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China's aging population has reached unprecedented levels.
, in particular Alzheimer's disease (AD), has become a serious social and family burden, with AD divided into familial Alzheimer's disease (FAD) and extrinsic Alzheimer's disease (SAD).
FAD is almost entirely determined by genes, the genetic rate is 92% to 100%, which is characterized by early onset age, showing the characteristics of family aggregation.
FAD has been extensively studied for many years since it was first discovered.
-carrier lipoprotein E (APOE) is considered to be the most risky gene for AD, and APOE 4 is considered the main genetic risk factor among the three isotype alleloloydes (2, 3 and 4), and the same source APOE 4 carriers usually become ill earlier than the heterogenetic carrier, highlighting the dose effect of the iso-4 allegen on AD.
copy of the
-4 allethon gene increases the risk of AD by about 2 to 6 times, and the presence of two copies increases the risk by 7.2 to 21.8 times (African-American 7.2, Hispanic 8.6, white 11.8, Japanese 21.8).
APOE 4 allegens range in frequency from 9% to 23% among people of different races (Asians 9%, Hispanics 12%, whites 14%, African Americans 19%, other/mixed 23%), but there has been a sharp increase in AD patients (Hispanics 24%, Asians 28%, African Americans 35%, whites 38%, other/mixed 45%).
a recent team study of 404 Chinese FAD subjects showed that 44.31 percent of patients without PSENs/APP mutations carried an APOE 4 allegant gene, while 14.85 percent carried two APOE 4 allegants, indicating that APOE 4 played an important role in the absence of PSENs/APP mutations.
these results challenge the role of APOE as a risk factor primarily for SAD development.
, it is necessary to conduct large-scale, multi-center studies to investigate the effects of APOE in FAD, especially in cases where there is no PSENs/APP mutation.
recently, the Jia Jianping team at Xuanwu Hospital published a study in the alzheimer's journal Alzheimer's and Dementia to explore the distribution and genetic effects of the APOE 4 genotype in HAD, PSEN1, PSEN2, TREM2, and SORL1 mutations.
, the researchers compared Chinese frequency of APOEs in the group with data from other countries.
the study included 15,119 subjects, including 311 FAD patients without PSEN1, PSEN2, APP, TREM2, and SORL1 disease-caused mutations (FAD (unknown);
researchers analyzed the risk effects of APOE 4 on each group.
, FAD patients come from the Family Alzheimer's Network (CFAN), a national multi-center longitudinal study .
results showed that the prevalence of the APOE 4 genotype in fad (unknown), FAD (PSENs/APP), SAD and NC groups was 56.27 percent, 26.19 percent, 36.23 percent, and 19.54 percent, respectively.
to explore the predictive effects of APOE in different AD subsypes, the researchers used binary logic regression models to adjust the age, gender, education, and region of the subjects.
researchers found that the APOE-4-positive genotype was positive for FAD (unknown) (OR: 4.51,95% confidence interval (CI): 3.57-5.45, P-lt; .001) and SAD (OR:2.26, 95% CI: 2.17-2.35, P .lt; .001) are predictive.
researchers also studied the effects of the dose of the APOE 4 gene on disease risk and found that in the FAD (unknown) and SAD groups, two APOE 4 copies (same source) had an OR value higher than the OR value of a single copy (heterogeneity), especially in the FAD (unknown) group (APO) E-4 hems: OR: 3.26, 95% CI: 2.5 3.26, 95% CI: 2.61-3.91, P.lt;.001; APOE?4 pure helies.
OR: 22.13, 95% CI: 15.79-28.47, P slt;.001).
) As a result, the APOE-4-positive genotype is predictive of FAD (unknown) risk (odds ratio: 4.51, 95% confidence interval: 3.57-5.45, P.001).
, the study showed that APOE-4-positive genotypes may lead to familial aggregation, and studies of multiple interventions for APOE pathological function are noteworthy in order to reduce the risk of disease.
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