Abstract

The biologically active pancreatic hormone peptide islet amyloid polypeptide (IAPP) regulates brain functions such as appetite and cognition. It also plays a role in clearance of amyloid beta (Aβ), a peptide implicated in the dementia disorder Alzheimer’s disease (AD). If IAPP becomes modified, it loses its biological activity and starts to aggregate. Such aggregations have been found in the AD brain and decreased plasma levels of the unmodified IAPP (uIAPP) have been shown in the same patients. In the current study, we analyze levels of uIAPP and total IAPP (unmodified and modified) in cerebrospinal fluid (CSF) to investigate its potential as a biomarker for AD. We found no differences in neither CSF nor plasma levels of uIAPP or total IAPP in AD patients compared to cognitive healthy individuals (NC). The levels of uIAPP in CSF of NC were positively correlated with uIAPP in plasma, Q-albumin and albumin levels in CSF, but negatively correlated with CSF levels of t-tau and p-tau. These findings were not seen in AD patients. Levels of total CSF IAPP correlated positively with total Q-albumin and albumin levels in CSF in both AD and NC. In addition, total plasma IAPP correlated positively with CSF t-tau and p-tau in NC and negatively with CSF Aβ42 in AD patients. To conclude, our studies did not find evidence supporting the use of CSF IAPP as an AD biomarker. However, our findings, indicating a compromised translocation of uIAPP in and out of the brain in AD patients as well as the correlations between total plasma IAPP and AD biomarkers, encourage further research on the role for IAPP in AD.

Highlights

  • The neurodegenerative disorder Alzheimer’s disease (AD) is neuropathologically characterized by progressive accumulation of amyloid beta (Aβ)42 into senile plaques, as well as intraneuronal tangles, composing of hyperphosphorylated tau (p-tau)

  • Our analysis showed that plasma and cerebrospinal fluid (CSF) unmodified IAPP (uIAPP) levels correlated positively across the group (r = 0.364, p = 0.001)

  • The CSF levels in AD and AD+type 2 diabetes (T2D) remained unaltered compared to NC when plasma levels of unmodified islet amyloid polypeptide (IAPP) were included as a covariate (p = 0.899) and the ratio between plasma IAPP levels and CSF IAPP levels did not differ between AD patients, AD+T2D patients and NCs (p = 0.482)

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Summary

Introduction

The neurodegenerative disorder Alzheimer’s disease (AD) is neuropathologically characterized by progressive accumulation of amyloid beta (Aβ) into senile plaques, as well as intraneuronal tangles, composing of hyperphosphorylated tau (p-tau). These hallmarks are in clinical routine monitored by analysis of cerebrospinal fluid (CSF), where reduced levels of Aβ42 and increased levels of p-tau and total tau (t-tau) are considered to reflect increased. IAPP in CSF of AD patients www.ahlenstiftelsen.se; Crafoord foundation 20180776, https://www.crafoord.se; Greta and Johan Kocks foundations 2018, http://www. Kockskastiftelsen.se; Alzheimer foundation AF640421, https://www.alzheimerfonden.se; Olle Engkvist 194-0643 http://engkviststiftelserna.se to MW. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

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