Ozaki Kouichi, Niida Shumpei
Medical Genome Center, National Center for Geriatrics and Gerontology.
Brain Nerve. 2019 Oct;71(10):1039-1051. doi: 10.11477/mf.1416201403.
Dementia is a leading cause of death in many countries. Late-onset Alzheimer's disease (LOAD) is the most common form of dementia, with approximately 35 million affected people. LOAD shows a high heritability (h2) of 58-79%. Clarifying the genetic architecture of LOAD could contribute to precision medicine. In recent years, large-scale genome-wide association studies (GWASs) and their meta-analyses with a large sample size have elucidated the disease-susceptible genes and disease-causing pathways. To date, meta-analyses of GWASs in the Caucasian population have successfully identified approximately 40 LOAD risk loci. The gene set and disease pathway analysis obtained from the results of GWASs suggested biological mechanisms involving brain immune function, lipid-related processes, tau binding proteins, and degradation of amyloid precursor proteins in the pathogenesis of LOAD. Furthermore, the exome sequencing analysis in Japanese individuals with LOAD also revealed a rare variant with a large effect of SHARPIN in LOAD susceptibility, and the variant protein possibly affects the immune response through aberrant cellular localization, which may result in attenuated NF-κB activity in the brain. These findings could provide biological and pharmaceutical approaches in precision medicine for LOAD.
痴呆症是许多国家的主要死因。晚发性阿尔茨海默病(LOAD)是最常见的痴呆症形式,约有3500万人受其影响。LOAD显示出58%-79%的高遗传力(h2)。阐明LOAD的遗传结构有助于精准医学。近年来,大规模全基因组关联研究(GWAS)及其大样本量的荟萃分析已经阐明了疾病易感基因和致病途径。迄今为止,对白种人群体GWAS的荟萃分析已成功鉴定出约40个LOAD风险位点。从GWAS结果中获得的基因集和疾病途径分析表明,LOAD发病机制中的生物学机制涉及脑免疫功能、脂质相关过程、tau结合蛋白以及淀粉样前体蛋白的降解。此外,对日本LOAD患者的外显子组测序分析还揭示了一种在LOAD易感性中具有较大影响的罕见变异体SHARPIN,该变异体蛋白可能通过异常的细胞定位影响免疫反应,这可能导致大脑中NF-κB活性减弱。这些发现可为LOAD精准医学提供生物学和药物学方法。