨海默病病理和神经变性的生物标志物。这些生物标志物可以帮助诊断,并已被用于预测认知能力下降和阿尔茨海默病的风险。血液采集的简便性和成本效益意味着这些生物标志物可以更广泛地应用于基于人群的筛查,但是首先了解哪些其他因素会影响血液中的生物标志物水平至关重要。本综述旨在确定社会人口、生活方式和健康因素与阿尔茨海默病血液生物标志物和神经病理学的关联程度。在纳入本综述的 32 项研究中,除一项研究外,其他所有研究都测量了血浆中的生物标志物水平,而年龄和性别是最常见的调查因素。最一致的重要发现是年龄与神经丝蛋白轻链(NfL)和胶质纤维酸性蛋白(GFAP)呈正相关,女性的GFAP高于男性。载脂蛋白ε4等位基因携带者的Aβ42和Aβ42/40比值较低。体重指数与GFAP和NfL呈负相关,而慢性肾病与所有生物标志物的较高水平呈负相关。对其他慢性健康状况进行调查的研究太少,这需要进一步研究。鉴于血浆生物标记物有可能提高基层医疗机构对阿尔茨海默病的诊断水平,因此了解如何根据影响血液生物标记物水平的生理因素来解释生物标记物非常重要。这些信息对于确定参考范围,从而在临床筛查中正确解释这些生物标记物至关重要。
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引用次数: 0
Universal Prevention of Dementia in Italy: A Document Analysis of the 21 Italian Regional Prevention Plans 意大利全民预防痴呆症:对意大利 21 个地区预防计划的文件分析
IF 6.4 Q2 BUSINESS Pub Date : 2024-07-11 DOI: 10.14283/jpad.2024.144
S. Salemme, D. Marconi, S. M. Pani, G. Zamboni, C. Sardu, G. Lazzeri, M. Corbo, E. Lacorte, N. Locuratolo, A. Ancidoni, N. Vanacore, Guido Bellomo

Background

Up to 40% of dementia cases are theoretically avoidable and population-level interventions (i.e., universal prevention) are a key component in facing the global public health challenge of dementia. However, information on the agenda for the universal prevention of dementia at the national and sub-national levels is still lacking.

Objectives

We aim to provide a comprehensive description of the universal prevention strategies specific to dementia in Italian regions and autonomous provinces (APs).

Design

We conducted a document analysis of the 21 Italian Regional Prevention Plans (RPPs), with a focus on interventions that target potentially modifiable risk factors for dementia. We analysed the final version of the documents, which were previously downloaded from the dedicated section of the Italian Ministry of Health website in January 2023. We classified the interventions as direct, indirect, or absent. Additionally, we created a quality checklist to outline the essential programmatic elements and applied it to summarise the key findings of the RPPs.

Measurements

We reported the number of populationlevel interventions specific for dementia with sub-national detail. We reported information on the risk factor targeted by the interventions, the age groups and populations they were designed for. We summarized the presence or absence of 63 programmatic items using a four-domain checklist.

Results

We identified 248 interventions for dementia prevention among the assessed RPPs: 100% of the plans addressed physical inactivity; 30–35% addressed smoking, alcohol, obesity, and social isolation; 25% addressed hypertension, diabetes, and air pollution; only 5–10% addressed education, depression, and hearing loss. Most interventions targeted the general population. Quality checklist scores significantly varied among regions, with demographics and prevention strategies domains scoring higher than disease burden and intervention feasibility ones.

Conclusions

The population-level interventions in the Italian Regional Prevention Programs dedicated to dementia prevention primarily focus on vascular risk factors, with limited coverage of dementia-specific factors such as traumatic brain injury and hearing loss. This data should be considered when planning future interventions for dementia prevention.

背景高达 40% 的痴呆症病例理论上是可以避免的,人口层面的干预措施(即全民预防)是应对痴呆症这一全球公共卫生挑战的关键组成部分。目标我们旨在全面描述意大利各地区和自治省(APs)针对痴呆症的全民预防战略。设计我们对 21 个意大利地区预防计划(RPPs)进行了文件分析,重点关注针对痴呆症潜在可改变风险因素的干预措施。我们分析了这些文件的最终版本,这些文件之前已于 2023 年 1 月从意大利卫生部网站的专门栏目下载。我们将干预措施分为直接干预、间接干预或无干预。此外,我们还创建了一份质量核对表来概述基本的计划要素,并将其应用于总结RPPs的主要发现。我们报告了干预措施所针对的风险因素、干预措施所针对的年龄组和人群。结果我们在接受评估的 RPPs 中发现了 248 项预防痴呆症的干预措施:100% 的计划涉及缺乏运动;30-35% 的计划涉及吸烟、酗酒、肥胖和社会隔离;25% 的计划涉及高血压、糖尿病和空气污染;只有 5-10% 的计划涉及教育、抑郁和听力损失。大多数干预措施针对的是普通人群。各地区的质量检查表得分差异很大,人口统计学和预防策略领域的得分高于疾病负担和干预措施可行性领域。在规划未来的痴呆症预防干预措施时,应考虑这些数据。
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引用次数: 0
No Association Found: Adverse Childhood Experiences and Cognitive Impairment in Older Australian Adults 未发现关联:童年不良经历与澳大利亚老年人的认知障碍
IF 6.4 Q2 BUSINESS Pub Date : 2024-07-11 DOI: 10.14283/jpad.2024.133
James Lian, K. M. Kiely, B. L. Callaghan, R. Eramudugolla, M. Mortby, K. J. Anstey

Objective

This study aimed to investigate the relationship between childhood adversity and cognitive impairment in older adults.

Methods

We analysed data from 1568 participants aged 72–79 (M = 75.1, SD = 1.5, % male = 52.6%) from Wave 4 of the Personality and Total Health (PATH) Through Life Project. The outcome variable was the presence of mild cognitive impairment (MCI) or dementia, determined through a clinically validated algorithmic diagnostic criteria. Childhood adversity was assessed using a 17-item scale covering various domestic adversities such as poverty, neglect, physical abuse, and verbal abuse. Adversity was operationalised using cumulative analysis, dichotomisation (<3 adversities; 3+ adversities), and latent class analysis. Multiple logistic regressions were employed to estimate the association between childhood adversity and cognitive impairment, while controlling for covariates including education, gender, ethnicity, and APOE ε4 status.

Results

Our analyses revealed no significant association between childhood adversity and the presence of MCI or dementia across all tested models. Sensitivity analyses, exploring alternative scenarios, consistently failed to yield statistically significant findings.

Conclusion

In contrast to prevailing research findings, this study does not support a link between childhood domestic adversity and late-life cognitive outcomes. These results underscore the mixed results on adversity and cognition, highlighting the need for further research. Future investigations should consider the roles of potential mediating and protective factors within this complex relationship.

本研究旨在探讨童年逆境与老年人认知障碍之间的关系。方法我们分析了 "人格与全面健康(PATH)贯穿生命项目 "第 4 波的 1568 名 72-79 岁参与者(男 = 75.1,女 = 1.5,男性 = 52.6%)的数据。结果变量为是否患有轻度认知障碍(MCI)或痴呆症,通过临床验证的算法诊断标准确定。童年逆境采用 17 个项目的量表进行评估,涵盖贫困、忽视、身体虐待和辱骂等各种家庭逆境。通过累积分析、二分法(3 种逆境;3 种以上逆境)和潜类分析对逆境进行操作。结果我们的分析表明,在所有测试模型中,童年逆境与MCI或痴呆症之间没有显著的关联。结论与普遍的研究结果不同,本研究并不支持童年家庭逆境与晚年认知结果之间存在联系。这些结果表明,关于逆境和认知的研究结果喜忧参半,需要进一步研究。未来的研究应考虑潜在的中介和保护因素在这一复杂关系中的作用。
{"title":"No Association Found: Adverse Childhood Experiences and Cognitive Impairment in Older Australian Adults","authors":"James Lian, K. M. Kiely, B. L. Callaghan, R. Eramudugolla, M. Mortby, K. J. Anstey","doi":"10.14283/jpad.2024.133","DOIUrl":"https://doi.org/10.14283/jpad.2024.133","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objective</h3><p>This study aimed to investigate the relationship between childhood adversity and cognitive impairment in older adults.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We analysed data from 1568 participants aged 72–79 (M = 75.1, SD = 1.5, % male = 52.6%) from Wave 4 of the Personality and Total Health (PATH) Through Life Project. The outcome variable was the presence of mild cognitive impairment (MCI) or dementia, determined through a clinically validated algorithmic diagnostic criteria. Childhood adversity was assessed using a 17-item scale covering various domestic adversities such as poverty, neglect, physical abuse, and verbal abuse. Adversity was operationalised using cumulative analysis, dichotomisation (&lt;3 adversities; 3+ adversities), and latent class analysis. Multiple logistic regressions were employed to estimate the association between childhood adversity and cognitive impairment, while controlling for covariates including education, gender, ethnicity, and APOE ε4 status.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Our analyses revealed no significant association between childhood adversity and the presence of MCI or dementia across all tested models. Sensitivity analyses, exploring alternative scenarios, consistently failed to yield statistically significant findings.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>In contrast to prevailing research findings, this study does not support a link between childhood domestic adversity and late-life cognitive outcomes. These results underscore the mixed results on adversity and cognition, highlighting the need for further research. Future investigations should consider the roles of potential mediating and protective factors within this complex relationship.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"40 1","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141570988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lower Incidence of Dementia Following Cancer Diagnoses: Evidence from a Large Cohort and Mendelian Randomization Study 癌症诊断后痴呆症发病率降低:来自大型队列和孟德尔随机研究的证据
IF 6.4 Q2 BUSINESS Pub Date : 2024-07-09 DOI: 10.14283/jpad.2024.135
D. T. Bassil, B. Zheng, B. Su, D. Kafetsouli, C. Udeh-Momoh, I. Tzoulaki, S. Ahmadi-Abhari, D. C. Muller, Elio Riboli, L. T. Middleton

Background

The reported inverse association between cancer and subsequent Alzheimer’s disease and related dementias (ADRD) remains uncertain.

Objectives

To investigate the association between these common conditions of old age and explore possible causal factors.

Design, Setting, Participants and Measurements

We conducted a large population-based cohort analysis using data from 3,021,508 individuals aged 60 and over in the UK Clinical Practice Research Datalink (CPRD), over a period up to 30 years (1988–2018). Cox proportional hazards models were fitted to estimate hazard ratios (HR) for risk of dementia associated with previous cancer diagnosis. Competing risk models were employed to account for competing risk of death. Two-sample Mendelian Randomization analysis based on meta-analysis data from large-scale GWAS studies was also conducted.

Results

In the CPRD cohort, 412,903 participants had cancer diagnosis and 230,558 were subsequently diagnosed with dementia over a median follow-up period of 7.9 years. Cancer survivors had a 25% lower risk of developing dementia (HR=0.75, 95% CI:0.74–0.76) after adjustment for potential confounders. Accounting for competing risk of death provided a sub-distribution HR of 0.56 (95% CI:0.55–0.56). Results were consistent for prevalent and incident cancer and different common cancer types. Two-sample Mendelian Randomization analysis, using 357 cancer-related instrumental single-nucleotide polymorphisms (SNPs) revealed evidence of vertical pleiotropy between genetically predicted cancer and reduced risk of Alzheimer’s disease (OR=0.97,95% CI:0.95–0.99).

Conclusion

Our results provide strong epidemiological evidence of the inverse association between cancer and risk of ADRD and support the potential causal nature of this association via genetic instruments. Further investigations into the precise underlying biological mechanisms may reveal valuable information for new therapeutic approaches.

背景据报道,癌症与阿尔茨海默病及相关痴呆症(ADRD)之间的反比关系仍不确定。目的研究这些常见老年疾病之间的关系,并探讨可能的致病因素。设计、设置、参与者和测量我们利用英国临床实践研究数据链接(CPRD)中 3,021,508 名 60 岁及以上的人的数据进行了一项大型人群队列分析,分析时间跨度长达 30 年(1988-2018 年)。采用 Cox 比例危险模型估算与既往癌症诊断相关的痴呆症风险的危险比 (HR)。采用竞争风险模型来考虑死亡的竞争风险。结果在 CPRD 队列中,有 412,903 人曾被诊断患有癌症,230,558 人随后被诊断患有痴呆症,随访时间中位数为 7.9 年。在对潜在的混杂因素进行调整后,癌症幸存者患痴呆症的风险降低了25%(HR=0.75,95% CI:0.74-0.76)。考虑到死亡的竞争风险,亚分布HR为0.56(95% CI:0.55-0.56)。流行性癌症和偶发性癌症以及不同常见癌症类型的结果是一致的。使用 357 个与癌症相关的工具性单核苷酸多态性(SNPs)进行的双样本孟德尔随机分析表明,在遗传预测的癌症与阿尔茨海默病风险降低之间存在垂直多效性(OR=0.97,95% CI:0.95-0.99)。进一步研究其确切的生物学机制可能会为新的治疗方法提供有价值的信息。
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引用次数: 0
Hypothetical Interventions on Cardiovascular Health Metrics for Abnormal Cognitive Aging: An Application of the Parametric g-formula in the CLHLS Cohort Study with 12 Years Follow-Up 针对认知异常老化的心血管健康指标的假设干预:参数 g 公式在 12 年随访的 CLHLS 队列研究中的应用
IF 6.4 Q2 BUSINESS Pub Date : 2024-07-09 DOI: 10.14283/jpad.2024.143
S. Huang, Z. Zhao, S. Wang, Y. Xu, Z. Wang, J. Wang, H. Wang, X. Yu, Xiaozhen Lv

Background

Abnormal cognitive aging is closely related to dementia.

Objectives

This study aimed to estimate the effect of cardiovascular health (CVH) metrics on abnormal cognitive aging.

Design

A longitudinal cohort study.

Setting

Participants were recruited from the Chinese Longitudinal Health Longevity Survey.

Participants

A total of 3298 participants aged ≥65 years with normal cognitive performance at baseline were included.

Measurements

Cognitive performance was measured by the Chinese version of the Mini-Mental State Examination (MMSE). CVH was assessed with six metrics, including hypertension, diabetes, exercise, body mass index (BMI), diet, and smoking. Group-based trajectory model was used to identify the trajectory groups of cognitive aging over 12 years (2002–2014 and 2005–2018). The parametric g-formula was applied to estimate the effect of each single six CVH metrics and their combinations on the 12-year cognitive aging trajectory.

Results

Four trajectory groups of cognitive aging were identified: Stable-high (77.4%), Unstable (4.9%), Slow decline (11.1%), and Rapid decline (6.6%). Unstable, Slow decline, and Rapid decline trajectory groups were considered as abnormal cognitive aging (22.6%). Single interventions on hypertension, exercise, BMI, and diet could reduce the risk of abnormal cognitive aging. Moreover, the risk ratios of joint intervention on exercise, BMI, and diet for Unstable, Slow decline, and Rapid decline trajectory groups were 0.38 (95% CI: 0.30–0.48), 0.45 (95% CI: 0.37–0.54), and 0.3 (95% CI: 0.23–0.41), respectively.

Conclusion

A considerable proportion of the participants experienced abnormal cognitive aging during their aging process. Interventions on these CVH metrics (i.e., exercise, BMI, and diet), which are fairly practical and feasible for older adults, may be effective strategies for preventing abnormal cognitive aging.

背景异常认知衰老与痴呆症密切相关。目的本研究旨在估测心血管健康指标对异常认知衰老的影响。CVH通过六项指标进行评估,包括高血压、糖尿病、运动、体重指数(BMI)、饮食和吸烟。采用基于群体的轨迹模型来识别 12 年(2002-2014 年和 2005-2018 年)间认知老化的轨迹群体。应用参数 g 公式估算了六项 CVH 指标及其组合对 12 年认知老化轨迹的影响:稳定-高(77.4%)、不稳定(4.9%)、缓慢衰退(11.1%)和快速衰退(6.6%)。不稳定、缓慢衰退和快速衰退轨迹组被视为异常认知老化(22.6%)。对高血压、运动、体重指数和饮食进行单一干预可降低认知异常老化的风险。此外,对不稳定、缓慢衰退和快速衰退轨迹组进行运动、体重指数和饮食联合干预的风险比分别为 0.38(95% CI:0.30-0.48)、0.45(95% CI:0.37-0.54)和 0.3(95% CI:0.23-0.41)。对于老年人来说,这些 CVH 指标(即运动、体重指数和饮食)是相当实用和可行的,对其进行干预可能是预防认知异常老化的有效策略。
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引用次数: 0
The Causal Relationship between Genetically Predicted Biological Aging, Alzheimer’s Disease and Cognitive Function: A Mendelian Randomisation Study 基因预测的生物衰老、阿尔茨海默病和认知功能之间的因果关系:孟德尔随机研究
IF 6.4 Q2 BUSINESS Pub Date : 2024-07-02 DOI: 10.14283/jpad.2024.128
Y. Hao, W. Tian, B. Xie, X. Fu, S. Wang, Yu Yang

Aging is one of the most important risk factors for Alzheimer’s disease (AD). Biological aging is a better indicator of the body’s functional state than age (chronological aging). Leukocyte telomere length (LTL) and epigenetic clocks constructed from DNA methylation patterns have emerged as reliable markers of biological aging. Recent studies have shown that it may be possible to slow down or even reverse biological aging, offering promising prospects for treating AD. Several observational studies have reported an association between biological aging, AD, and cognitive function, but the causality behind this association and the effects of different biological aging markers on AD risk and cognitive function remain unclear. Therefore, we explored the causal relationship between them by Mendelian randomization (MR) study. Inverse-variance weighted (IVW) method is the most dominant analytical method in MR studies, which is a weighted average of estimates from different genotype combinations, and this weighted average provides an overall estimate of the causal effect. The results of the IVW analyses showed that HannumAge acceleration and LTL shortening were able to increase the risk of late-onset AD (LOAD), but not early-onset AD (EOAD). Excellent prospective memory and fluid intelligence are potentially protective against GrimAge acceleration. GrimAge acceleration and HorvathAge acceleration increase the risk of LOAD through effects on LTL. Our findings provide important insights into the role of biological aging in the pathogenesis of AD, while also highlighting the interplay of different biological aging markers and their complexity in different AD subtypes.

衰老是阿尔茨海默病(AD)最重要的风险因素之一。与年龄(计时衰老)相比,生物衰老是人体功能状态的更好指标。白细胞端粒长度(LTL)和根据 DNA 甲基化模式构建的表观遗传时钟已成为生物衰老的可靠标志。最近的研究表明,延缓甚至逆转生物衰老是可能的,这为治疗注意力缺失症提供了广阔的前景。一些观察性研究报告了生物衰老、AD 和认知功能之间的关联,但这种关联背后的因果关系以及不同生物衰老标志物对 AD 风险和认知功能的影响仍不清楚。因此,我们通过孟德尔随机化(MR)研究探讨了它们之间的因果关系。逆方差加权(IVW)法是MR研究中最主要的分析方法,它是对不同基因型组合的估计值进行加权平均,这种加权平均提供了对因果效应的总体估计。IVW分析结果显示,HannumAge加速和LTL缩短能够增加晚发AD(LOAD)的风险,但不会增加早发AD(EOAD)的风险。出色的前瞻性记忆和流体智力可能对格林年龄加速具有保护作用。GrimAge加速和HorvathAge加速通过对LTL的影响增加了LOAD的风险。我们的研究结果为了解生物衰老在AD发病机制中的作用提供了重要见解,同时也强调了不同生物衰老标志物的相互作用及其在不同AD亚型中的复杂性。
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引用次数: 0
Unveiling Potential Biomarkers in Cerebrospinal Fluid for Amyloid Pathological Positivity in Non-Demented Individuals 揭示非痴呆患者脑脊液中淀粉样病理阳性的潜在生物标志物
IF 6.4 Q2 BUSINESS Pub Date : 2024-07-02 DOI: 10.14283/jpad.2024.129
F. Meng, Xi Zhang

Background

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by amyloid-beta (Aβ) plaque accumulation and neurofibrillary tangles. The recent approval of anti-amyloid therapeutic medications highlights the crucial need for early detection of Aβ pathological abnormalities in individuals without dementia to facilitate timely intervention and treatment.

Objective

The primary aim of this study was to identify cerebrospinal fluid (CSF) biomarkers strongly associated with Aβ pathological positivity in a non-demented cohort and evaluate their clinical values.

Methods

A comprehensive analysis was conducted on 51 CSF proteins (excluding Aβ42, pTau, and Tau) obtained from 474 non-demented participants sourced from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. By utilizing the Least Absolute Shrinkage and Selection Operator (LASSO) regression, we identified potential proteins indicative of Aβ pathological positivity and evaluated their performance in tracking longitudinal pathological progression.

Results

Our LASSO analysis unveiled three candidates: apolipoprotein E (APOE), chitinase-3-like protein 1 (CHI3L1), and SPARC-related modular calcium-binding protein 1 (SMOC1). While SMOC1 did not correlate with Aβ42-related cognitive alterations, it displayed better abilities in discriminating both CSF-Aβ positivity and Aβ-positron emission tomography (PET) positivity than the other two candidates. It could precisely predict longitudinal Aβ-PET status conversion. Notably, SMOC1 was the only protein showing associations with longitudinal Aβ-PET trajectory and enhancing the diagnostic accuracy of Aβ42. The assessment of combined Aβ42 and SMOC1 yielded valuable clinical insights.

Conclusion

Our findings elucidated SMOC1 as a potential biomarker for detecting Aβ abnormalities. Aβ42 combining SMOC1 offered critical implications in AD pathological diagnosis and management.

背景阿尔茨海默病(AD)是一种以淀粉样β(Aβ)斑块堆积和神经纤维缠结为特征的进行性神经退行性疾病。最近,抗淀粉样蛋白治疗药物获得批准,这凸显了在未患痴呆症的患者中及早发现 Aβ 病理异常以促进及时干预和治疗的迫切需要。本研究的主要目的是在非痴呆人群中鉴定与Aβ病理阳性密切相关的脑脊液(CSF)生物标志物,并评估其临床价值。方法对来自阿尔茨海默病神经影像学倡议(ADNI)数据库的474名非痴呆参与者的51种CSF蛋白(不包括Aβ42、pTau和Tau)进行了综合分析。结果我们的 LASSO 分析发现了三种候选蛋白:脂蛋白 E (APOE)、甲壳素酶-3 样蛋白 1 (CHI3L1) 和 SPARC 相关模块化钙结合蛋白 1 (SMOC1)。虽然SMOC1与Aβ42相关的认知改变并不相关,但它在鉴别CSF-Aβ阳性和Aβ-正电子发射断层扫描(PET)阳性方面的能力优于其他两种候选蛋白。它可以精确预测 Aβ-PET 状态的纵向转换。值得注意的是,SMOC1是唯一一个与纵向Aβ-PET轨迹相关的蛋白质,它提高了Aβ42的诊断准确性。我们的研究结果阐明了 SMOC1 是检测 Aβ 异常的潜在生物标志物。Aβ42与SMOC1的结合对AD的病理诊断和管理具有重要意义。
{"title":"Unveiling Potential Biomarkers in Cerebrospinal Fluid for Amyloid Pathological Positivity in Non-Demented Individuals","authors":"F. Meng, Xi Zhang","doi":"10.14283/jpad.2024.129","DOIUrl":"https://doi.org/10.14283/jpad.2024.129","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by amyloid-beta (Aβ) plaque accumulation and neurofibrillary tangles. The recent approval of anti-amyloid therapeutic medications highlights the crucial need for early detection of Aβ pathological abnormalities in individuals without dementia to facilitate timely intervention and treatment.</p><h3 data-test=\"abstract-sub-heading\">Objective</h3><p>The primary aim of this study was to identify cerebrospinal fluid (CSF) biomarkers strongly associated with Aβ pathological positivity in a non-demented cohort and evaluate their clinical values.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A comprehensive analysis was conducted on 51 CSF proteins (excluding Aβ42, pTau, and Tau) obtained from 474 non-demented participants sourced from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. By utilizing the Least Absolute Shrinkage and Selection Operator (LASSO) regression, we identified potential proteins indicative of Aβ pathological positivity and evaluated their performance in tracking longitudinal pathological progression.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Our LASSO analysis unveiled three candidates: apolipoprotein E (APOE), chitinase-3-like protein 1 (CHI3L1), and SPARC-related modular calcium-binding protein 1 (SMOC1). While SMOC1 did not correlate with Aβ42-related cognitive alterations, it displayed better abilities in discriminating both CSF-Aβ positivity and Aβ-positron emission tomography (PET) positivity than the other two candidates. It could precisely predict longitudinal Aβ-PET status conversion. Notably, SMOC1 was the only protein showing associations with longitudinal Aβ-PET trajectory and enhancing the diagnostic accuracy of Aβ42. The assessment of combined Aβ42 and SMOC1 yielded valuable clinical insights.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Our findings elucidated SMOC1 as a potential biomarker for detecting Aβ abnormalities. Aβ42 combining SMOC1 offered critical implications in AD pathological diagnosis and management.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"18 1","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141526643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Modulatory Effect of Blood LDL Cholesterol on the Association between Cerebral Aβ and Tau Deposition in Older Adults 血液中低密度脂蛋白胆固醇对老年人大脑 Aβ 和 Tau 沉积之间关系的调节作用
IF 6.4 Q2 BUSINESS Pub Date : 2024-07-02 DOI: 10.14283/jpad.2024.131
S. M. Han, M. S. Byun, D. Yi, J. H. Jung, N. Kong, Y. Y. Chang, M. Keum, G. J. Jung, J.-Y. Lee, Y.-S. Lee, Y. K. Kim, K. M. Kang, C.-H. Sohn, Dong Young Lee

Background

This study investigates the synergistic relationship between blood low-density lipoprotein cholesterol (LDL-C) and cerebral beta-amyloid (Aβ) in relation to tau deposition, a key factor in the pathology of Alzheimer’s disease (AD), in older adults across a diverse cognitive spectrum.

Objectives

To examine whether higher levels of LDL-C in the blood moderate the association of cerebral Aβ with tau deposition in older adults, including those with normal cognition, mild cognitive impairment, and Alzheimer’s disease dementia.

Design

Cross-sectional design. Setting: The study was conducted as a part of a prospective cohort study. All assessments were done at the Seoul National University Hospital, Seoul, South Korea. Participants: A total of 136 older adults (aged 60–85 years) with normal cognition, mild cognitive impairment or Alzheimer’s disease (AD) dementia were included.

Measurements

Serum lipid measurements, [11C] Pittsburgh Compound B-positron emission tomography (PET), [18F] AV-1451 PET, and magnetic resonance imaging were performed on all participants.

Results

There was a significant Aβ × LDL-C interaction effect on tau deposition indicating a synergistic moderation effect of LDL-C on the relationship between Aβ and tau deposition. Subsequent subgroup analysis showed that the positive association between Aβ and tau deposition was stronger in higher LDL-C group than in lower LDL-C group. In contrast, other lipids, such as total cholesterol, high-density lipoprotein cholesterol, and triglycerides, did not show a similar moderation effect on the relationship between Aβ deposition and tau deposition.

Conclusion

Our findings suggest that blood LDL-C synergistically enhances the influence of Aβ deposition on tau pathology, emphasizing the need for greater attention to the role of LDL-C in AD progression.

背景本研究探讨了血液中低密度脂蛋白胆固醇(LDL-C)和脑β-淀粉样蛋白(Aβ)之间的协同关系,这种协同关系与不同认知范围的老年人中阿尔茨海默病(AD)病理学的关键因素--tau沉积有关。目的 研究血液中较高水平的低密度脂蛋白胆固醇是否会缓和老年人(包括认知正常、轻度认知障碍和阿尔茨海默病痴呆症患者)脑Aβ与tau沉积的关系。地点该研究是前瞻性队列研究的一部分。所有评估均在韩国首尔的首尔国立大学医院进行。参加者:136 名老年人(其中包括一名老年痴呆症患者):测量对所有参与者进行了血清脂质测量、[11C] 匹兹堡化合物 B 正电子发射断层扫描(PET)、[18F] AV-1451 正电子发射断层扫描和磁共振成像。结果Aβ×LDL-C对tau沉积有明显的交互作用,表明LDL-C对Aβ和tau沉积之间的关系有协同调节作用。随后的亚组分析显示,Aβ与tau沉积之间的正相关在高LDL-C组比低LDL-C组更强。结论我们的研究结果表明,血液中的低密度脂蛋白胆固醇会协同增强Aβ沉积对tau病理学的影响,这强调了需要更加关注低密度脂蛋白胆固醇在AD进展中的作用。
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引用次数: 0
Independent and Joint Associations of Socioeconomic Status and Lifestyle behaviors with Cognitive Impairment among Elderly Chinese Population 中国老年人群中社会经济地位和生活方式行为与认知障碍的独立和联合关系
IF 6.4 Q2 BUSINESS Pub Date : 2024-07-02 DOI: 10.14283/jpad.2024.127
Y. Feng, S. Jia, W. Zhao, X. Wu, Y. Zuo, S. Wang, L. Zhao, M. Ma, X. Guo, C. S. Tarimo, Y. Miao, Jian Wu

Background

Numerous studies have shown that there are socioeconomic disparities in people’s health. Health behavior is considered to be an effective strategy to alleviate socioeconomic differences. However, the independent or joint relationship between socioeconomic status (SES) and lifestyle behaviors (LBs) on the cognition of Chinese elderly are not clear. Therefore, this study aimed to reveal the impact of SES and LBs on cognitive impairment in elder Chinese.

Methods

The data from the 2017–2018 wave of Chinese Longitudinal Healthy Longevity Survey was used. SES was created using latent class analysis based on annual percapita household income, education level, and occupation. Six LBs were considered in calculating LB scores. Restricted cubic splines were used to model the association of LB scores and cognitive impairment to investigate the dose-response relationship. LB scores were divided into three groups: unhealthy, intermediate, and healthy lifestyle. Multivariate Logistic regression models were applied to explore both the independent and joint effects of SES and LB scores on cognitive impairment.

Results

Among 10,116 participants, 1,872 (18.51%) were recorded as having cognitive impariment. After adjusting for multivariable confounding factors, compared with participants of high SES, those of low SES had higher risks of cognitive impairment [Odds ratio (OR): 1.385; 95% confidence interval (CI): 1.137–1.689]. In contrast to those with unhealthy lifestyle, participants adhering to a healthy lifestyle were found to be associated with a reduced risk of cognitive impairment (OR: 0.198; 95%CI: 0.150–0.263). A non-linear relationship was observed between LB scores and cognitive impairment (Pnonlinearity =0.001), indicating a protective effect on cognitive impairment when having more than two LBs. Participants with high SES and engaged in healthy lifestyle had the lowest risk of cognitive impairment compared to those with low SES and unhealthy lifestyle (OR: 0.123; 95% CI 0.073–0.207).

Conclusion

Cognitive impairment has socioeconomic disparities among the elderly Chinese population. A healthy lifestyle may attenuate the impact of socioeconomic inequality on cognitive impairment, emphasizing the important role of LBs modification in reducing the disease burden of cognitive impairment, especially in the elderly population with low SES.

背景大量研究表明,人们的健康存在社会经济差异。健康行为被认为是缓解社会经济差异的有效策略。然而,社会经济地位(SES)和生活方式行为(LBs)对中国老年人认知能力的独立或联合关系尚不清楚。因此,本研究旨在揭示SES和生活行为对中国老年人认知障碍的影响。方法采用2017-2018年中国健康长寿纵向调查数据。根据家庭人均年收入、教育程度和职业,采用潜类分析法创建 SES。在计算 LB 分数时考虑了六个 LB。为了研究剂量-反应关系,我们使用了限制性三次样条来建立 LB 分数与认知障碍的关联模型。LB 评分分为三组:不健康生活方式组、中等生活方式组和健康生活方式组。结果 在 10,116 名参与者中,1,872 人(18.51%)被记录为有认知障碍。在对多变量混杂因素进行调整后,与高社会经济地位的参与者相比,低社会经济地位的参与者出现认知障碍的风险更高[比值比(OR):1.385;95% 置信区间(CI):1.137-1.689]。与生活方式不健康的人相比,坚持健康生活方式的人患认知障碍的风险较低(OR:0.198;95%CI:0.150-0.263)。LB 分数与认知障碍之间存在非线性关系(Pnonlinearity =0.001),表明当 LB 超过两个时,对认知障碍有保护作用。与社会经济地位低、生活方式不健康的人群相比,社会经济地位高、生活方式健康的人群发生认知障碍的风险最低(OR:0.123;95% CI 0.073-0.207)。健康的生活方式可减轻社会经济不平等对认知障碍的影响,强调了改变生活方式在减轻认知障碍疾病负担方面的重要作用,尤其是在社会经济地位较低的老年人群中。
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引用次数: 0
期刊
The Journal of Prevention of Alzheimer's Disease
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