PROJECT SUMMARY
Alzheimer’s disease (AD) is sexually dimorphic in its prevalence, incidence, symptomology, and neuropathology,
but the mechanisms underlying these sex differences are not well understood. While sex differences in
susceptibility to inflammation and AD progression have been reported, the relationship between neuro and
systemic inflammation and sex differences remains understudied. Our preliminary single-nucleus genomic
analyses have identified sex-specific microglial gene signatures in AD patient brains. Single-cell transcriptomic
data analysis of human peripheral blood mononuclear cells (PBMCs) implies that multiple sex-specific, candidate
pro-inflammatory genes highly overexpressed in myeloid-derived suppressor cells (MDSCs) and other immune
cell types in AD. We therefore posit that an interplay between microglia and systematic inflammatory
mechanisms (termed the “Microglial activation and inflammatory endophenotypes”) exists and that
understanding this system will be essential to improve the mechanistic elucidation of AD pathogenesis and
therapeutic development in a sex-specific manner. Recent advances of multimodal single-cell genomic and
epigenomic analyses have shed insights into a comprehensive understanding of the neuro-immune and
peripheral immune systems underlying sex differences in AD. Integration of the single-cell transcriptome,
epigenome, the human interactome, along with large-scale AD genetic loci and functional genomic data from
existing diverse AD cohorts are essential for such identification. To address this hypothesis, our short-term goal
is to identify next-generation immune modulators for AD sex differences and molecularly targeted treatment
development in both male and female patients with AD. We will leverage large-scale single-cell genomic and
epigenomic data generated from human brains and bloods with varying degrees of AD pathology available at
our National Institute of Aging (NIA)-funded Alzheimer's Disease Research Centers (ADRCs). Aim 1 will test the
hypothesis that microglial activation and central neuro-immune transcriptional networks mediate sex differences
in AD using single-nucleus genomic (snRNA-seq) and epigenomic (snATAC-seq) analyses of human frozen
brain tissues. In parallel, we will utilize network-based, integrative analyses of snRNA-seq and snATAC-seq data
from human frozen brains and large-scale genetic and functional genomic data from existing AD cohorts with
diverse population to identify glial cell type-specific promoters and enhancers that encode sex-specific master
gene regulatory networks for AD. Aim 2 will test the hypothesis that cell type-specific peripheral immune
signatures and interactome network changes in AD pathogenesis and progression act in a sex-specific manner.
In summary, our project will identify clinically actionable immune molecular mechanisms underlying sex
differences in AD pathobiology from the central neuro-immune and peripheral immune systems. The successful
completion of this project will advance the understanding of sex difference in AD and serve as the foundation for
future translational studies to inform the development of precision medicine in a sex-specific manner.