Alzheimer's disease (AD) is a chronic neurodegenerative disorder characterized by the progressive accumulation of amyloid-β (Aβ) plaques and neurofibrillary tangles in the neocortex. Recent studies have implicated a role for regulatory genomic variation in AD progression, finding widespread evidence for altered DNA methylation associated with neuropathology. To date, however, no study has systematically examined other types of regulatory genomic modifications in AD. In this study, we quantified genome-wide patterns of lysine H3K27 acetylation (H3K27ac) -a robust mark of active enhancers and promoters that is strongly correlated with gene expression and transcription factor binding -in entorhinal cortex samples from AD cases and matched controls (n = 47) using chromatin immunoprecipitation followed by highly parallel sequencing (ChIP-seq). Across ~182,000 robustly detected H3K27ac peak regions, we found widespread acetylomic variation associated with AD neuropathology, identifying 4,162 differential peaks (FDR < 0.05) between AD cases and controls. These differentially acetylated peaks are enriched in disease-specific biological pathways and include regions annotated to multiple genes directly involved in the progression of Aβ and tau pathology (e.g. APP, PSEN1, PSEN2, MAPT), as well as genomic regions containing variants associated with sporadic late-onset AD. This is the first study of variable H3K27ac yet undertaken in AD and the largest study investigating this modification in the entorhinal cortex. In addition to identifying molecular pathways associated with AD neuropathology, we present a framework for genome-wide studies of histone modifications in complex disease, integrating our data with results obtained from genome-wide association studies as well as other epigenetic marks profiled on the same samples.. CC-BY 4.0 International license It is made available under a (which was not peer-reviewed) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity.The copyright holder for this preprint . http://dx.doi.org/10.1101/183541 doi: bioRxiv preprint first posted online 3 Alzheimer's disease (AD) is a chronic neurodegenerative disorder characterized by cognitive decline and memory loss that contributes substantially to the global burden of disease, affecting in excess of 26 million people worldwide 1 . The symptoms of AD are associated with progressive neuropathology in the neocortex, with regions surrounding the entorhinal cortex being particularly affected early in the disease 2 . These neuropathological hallmarks of AD include the extracellular deposition of neurotoxic amyloid-β (Aβ) in the form of amyloid plaques and an accumulation of intracellular neurofibrillary tangles composed of hyperphosphorylated tau 3 . Despite progress in understanding risk factors contributing to AD progression, the mechanisms involved in disease progression are not fully understood and long-term treatments, reversing the cellular disease process in the cortex, are elusive.The...