NIH Adds Funding for Biomarker-Based Alzheimer Disease Studies

Eliezer Masliah, MD

The National Institutes of Health (NIH) announced that it is has added an additional funding for more biomarker measures, including positron emission tomography (PET) imaging, to the ongoing Health and Aging Brain Among Latino Elders (HABLE) study.¹

The NIH’s National Institute on Aging (NIA) also awarded an expected $45.5 million over 5 years to the University of North Texas Health Science Center (HSC) for the Health and Aging Brain Among Latino Elders-Amyloid, Tau, and Neurodegeneration (HABLE-AT [N]) study. The combined investment is geared towards learning more about the disparities of brain aging and Alzheimer disease (AD) between Mexican Americans and non-Latino whites.

HABLE, launched in September 2017, has nearly completed recruitment of 1000 Mexican Americans and 1000 non-Latino whites, all of whom are aged 50 years and older. Patients within the study are expected to receive a functional exam, clinical labs, neuropsychological testing, bloodwork, and magnetic resonance imaging (MRI) on the brain.

“To successfully battle and ultimately prevent or treat a complex disease such as Alzheimer’s, we need to understand how this disease and other forms of dementia affect our nation’s diverse communities differently,” Eliezer Masliah, MD, director, NIA Division of Neuroscience, said in a statement.

Amyloid and tau PET will be among the 2 major neuroimaging components from HABLE-AT(N) that will benefit the most from the additional funding. The study will also examine whether traces of amyloid peptides such as amyloid-beta 40 (Aß40) and 42 (Aß42), other biomarkers including tau, neurofilament light (NfL), and exosomes in the blood, can be used to screen across the spectrum of AD. This would include patients who are asymptomatic to mild cognitive impairment and advanced stages of the disease.

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Sid O’Bryant, PhD, professor and executive director, HSC Institute for Translational Research, and professor, HSC’s Pharmacology & Neuroscience Unit, was named the principal investigator for both studies. He will lead both research teams which consist of leading experts in Mexican American cognitive aging, neuroimaging, blood-based biomarkers, as well as advanced statistical modeling.

“The scope and urgency of HABLE and HABLE-AT(N) is crucial for this underserved population,” Dallas Anderson, PhD, a program director in the Population Studies and Genetics Branch of NIA’s Division of Neuroscience, said in a statement. “Most importantly, it will help to clarify questions in the diagnosis of Alzheimer’s disease and related dementias in Mexican Americans.”

HABLE-AT(N) is aligned with the NIA-Alzheimer’s Association Research Framework, which is constructed based on 3 general groups of biomarkers. Beta-amyloid (A), tau (T), and neurodegeneration or neuronal injury (N), combined are referred to as the AT(N) research framework, which is designed to facilitate a better understanding of the disease process and the sequence of events that lead to cognitive impairment and dementia.

Investigators within HABLE-AT(N) will assess a variety of biological, behavioral, environmental, and sociocultural data to examine the big picture of how AD affects people throughout their lives. “Measuring additional biomarkers in this population will provide important clues to guide approaches to target the right disease processes in the right people at the right time,” Masliah added.

Projections from the US Census Bureau show that the number of Latinos age 65 and older are expected to quadruple by 2060. In contrast, the number of non-Hispanic whites are expected to increase by about 23% and the number of Blacks will more than double.²

HSC’s Institute for Translational Research plans on releasing data from HABLE and HABLE-AT(N) to the scientific community to facilitate rapid scientific advancements and thus meeting an NIA goal of open access to research data.

A study presented at the 2020 Alzheimer’s Association International Conference (AAIC) by Katrina Celis, MD, uncovered further information about the APOE ε4 allele, suggesting there is an increased risk for AD in non-Hispanic Whites compared to African Americans because of the increased APOE ε4 expression in carriers with the European local genomic ancestry. Celis detailed the role that increased APOE ε4 expression can have on future research and clinical care. Click here to listen to the conversation.

REFERENCES

1. NIH augments large scale study of Alzheimer’s disease biomarkers. News release. NIH. September 14, 2020. Accessed September 29, 2020. https://www.nih.gov/news-events/news-releases/nih-augments-large-scale-study-alzheimers-disease-biomarkers​

2. 2017 national population projections tables: main series. United States Census. https://www.census.gov/data/tables/2017/demo/popproj/2017-summary-tables.html. Updated February 20, 2020. Accessed September 29, 2020.