The Stanford Extreme Phenotypes in Alzheimer's Disease (StEP AD) Cohort

项目摘要/摘要 阿尔茨海默病(AD)是一种常见的、进行性的、最终致命的脑部疾病。目前已批准 治疗只提供最小的症状益处，并不能阻止疾病的进展。田野 迫切需要新的药物靶点，从而可能导致疾病修改疗法。最常见的 阿尔茨海默病的遗传危险因素是载脂蛋白E基因的ε4变异体。目前的研究将需要 利用APOE4的强大效应发现新的遗传变异，这些变异要么会增加AD的风险，要么 降低AD的风险。该研究团队以斯坦福大学为基础，但包括其他13个组织的合作者 研究中心-将招募和研究属于以下两个罕见类别的参与者：认知正常 携带一到两份高危APOE4基因的人(受保护的APOE4携带者)和年轻患者 尽管没有携带APOE4基因，世卫组织仍可在65岁之前早发性阿尔茨海默病(Eoad)。这些科目，斯坦福大学 AD(STEP AD)队列中的极端表型将进行全外显子组测序，其外显子组将被 结合来自约4500名健康老年对照和约5000名AD患者的大型公开可用外显子。在……里面 目标1研究小组将寻找在受保护的APOE4携带者中更常见的罕见基因变异 AD患者。在AIM 2中，研究小组将寻找APOE4阴性EoAD患者中罕见的基因变异，但 在健康的老年对照组中则不是这样。大多数STEP AD队列将接受“深度表型分析”，以包括结构 以及分子脑成像、脊髓液分析、免疫表型和参与者特异性培养 神经元。在目标3中，深入的表型数据将被用来开始理解 AIMS 1和AIMS 2中发现的罕见保护性或因果遗传变异。罕见但强大的遗传变异 这项研究的鉴定和表征将为潜在疾病的设计提供新的药物靶点。 修改治疗方法。

Project Summary/Abstract Alzheimer's disease (AD) is a common, progressive, and ultimately fatal brain disease. Currently approved treatments provide only minimal symptomatic benefits and do not stop the disease from progressing. The field is in dire need of novel drug targets which could lead to disease-modifying therapies. The most common genetic risk factor for AD is the ε4 variant of the apolipoprotein E gene (APOE4). The current study will take advantage of the strong effect of APOE4 to discover new genetic variants that either increase risk for AD or reduce risk for AD. The research team—based at Stanford University but including collaborators at 13 other research centers—will recruit and study participants that fall into one two rare categories: cognitively normal people carrying one or two copies of the high risk APOE4 gene (protected APOE4 carriers) and young patients who early-onset AD (EOAD) before age 65 despite not carrying APOE4 gene. These subjects, the Stanford Extreme Phenotypes in AD (StEP AD) cohort, will undergo whole-exome sequencing and their exomes will be combined with large, publicly available exomes from ~4500 healthy older controls and ~5000 AD patients. In Aim 1 the research team will look for rare genetic variants seen more often in protected APOE4 carriers than in AD patients. In Aim 2 the team will look for rare genetic variants seen in APOE4-negative EOAD patients but not in healthy older controls. Most of the StEP AD cohort will undergo “deep phenotyping” to include structural and molecular brain imaging, spinal fluid analysis, immunophenotyping, and culturing of participant-specific neurons. In Aim 3, the deep phenotyping data will be used to begin to understand the molecular effects of the rare protective or causal genetic variants identified in Aims 1 and 2. Rare but powerful genetic variants identified and characterized in this study will provide novel drug targets for the design of potentially disease- modifying treatments.