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Alzheimer's & dementia : the journal of the Alzheimer's Association
Published

APOE ɛ4 carriership determines a faster plasma p-tau217 progression in Aβ-positive individuals

Authors

Marcel S Woo, Arthur C Macedo, Seyyed Ali Hosseini, Joseph Therriault, Yi-Ting Wang, Nesrine Rahmouni, Étienne Aumont, Stijn Servaes, Cécile Tissot, Jaime Fernandez-Arias, Lydia Trudel, Brandon Hall, Gleb Bezgin, Kely Quispialaya-Socualaya, Marina Goncalves, Tevy Chan, Jenna Stevenson, Yansheng Zheng, Robert Hopewell, Stuart Mitchell, Firoza Z Lussier, Alzheimer's Disease Neuroimaging Initiative (ADNI), Paolo Vitali, Gassan Massarweh, Jean-Paul Soucy, Andréa L Benedet, Serge Gauthier, Henrik Zetterberg, Kaj Blennow, Tharick A Pascoal, Pedro Rosa-Neto

Abstract

Alzheimers Dement. 2025 Dec;21(12):e71048. doi: 10.1002/alz.71048.

ABSTRACT

INTRODUCTION: It is unclear whether the different Alzheimer's disease (AD) progression trajectories of apolipoprotein E (APOE) ɛ4 carriers is reflected by blood phosphorylated tau (p-tau) analytes.

METHODS: We assessed longitudinal trajectories in plasma p-tau181, 217, and 231, in amyloid beta-positive (A+) and negative (A-) APOE ɛ4 carriers (E+) or non-carriers (E-). We included 2039 participants from the observational Translational Biomarkers in Aging and Dementia (TRIAD) and Alzheimer's Disease Neuroimaging Initiative cohorts, categorized into 840 A-E-, 251 A-E+, 386 A+E4-, and 616 A+E4+. Longitudinal data were available for 1045 participants.

RESULTS: In TRIAD, ALZpath p-tau217 (β = 0.45, p = 0.02) and p-tau217+Janssen (β = 0.67, p = 0.002), and in ADNI p-tau217 (β = 0.90, p = 0.002) increased faster in A+E4+. This was not the case in E- or A- individuals or for p-tau181 and p-tau231.

DISCUSSION: These findings suggest p-tau217 as a marker of faster progression in APOE ɛ4 carriers, highlighting its potential in disease stratification.

HIGHLIGHTS: Blood phosphorylated tau (p-tau)217 increases faster in apolipoprotein E (APOE) ɛ4 carriers with amyloid pathology. p-tau181 and p-tau231 do not increase faster in APOE ɛ4 carriers. APOE ɛ4 carriership does not change p-tau in individuals without amyloid pathology.

PMID:41451854 | DOI:10.1002/alz.71048

UK DRI Authors

Profile picture of Henrik Zetterberg

Prof Henrik Zetterberg

Group Leader

Pioneering the development of fluid biomarkers for dementia

Prof Henrik Zetterberg