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The Role of Genetics in Advancing Precision Medicine for Alzheimer’s Disease—A Narrative Review

Alzheimer’s disease (AD) is the most common type of dementia, which has a substantial genetic component. AD affects predominantly older people. Accordingly, the prevalence of dementia has been rising as the population ages. To date, there are no effective interventions that can cure or halt the prog...

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Autores principales: Freudenberg-Hua, Yun, Li, Wentian, Davies, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5928202/
https://www.ncbi.nlm.nih.gov/pubmed/29740579
http://dx.doi.org/10.3389/fmed.2018.00108
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author Freudenberg-Hua, Yun
Li, Wentian
Davies, Peter
author_facet Freudenberg-Hua, Yun
Li, Wentian
Davies, Peter
author_sort Freudenberg-Hua, Yun
collection PubMed
description Alzheimer’s disease (AD) is the most common type of dementia, which has a substantial genetic component. AD affects predominantly older people. Accordingly, the prevalence of dementia has been rising as the population ages. To date, there are no effective interventions that can cure or halt the progression of AD. The only available treatments are the management of certain symptoms and consequences of dementia. The current state-of-the-art medical care for AD comprises three simple principles: prevent the preventable, achieve early diagnosis, and manage the manageable symptoms. This review provides a summary of the current state of knowledge of risk factors for AD, biological diagnostic testing, and prospects for treatment. Special emphasis is given to recent advances in genetics of AD and the way genomic data may support prevention, early intervention, and development of effective pharmacological treatments. Mutations in the APP, PSEN1, and PSEN2 genes cause early onset Alzheimer’s disease (EOAD) that follows a Mendelian inheritance pattern. For late onset Alzheimer’s disease (LOAD), APOE4 was identified as a major risk allele more than two decades ago. Population-based genome-wide association studies of late onset AD have now additionally identified common variants at roughly 30 genetic loci. Furthermore, rare variants (allele frequency <1%) that influence the risk for LOAD have been identified in several genes. These genetic advances have broadened our insights into the biological underpinnings of AD. Moreover, the known genetic risk variants could be used to identify presymptomatic individuals at risk for AD and support diagnostic assessment of symptomatic subjects. Genetic knowledge may also facilitate precision medicine. The goal of precision medicine is to use biological knowledge and other health information to predict individual disease risk, understand disease etiology, identify disease subcategories, improve diagnosis, and provide personalized treatment strategies. We discuss the potential role of genetics in advancing precision medicine for AD along with its ethical challenges. We outline strategies to implement genomics into translational clinical research that will not only improve accuracy of dementia diagnosis, thus enabling more personalized treatment strategies, but may also speed up the discovery of novel drugs and interventions.
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spelling pubmed-59282022018-05-08 The Role of Genetics in Advancing Precision Medicine for Alzheimer’s Disease—A Narrative Review Freudenberg-Hua, Yun Li, Wentian Davies, Peter Front Med (Lausanne) Medicine Alzheimer’s disease (AD) is the most common type of dementia, which has a substantial genetic component. AD affects predominantly older people. Accordingly, the prevalence of dementia has been rising as the population ages. To date, there are no effective interventions that can cure or halt the progression of AD. The only available treatments are the management of certain symptoms and consequences of dementia. The current state-of-the-art medical care for AD comprises three simple principles: prevent the preventable, achieve early diagnosis, and manage the manageable symptoms. This review provides a summary of the current state of knowledge of risk factors for AD, biological diagnostic testing, and prospects for treatment. Special emphasis is given to recent advances in genetics of AD and the way genomic data may support prevention, early intervention, and development of effective pharmacological treatments. Mutations in the APP, PSEN1, and PSEN2 genes cause early onset Alzheimer’s disease (EOAD) that follows a Mendelian inheritance pattern. For late onset Alzheimer’s disease (LOAD), APOE4 was identified as a major risk allele more than two decades ago. Population-based genome-wide association studies of late onset AD have now additionally identified common variants at roughly 30 genetic loci. Furthermore, rare variants (allele frequency <1%) that influence the risk for LOAD have been identified in several genes. These genetic advances have broadened our insights into the biological underpinnings of AD. Moreover, the known genetic risk variants could be used to identify presymptomatic individuals at risk for AD and support diagnostic assessment of symptomatic subjects. Genetic knowledge may also facilitate precision medicine. The goal of precision medicine is to use biological knowledge and other health information to predict individual disease risk, understand disease etiology, identify disease subcategories, improve diagnosis, and provide personalized treatment strategies. We discuss the potential role of genetics in advancing precision medicine for AD along with its ethical challenges. We outline strategies to implement genomics into translational clinical research that will not only improve accuracy of dementia diagnosis, thus enabling more personalized treatment strategies, but may also speed up the discovery of novel drugs and interventions. Frontiers Media S.A. 2018-04-24 /pmc/articles/PMC5928202/ /pubmed/29740579 http://dx.doi.org/10.3389/fmed.2018.00108 Text en Copyright © 2018 Freudenberg-Hua, Li and Davies. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Freudenberg-Hua, Yun
Li, Wentian
Davies, Peter
The Role of Genetics in Advancing Precision Medicine for Alzheimer’s Disease—A Narrative Review
title The Role of Genetics in Advancing Precision Medicine for Alzheimer’s Disease—A Narrative Review
title_full The Role of Genetics in Advancing Precision Medicine for Alzheimer’s Disease—A Narrative Review
title_fullStr The Role of Genetics in Advancing Precision Medicine for Alzheimer’s Disease—A Narrative Review
title_full_unstemmed The Role of Genetics in Advancing Precision Medicine for Alzheimer’s Disease—A Narrative Review
title_short The Role of Genetics in Advancing Precision Medicine for Alzheimer’s Disease—A Narrative Review
title_sort role of genetics in advancing precision medicine for alzheimer’s disease—a narrative review
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5928202/
https://www.ncbi.nlm.nih.gov/pubmed/29740579
http://dx.doi.org/10.3389/fmed.2018.00108
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