By Kevin Griffin

Clinical Assessment May Benefit Postpartum Women with Methadone Treatment Changes

August 26th, 2014 in 2014, Health & Medicine, News Releases, School of Medicine 0 comments

For Immediate Release, Aug. 25, 2014
Contact:
Jenny Eriksen Leary, 617-638-6841, jenny.eriksen@bmc.org

A recent study led by researchers at Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) found that women may not need significant methadone dose reductions in the first three months after pregnancy. Researchers reviewed the charts of 101 women who received care at a methadone maintenance treatment program between 2006 and 2010 after giving birth. They discovered that under the clinical assessment model—in which clinicians estimate patients’ methadone dose based on their individual physiologic parameters, rather than using a standard formula to reduce doses—women experienced on average only a small reduction in methadone dose. This suggests that, contrary to prior belief, changes in the physiology of women’s bodies from delivery to 12 weeks postpartum did not significantly affect their response to methadone.

Treatment for addiction in pregnant women is a complex topic. The gold standard for treatment is methadone maintenance, which has been shown to reduce illicit drug use and improve neonatal outcomes such as birth weight. Given the physical changes that happen to a woman’s body while pregnant, women often need higher doses to help them effectively manage their addiction during and after pregnancy. Yet, the optimal approach to adjusting methadone maintenance dosages during the postpartum period has long been unclear. Nonetheless, ensuring that women receive an appropriate dose is crucial to ensure ongoing sobriety while avoiding dangerous oversedation.

“This is an important issue because the postpartum period can be vulnerable for women struggling with opioid dependence, and it is crucial to ensure that the methadone dose is adequately high to continue to support recovery, while not causing oversedation,” said lead author Christine Pace, MD, an internist at BMC who specializes in addiction. “Oversedation is dangerous because women who are lethargic or sleepy are not able to care appropriately for themselves or their infants. In addition, patients who become over sedated from an excessive dose of methadone, with or without the addition of other medications or illicit drugs, may be at risk for overdose.”

The number of events where women appeared oversedated was slightly increased during the postpartum period, but still rare, occurring less than 6 times per 10,000 visit days. Many of the women who experienced these were also concurrently prescribed benzodiazepines. The authors caution that women receiving multiple sedating medications are particularly vulnerable and require more frequent surveillance.

“Our findings suggest that, given the physiologic changes and psychosocial stressors unique to the postpartum period, it is appropriate for methadone clinics to implement regular postpartum assessments at intervals extending at least up to 12 weeks after delivery. Clinicians also should take into account benzodiazepine use,” said Pace, also an assistant professor of medicine at BUSM. “Further studies are needed to guide safe and effective methadone dosing during the postpartum period in order to improve outcomes for both mother and child.”

Funding for this study was provided by National Institute on Drug Abuse (award number R25DA13582) and National Institute of Allergy and Infectious Disease (award AI052074-06A2).

 

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Low Birth Weight Linked to Higher Incidence of Type 2 Diabetes in African American Women

August 26th, 2014 in 2014, Health & Medicine, News Releases 0 comments

EMBARGOED by Diabetes Care until 3 p.m. ET, Thursday, August 21, 2014
Contact: Jenny Eriksen, 617-638-6841, jenny.eriksen@bmc.org

(Boston)— African American women born at a low or very low birth weight may be at a higher risk for developing type 2 diabetes. The findings, which appear in Diabetes Care, may explain in part the higher occurrence of type 2 diabetes in African American populations, which has a high prevalence of low birth weight.

Researchers from Boston University’s Slone Epidemiology Center followed more than 21,000 women enrolled in the Black Women’s Health Study over the course of 16 years, analyzing characteristics such as birth weight, current age, family history of diabetes, body mass index, physical activity and socioeconomic status.

The study results indicate that women with low birth weight had a 13 percent higher chance of developing type 2 diabetes than those with normal birth weight, and those with very low birth weight had a 40 percent higher chance of developing the disease. Low birth weight was defined as less than 2.5 kg, and very low birth weight as less than 1.5 kg. It appeared that body size did not play a role in this relationship as there was a clear association between birth weight and diabetes even for women who were not obese.

Although previous studies have shown that birth characteristics such as birth weight can have a major impact on adult health, this is the first large-scale study to demonstrate this effect in an African American population.

“African American women are at increased risk of developing type 2 diabetes, and also have higher rates of low birth weight than white women,” said Edward Ruiz-Narváez, ScD, assistant professor of epidemiology at Boston University School of Public Health. “Our study shows a clear relationship between birth weight and diabetes that highlights the importance of further research for this at-risk group.”

According to the researchers, there are two leading hypotheses for the phenomenon. The first, known as the “thrifty phenotype hypothesis,” states that once the newborn body perceives that it lacks nutrition, it reprograms itself to absorb more nutrition, causing an imbalance in metabolism that eventually leads to type 2 diabetes. The second, known as the “fetal insulin hypothesis,” states that genes that are responsible for impaired insulin secretion also have a negative effect on birth weight. Some of these genes have been discovered in recent studies, supporting the latter hypothesis.

Funding for this study was provided by grants from the National Institute on Minority Health and Health Disparities, the National Cancer Institute and the American Heart Association.

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Review of Clinical Treatment of Bronchiolitis in Infants Reveals Overreliance on One Test

August 19th, 2014 in 2014, Health & Medicine, News Releases, School of Medicine 0 comments

EMBARGOED BY JAMA until 4 p.m. Tuesday, Aug. 19, 2014
Contact: Jenny Eriksen Leary, 617-638-6841, jenny.eriksen@bmc.org

(Boston) – An editorial published in this week’s JAMA highlights the importance of physicians using all available clinical assessment tools when considering how to treat patients. Written by Robert Vinci, MD, chief of pediatrics at Boston Medical Center and chair of pediatrics at Boston University School of Medicine and Howard Bauchner, MD, editor-in-chief of JAMA, the editorial examines results of a study published in the same issue of the journal as an example of how doctors can often over-emphasize certain types of data.

The study examined how pediatric emergency medicine physicians treat a respiratory tract infection called bronchiolitis in infants, and how they incorporate factors such as respiratory exam, imaging tools and blood tests when deciding on treatment. Doctors also commonly use the level of oxygen saturation, measured by a simple machine called an oximeter, which measures how well the blood carries oxygen; generally, the higher the number, the better. In the study, emergency department physicians were presented with two groups of infants with bronchiolitis, one in which they were shown the true oxygen saturation level and the other in which they were shown an altered number that was three percent higher than the actual saturation level.

The results indicated that the clinicians were 40 percent less likely to admit the patients with the falsely higher oxygen saturation level into the hospital even though the two groups had otherwise similar symptoms and illness severity. This supports the notion that clinicians may often overlook other important components of the clinical assessment in favor of a single parameter.

The editorial stresses the challenges that clinicians often face in treating disorders where there are no standard treatment protocols and emphasizes that analyzing all available data to make the best clinical judgments and decisions is the true art of medicine.

“Although it may seem wrong, the study authors followed established guidelines such as obtaining consent from parents and also ensured the safety of patients by only enrolling patients with mild disease,” said Vinci about the ethics of deceiving physicians for the purpose of research in the editorial. “In an area of research where there is much uncertainty about how we should best treat patients, studies such as this may be necessary to gather important information, as long as researchers ensure patient safety.”

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In-Utero Methadone or Subutex Exposure Could Alter Gene Expression, Cause Severe Neonatal Abstinence Syndrome

August 19th, 2014 in 2014, Health & Medicine, News Releases, School of Medicine 0 comments

For Immediate Release, Aug. 19, 2014

Contact: Jenny Eriksen Leary, 617-638-6841, jenny.eriksen@bmc.org

(Boston) – Some infants born with neonatal abstinence syndrome (NAS) secondary to in-utero opioid exposure have a more difficult time going through withdrawal than others, but the underlying reasons are not well understood. While genetic and epigenetic (when genes are turned on or off) changes have recently been identified as potential factors, researchers at Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) conducted a first of its kind study to identify some of these epigenetic changes that may influence symptom severity.

The researchers focused on how exposure to opioids such as methadone or subutex may alter expression of the mu-opioid receptor (OPRM1) gene, which is known as a primary site of action for narcotics in the nervous system and plays an important role in opioid dependent adults.

Looking at data from 86 infants whose mothers took either methadone or subutex during pregnancy, the results showed that infants with higher levels of the DNA modification called DNA methylation had more severe NAS symptoms. This meant that they required more medication(s) over a longer period of time to get through withdrawal. The researchers hypothesize that this may be due to a decrease in number of opioid receptors due to the silencing of the OPRM1 gene.

Future research in this area will focus on comparing methylation levels of mothers and infants to evaluate if the epigenetic changes are passed on from mother to child. The implications are that this very early in-utero and neonatal exposure to opioids may lead to lasting epigenetic changes that may alter one’s future sensitivity to opioid and other addictive medications.

“What makes these results so intriguing is that these epigenetic changes could be passed on from mother to child, resulting in these children potentially having future issues and sensitivities around opioid and other addictive substances,” said Elisha Wachman, MD, a staff neonatologist at BMC and assistant professor of pediatrics at BUSM.

This study is published in the Journal of Pediatrics and was supported in part by the National Institutes of Health under notice of grant award numbers DA024806-01A2, R01DA032889-01A1, DA018197-05 and DA026120; the Tufts Medical Center Natalie Zucker and Susan Saltonstall Grants; the National Center for Advancing Translational Sciences; the Toomim Family Fund; the Boston University Genome Science Institute; and the Alpert Foundation.

 

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BU Researchers Find Provider and Parental Assumptions About Teenage Sexual Activity Yield “Missed Opportunities” For HPV Vaccination

August 18th, 2014 in 2014, Health & Medicine, News Releases, School of Medicine 0 comments

EMBARGOED by Pediatrics until Monday, August 18, 2014, 12:01 a.m., ET

Contact: Jenny Eriksen Leary, 617-638-6841, jenny.eriksen@bmc.org

(Boston)—Probing deeper into the complex decisions that parents and providers face regarding the human papilloma virus (HPV) vaccine, researchers found that though both parties appreciated importance of the HPV vaccine, their personal assumptions surrounding timing of administration relative to onset of sexual activity resulted in decreased vaccination rates.

Researchers at Boston University School of Medicine (BUSM) conducted hundreds of interviews to offer new insights into this frequent—and often controversial—clinic room conversation. Their findings and recommendations will appear in the September 2014 issue of Pediatrics.

Specifically researchers found that vaccination rates could be traced to personal biases and communication styles of providers. Providers who believed a child was at low risk for sexual activity—an assessment, they admitted, not always accurate—were more likely to delay administration. Often, this deferred decision was never readdressed. Those with high vaccination rates approached HPV vaccines as a routine part of the age 11 vaccine bundle, unequivocally recommended it to parents, and framed the conversation as one about cancer prevention.

“Emphasis on cancer prevention and concurrent administration with other routine childhood vaccines has the potential to dramatically reduce missed opportunities occurring among well- intentioned providers and parents,” explained lead author Rebecca Perkins, MD, MSc, assistant professor of Obstetrics and Gynecology at BUSM and a gynecologist at Boston Medical Center.

The researchers interviewed 124 parents and 37 health-care providers at four clinics between September 2012 and August 2013. Parents and providers were asked to discuss their reasons why their HPV vaccine eligible girls did or did not ultimately receive the vaccine. Remarkably, the most common parental reason (44 percent) was that their child was never offered the vaccine. Other common reasons included the perception that the vaccination was optional instead of recommended or being told by their provider that it was unnecessary prior to sexual debut. Among those that declined the vaccine, the rationale often involved safety concerns and a belief that their daughters were too young to need it.

About HPV

A common and deadly cancer—12,000 women are diagnosed and 4,000 will die from it annually—cervical cancer is unique in that it is the only cancer that can be prevented by a vaccine. HPV causes not only cervical, vaginal and vulvar cancers in women, but penile cancers in men, as well as cancers of the mouth, tongue, tonsils and anus in men and women. The same viral strains are responsible for most of these cancers, and are covered by currently available vaccines.

Cervical cancer arises from abnormal cells on the cervix, known as cervical dysplasia; the majority of dysplasia arises from HPV strains numbered 16 and 18. The HPV vaccine, in turn, prevents 98 percent of cases caused by strains 16 and 18. Despite this evidence, HPV vaccination rates for girls lag far behind that of other types of vaccination; only 54 percent of eligible girls will ever get one of the three required doses, whereas only 33 percent will ever complete the entire sequence. This lag in uptake stems, in large part, from unfounded concerns about vaccine safety promulgated in popular media and, because HPV is transmitted sexually, parental / provider discomfort when contemplating a child’s future sexuality.  The HPV vaccine is currently recommended to be administered to girls and boys at ages 11-12, with catch-up vaccination through age 26 for girls and 21 for boys.

Funding for this study was provided by Centers for Disease Control and the American Cancer Society.

Exercise Associated with Reduced Risk of Breast Cancer in African American Women

August 15th, 2014 in 2014, Health & Medicine, News Releases, School of Medicine 0 comments

FOR IMMEDIATE RELEASE, August 13, 2014

Contact: Gina DiGravio, 617-638-8480, gina.digravio@bmc.org

(Boston)—Regular exercise, including brisk walking, is associated with a decrease in the incidence of breast cancer in African American women. In a recently published study in Cancer Epidemiology, Biomarkers & Prevention, researchers from Boston University’s Slone Epidemiology Center found strong evidence linking physical exercise to a lower rate of breast cancer in African American women, a group in which previous evidence has been lacking.

In a large prospective study of the health of black women, the Black Women’s Health Study (BWHS), researchers collected information about exercise habits, such as time spent exercising per week and type of exercise. They followed more than 44,000 African American women over a span of 16 years and observed whether they developed breast cancer.

They found that women who exercised vigorously for seven or more hours each week were 25 percent less likely to develop breast cancer, compared to those who exercised less than one hour each week. Examples of vigorous activity include basketball, swimming, running and aerobics. The results were similar if women walked briskly, but there was no benefit for walking at normal pace. The results did not differ by the estrogen receptor status of the breast cancer

Lynn Rosenberg, ScD, professor of Epidemiology at Boston University School of Public Health and principal investigator of the Black Women’s Health Study, states, “Although expert review panels have accepted a link between physical exercise and breast cancer incidence, most study participants have been white women. This is the first large scale study to support that vigorous exercise may decrease incidence of breast cancer in African American women.”

Funding for this study was provided by the National Cancer Institute (grants CA058420 and UM1 CA164974).

Researchers Identify a Mechanism That Stops Progression of Abnormal Cells Into Cancer

August 15th, 2014 in 2014, Health & Medicine, News Releases, School of Medicine 0 comments

Contact: Gina DiGravio, 617-638-8480, gina.digravio@bmc.org

(Boston)– Researchers from Boston University School of Medicine (BUSM) report that a tumor suppressor pathway, called the Hippo pathway, is responsible for sensing abnormal chromosome numbers in cells and triggering cell cycle arrest, thus preventing progression into cancer.

Although the link between abnormal cells and tumor suppressor pathways—like that mediated by the well known p53 gene—has been firmly established, the critical steps in between are not well understood.  According to the authors, whose work appears in Cell, this work completes at least one of the missing links.

Normal human cells contain 23 pairs of chromosomes, but this number doubles to 46 pairs as a cell prepares to divide. At the end of a normal cell division cycle, these chromosomes evenly divide to produce two identical cells with 23 pairs of chromosomes each. Sometimes, however, errors occur during division and cells fail to divide properly, resulting in giant cells with double the number of chromosomes, known as a tetraploid cells. Normally, p53 dependent pathways stop these tetraploid cells from proliferating. This response is critical because those tetraploid cells that escape detection can facilitate cancer development: Recent studies suggest that as many as 40% of all solid tumors have passed through a tetraploid stage at some point during their development. Thus, there has been great interest in understanding how a cell “knows” it has a tetraploid complement of chromosomes and is in need of tumor suppression.

Using a technique known as genome-wide screening, the scientists systematically depleted every human gene from tetraploid cells in order to discover which ones were important to prevent proliferation.  They found that when one specific gene, LATS2, was eliminated, the arrested tetraploid cells resumed proliferation, thus demonstrating that LATS2 was an upstream gene responsible for halting abnormal cell division. The LATS2 gene is known to activate the Hippo tumor suppressor pathway, which is the same pathway our bodies use to ensure our vital organs don’t grow out of control. Now, the authors demonstrate that the Hippo pathway also represents the underlying pathway that prevents tetraploid cells from proliferating and causing tumors. “Although more studies are needed to further clarify this critical pathway, this work may help guide the development of new therapies that specifically target tumor cells with abnormal numbers of chromosomes, while sparing the normal healthy cells from which they originated,” explained corresponding author Neil J. Ganem, PhD, Assistant Professor of Pharmacology and Medicine in the Shamim and Ashraf Dahod Breast Cancer Research Laboratories at BUSM.

Funding for this study was provided in part by a K99/R00 from the National Cancer Institute.

New Research from Boston and Duke Universities Offers New Hope for HIV Vaccine Development

August 13th, 2014 in 2014, Health & Medicine, News Releases, School of Medicine 0 comments

BUSM Contact: Gina DiGravio, 617-638-8480, gina.digravio@bmc.org

Duke Contact: Sarah Avery, 919-660-1306, sarah.avery@duke.edu

(Boston)- In a scientific discovery that has significant implications for HIV vaccine development, collaborators at the Boston University School of Medicine (BUSM) and Duke University School of Medicine have uncovered novel properties of special HIV antibodies. The paper, published in Host Cell and Microbe, describes how some HIV antibodies experience an unusual type of mutation, a phenomenon that allows them to neutralize many different strains of HIV. These antibodies are called “broadly neutralizing antibodies,” or BNAbs.

Antibodies develop from immune cells known as B cells. When B cells are confronted with foreign elements (known as antigens), some of them experience a high rate of mutations resulting in the substitution of an amino acid within the antibody for another. B cells whose antibodies carry variations that allow them to bind tightly with antigens proliferate, whereas those that do not die off. Thus, the immune system is able to adapt constantly by utilizing its own very fast version of evolution. More rarely, the antibodies will experience more dramatic changes than single amino acid substitutions. When whole strings of amino acids are inserted or deleted, this is known as an indel. Less than four percent of human antibodies contain indels; in BNAbs this figure is more than 50 percent. Only a small subset of HIV-infected individuals produce BNAbs.

Comparing the antibody genes of HIV infected and non-infected individuals, scientists discovered that HIV infected individuals had 27 percent more insertions and 23 percent more deletions than non-infected individuals. They also found this elevated rate of mutation persisted in all HIV-infected individuals, regardless of their ability to produce BNAbs. Most importantly, this high rate of indels was due to an overall increase in mutation frequency rather than something special associated with HIV itself, or unusual characteristics of the people who are able to make BNAbs. “This result suggests that a BNAb-eliciting vaccine is possible after all,” explained lead and corresponding author Thomas B. Kepler, PhD, professor of microbiology at BUSM. “More than 80 percent of indels were found in genetic regions responsible for binding to the HIV virus,” he added.

Since the BNAb indels don’t result from special characteristics of the people who make them, the researchers suspected that the indels may be important for the antibody function. They  studied one particular BNAb called CH31, which has a very large indel, to see what role these indels might have played in the acquisition of broad neutralizing activity. They found that the indel was the key event in the development of CH31. According to the researchers just putting the indel into antibodies that did not originally have it, increased its effectiveness eight-fold; taking it away from ones that did have it initially, made them much worse. “When tested on their ability to broadly neutralize HIV, only those CH31 antibodies with indels were able to accomplish the task,” said Kepler.

Barton Haynes, MD, director of the Duke Human Vaccine Institute and senior author noted, The more we understand about the unusual pathway the BNAbs take to develop, the better chance we will have in inducing them. This news study unravels a particularly complex BNAb pathway.”  The great hope in the quest to prevent HIV-1 is the development of a single vaccine that can cover multiple forms of HIV-1. A vaccine that works by eliciting BNAbs is a major goal, and this new work suggest that strategies for such a vaccine should focus on speeding up the antibody evolution that occurs after every immunization. The study suggests that such a strategy could work in everyone, not just a lucky few.

Other institutions involved in this study included the National Institute for Communicable Diseases, Sandringham, Johannesburg, South Africa; the Center for AIDS Program of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa; the Vaccine Research Center, NIAID, NIH, Bethesda, MD and Stanford University Medical Center, Stanford, CA

Funding for this study was provided by the National Institutes of Allergy and Infectious Diseases.

Common Chemical in Mothers May Negatively Affect the IQ of Their Unborn Children

August 6th, 2014 in 2014, Health & Medicine, News Releases, School of Medicine 0 comments

FOR IMMEDIATE RELEASE, August 5, 2014

Contact: Gina DiGravio, 617-638-8480, gina.digravio@bmc.org

(Boston)–In some women abnormally high levels of a common and pervasive chemical may lead to adverse effects in their offspring. The study, published recently in the Journal of Clinical Endocrinology & Metabolism, is the first of its kind to shed light on the possible harmful side effects of perchlorate in mothers and their children.

Using data from the Controlled Antenatal Thyroid Study (CATS) cohort, researchers at Boston University School of Medicine (BUSM) and Cardiff University studied the effect of perchlorate, an environmental contaminant found in many foods and in some drinking water supplies, and its effects on children born to mothers with above average levels of this substance in their system. They studied 487 mother-child pairs from women with underactive thyroid glands and in the 50 women with the highest levels of perchlorate in their body, their offspring had below average IQ levels when compared to other children.

“The reason people really care about perchlorate is because it is ubiquitous.  It’s everywhere,” said Elizabeth Pearce, MD, MSc, associate professor of medicine at BUSM. “Prior studies have already shown perchlorate, at low levels, can be found in each and every one of us.”

Perchlorate is a compound known to affect the thyroid gland, an organ needed to help regulate hormone levels in humans. According to Pearce previous studies have attempted to implicate this anti-thyroid activity in pregnant mothers as a possible cause of hypothyroidism, or an underactive thyroid gland. Hypothyroidism in newborns and children can lead to an array of unwelcome side effects, including below average intelligence.

Funding for the original CATS study was provided by the Wellcome Trust and Compagnia de San Paulo, Turin.

RESEARCHERS IDENTIFY POTENTIAL GENE THAT MAY INCREASE RISK OF ALZHEIMER’S DISEASE IN AFRICAN AMERICANS

August 4th, 2014 in 2014, Health & Medicine, School of Medicine 0 comments

FOR IMMEDIATE RELEASE, August 4, 2014

Contact: Gina DiGravio, 617-638-8480, gina.digravio@bmc.org

 

 RESEARCHERS IDENTIFY POTENTIAL GENE THAT MAY INCREASE RISK OF ALZHEIMER’S DISEASE IN AFRICAN AMERICANS

 

(Boston)– Researchers from Boston University School of Medicine (BUSM) report that two rare variants in the AKAP9 gene significantly increase the risk of Alzheimer’s disease (AD) in African-Americans.

 

This previously unknown association furthers the understanding of the role of genetic factors in the development of AD, according to the researchers, whose findings appear in Alzheimer’s & Dementia.

 

AD is the most frequent age-related dementia affecting 5.4 million Americans including 13 percent of people age 65 and older and more than 40 percent of people age 85 and older. Up to 75 percent of AD cases are thought to have a genetic basis; however the specific genes involved likely differ between ethnic populations.  The most well-known AD risk gene, APOE4, does not play as strong a role in AD risk in African Americans as it does in Caucasians, despite the fact that a higher proportion of African Americans than Caucasians are afflicted with this disorder.

 

By analyzing the DNA sequence for all genes from participants of the Multi-Institutional Research on Alzheimer Genetic Epidemiology (MIRAGE) Study and Genetic and Environmental Risk Factors for Alzheimer’s Disease among African Americans (GenerAAtions) Study, researchers identified two genetic variants in AKAP9 unique to African Americans that are enriched in individuals with AD. They then confirmed this association in several thousand other African American subjects in the Alzheimer Disease Genetics Consortium dataset. Carriers of either of these AKAP9 variants have a respective 2.8 and 3.6 times greater risk of developing AD.

 

According to the researchers AKAP9 encodes a protein with multiple forms, One of these, AKAP450, is expressed in the brain and responsible for microtubule anchoring and organization.  Another protein, tau, which is responsible for microtubule functioning is well known to be the key constituent of neurofibrillary tangles that accumulate in AD brains. “While further work is needed to clarify the causal link between these AKAP9 variants and AD, “this study indicates a new potential disease mechanism in the quest for a better understanding of AD, particularly in African Americans,” explained senior author Lindsay Farrer, PhD, Chief of Biomedical Genetics and professor of medicine, neurology, ophthalmology, epidemiology and biostatistics at BUSM. “Moreover, this is the first authentic example of rare genetic variants conferring a high risk of AD in African Americans,” he added.

 

Funding for this study was provided by the National Institute on Aging (R01-AG025259, R01-AG09029, P30-AG13846, and U01-032984)