Cited by 89Down syndrome and intellectual disability researchAlzheimer's disease research and treatmentsSingle-cell and spatial transcriptomics

Altered cell and RNA isoform diversity in aging Down syndrome brains

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Palmer, Carter R., Liu, Christine S., Romanow, William J., Lee, Ming-Hsiang, Chun, Jerold·2021·Proceedings of the National Academy of Sciences

Abstract

Down syndrome (DS), trisomy of human chromosome 21 (HSA21), is characterized by lifelong cognitive impairments and the development of the neuropathological hallmarks of Alzheimer’s disease (AD). The cellular and molecular modifications responsible for these effects are not understood. Here we performed single-nucleus RNA sequencing (snRNA-seq) employing both short- (Illumina) and long-read (Pacific Biosciences) sequencing technologies on a total of 29 DS and non-DS control prefrontal cortex samples. In DS, the ratio of inhibitory-to-excitatory neurons was significantly increased, which was not observed in previous reports examining sporadic AD. DS microglial transcriptomes displayed AD-related aging and activation signatures in advance of AD neuropathology, with increased microglial expression of C1q complement genes (associated with dendritic pruning) and the HSA21 transcription factor gene RUNX1 . Long-read sequencing detected vast RNA isoform diversity within and among specific cell types, including numerous sequences that differed between DS and control brains. Notably, over 8,000 genes produced RNAs containing intra-exonic junctions, including amyloid precursor protein ( APP ) that had previously been associated with somatic gene recombination. These and related results illuminate large-scale cellular and transcriptomic alterations as features of the aging DS brain.

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Crossref · 10.1073/pnas.2114326118

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  • In tissue from the prefrontal cortex of adolescents and young adults with Down syndrome (13-32 years), no difference in percentage of interneurons (measured by GAD67 protein expression) was identified, but the proportion of interneurons to total neurons was significantly increased in Down syndrome.

    “Again, no difference in percentage of interneurons (measured by GAD67 protein expression) was identified, but the proportion of interneurons to total neurons was significantly increased in DS (Palmer et al., 2021).”

    From Neurodevelopment in Down syndrome: Concordance in humans and models (2022) · cites this paper as Palmer et al., 2021

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  • There is substantial evidence of neuropathology from early in life in DS, including defects in neuronal development, increased ratio of inhibitory to excitatory neurons, alterations in neuronal dendritic spine dynamics, activation of microglia, astrocyte reactivity, and elevated production of inflammatory cytokines in the brain.

    “There is substantial evidence of neuropathology from early in life in DS,6,9,10,21 including defects in neuronal development, an increased ratio of inhibitory to excitatory neurons, alterations in neuronal dendritic spines dynamics, activation of microglia, astrocyte reactivity, and elevated production of inflammatory cytokines in the brain.22,23,24,25”

    From Interferon signaling modulates Down syndrome-associated Alzheimer’s disease pathology in a mouse model (2025) · cites this paper as [24]

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  • Recent studies indicate an increased ratio of inhibitory to excitatory neurons in the cortex and hippocampus in Dp16 mice that is associated with deficits in learning, memory, and motor function.

    “recent studies that indicate an increased ratio of inhibitory to excitatory neurons in the cortex and hippocampus in Dp16 mice that is associated with deficits in learning, memory, and motor function.”

    From Interferon signaling modulates Down syndrome-associated Alzheimer’s disease pathology in a mouse model (2025) · cites this paper as [24]

    The Results section on DS prefrontal cortex reports an increased proportion of inhibitory neurons in human Down syndrome brains and notes a similar imbalance in the Ts65Dn mouse model. It does not establish that the ratio is increased in the cortex and hippocampus of Dp16 mice or associate that ratio with learning, memory, and motor deficits. The passage mentioning Dp16 instead concerns dendritic spine density. (LLM, conf=0.87)

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  • The fraction of neurons that expressed ADARB2 was significantly increased in the samples from individuals with Down syndrome, while the fraction of neurons that expressed LHX6 was significantly decreased.

    “Interestingly, the fraction of neurons that expressed ADARB2 was significantly increased in the samples from individuals with DS, while the fraction of neurons that expressed LHX6 was significantly decreased.”

    From Neurodevelopment in Down syndrome: Concordance in humans and models (2022) · cites this paper as Palmer et al., 2021

    The Results section on neuronal subtype alterations reports that ADARB2-expressing neurons were overrepresented in Down syndrome brains (Fig. 1G; P < 0.01). It says LHX6-expressing neurons were present at similar proportions to controls, not significantly decreased. (LLM, conf=0.90)

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  • Single nucleus RNA-seq identified six clusters of inhibitory neurons that expressed ADARB2, indicating they arose from the CGE, and four clusters that expressed LHX6, indicating they arose from the MGE.

    “They identified six clusters of inhibitory neurons that expressed ADARB2, indicating they arose from the CGE, and four clusters that expressed LHX6, indicating they arose from the MGE.”

    From Neurodevelopment in Down syndrome: Concordance in humans and models (2022) · cites this paper as Palmer et al., 2021

    The Results section on neuronal subtype alterations links ADARB2-expressing inhibitory neurons to the CGE and LHX6-expressing neurons to the MGE, and reports that this distinction is observed in humans. It identifies the groups as In1–In4 and In6–In8, however, and does not substantiate the claimed counts of six ADARB2 clusters and four LHX6 clusters. (LLM, conf=0.88)

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Authors
Palmer, C. R., Liu, C. S., Romanow, W. J., Lee, M.-H., & Chun, J.
Affiliations
Sanford Burnham Prebys Medical Discovery Institute (US)
Corresponding author
Chun, Jerold
Venue
Proceedings of the National Academy of Sciences
Published
2021-11-18
Volume
118
Issue
47
ISSN
  • 0027-8424 (ISSN-L)
  • 1091-6490
OpenAlex
W3214599091
Cited by
89
References
76
Citations by year
2026: 16 · 2025: 23 · 2024: 17 · 2023: 16 · 2022: 17
FWCI
10.83
Type
journal article
Language
en
Open access
Locations
  • Proceedings of the National Academy of Sciences (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
  • HHS | NIH | National Institute on Aging (R56AG073965, R01AG065541, R01AG071465)
  • HHS | NIH | National Institute of General Medical Sciences (T32GM007752)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Single-cell and spatial transcriptomics
Keywords
Down syndrome, brain aging, Alzheimer's disease, prefrontal cortex, single-nucleus RNA sequencing, microglia, RUNX1, amyloid precursor protein, long-read sequencing, dendritic pruning
MeSH terms
Aging, Alzheimer Disease, Brain, Chromosomes, Human, Pair 21, Down Syndrome, Humans, RNA, Up-Regulation, Gene Expression, Amyloid beta-Protein Precursor, Sequence Analysis, RNA, Microglia, Core Binding Factor Alpha 2 Subunit, RNA Isoforms

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