Abstract

The identification of novel genetic variants contributing to the widespread in the age of onset (AOO) of Alzheimer’s disease (AD) could aid in the prognosis and/or development of new therapeutic strategies focused on early interventions. We recruited 78 individuals with AD from the Paisa genetic isolate in Antioquia, Colombia. These individuals belong to the world largest multigenerational and extended pedigree segregating AD as a consequence of a dominant fully penetrant mutation in the PSEN1 gene and exhibit an AOO ranging from the early 1930s to the late 1970s. To shed light on the genetic underpinning that could explain the large spread of the age of onset (AOO) of AD, 64 single nucleotide polymorphisms (SNP) associated with neuroanatomical, cardiovascular, and cognitive measures in AD were genotyped. Standard quality control and filtering procedures were applied, and single- and multi-locus linear mixed-effects models were used to identify AOO-associated SNPs. A full two-locus interaction model was fitted to define how identified SNPs interact to modulate AOO. We identified two key epistatic interactions between the APOE*E2 allele and SNPs ASTN2-rs7852878 and SNTG1-rs16914781 that delay AOO by up to ~ 8 years (95% CI 3.2–12.7, P = 1.83 × 10−3) and ~ 7.6 years (95% CI 3.3–11.8, P = 8.69 × 10−4), respectively, and validated our previous finding indicating that APOE*E2 delays AOO of AD in PSEN1 E280 mutation carriers. This new evidence involving APOE*E2 as an AOO delayer could be used for developing precision medicine approaches and predictive genomics models to potentially determine AOO in individuals genetically predisposed to AD.

Highlights

  • The prevalence of Alzheimer’s disease (AD) continues growing at an alarming pace

  • The average Alzheimer’s disease age of onset (ADAOO) differed across education groups (F3,74 = 3.724, P = 0.015) (Fig. 1b)

  • The average ADAOO was statistically different between these groups

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Summary

Introduction

The prevalence of Alzheimer’s disease (AD) continues growing at an alarming pace. In 2006, the number of patients with AD was reported to be over 26.6 million worldwide, and it could rise by approximately fourfold to over 106.2 million by 2050 [1]. For more than three decades, we have been studying the world’s largest known pedigree segregating AD in which the E280A (p.Glu280Ala) mutation in the Presenilin-1 (PSEN1) gene causes early-onset AD [3, 4]. This pedigree is genetically homogeneous, exhibits a high degree of endogamy, and originated centuries ago as a consequence of a founder effect during the colonizing of Colombia by Spaniards [2,3,4,5,6]. It is hypothesized that this substantial variation in the ADAOO is the result of interactions between PSEN1 and other key genes to modify ADAOO, and that this modification results in some members of this pedigree developing signs and symptoms of AD at an earlier or later age than other members (that is, these gene interactions with PSEN1 either accelerate or decelerate ADAOO)

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