Alzheimer’s Risk Factors Age, APOE Genotype, and Sex Drive Distinct Molecular Pathways
Open accessAbstract
Evidence suggests interplay among the three major risk factors for Alzheimer's disease (AD): age, APOE genotype, and sex. Here, we present comprehensive datasets and analyses of brain transcriptomes and blood metabolomes from human apoE2-, apoE3-, and apoE4-targeted replacement mice across young, middle, and old ages with both sexes. We found that age had the greatest impact on brain transcriptomes highlighted by an immune module led by Trem2 and Tyrobp, whereas APOE4 was associated with upregulation of multiple Serpina3 genes. Importantly, these networks and gene expression changes were mostly conserved in human brains. Finally, we observed a significant interaction between age, APOE genotype, and sex on unfolded protein response pathway. In the periphery, APOE2 drove distinct blood metabolome profile highlighted by the upregulation of lipid metabolites. Our work identifies unique and interactive molecular pathways underlying AD risk factors providing valuable resources for discovery and validation research in model systems and humans.
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These lipid species are known to accumulate with aging and AD.
“lipid species known to accumulate with aging and AD 32,55,56”
From APOE2 attenuates APOE4-associated amyloid pathology and related toxicity in a mouse model of Alzheimer’s disease (2026) · cites this paper as [55]
The Results section on mouse serum metabolite modules reports that acylcarnitines, particularly long-chain fatty acids, increase with aging. It does not establish that those lipid species also accumulate in AD; the Discussion instead reports lower blood phospholipids associated with progression to AD. No page numbers were provided for these passages. (LLM, conf=0.86)
Experimental — accuracy not yet measuredDEGs associated with the E4 to E2 switch strongly reflected several APOE-associated and AD-associated gene lists, particularly LOAD genes from publicly available human transcriptomic datasets.
“Finally, the DEGs associated with the E4 to E2 switch also strongly reflected several APOE-associated and AD-associated gene lists, particularly the late-onset AD (LOAD) genes identified in and merged from publicly available human transcriptomic datasets (Fig. 3i)25–28.”
From APOE4 to APOE2 allelic switching in mice improves Alzheimer’s disease-related metabolic signatures, neuropathology and cognition (2025) · cites this paper as [26]
The Results section on mouse-brain DEGs reports differences between APOE2 and APOE4 genotypes, and the section on human AD brains examines preservation of gene modules. Neither passage reports that DEGs from an E4-to-E2 switch strongly overlap APOE- or AD-associated gene lists, particularly a merged LOAD list. Searches for “LOAD genes” and overlap with human transcriptomic gene lists did not find that analysis in our copy. (LLM, conf=0.74)
Experimental — accuracy not yet measured
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- Authors
- Zhao, N., Ren, Y., Yamazaki, Y., Qiao, W., Li, F., Felton, L. M., Mahmoudiandehkordi, S., Kueider-Paisley, A., Sonoustoun, B., Arnold, M., Shue, F., Zheng, J., Attrebi, O. N., Martens, Y. A., Li, Z., Bastea, L., Meneses, A. D., Chen, K., Thompson, J. W., St John-Williams, L., Tachibana, M., Aikawa, T., Oue, H., Job, L., Yamazaki, A., Liu, C.-C., Storz, P., Asmann, Y. W., Ertekin-Taner, N., Kanekiyo, T., Kaddurah-Daouk, R., & Bu, G.
- Affiliations
- Mayo Clinic (US)
- Duke University (US)
- Mayo Clinic in Florida (US)
- Corresponding author
- Zhao, Na
- Bu, Guojun
- ORCID
- Zhao, Na
- Ren, Yingxue
- Yamazaki, Yu
- Qiao, Wenhui
- Li, Fuyao
- Mahmoudiandehkordi, Siamak
- Arnold, Matthias
- Shue, Francis
- Zheng, Jiaying
- Martens, Yuka A.
- Li, Zonghua
- Bastea, Ligia
- Meneses, Axel D.
- Tachibana, Masaya
- Aikawa, Tomonori
- Oue, Hiroshi
- Job, Lucy
- Liu, Chia-Chen
- Asmann, Yan W.
- Kanekiyo, Takahisa
- Kaddurah-Daouk, Rima
- Bu, Guojun
- Venue
- Neuron
- Publisher
- Elsevier BV
- Published
- 2020-06
- Volume
- 106
- Issue
- 5
- Pages
- 727-742.e6
- ISSN
- 0896-6273 (ISSN-L)
- PMC
- PMC7388065
- OpenAlex
- W3011658331
- Cited by
- 225
- References
- 101
- Citations by year
- 2026: 17 · 2025: 24 · 2024: 33 · 2023: 50 · 2022: 51 · 2021: 39 · 2020: 10
- FWCI
- 22.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Neuron (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Rare & Special e-Zone (The Hong Kong University of Science and Technology) (submittedVersion)
- PuSH - Publication Server of Helmholtz Zentrum München (submittedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (R01 NS080820, U24 NS072026)
- Arizona Department of Health Services (211002)
- National Institute on Aging (P30 AG19610, RF1 AG062110, RF1 AG051504, R37 AG027924, R21 AG052423, RF1 AG057181, RF1 AG046205, R01 AG035355)
- BrightFocus Foundation (A2018777F, R01 AG032990, R01 AG017216, R01 AG018023, P50 AG016574, U01 AG006576, U01 AG006786, R01 AG025711, U01 AG046139, R01 AG003949)
- Club Foundation
- Mayo Foundation for Medical Education and Research
- Mayo Clinic
- Michael J. Fox Foundation for Parkinson's Research (WO2018049268, U01 AG51356, RF1 AG051550, R01 AG046171, R01 AG15819, R01 AG17917, P30 AG10161)
- Arizona Biomedical Research Commission (1001, 0011, 05-901, 4001)
- 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, APOE genotype, APOE ε4, APOE2, APOE3, age, sex differences, brain transcriptome, blood metabolome, TREM2, TYROBP, alpha-1-antichymotrypsin, unfolded protein response, lipid metabolites
- MeSH terms
- Age Factors, Aging, Alzheimer Disease, Animals, Apolipoproteins E, Brain, Female, Genotype, Humans, Male, Membrane Glycoproteins, Membrane Proteins, Mice, Transgenic, Receptors, Immunologic, Risk Factors, Sex Factors, Serpins, Gene Expression, Gene Expression Profiling, Adaptor Proteins, Signal Transducing, Mice, Gene Regulatory Networks, Apolipoprotein E3, Apolipoprotein E4, Apolipoprotein E2, Metabolome, Unfolded Protein Response, Protective Factors
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