Un cas révolutionnaire fournit des indices sur le traitement et la prévention de la démence

champ énergétique du cerveau

Les chercheurs pensent que le cerveau de la femme pourrait fournir des informations importantes pour le traitement de la démence.

Une mutation connue sous le nom d’APOE3 Christchurch semble avoir protégé la femme.

En raison d’une mutation génétique rare, Aliria Rosa aurait eu Piedrahita de Villegas[{” attribute=””>Alzheimer’s disease in her 40s and passed away from it in her 60s.

Her brain is now providing important information on the pathology of dementia and potential treatments for Alzheimer’s disease since she lived dementia-free into her 70s.

The lady, from Medellin, Colombia, was a member of an extended family with a mutation in the PSEN1 gene, as researchers at Massachusetts General Hospital (MGH) and other institutions initially reported in 2019.

Because the PSEN1 E280A mutation is autosomal dominant, only one copy of the gene is necessary to cause disease.

This woman did not start displaying symptoms of Alzheimer’s until she was in her early 70s when carriers of the mutation normally display signs of the disease in their 40s or 50s and pass away from it shortly after. She passed away at the age of 77 in 2020 from metastatic melanoma.

“This is a ground-breaking case for Alzheimer’s disease and has already opened new paths for treatment and prevention, which we’re currently pursuing with some collaborators. This work is now bringing light into some of the mechanisms of resistance to Alzheimer’s disease” says investigator Yakeel T. Quiroz, Ph.D.

Quiroz is director of the Multicultural Alzheimer Prevention Program (MAPP) at Mass General, an Associate Professor of Psychology in the Department of Psychiatry at Harvard Medical School, and Paul B. and Sandra M. Edgerley MGH Research Scholar 2020-2025.

The key difference in the Colombian woman’s ability to fend off the disease for three decades appeared to be that in addition to having the PSEN1 E280A mutation, she was also a carrier of both copies of a mutation known as APOE3 Christchurch.

The APOE family of genes controls the production of apolipoproteins, which transport lipids (fats) in blood and other bodily fluids.

The APOE2 variant is known to be protective against Alzheimer’s dementia, while the APOE4 variant is linked to an increased risk for the disease.

APOE3, the most common variant, is not typically associated with either reduced or increased risk for Alzheimer’s.

As Quiroz and colleagues now report in the neuropathology journal Acta Neuropathologica, the woman did, in fact, have pathologic features of Alzheimer’s disease in her brain, but not in regions of the brain where the hallmarks of Alzheimer’s are typically found.

“This patient gave us a window into many competing forces — abnormal protein accumulation, inflammation, lipid metabolism, homeostatic mechanisms — that either promote or protect against disease progression, and begin to explain why some brain regions were spared while others were not,” says Justin Sanchez, AB, co-first author, and an investigator at MGH Neurology.

Researchers identified in Aliria’s brain a distinct pattern of abnormal aggregation or “clumping” of tau, a protein known to be altered in Alzheimer’s disease and other neurologic disorders.

In this case, the tau pathology largely spared the frontal cortex, which is important for judgment and other “executive” functions, and the hippocampus, which is important for memory and learning.

Instead, the tau pathology involved the occipital cortex, the area of the brain at the back of the head that controls visual perception.

The occipital cortex was the only major brain region to exhibit typical Alzheimer’s features, such as chronic inflammation of protective brain cells called microglia, and reduced levels of APOE expression.

“Thus, the Christchurch variant may impact the distribution of tau pathology, modulates age at onset, severity, progression, and clinical presentation of [autosomal dominant Alzheimer’s disease]ce qui suggère des stratégies thérapeutiques potentielles », écrivent les chercheurs.

“Il est rare que nous ayons de belles surprises en étudiant les cerveaux de la maladie d’Alzheimer familiale. Ce cas a montré un phénotype protégé étonnamment clair. Je suis sûr que nos découvertes moléculaires et pathologiques fourniront au moins quelques pistes de recherche et l’espoir d’un traitement réussi de cette maladie », déclare le co-premier auteur Diego Sepulveda-Falla, MD, directeur de recherche à l’Universitätsklinikum Hamburg-Eppendorf à Hambourg, en Allemagne. .

“Ce cas exceptionnel est une expérience conçue par la nature qui nous enseigne un moyen de prévenir la maladie d’Alzheimer : observons, apprenons et imitons la nature”, conclut Francisco Lopera, MD, directeur du groupe de neurosciences d’Antioquia à Medellín, en Colombie. Lopera est le co-auteur principal et neurologue qui a découvert cette famille et la suit depuis 30 ans.

Référence : “Neuropathologie tau distincte et profils cellulaires d’un homozygote APOE3 de Christchurch protégé contre la maladie d’Alzheimer autosomique dominante.” , , , , , , , , , , , , , , , , , , , , , , , , , , , , soit ou Sperling, Eric M. Reiman, Joseph F. Arboleda-Velasquez, Kenneth S. Kosik, Francisco Lopera et Yakeel T. Quiroz, 15 juillet Acta Neuropathologique.
DOI : 10.1007/s00401-022-02467-8

L’étude a été financée par les Instituts nationaux de la santé, le Comité exécutif de la recherche du MGH (MGH Research Scholar Award), l’Association Alzheimer, la Fondation allemande pour la recherche, l’Université d’Antioquia, la Fondation Werner Otto et le ministère fédéral de l’Éducation et de la Recherche. .

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