RESUMO
Alzheimer's disease (AD) is the most common form of progressive dementia in the elderly. It is a neurodegenerative disorder characterized by the neuropathologic findings of neurofibrillary tangles and amyloid plaques that accumulate in vulnerable brain regions. AD etiology has been studied by many groups, but since the discovery of the APOE epsilon4 allele, no further genes have been mapped conclusively to late-onset AD (LOAD). In this study, we examined genetic association with LOAD susceptibility in 738 Caucasian families (4,704 individuals) and an independent case-control dataset with 296 cases and 566 controls exploring 11 candidate genes (47 SNPs common to both samples). In addition to tests for main effects and haplotypes, the MDR-PDT was used to search for gene-gene interactions in the family data. We observed significant haplotype effects in ACE in family and case-control samples using standard and cladistic haplotype models. ACE was also part of significant 2 and 3-locus MDR-PDT joint effects models with Alpha-2-Macroglobulin (A2M), which mediates the clearance of Abeta, and Leucine-Rich Repeat Transmembrane-3 (LRRTM3), a nested gene in Alpha-3 Catenin (CTNNA3) which binds Presenilin-1. This result did not replicate in the case-control sample, and may not be a true positive. These genes are related to Abeta clearance; thus this constellation of effects might constitute an axis of susceptibility for LOAD. The consistent ACE haplotype result between independent family-based and unrelated case-control datasets is strong evidence in favor of ACE as a susceptibility locus for AD, and replicates results from several other studies in a large sample.