A Rare Gene Mutation Offers Clues to Combating Alzheimer’s and Cancer

The human immune system is not only our first line of defense against infectious threats, but it also plays an essential role in regulating how our bodies respond to internal dangers like cancer and neurodegenerative diseases.

One of the immune system’s tools is a molecular pathway known as cGAS-STING. This pathway functions as a sensor, detecting misplaced DNA in cells — a common feature in viral infections, cancer transformations, and some brain disorders.

A rare genetic mutation, first observed in 2019 in a woman with a strong inherited risk for Alzheimer’s disease, may help us better understand and even treat conditions such as Alzheimer’s, cancer, and autoimmune disorders. This woman, who carried a high-risk PSEN1 mutation that usually causes early-onset Alzheimer’s, remained cognitively intact into her seventies. Postmortem analysis revealed extensive amyloid plaques in her brain (a hallmark of Alzheimer’s) but very low tau pathology, which is more closely linked to memory loss and cognitive decline.

Genetic testing showed she carried two copies of a rare variant of the APOE3 gene: R136S, also known as the Christchurch mutation. APOE is a gene long known to influence Alzheimer’s risk, with different variants (APOE2, APOE3, and APOE4) conferring varying levels of protection or susceptibility.

What roles does the cGAS-STING pathway play? Under normal conditions, our cells keep their DNA tightly stored in the nucleus. But sometimes, DNA ends up in the wrong place — floating in the cytoplasm, the main body of the cell. This can happen due to viral infection, cellular stress, or genetic damage. The immune system interprets this misplaced DNA as a danger signal.

cGAS acts as a sensor activated primarily in two pathological contexts: microbial invasion by DNA viruses, bacteria, or retroviruses that introduce exogenous DNA into the cytoplasm, and aberrant leakage of nuclear or mitochondrial self-DNA into the cytosol. When cGAS detects double-stranded DNA in the cytoplasm, it produces a signaling molecule called cGAMP. This molecule then binds to a protein called STING (stimulator of interferon genes), activating a cascade that results in the production of type I interferons and inflammatory cytokines. These signals alert the immune system to potential threats and mobilize a defensive response. Interestingly, TDP-43, which is involved in several degenerative diseases, also has roles in protecting against DNA damage and viruses such as HIV.

While this response is critical for fighting infections and catching early-stage tumors, it can also become problematic when overactive. Persistent or misdirected cGAS-STING activity has been linked to autoimmune diseases, chronic inflammation, and cellular aging (senescence).

New Insights from Mouse Models To explore how exactly the R136S mutation offers protection, researchers engineered mice with human APOE3 or APOE3-R136S genes and introduced a tauopathy-causing mutation (P301S) mimicking key features of Alzheimer’s and frontotemporal dementia.

The findings were compelling: Mice carrying the R136S mutation showed less tau buildup, fewer signs of synaptic and myelin loss, and better brain activity patterns (theta and gamma oscillations important for learning and memory).

At the molecular level, the R136S mutation suppressed the cGAS-STING pathway in microglia, the brain’s resident immune cells.

When researchers treated APOE3 mice (a model of Alzheimer's) with a cGAS inhibitor, these animals exhibited many of the same benefits seen in people who are R136S carriers, including protection from tau-induced synaptic damage and similar gene expression changes across multiple brain cell types.

cGAS-STING: From Immunity to Neurodegeneration This research highlights a key insight: overactivation of cGAS-STING in microglia plays a damaging role in tau-driven neurodegeneration. Misfolded tau proteins can cause inflammation and disrupt brain networks, and microglia that respond too strongly—especially by ramping up interferon signaling through cGAS-STING—may inadvertently worsen the damage.

By reducing this response, the R136S mutation appears to create a more balanced immune environment in the brain. Instead of amplifying harmful inflammation, microglia can more effectively process and break down tau. enter image description here

The discoveries related to R136S and the cGAS-STING pathway have broad implications:

  • Cancer Immunotherapy: The same pathway that detects misplaced DNA in Alzheimer’s also helps identify cancer cells. Modulating cGAS-STING could improve immune responses against tumors or reduce chronic inflammation that promotes their growth.
  • Autoimmune Disorders: Conditions like Aicardi–Goutières syndrome involve constant activation of the cGAS-STING pathway, leading the body to attack itself. Understanding how mutations like R136S impact this response may aid in developing treatments that dial down harmful immune activity without compromising protective responses.
  • Healthy Aging and Senescence: The cGAS-STING pathway is also involved in cellular aging and the development of the senescence-associated secretory phenotype (SASP). Inhibiting this pathway could delay age-related degeneration and lessen age-related inflammation.

Looking Forward: From Mutation to Medicine

As discussed above, reducing cGAS-STING activity carries risks, including the potential to increase cancer susceptibility in older adults. Additionally, effects may vary across different cell types, benefiting the brain while impairing other vital organs. There are multiple schools of thought about what causes Alzheimer's disease; some incriminate the tau protein, but a majority of researchers are working on mitigating amyloid plaques. Another consideration —though obvious but not often explicitly stated— is that this research provides a preventive tool against Alzheimer's disease. In its early stages, it may slow the disease's progression, but it cannot cure someone who experiences the full impact of the disease.

In conclusion, the cGAS-STING pathway is a crucial sensor of misplaced DNA and a regulator of immune responses. A rare mutation in APOE3 (R136S) has been shown to suppress this pathway in brain immune cells, protecting against tau-related damage in Alzheimer’s models. This discovery opens new avenues for treating neurodegenerative diseases, autoimmune disorders, and cancer through precise modulation of our immune system’s ancient alarm system.

Perineuronal net modulation in a Parkinson's disease mouse model

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A growing number of studies are exploring the role of perineuronal nets (PNNs) in Parkinson’s disease. PNNs are specialized structures in the brain’s extracellular matrix that limit synaptic plasticity, like a stabilizing "glue" between neurons. While this stabilization helps maintain brain function in adulthood, it also reduces the brain’s ability to rewire or adapt, which is important for learning and recovery after injury. enter image description here PNNs are especially important during brain development. They help close the "critical period" of heightened plasticity in childhood. Interestingly, while PNNs are degraded in adults, this plasticity can be partially restored. For example, PNN removal can promote recovery in stroke models

PNNs serve multiple functions: protecting neurons from oxidative stress and harmful molecules, regulating plasticity, and helping stabilize long-term memories. Abnormal changes in PNNs have been observed in aging and various neurological conditions, making them a promising target for therapeutic intervention.

In the cerebral cortex, PNNs are primarily found around inhibitory interneurons, particularly those that produce the protein parvalbumin. These interneurons help maintain a balance between excitatory and inhibitory signals in the brain. In Parkinson’s disease, where dopamine-producing neurons in the substantia nigra are lost, this balance is disrupted—suggesting that changes in PNNs may contribute to the disorder.

A recent study investigated the effects of temporarily reducing PNNs in the primary motor cortex (M1) of healthy adult mice using chondroitinase ABC (ChABC). This intervention caused temporary impairments in motor function, suggesting that PNNs contribute to motor stability. Using ChABC makes sense as perineuronal nets are composed of chondroitin sulfate proteoglycans, and ChABC is an enzyme that digests them. Chondroitinase treatment has been shown to allow adults' vision to be restored; moreover, there is some evidence that Chondroitinase could be used for the treatment of spinal injuries.

The researchers created a Parkinson’s disease mouse model by damaging one side of the midbrain of mice with 6-hydroxydopamine (6-OHDA). Two weeks after the lesion, PNN levels dropped in both hemispheres of the motor cortex but returned to normal within five weeks.

The researchers then applied ChABC to reduce PNNs again in the motor cortex and paired this with motor training. This combination improved motor recovery slightly in the Parkinsonian mice. The improvement was linked to an increase in parvalbumin interneurons surrounded by PNNs and a normalization of excitatory signals at their cell bodies. These findings suggest that PNNs respond dynamically—first to the injury and later to therapeutic intervention—and that manipulating them could help restore motor function.

In summary, perineuronal nets in the motor cortex appear to play a subtle but significant role in regulating movement. Modifying their structure could open new avenues for motor rehabilitation in Parkinson’s disease.

Parkinson's disease and acupuncture

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I am somewhat skeptical about the benefits of acupuncture beyond the placebo effect. However, this article suggests it could be beneficial for individuals with Parkinson's disease.
enter image description here This study investigates whether acupuncture has any impact on long-term health outcomes, such as mortality, disease progression, or complications, in individuals newly diagnosed with Parkinson’s disease (PD) in South Korea. Indeed, it is unclear what constitutes an effective acupuncture session for Parkinson's disease, and individuals interested should receive at least one session every two months. It is commonly believed that in PD, reduced mobility due to tremors, postural imbalance, and rigidity likely contributes to poor circulation and decreased gastrointestinal motility, leading to bowel obstructions and impaired swallowing, which can, in turn, result in recurrent aspiration pneumonia. The benefits may arise from the fact that people with PD might find it easier to move.

As is often the case, the Korean authors used a database to select patients and gather information about their health over the following years. They did not see any patients in person; it was purely a matter of processing numbers in the database. The NHIS database contains extensive patient information, including diagnostic codes, healthcare utilization, prescriptions, vital signs, disability grades, sex, age, and socioeconomic factors such as health insurance. However, this database does not provide precise medical details.

Who Was Included in the Study?

The study focused on adults (age 19 or older) newly diagnosed with idiopathic Parkinson’s disease (IPD) between 2012 and 2016.

To ensure a cleaner analysis, the authors excluded individuals diagnosed with Parkinson’s before 2012 or who were disabled at the time of diagnosis. They also excluded patients diagnosed with dementia or who died within a year of their diagnosis. To strengthen the results, they excluded patients who had received acupuncture in the six months preceding their diagnosis.

After applying these exclusions, about 41,000 patients remained. From this group, the researchers employed "propensity score matching" to pair patients from both groups who had similar health and demographic profiles (like age, sex, income, location, and other health conditions). After further exclusions and matching, 6,394 patients remained in each group.

The researchers measured all-cause mortality (death from any cause), tracked for up to six years following diagnosis. They also recorded fractures (such as hip or spine fractures), emergency room visits, and deep brain stimulation (DBS) surgery. These outcomes serve as proxies to assess whether acupuncture is associated with slower disease progression or fewer complications.

How Were Acupuncture and Non-Acupuncture Groups Defined?

Acupuncture was counted only if a person had six or more sessions in the year following diagnosis. This cutoff is based on previous studies suggesting that at least six sessions may be necessary to observe an effect. The acupuncture types included conventional methods as well as specialized forms like ocular or electroacupuncture.

Results:

Overall, the mortality in the acupuncture group (960) was significantly lower than in the control group (1,118). Deaths due to neoplasms (174 vs 234), circulatory (172 vs 208), and digestive diseases were also lower in the acupuncture group. In all cases, the acupuncture group had equal or better results than the control group. However, no significant differences were observed between groups in fracture risk, emergency room visits, or DBS procedures.

Key Takeaways

The study aimed to explore whether acupuncture might influence survival or disease progression in Parkinson’s disease. To achieve this, it utilized a large, high-quality national health dataset and careful matching to compare similar patients. While the text does not cover the results themselves (e.g., whether acupuncture improved survival or reduced complications), the methods ensure that any differences found are likely due to the treatment rather than other health or demographic factors.

Blood Lipoprotein Levels and Alzheimer Disease

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Recent research continues to highlight the complex relationship between cardiovascular health and brain aging. For instance, vascular dementia is one type of dementia. Furthermore, universities are encouraging their teams to identify useful biomarkers for neurodegenerative diseases, as they believe they can generate revenue from potential patents. One quick and inexpensive method to conduct a study is to utilize databases available online.

The Framingham Study is a long-term epidemiological study (since 1948) that initially focused on cardiovascular disease. We owe much of our knowledge about cardiovascular disease to the Framingham Study, particularly regarding the identification of cardiovascular risk factors, including the effects of smoking and diet. Thus, the recognition of high blood pressure as a risk factor for heart disease dates back to 1957, for neurological diseases to 1967, and heart failure to 1971. enter image description here By Manu5 - http://www.scientificanimations.com/wiki-images/

At the same time, the Framingham Study focused on a relatively affluent population of European origin, meaning the conclusions drawn from it may not necessarily apply to other populations. Furthermore, marker values vary depending on the data collection devices and methods (some values date back to 1948!), so an a priori analysis must consider these difficulties, which is rarely addressed in rapid studies.

The authors of the article discussed in this post selected 822 elderly individuals (mean age: approximately 72 years) from the database who were not suffering from dementia at the time of their first blood test with the Framingham Study. Participants were monitored for Alzheimer's disease until 2020. Over a median follow-up period of 12.5 years, 128 of these individuals developed Alzheimer's disease.

The article authors measured levels of high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), small dense LDL cholesterol (sdLDL-C), lipoprotein a (Lp(a)), apolipoprotein B (ApoB), and the ApoB48 isoform of ApoB in the blood samples collected from 1985 to 1988 by the Framingham Study.

It has long been acknowledged that, although the mechanism is not fully understood, elevated levels of apolipoprotein B (ApoB) are associated with higher concentrations of LDL particles and are the primary driver of plaques that cause vascular disease (atherosclerosis), which typically first manifests as obvious symptoms such as heart disease, stroke, and various other body-wide complications after decades of progression.

Furthermore, the causes of Alzheimer's disease remain poorly understood, but the most significant genetic risk factor arises from an allele of apolipoprotein E. Other risk factors include a history of head trauma, clinical depression, and high blood pressure. The progression of the disease is largely characterized by the accumulation of malformed protein deposits in the cerebral cortex, known as amyloid plaques and neurofibrillary tangles.

Therefore, there is a possible link between dementia and cardiovascular risk, and the Framingham Study database allows us to statistically compare heart health and the risk of developing comorbidities.

The article authors considered a wide range of cholesterol-related markers:

  • HDL-C: "Good" cholesterol

  • LDL-C: "Bad" cholesterol

  • sdLDL-C: Small, dense particles of LDL cholesterol

  • ApoB and ApoB48: Proteins involved in cholesterol transport

  • Lp(a): A lipoprotein linked to the risk of heart disease

The researchers examined the relationship between these markers, standardized by their standard deviation units (SDUs), and the future risk of Alzheimer's disease.

** sdLDL-C ** They found that high sdLDL-C levels correlate with an increased risk of developing Alzheimer's disease. This result has also been observed by other teams, including a recent one that examined a database in Finland:

SdLDL-C stands for "small dense low-density lipoprotein cholesterol." It is a subclass of LDL particles that are smaller and denser than conventional LDL and more likely to penetrate blood vessel walls. This cholesterol subtype is rarely tested. sdLDL is regarded as a more atherogenic lipoprotein due to its higher retention rate in the arterial wall, better penetration, lower binding affinity to the LDL receptor, lower resistance to oxidative stress, and longer plasma half-life. In addition to being associated with a heightened risk of cardiovascular disease, sdLDL, particularly sdLDL-C levels, have been linked to type 2 diabetes mellitus, metabolic syndrome, obesity, and low-grade inflammation.

** ApoB48 ** Conversely, elevated ApoB48 levels are linked to a reduced risk of Alzheimer's disease. This finding was previously known.

** HDL-C ** However, the authors uncovered surprising results regarding HDL-C, often referred to as "good cholesterol". Numerous epidemiological studies have indicated that high circulating HDL levels are associated with a reduced risk of Alzheimer's disease. Yet, this new study's authors found that participants with the lowest HDL-C levels had a 44% reduced risk of developing Alzheimer's disease compared to those with higher HDL-C levels.

Because HDL-C is generally considered protective, this team's findings may reflect other age-related changes, such as metabolic status or weight loss, that occur before the onset of dementia.


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