Multiscale Analysis of Independent Alzheimer’s Cohorts Finds Disruption of Molecular, Genetic, and Clinical Networks by Human Herpesvirus
Open accessAbstract
Investigators have long suspected that pathogenic microbes might contribute to the onset and progression of Alzheimer's disease (AD) although definitive evidence has not been presented. Whether such findings represent a causal contribution, or reflect opportunistic passengers of neurodegeneration, is also difficult to resolve. We constructed multiscale networks of the late-onset AD-associated virome, integrating genomic, transcriptomic, proteomic, and histopathological data across four brain regions from human post-mortem tissue. We observed increased human herpesvirus 6A (HHV-6A) and human herpesvirus 7 (HHV-7) from subjects with AD compared with controls. These results were replicated in two additional, independent and geographically dispersed cohorts. We observed regulatory relationships linking viral abundance and modulators of APP metabolism, including induction of APBB2, APPBP2, BIN1, BACE1, CLU, PICALM, and PSEN1 by HHV-6A. This study elucidates networks linking molecular, clinical, and neuropathological features with viral activity and is consistent with viral activity constituting a general feature of AD.
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Recent analyses of post-mortem samples indicate HHV6 may be more abundant in the brains of AD individuals, but these results were contrasted by a re-analysis of the same samples using different bioinformatic techniques.
“Although recent analyses of post-mortem samples indicate HHV6 may be more abundant in the brains of AD individuals, these results were contrasted by a re-analysis of the same samples using different bioinformatic techniques [43,44].”
From What would it take to prove that a chronic infection is a causal agent in Alzheimer’s disease? (2025) · cites this paper as [44]
The Results section reports increased HHV-6A abundance in post-mortem brain samples from people with Alzheimer’s disease. The cited paper does not report a contrasting re-analysis of the same samples using different bioinformatic techniques, so it supports only the first part of the sentence. (LLM, conf=0.88)
Experimental — accuracy not yet measuredMany studies have linked AD to a diverse variety of bacterial and viral pathogens.
“Many studies have linked AD to a diverse variety of bacterial and viral pathogens [529–531].”
From Molecular and cellular mechanisms underlying the pathogenesis of Alzheimer’s disease (2020) · cites this paper as [529]
A recent multi-omic study identified enrichment of HHV-6A and HHV-7 in AD patients compared to controls.
“A recent multi-omic study identified an enrichment of HHV-6A and HHV-7 in AD patients compared to controls [529–531].”
From Molecular and cellular mechanisms underlying the pathogenesis of Alzheimer’s disease (2020) · cites this paper as [529]
Significant overlap exists between expression of AD-associated genes and genomic viral load in the CNS; viral abundance may determine AD progression through regulation of genes associated with APP processing.
“Significant overlap exists between the expression of AD-associated genes and genomic viral load in the CNS; for example, viral abundance may determine AD progression through the regulation of genes associated with APP processing [529–531].”
From Molecular and cellular mechanisms underlying the pathogenesis of Alzheimer’s disease (2020) · cites this paper as [529]
Nucleic acids and proteins derived from bacteria, viruses, and fungi have been detected in brain tissue of Alzheimer's disease patients after death.
“Recent studies have detected nucleic acids and proteins derived from bacteria, viruses, and fungi in the brain tissue of Alzheimer’s disease (AD) patients after death”
From The modulatory effects of gut microbes and metabolites on blood-brain barrier integrity and brain function in sepsis-associated encephalopathy (2023) · cites this paper as Readhead et al., 2018
Microbial metabolites such as SCFAs may be produced by microorganisms that reside in or penetrate the brain.
“suggesting that microbial metabolites such as SCFAs may be produced by microorganisms that reside in or penetrate the brain (Emery et al., 2017; Readhead et al., 2018).”
From The modulatory effects of gut microbes and metabolites on blood-brain barrier integrity and brain function in sepsis-associated encephalopathy (2023) · cites this paper as Readhead et al., 2018
A systems-level network analysis of preclinical Alzheimer disease brain identified driver genes enriched for viral susceptibility genes.
“A recent systems-level molecular network analysis of preclinical AD brain identified a set of network driver genes noted to be enriched for viral susceptibility genes.”
From Alzheimer Disease: An Update on Pathobiology and Treatment Strategies (2019) · cites this paper as Readhead et al., 2018
HHV-6 and HSV-1 DNA were detected in Alzheimer disease brain specimens across three cohorts, with viral-host interactions regulating AD-related gene networks.
“Follow-up analyses in AD brain specimens found detectable human herpesvirus (HHV)-6 and herpes simplex virus (HSV)-1 DNA in 3 separate cohorts, and identified many putative viral-host interactions that regulate gene networks pertinent to AD biology, including innate immunity and APP processing (Readhead et al., 2018)”
From Alzheimer Disease: An Update on Pathobiology and Treatment Strategies (2019) · cites this paper as Readhead et al., 2018
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“Moreover, other studies have noted the antimicrobial peptide-like properties of A β , suggesting that external factors such as viral pathogens can contribute to AD pathogenesis by triggering the body ’ s antimicrobial response 10,11 .”
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Testing the amyloid cascade hypothesis: Prevention trials in autosomal dominant Alzheimer disease
Levin, J., Vöglein, J., Quiroz, Y. T., Bateman, R. J., Ghisays, V., Lopera, F., McDade, E., Reiman, E., Tariot, P. N., & Morris, J. C. (2022) · Alzheimer's & Dementia · doi:10.1002/alz.12624 · Cited by 40 · see citing works
Self-citationPeddu, V., Dubuc, I., Gravel, A., Xie, H., Huang, M.-L., Tenenbaum, D., Jerome, K. R., Tardif, J.-C., Dubé, M.-P., Flamand, L., et al. (2019) · Journal of Virology · doi:10.1128/jvi.01418-19 · Cited by 39 · see citing works
Herpes viruses and Alzheimer's disease: new evidence in the debate
Balin, B. J., & Hudson, A. P. (2018) · The Lancet Neurology · doi:10.1016/s1474-4422(18)30316-8 · Cited by 38 · see citing works
Can Infections Cause Alzheimer Disease?
Komaroff, A. L. (2020) · JAMA · doi:10.1001/jama.2020.4085 · Cited by 36 · see citing works
Licastro, F., & Porcellini, E. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22147263 · Cited by 33 · see citing works
Mullane, K., & Williams, M. (2018) · Biochemical Pharmacology · doi:10.1016/j.bcp.2018.09.027 · Cited by 32 · see citing works
Lutz, B. M., & Peng, J. (2018) · Proteomes · doi:10.3390/proteomes6040046 · Cited by 27 · see citing works
Duggan, M. R., Peng, Z., An, Y., Kitner Triolo, M. H., Shafer, A. T., Davatzikos, C., Erus, G., Karikkineth, A., Lewis, A., Moghekar, A., et al. (2022) · Neurology · doi:10.1212/wnl.0000000000201036 · Cited by 24 · see citing works
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Zhao, M., Ma, G., Yan, X., Li, X., Wang, E., Xu, X.-X., Zhao, J.-B., Ma, X., & Zeng, J. (2024) · Molecular Psychiatry · doi:10.1038/s41380-024-02428-5 · Cited by 21 · see citing works
Potential Role for Herpesviruses in Alzheimer’s Disease
Duggan, M. R., Torkzaban, B., Ahooyi, T. M., & Khalili, K. (2020) · Journal of Alzheimer's Disease · doi:10.3233/jad-200814 · Cited by 13 · see citing works
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What would it take to prove that a chronic infection is a causal agent in Alzheimer’s disease?
Brutkiewicz, R. R., Cao, W., Morgan, D., Reis, R. S. D., Suryadevara, V., Willette, A. A., Willette, S. A., Wyatt-Johnson, S. K., & Duggan, M. R. (2025) · Trends in Neurosciences · doi:10.1016/j.tins.2025.05.009 · Cited by 3 · see citing works
- Authors
- Readhead, B., Haure-Mirande, J.-V., Funk, C. C., Richards, M. A., Shannon, P., Haroutunian, V., Sano, M., Liang, W. S., Beckmann, N. D., Price, N. D., Reiman, E. M., Schadt, E. E., Ehrlich, M. E., Gandy, S., & Dudley, J. T.
- Affiliations
- Arizona State University (US)
- Institute for Systems Biology (US)
- James J. Peters VA Medical Center (US)
- Translational Genomics Research Institute (US)
- Icahn School of Medicine at Mount Sinai (US)
- Sema4 (United States) (US)
- Mount Sinai Hospital (US)
- Mount Sinai Health System (US)
- Corresponding author
- Dudley, Joel T.
- ORCID
- Venue
- Neuron
- Publisher
- Elsevier BV
- Published
- 2018-07
- Volume
- 99
- Issue
- 1
- Pages
- 64-82.e7
- ISSN
- 0896-6273 (ISSN-L)
- PMC
- PMC6551233
- OpenAlex
- W2809045422
- Cited by
- 708
- References
- 128
- Citations by year
- 2026: 48 · 2025: 63 · 2024: 72 · 2023: 59 · 2022: 85 · 2021: 105 · 2020: 113 · 2019: 105 · 2018: 57 · 2016: 1
- FWCI
- 65.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Neuron (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NIA (U01AG046139, P50 AG016574, R01 AG032990, U01 AG046139, R01 AG018023, U01 AG006576, U01 AG006786, R01 AG025711, R01 AG017216, R01 AG003949, P30AG10161, R01AG15819, R01AG17917, R01AG30146, R01AG36836, U01AG32984, U01AG46152, 1R56AG058469)
- NIH (U54EB020406)
- NINDS (R01 NS080820)
- CurePSP Foundation
- Mayo Foundation
- National Institute of Neurological Disorders and Stroke (U24 NS072026)
- National Institute on Aging (P30 AG19610)
- Arizona Department of Health Services (211002)
- Arizona Biomedical Research Commission (4001, 0011, 05-901, 1001)
- Michael J. Fox Foundation for Parkinson's Research
- Illinois Department of Public Health
- Translational Genomics Research Institute (U01 AG046170)
- Katherine Gehl
- Topics
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Keywords
- Alzheimer's disease, HHV-6A, human herpesvirus 7, virome, viral infection, APP metabolism, BACE1, BIN1, presenilin 1, clusterin, PICALM, postmortem brain, multi-scale network, neuropathology, transcriptomics, proteomics
- MeSH terms
- Alzheimer Disease, Animals, Brain, Humans, Mice, Transgenic, Nuclear Proteins, Cohort Studies, Herpesvirus 6, Human, Case-Control Studies, Herpesvirus 7, Human, Aspartic Acid Endopeptidases, Amyloid beta-Protein Precursor, Mice, Knockout, Encephalitis, Viral, Roseolovirus Infections, Viral Load, Gene Expression Profiling, Genomics, Tumor Suppressor Proteins, Monomeric Clathrin Assembly Proteins, MicroRNAs, Proteomics, Adaptor Proteins, Signal Transducing, Clusterin, Mice, Gene Regulatory Networks, Presenilin-1, Amyloid Precursor Protein Secretases, Microbiota
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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