BackgroundAlzheimers disease (AD) is a complex neurodegenerative disorder strongly influenced by genetic factors, with apolipoprotein E (APOE) {varepsilon}4 allele being the most established risk variant. Although DNA-based genotyping remains standard, plasma proteotyping may provide scalable, isoform-specific alternatives. Here, we aimed to investigate the clinical utility of APOE proteotyping as a surrogate for genotyping in different clinical and research cohorts.

MethodsPlasma APOE4 protein were quantified using the NULISAseq CNS panel across four cohorts (ADRC, HeartSCORE, LATTICE, and ALPS). DNA-based APOE genotyping was the reference standard. Proteotyping thresholds for APOE {varepsilon}4 carrier status and copy number were derived in ADRC and externally validated in the other cohorts. Logistic, proportional-odds, and Cox proportional-hazards models compared genotype- and proteotype-defined groups in relation to amyloid positivity, cross-sectional CDR global scores, and time to CDR-SB worsening, respectively.

ResultsPlasma APOE4 accurately classified APOE {varepsilon}4 carrier status in ADRC (AUC=0.977, 95%CI 0.967-0.985; threshold 5.78 NULISA protein quantification [NPQ] value) and achieved near-perfect external validation in HeartSCORE, LATTICE, and ALPS (all AUCs=1.000, 95%CI 1.000-1.000). Plasma APOE4 also well-differentiated heterozygous from homozygous {varepsilon}4 carriers (ADRC AUC=0.879, 95%CI 0.834-0.921; threshold 12.23 NPQ value). Genotype- and proteotype-defined {varepsilon}4 carrier status showed similar associations with amyloid positivity (OR=4.40 vs 4.45), higher CDR global scores (OR=1.50 for both), and CDR-SB worsening (HR=1.22 for both).

DiscussionPlasma APOE4 proteotyping accurately distinguished genotype-defined APOE {varepsilon}4 carrier status and copy number while demonstrating AD-related associations comparable to DNA genotyping.

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Significance, Importance, Timeliness, and Relevance:

The topic of this text revolves around the genetic connection between TAS2R38, a taste receptor implicated in innate immunity, and Alzheimer's disease (AD). The significance of this research lies in its potential to aid in the development of new treatments or repurpose existing ones for AD management. This is crucial as AD remains a leading cause of dementia worldwide, with limited treatment options available.

The importance of this study is twofold: it explores a novel relationship between a taste receptor and AD risk, which could lead to new therapeutic targets. The timeliness of this research is also evident, given the growing understanding of the role of genetics in disease susceptibility and the increasing emphasis on precision medicine.

In terms of relevance, the study leverages existing databases (ADNI and ROSMAP) and utilizes established methodologies (linear mixed-effects models and RNA-seq analysis), making it a valuable contribution to the field of AD research.

Relationship between items in the text:

  • The genetic connection between TAS2R38 and AD biomarkers was identified using linear mixed-effects models, utilizing data from the ADNI study (n = 2,342).
  • The molecular mechanisms underlying this association were explored using eQTL analysis, which connected the nontaster allele to increased expression of the gene MGAM in AD-affected brain regions.
  • The expression of MGAM was also associated with more severe Tau burdens, suggesting a link between MGAM expression and AD pathology.
  • A cohort study using the NACC dataset found that individuals taking MGAM-inhibiting diabetes drugs (Acarbose and Miglitol) had slower CDR progression compared to non-takers.

Usefulness for disease management or drug discovery:

This study suggests that TAS2R38 haplotypes could guide precision drug repurposing strategies for AD. Specifically, the identification of MGAM as a novel drug target with existing FDA-approved inhibitors (Acarbose and Miglitol) provides a valuable lead for future research.

Originality:

While the study builds upon existing knowledge in the field, it presents novel connections between TAS2R38, MGAM, and AD pathology. The identification of MGAM as a potential therapeutic target is a notable finding, as it suggests a new avenue for AD treatment.

Comparison to the state of the art:

This study contributes to our understanding of the genetic and molecular mechanisms underlying AD susceptibility. However, it should be noted that the sample sizes used in this study are relatively small compared to other AD research studies.

In conclusion, this study provides a valuable addition to the growing body of evidence on the genetic and molecular mechanisms of AD. The identification of MGAM as a potential therapeutic target with existing FDA-approved inhibitors holds promise for future research and potential clinical applications.

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BackgroundTo determine the crude and age-adjusted point prevalence of motor neuron disease (MND) and its phenotypes (classical amyotrophic lateral sclerosis [ALS], primary lateral sclerosis [PLS] and progressive muscular atrophy [PMA]) using a comprehensive multi-source case ascertainment strategy.

MethodsCross-sectional population-based study with a prevalence date of 1 January 2025. Cases were identified through five complementary regional data sources and confirmed by clinical review against the revised El Escorial and Gold Coast criteria. Cases were classified by phenotype as ALS, PLS or PMA. The reference population was the population aged 15 years or older in Valencian Community (n=4,433,999). Crude prevalence was calculated per 100,000 with 95% Poisson confidence intervals; age-adjusted rates were obtained by direct standardisation to the 2013 European Standard Population.

ResultsA total of 374 confirmed MND cases were identified. The overall crude prevalence of MND was 8.43 per 100,000 (95% CI: 7.60-9.29) and the age-adjusted prevalence was 7.85 per 100,000 (95% CI: 7.05-8.65). By phenotype, ALS accounted for 325 cases (86.9%; crude prevalence 7.33 per 100,000), PLS for 26 (7.0%; 0.59 per 100,000) and PMA for 23 (6.1%; 0.52 per 100,000). Prevalence was consistent across provinces. Mean age was 65.9 years, the male-to-female ratio was 1.37:1, and 83.4% were receiving riluzole.

ConclusionsThis is the first comprehensive, multi-source population-based estimate of MND prevalence and its subtypes in the Valencian Community. The estimate is higher than the previous single-unit figure and consistent with recent European data, underscoring the value of multi-source ascertainment.

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BackgroundSleep-wake-circadian disorders are prevalent and contribute substantially to morbidity, mortality and reduced quality of life. Evaluation in real-world settings is essential to capture their complexity and association with long-term outcomes. Most sleep-wake registries are restricted to selected populations, lack systematic integration of objective sleep-wake-circadian assessments with the clinical data and provide limited follow-up. To address these limitations, we established the Bern Sleep-Wake Registry based on real-world data from a tertiary University Hospital sleep center.

MethodsThe registry includes data from patients referred to the multidisciplinary Sleep-Center at Inselspital, University Hospital Bern (founded in 1990), from the year 2000 onwards who underwent at least one objective assessment such as polysomnography, daytime sleep-wake recordings, vigilance tests, and actigraphy. The registry integrates clinical information, questionnaire scores, outputs of objective assessments and raw signal data, and is regularly updated to incorporate new patients and longitudinal follow-up information.

ResultsAs of September 2025, records from over 11000 patients were evaluated (median age: 50 years (interquartile range 36, 61); 65% male). The most common sleep-wake-circadian disorders were "sleep-related breathing disorders" (67%), "insomnia disorders" (15%) and "central disorders of hypersomnolence" (9%). Available assessments included more than 12000 polysomnographies, 2400 multiple sleep latency tests, 2100 maintenance of wakefulness tests, 1800 vigilance tests and 4500 actigraphies.

ConclusionsBy longitudinally integrating multimodal deep clinical phenotyping with objective assessments and raw physiological signals, the Bern Sleep-Wake Registry provides a foundation for investigating disease trajectories, identifying novel biomarkers and developing data-driven approaches to precise diagnosis, prognosis and individualized treatment.

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IsomiR Utility in ALS Prognostication

- Posted by system in English

Significance of the Topic:

Amyotrophic Lateral Sclerosis (ALS) is a devastating neurodegenerative disease with limited treatment options. Early diagnosis and prognostication are critical in managing ALS, as they can significantly impact the quality of life for patients and their caregivers. The discovery of reliable biomarkers for ALS can provide valuable insights into disease progression and enable clinicians to develop more effective treatment strategies.

Importance:

The identification of plasma isomiRs as potential biomarkers for ALS is significant because it opens up new avenues for non-invasive monitoring of disease progression and response to treatment. IsomiRs are microRNA isoforms that are distinct from their parent microRNAs, and their presence in the plasma can be indicative of cellular stress or damage. The potential utility of isomiRs as biomarkers for neurodegenerative diseases is an area of active research, and this study contributes to our understanding of their role in ALS.

Timeliness:

The study's focus on plasma isomiRs as biomarkers for ALS is timely, given the growing interest in using liquid biopsies for disease diagnosis and monitoring. Liquid biopsies offer a non-invasive and cost-effective way to monitor disease progression and response to treatment, making them an attractive option for clinicians and researchers.

Relevance:

The study's findings are relevant to ALS research and clinical practice because they provide evidence that plasma isomiRs can be used to predict survival in ALS patients. The identified isomiR, let-7g-5p.t, has prognostic utility comparable to that of established biomarkers, such as neurofilament light chain (NfL) and miR-181. This suggests that plasma isomiRs could be used as a novel class of biomarkers for ALS, potentially refining prognostication in clinical trials and improving patient outcomes.

Items of the text and their relationships:

  1. Background: The text provides context on ALS and isomiRs, explaining that while isomiRs have distinct biological and clinical relevance, their potential as cell-free biomarkers in neurodegeneration remains largely unexplored.
  2. Method: The researchers used next-generation sequencing and two orthogonal statistical approaches to investigate the prognostic utility of plasma isomiRs in ALS.
  3. Findings: The study identified higher levels of let-7g-5p.t in ALS patients, which was associated with longer survival and independently validated in an international ALS cohort.
  4. Conclusion: The results establish isomiRs as a novel class of blood-based biomarkers in ALS, with potential to refine prognostication in clinical trials for neurodegenerative diseases.

Usefulness for disease management or drug discovery:

The study's findings are useful for disease management and drug discovery because they:

  1. Provide new biomarkers: The identified isomiR, let-7g-5p.t, can be used as a biomarker for ALS, potentially improving prognostication and patient outcomes.
  2. Inform treatment strategies: The study's findings can inform the development of new treatment strategies for ALS, such as targeted therapies that modulate the expression of isomiRs.

Originality:

The study provides original information beyond the obvious because it:

  1. Investigates a novel biomarker: The study investigates the use of plasma isomiRs as biomarkers for ALS, which is a new area of research.
  2. Provides evidence: The study provides evidence that plasma isomiRs can be used to predict survival in ALS patients, which is a significant finding in the field of neurodegenerative diseases.

Comparison with the state of art:

The study's findings are comparable to existing biomarkers for ALS, such as neurofilament light chain (NfL) and miR-181. However, the study's focus on plasma isomiRs as biomarkers for ALS is a new area of research that contributes to our understanding of the potential utility of isomiRs in neurodegenerative diseases.

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