Integrative multiomics reveals common endotypes across PSEN1, PSEN2, and APP mutations in familial Alzheimer’s disease

Abstract

Abstract Background Mutations in PSEN1, PSEN2, and APP can lead to Alzheimer’s disease (AD) with an early age at onset (AAO) and hallmark progressive cognitive decline. These mutations are highly penetrant. Although mutations in PSEN1 are more common and usually have an earlier AAO, certain mutations in PSEN1 cause a later AAO, similar to PSEN2 and APP mutations. We sought to determine whether common disease endotypes exist across these mutations with a relatively late AAO. Methods We generated hiPSC-derived neurons from patients harboring autosomal-dominant, familial Alzheimer’s disease (FAD) mutations in PSEN1, PSEN2, and APP with a documented age at onset (AAO) around 55 years: PSEN1A79V, PSEN2N141I, and APPV717I. We carried out RNA-seq and ATAC-seq to mechanistically characterize the gene expression and chromatin accessibility changes, respectively. Differential expression analysis, enrichment analysis, TF activity identification, and co-expression module detection were performed for RNA-seq. Differential peak analysis and annotation, TF motif footprinting and differential motif accessibility, and peak functional enrichment were performed for ATAC-seq. This approach allowed us to identify the correlation between gene expression and chromatin accessibility associated with key disease endotypes. Results Using a multiomics approach, we identify and characterize common endotypes in mutations across all three FAD genes: dedifferentiation of a mature neuron to a less differentiated quasi-neuron state, dysregulation of synaptic signaling, repression of mitochondrial function and metabolism, and inflammation. The integrativeanalysis allowed us to ascertain the master transcriptional regulators associated with these endotypes, including REST, ASCL1, and ZIC family members (activation), as well as NRF1 (repression). Conclusions Our findings characterize the common regulatory changes within endotypes across these FAD mutations. However, the severity of dysregulation often differs between PSEN1, PSEN2, and APP mutations both in magnitude and direction. The overarching common link between mutations in FAD genes is the reversion to a less-differentiated neuron state. The transcriptional regulatory mechanisms described within disease endotypes offer potential targets for therapeutic interventions.