CSF proteomics related to the neurovascular unit are associated with white matter hyperintensity volumes and cerebral microhemorrhages in autosomal dominant Alzheimer disease
AbstractBackgroundAutosomal dominant Alzheimer disease (ADAD) is characterized by genetic mutations affecting the beta‐amyloid (Aβ) pathway. However, vascular and immune factors play important roles which are not completely understood. Understanding the function of the neurovascular unit (NVU) comprised of neurons, glial cells, and vasculature, at different disease stages appears ideal to developing and evaluating therapeutics. Omics approaches can inform NVU changes and their disease associations.MethodsCSF proteomic data using the Somalogic® platform was generated from 485 participants in the DIAN study, who also had PiB‐PET and MRI assessing Aβ burden, white matter hyperintensity (WMH), and cerebral microhemorrhage (CMH). From previously published AD studies, we identified 33 NVU‐associated proteins with corresponding Somalogic aptamers (Figure 1). We used Principal Component Analysis (PCA) on participants with complete data (n=262, 166 mutation‐carriers and 96 non‐carriers) to find groups of proteins associated with mutation status and disease stage as measured with estimated year to symptom onset (EYO), PiB‐PET, and clinical status. Linear‐mixed effect models and two‐part zero‐inflated negative binomial mixed models further evaluated the link between significant principal components (PCs) and WMH and CMH, respectively. Models accounted for age, APOE‐e4 status, sex, and education.ResultsThe first ten PCs explained >60% of the variance in NVU‐related protein levels (Figure 2A) with only PC5 (4.8%) associated with mutation*EYO, suggesting relationship with ADAD‐specific disease progression (***p<0.0001, Figure 2B). While asymptomatic PiB‐negative individuals were not significantly different from non‐carriers, asymptomatic PiB‐positive individuals had higher PC5 scores than non‐carriers and symptomatic individuals scored still higher (**p<0.005, ***p<0.0001, Figure 2C). The main proteins composing PC5 were: neurofilament light‐chain, angiopoietin‐2, SMOC1, LRP1, E‐selectin, and sTREM2, suggesting strong association with proinflammatory glial response from neuronal injury (Figure 2D). PC5 was also associated with WMH volumes (*p<0.05, Figure 3A) and with CMH count in participants with CMH (**p<0.005, Figure 3B).ConclusionsThis PCA approach indicates that some groups of NVU‐associated proteins are related with mutation status and disease stage, and that they are differentially associated with features of ADAD such as white matter integrity as measured by WMH volume. Weighted Correlation Network Analysis will be of interest to further understand these associations.Funding: K01AG080123, RF1‐AG044546, UF1AG032438
CSF proteomics related to the neurovascular unit are associated with white matter hyperintensity volumes and cerebral microhemorrhages in autosomal dominant Alzheimer disease
AbstractBackgroundAutosomal dominant Alzheimer disease (ADAD) is characterized by genetic mutations affecting the beta‐amyloid (Aß) pathway. However, vascular and immune factors play important roles which are not completely understood. Understanding the function of the neurovascular unit (NVU) comprised of neurons, glial cells, and vasculature, at different disease stages appears ideal to developing and evaluating therapeutics. Omics approaches can inform NVU changes and their disease associations.MethodsCSF proteomic data using the Somalogic® platform was generated from 485 participants in the DIAN study, who also had PiB‐PET and MRI assessing Aß burden, white matter hyperintensity (WMH), and cerebral microhemorrhage (CMH). From previously published AD studies, we identified 33 NVU‐associated proteins with corresponding Somalogic aptamers (Figure 1). We used Principal Component Analysis (PCA) on participants with complete data (n = 262, 166 mutation‐carriers and 96 non‐carriers) to find groups of proteins associated with mutation status and disease stage as measured with estimated year to symptom onset (EYO), PiB‐PET, and clinical status. Linear‐mixed effect models and two‐part zero‐inflated negative binomial mixed models further evaluated the link between significant principal components (PCs) and WMH and CMH, respectively. Models accounted for age, APOE‐e4 status, sex, and education.ResultsThe first ten PCs explained >60% of the variance in NVU‐related protein levels (Figure 2A) with only PC5 (4.8%) associated with mutation*EYO, suggesting relationship with ADAD‐specific disease progression (***p<0.0001, Figure 2B). While asymptomatic PiB‐negative individuals were not significantly different from non‐carriers, asymptomatic PiB‐positive individuals had higher PC5 scores than non‐carriers and symptomatic individuals scored still higher (**p<0.005, ***p<0.0001, Figure 2C). The main proteins composing PC5 were: neurofilament light‐chain, angiopoietin‐2, SMOC1, LRP1, E‐selectin, and sTREM2, suggesting strong association with proinflammatory glial response from neuronal injury (Figure 2D). PC5 was also associated with WMH volumes (*p<0.05, Figure 3A) and with CMH count in participants with CMH (**p<0.005, Figure 3B).ConclusionsThis PCA approach indicates that some groups of NVU‐associated proteins are related with mutation status and disease stage, and that they are differentially associated with features of ADAD such as white matter integrity as measured by WMH volume. Weighted Correlation Network Analysis will be of interest to further understand these associations. Funding: K01AG080123, RF1‐AG044546, UF1AG032438
Ubiquitin-Proteasome System in the Different Stages of Dominantly Inherited Alzheimer’s Disease
Abstract This study explored the role of the ubiquitin-proteasome system (UPS) in dominantly inherited Alzheimer’s disease (DIAD) by examining changes in cerebrospinal fluid (CSF) levels of UPS proteins along with disease progression, AD imaging biomarkers (PiB PET, tau PET), neurodegeneration imaging measures (MRI, FDG PET), and Clinical Dementia Rating® (CDR®). Using the SOMAscan assay, we detected subtle increases in specific ubiquitin enzymes associated with proteostasis in mutation carriers (MCs) up to two decades before the estimated symptom onset. This was followed by more pronounced elevations of UPS-activating enzymes, including E2 and E3 proteins, and ubiquitin-related modifiers. Our findings also demonstrated consistent correlations between UPS proteins and CSF biomarkers such as Aβ42/40 ratio, total tau, various phosphorylated tau species to total tau ratios (ptau181/T181, ptauT205/T205, ptauS202/S202, ptauT217/T217), and MTBR-tau243, alongside Neurofilament light chain (NfL) and the CDR®. Notably, a positive association was observed with imaging markers (PiB PET, tau PET) and a negative correlation with markers of neurodegeneration (FDG PET, MRI), highlighting a significant link between UPS dysregulation and neurodegenerative processes. The correlations suggest that the increase in multiple UPS proteins with rising tau levels and tau-tangle associated markers, indicating a potential role for the UPS in relation to misfolded tau/neurofibrillary tangles (NFTs) and symptom onset. These findings indicate that elevated CSF UPS proteins in DIAD MCs could serve as early indicators of disease progression and suggest a link between UPS dysregulation and amyloid plaque, tau tangles formation, implicating the UPS as a potential therapeutic target in AD pathogenesis.