Investigators of the GMAJ project 12Studying rare extreme forms of Alzheimer disease (AD) may prove to be a useful strategy in identifying new genes involved in monogenic determinism of AD. Amyloid precursor protein (APP), PSEN1, and PSEN2 mutations account for only 85% of autosomal dominant early-onset AD (ADEOAD) families. We hypothesised that rare copy number variants (CNVs) could be involved in ADEOAD families without mutations in known genes, as well as in rare sporadic young-onset AD cases. Using high-resolution array comparative genomic hybridisation, we assessed the presence of rare CNVs in 21 unrelated ADEOAD cases, having no alteration on known genes, and 12 sporadic AD cases, with an age of onset younger than 55 years. The analysis revealed the presence of 7 singleton CNVs (4 in ADEOAD and 3 in sporadic cases) absent in 1078 controls and 912 late-onset AD cases. Strikingly, 4 out of 7 rearrangements target genes (KLK6, SLC30A3, MEOX2, and FPR2) encoding proteins that are tightly related to amyloid-b peptide metabolism or signalling. Although these variants are individually rare and restricted to particular subgroups of patients, these findings support the causal role, in human pathology, of a set of genes coding for molecules suspected for a long time to modify Ab metabolism or signalling, and for which animal or cellular models have already been developed. European Journal of Human Genetics (2012) 20, 613-617; doi:10.1038/ejhg.2011; published online 14 December 2011Keywords: Alzheimer disease; copy number variations; KLK6; MEOX2; SLC30A3; FPR2
INTRODUCTIONThe identification of major genes (PSEN1, PSEN2 and APP) responsible for autosomal dominant early-onset Alzheimer disease (ADEOAD, OMIM number #104300) has proved crucial to understanding the pathophysiology of the disease. It has allowed for the definition of the amyloid cascade hypothesis, 1,2 according to which accumulation of highly aggregable forms of the amyloid beta (Ab) peptide, that results from the amyloid precursor protein (APP) proteolytic cleavage, is the primum movens of this devastating neurodegenerative disease. ADEOAD is a rare condition with a prevalence rate estimated at 5.3 per 100 000 persons at risk. 2 Mutation screening of more than 150 ADEOAD families, ascertained in France by the National Centre for early-onset AD (CNR-MAJ), had shown that mutations of known genes account for 85% of ADEOAD families. 3 We hypothesised that rare copy number variants (CNVs) could be involved in ADEOAD families without mutations in known genes. Indeed, a previous analysis has shown that APP locus duplications were present in a subset of these families. 4 To further explore this issue, we conducted a genome-wide screen for CNVs, using high-resolution oligonucleotide array-based comparative genomic hybridisation (a-CGH) in still unexplained ADEOAD families. In addition, as rare pathogenic CNVs often occur de novo, 5 we decided to investigate by a-CGH another subgroup of patients consisting of 12 sporadic cases with particularly young disease onset...