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We found evidence of late-onset Alzheimer disease (LOAD)-associated genetic polymorphism within an exon of Mucin 6 (MUC6) and immediately downstream from another gene: Adaptor Related Protein Complex 2 Subunit Alpha 2 (AP2A2). PCR analyses on genomic DNA samples confirmed that the size of the MUC6 variable number tandem repeat (VNTR) region was highly polymorphic. In a cohort of autopsied subjects with quantitative digital pathology data (n = 119), the size of the polymorphic region was associated with the severity of pTau pathology in neocortex. In a separate replication cohort of autopsied subjects (n = 173), more pTau pathology was again observed in subjects with longer VNTR regions (p = 0.031). Unlike MUC6, AP2A2 is highly expressed in human brain. AP2A2 expression was lower in a subset analysis of brain samples from persons with longer versus shorter VNTR regions (p = 0.014 normalizing with AP2B1 expression). Double-label immunofluorescence studies showed that AP2A2 protein often colocalized with neurofibrillary tangles in LOAD but was not colocalized with pTau proteinopathy in progressive supranuclear palsy, or with TDP-43 proteinopathy. In summary, polymorphism in a repeat-rich region near AP2A2 was associated with neocortical pTau proteinopathy (because of the unique repeats, prior genome-wide association studies were probably unable to detect this association), and AP2A2 was often colocalized with neurofibrillary tangles in LOAD. © 2019 American Association of Neuropathologists, Inc.

Citation

Yuriko Katsumata, David W Fardo, Adam D Bachstetter, Sergey C Artiushin, Wang-Xia Wang, Angela Wei, Lena J Brzezinski, Bela G Nelson, Qingwei Huang, Erin L Abner, Sonya Anderson, Indumati Patel, Benjamin C Shaw, Douglas A Price, Dana M Niedowicz, Donna W Wilcock, Gregory A Jicha, Janna H Neltner, Linda J Van Eldik, Steven Estus, Peter T Nelson. Alzheimer Disease Pathology-Associated Polymorphism in a Complex Variable Number of Tandem Repeat Region Within the MUC6 Gene, Near the AP2A2 Gene. Journal of neuropathology and experimental neurology. 2020 Jan 01;79(1):3-21

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PMID: 31748784

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