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<div about="/news-events/nih-research-matters/gene-variation-may-protect-against-alzheimers-disease" typeof="sioc:Item foaf:Document" class="ds-1col node node--nih-research-matters view-mode-full node--full node--nih-research-matters--full clearfix">
<p class="publishdate"><span property="dc:date" datatype="xsd:dateTime" content="2019-11-19T00:00:00-05:00" class="date-display-single">November 19, 2019</span></p><div class='syndicate'><h1>Gene variation may protect against Alzheimers disease </h1><div class="callout callout-with-border"><h3>At a Glance</h3>
<ul>
<li>Researchers studied a woman with an inherited condition that causes early-onset Alzheimers disease but who didnt experience cognitive decline until her 70s.</li>
<li>Protection from the brain changes associated with Alzheimers may be explained by a rare variant in a gene called <em>APOE</em>.</li>
<li>Developing drugs to mimic the effects of this mutation may be a strategy for preventing the memory and thinking problems caused by the disease.</li>
</ul></div><div class="media-float-right"><div class="ds-1col file file-image file-image-jpeg view-mode-floated_media clearfix">
<picture title="Brain images of woman with inherited condition that causes early-onset Alzheimers disease ">
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-large/public/news-events/research-matters/2019/20191119-brain.jpg?itok=7lXXPRZu&amp;timestamp=1706627286 1x" media="screen and (min-width: 960px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-medium-small/public/news-events/research-matters/2019/20191119-brain.jpg?itok=Llu1HhA5&amp;timestamp=1706627286 1x" media="screen and (min-width: 600px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-tiny/public/news-events/research-matters/2019/20191119-brain.jpg?itok=C1grxm7A&amp;timestamp=1706627286 1x" media="screen and (min-width: 0)" />
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<img src="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-medium/public/news-events/research-matters/2019/20191119-brain.jpg?itok=kvyEsRUL&amp;timestamp=1706627286" alt="Brain images of woman with inherited condition that causes early-onset Alzheimers disease " title="Brain images of woman with inherited condition that causes early-onset Alzheimers disease " />
</picture><span class="caption">Brain images of a woman with an inherited condition that causes early-onset Alzheimers disease show high levels of amyloid plaques (top) but limited tau (bottom) for her age. Blue represents lowest levels and red represents highest. </span><span class="credit">Arboleda-Velasquez et al., Nature Medicine</span></div>
</div><p>Alzheimers disease is the most common cause of dementia in older adults. Brain changes associated with the disease include abnormal clumps (amyloid-β plaques), tangled bundles of fibers (tau tangles), and the eventual death of nerve cells. These changes lead to a progressive decline in memory and thinking skills.</p>
<p>In the search for potential therapies, researchers have been studying known genetic causes of Alzheimers. Some rare forms of Alzheimers can be caused by variations in a single gene. These variants almost always cause symptoms by the time carriers reach middle age—several decades earlier than the typical age of onset of the most common form of the disease.</p>
<p>Researchers led by Drs. Yakeel Quiroz from Harvard Medical School and Francisco Lopera from the University of Antioquia have been studying an extended family in Columbia, South America who are affected by one such variant, in a gene called <em>PSEN1</em>. Of more than 6,000 people in the family, about 1,200 carry the Alzheimers-causing <em>PSEN1</em> mutation.</p>
<p>With the exception of a single woman, all of the family members with the <em>PSEN1</em> mutation have developed symptoms of mild cognitive impairment and Alzheimers dementia in their 40s. This woman didnt develop any symptoms of cognitive decline until her 70s.</p>
<p>The woman volunteered to undergo comprehensive testing, including brain imaging and whole-genome sequencing, to look for possible protective factors. The study was funded in part by NIHs National Institute on Aging (NIA), Office of the Director (OD), and National Institute of Neurological Disorders and Stroke (NINDS). Results were published on November 25, 2019, in <em>Nature Medicine</em>.</p>
<p>Brain imaging showed that the woman had high levels of amyloid-β plaques in her brain. However, she had low levels of tau tangles. She also had less damage to her brain than would normally be seen in people with Alzheimers.</p>
<p>Whole-genome sequencing revealed that she carried two copies of a rare variation in the gene <em>APOE</em>, called <em>APOE3ch</em>. Different variations of <em>APOE</em> have previously been linked to either protection from or increased risk of Alzheimers disease. In an analysis of 117 other family members, 6% had one copy of <em>APOE3ch</em>. But the single copy alone didnt appear to provide protective effects.</p>
<p>The team performed further work to understand how two copies of <em>APOE3ch</em> might protect the brain. They found that the variation reduced the ability of the APOE protein to bind a type of sugar found on the surface of brain cells called heparan sulphate proteoglycans (HSPGs). This binding is thought to help tau tangles develop.</p>
<p>The researchers tested whether they could use this knowledge to protect cells that produce normal APOE. They made antibodies that targeted the region where the <em>APOE3ch</em> mutation is. These antibodies reduced the binding of normal APOE to HSPGs to levels seen with <em>APOE3ch.</em></p>
<p>The findings suggest that therapies to reduce the binding of APOE and HSPG may be a potential way to treat or prevent Alzheimers disease.</p>
<p>“Sometimes close analysis of a single case can lead to discovery that could have broad implications for the field,” says NIA Director Dr. Richard J. Hodes.</p></div><h2 class="label-above">Related Links</h2><ul class="spaced print-urls"><li><a href="https://www.nih.gov/news-events/nih-research-matters/gene-expression-signatures-alzheimers-disease" target="_top">Gene Expression Signatures of Alzheimers Disease</a></li><li><a href="https://www.nih.gov/news-events/nih-research-matters/impaired-brain-drainage-aging-alzheimers" target="_top">Impaired Brain Drainage in Aging and Alzheimers</a></li><li><a href="https://www.nih.gov/news-events/nih-research-matters/sleep-deprivation-increases-alzheimers-protein" target="_top">Sleep Deprivation Increases Alzheimers Protein</a></li><li><a href="https://www.nih.gov/news-events/nih-research-matters/clues-alzheimers-disease" target="_top">Clues to Alzheimers Disease</a></li><li><a href="https://www.nih.gov/news-events/nih-research-matters/new-genetic-risk-factors-alzheimers-disease" target="_top">New Genetic Risk Factors for Alzheimers Disease</a></li><li><a href="https://newsinhealth.nih.gov/special-issues/seniors/dealing-dementia" target="_top">Dealing with Dementia</a></li><li><a href="https://www.nia.nih.gov/health/video-how-alzheimers-changes-brain?utm_source=ADvideo&amp;utm_medium=web&amp;utm_campaign=rightrail" target="_top">Video: How Alzheimer's Changes the Brain</a></li><li><a href="https://www.nia.nih.gov/health/alzheimers" target="_top">Alzheimers Disease &amp; Related Dementias</a></li></ul><p class="footnote"><strong class="label-inline">References:&nbsp;</strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/31686034">Resistance to autosomal dominant Alzheimer's disease in an APOE3 Christchurch homozygote: a case report.</a> Arboleda-Velasquez JF, Lopera F, O'Hare M, Delgado-Tirado S, Marino C, Chmielewska N, Saez-Torres KL, Amarnani D, Schultz AP, Sperling RA, Leyton-Cifuentes D, Chen K, Baena A, Aguillon D, Rios-Romenets S, Giraldo M, Guzmán-Vélez E, Norton DJ, Pardilla-Delgado E, Artola A, Sanchez JS, Acosta-Uribe J, Lalli M, Kosik KS, Huentelman MJ, Zetterberg H, Blennow K, Reiman RA, Luo J, Chen Y, Thiyyagura P, Su Y, Jun GR, Naymik M, Gai X, Bootwalla M, Ji J, Shen L, Miller JB, Kim LA, Tariot PN, Johnson KA, Reiman EM, Quiroz YT. <em>Nat Med</em>. 2019 Nov;25(11):1680-1683. doi: 10.1038/s41591-019-0611-3. Epub 2019 Nov 4. PMID: 31686034.</p><p class="footnote"><strong class="label-inline">Funding:&nbsp;</strong>NIHs National Institute on Aging (NIA), Office of the Director (OD), and National Institute of Neurological Disorders and Stroke (NINDS); Massachusetts General Hospital; Alzheimers Association; Grimshaw-Gudewicz Charitable Foundation; Banner Alzheimers Foundation; Nomis Foundation; State of Arizona.</p>
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