Child and adult Metal exposures, gene expression and neuropathologically confirmed Alzheimer's Disease - We propose to study the relation between early childhood and late life exposure to metals and
neuropathological Alzheimer’s Disease and Related Dementias (ADRD) as well as clinical dementia, and
whether early life metal exposures modify effects of late life metal exposures in a large, racially diverse
population that will allow us to look separately by race and sex. We will also assess the relation between metal
exposures and brain mRNA profiles (gene expression) and their possible relation to neuropathological ADRD
and dementia, focusing, in particular, on AD-related genes found to be modified by early life lead exposure in
animal studies. We will conduct this work in a population of decedents from autopsy centers in Brazil that see
over 5,000 decedents per year as part of a government mandate to conduct autopsies resulting in a general
population sample. We will leverage another ongoing study (PARDoS) that is collecting biomaterial from
decedents to conduct whole genome sequencing and extensive neuropathology. Additional data is collected
from knowledgeable informants including clinical dementia rating. For the current study, we will additionally
collect bone, teeth, and additional brain tissue from 1,000 of the PARDoS decedents split equally among White
and Black/Mixed race, and male and female decedents over 65 years of age. Early childhood exposure to
several metals will be assessed by measuring metals in the teeth (using laser-ablation inductively coupled
plasma mass spectrometry). Late life metal exposures will be assessed using X-Ray Fluorescence to measure
metals in the bone samples. Brain tissue (frontal cortex) will be analyzed for mRNA expression levels. This
Brazilian autopsy setting provides a unique opportunity that will allow us to leverage an ongoing study that is
documenting neuropathology and clinical dementia, as well as performing whole genome sequencing, to have
individual-level biomarkers of early life and late life metal exposures as well as brain gene expression data.
This study setting allows us to have an unprecedented ability to examine whether early life metal exposures are
related to ADRD—a hypothesis suggested for metals exposure from animal research, but extremely hard to
test in humans without the biomarker of such early exposure that the teeth collected at autopsy can provide.
Similarly, while some human literature exists suggesting a role for adult metal exposures in dementia risk,
virtually none exists using individual biomarkers of cumulative exposure that our excised bone samples will
provide, and none look at neuropathology.