Phosphorylated tau in the Down syndrome brain: Age related increases and comparison to late‐onset Alzheimer’s Disease

Abstract

AbstractBackgroundIndividuals with Down Syndrome (DS) have an increased risk of developing Alzheimer’s Disease (AD) with nearly all individuals exhibiting neuropathological changes in the brain by age 40 years, and with a mean diagnosis of dementia by age ∼55 years. The purpose of this postmortem study was to characterize the age‐associated burden of several tau phosphorylation epitopes, including threonine (pT) 181, 217, and 231 by immunohistochemistry in the frontal cortex. We hypothesized that cerebral pT burden would increase with age in DS but not in controls and be higher in DS with AD neuropathology (DSAD) compared to late‐onset AD (LOAD).MethodWe examined 117 brains from: controls (non‐DS n = 53; ages 1‐91), DS without AD (n = 13; ages 1‐48), DSAD (n = 31; age 43‐68), and LOAD (n = 20; ages 63‐96). Serial sections from the frontal cortex were cut at 30µm and immunostained for phosphorylated tau pT181, pT217 and pT231. Whole slide images were digitized and analyzed by Aperio ImageScope software. The % area for each type of tau was quantified using positive pixel counts. Spearman rank correlations on log‐transformed data were used to test for positive age associations and t‐test was used to compare pT between DSAD and LOAD.ResultIn control cases, there was a positive correlation of age with pT181 (r = 0.47 p<0.001) but not with pT217 or pT231. In DS cases across the lifespan (DS and DSAD combined) displayed a positive correlation of age with pT181 (r = 0.70 p<.001), pT217 (r = 0.70 p<.001), and pT231 (r = 0.42 p = 0.005). DSAD cases had significantly higher pT181, pT217 and pT231 (p<.001) than late‐onset AD and control cases.ConclusionThese results suggest that tau phosphorylation for these epitopes is more positively correlated with age in people with DS than people without DS. Although pT181 increased with age in both cohorts, pT217 and pT231 showed a positive correlation with age in people with DS but not controls. Fluid biomarker studies focused on pTau in longitudinal cohorts of people with DS with subsequent brain donation will help reveal the link between peripheral and central pTau levels.