Project Details
Description
Project Abstract
Structural and functional alterations in brain endothelium are observed in ≥90% of Alzheimer Disease (AD) brains
in the absence of cerebrovascular disease or amyloid angiopathy. Despite its prevalence, the role of endothelial
dysfunction in AD pathogenesis has not been adequately investigated due to the absence of reliable endothelial
biomarkers. We have identified a novel panel of endothelial biomarkers whose brain ribonucleic acid (RNA) and
cerebrospinal fluid (CSF) protein levels are significantly altered in AD compared to controls. Exciting preliminary
data suggest that these proteins offer promise as novel diagnostic and prognostic biomarkers of brain endothelial
dysfunction and strongly correlate with cognitive and radiological outcomes in AD. Importantly, our preliminary
AD models suggest that endothelial dysfunction is an early pathological substrate which may precede amyloid
and tau. We here propose to conduct the first in-depth comprehensive translational study of endothelial
dysfunction in AD. In this study, we will utilize proteomics and transcriptomics to measure CSF protein and brain
RNA levels of these endothelial markers in 3 large well-characterized longitudinal cohorts of late-onset sporadic
AD, healthy controls, and non-AD dementias (combined n>3,400) who have been followed for 20-25 years and
for whom we have detailed longitudinal cognitive, CSF, magnetic resonance imaging (MRI including ASL, FLAIR,
and DTI), amyloid-positron emission tomography (amyloid-PET), and tau-PET imaging data. In Aim 1, we will
examine the diagnostic and prognostic utility of CSF endothelial markers in AD and their ability to predict
cognitive decline and brain atrophy over time, independently of amyloid and tau. We will also characterize
baseline and longitudinal associations of endothelial dysfunction with CSF and/or imaging markers of amyloid,
tau, inflammation, and neuronal/synaptic injury over 20-25 years of follow-up, including 10-15 years prior to
symptom onset. In Aim 2, we will leverage event-based modeling (EBM; Aim 2A) in our cross-sectional cohorts
and multifactorial data driven analyses (MFDDA; Aim 2B) in our longitudinal cohorts to propose new data-driven
predictive models for AD which will elucidate the temporal ordering of fluid and imaging AD markers and the
spatiotemporal progression of AD imaging markers (cerebral blood flow, amyloid and tau PET, and brain atrophy)
across 37 brain regions and over 10-15 years prior to symptom onset. Functional pathway analyses of proteomic
and RNA-seq data from our cohort and others will identify novel mechanisms by which endothelial dysfunction
contributes to neurodegeneration, and influences synaptic plasticity, axonal repair, and abnormal protein
aggregation in AD (Aim 2C). Through in-depth multi-omics analyses of endothelial dysfunction and the
integration of multimodal data from large well-characterized longitudinal multiracial AD cohorts, we aim to
propose a new disease model which will be the first to integrate endothelial dysfunction into the AD paradigm
and will capture the molecular and pathological heterogeneity of AD beyond amyloid and tau. Findings from this
study will provide novel insights into disease mechanisms and new molecular targets for AD drug discovery.
Status | Active |
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Effective start/end date | 09/1/23 → 08/31/26 |
Funding
- National Institute on Aging: $2,140,130.00
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