RT Journal Article SR Electronic T1 Leveraging selective hippocampal vulnerability among Alzheimer’s disease subtypes reveals a novel tau binding partner SERPINA5 JF bioRxiv FD Cold Spring Harbor Laboratory SP 2020.12.18.423469 DO 10.1101/2020.12.18.423469 A1 Angela M. Crist A1 Kelly M. Hinkle A1 Xue Wang A1 Christina M. Moloney A1 Billie J. Matchett A1 Sydney A. Labuzan A1 Isabelle Frankenhauser A1 Nkem O. Azu A1 Amanda M. Liesinger A1 Elizabeth R. Lesser A1 Daniel J. Serie A1 Zachary S. Quicksall A1 Tulsi A. Patel A1 Troy P. Carnwath A1 Michael DeTure A1 Xiaojia Tang A1 Ronald C. Petersen A1 Ranjan Duara A1 Neill R. Graff-Radford A1 Mariet Allen A1 Minerva M. Carrasquillo A1 Hu Li A1 Owen A. Ross A1 Nilufer Ertekin-Taner A1 Dennis W. Dickson A1 Yan W. Asmann A1 Rickey E. Carter A1 Melissa E. Murray YR 2020 UL http://biorxiv.org/content/early/2020/12/20/2020.12.18.423469.abstract AB Selective vulnerability is a central concept to the myriad of devastating neurodegenerative disorders. Although hippocampus and cortex are selectively vulnerable in Alzheimer’s disease (AD), the degree of involvement lies along a spectrum that we previously defined as AD subtypes revealing distinct clinical correlates. To operationalize heterogeneity of disease spectrum, we classified corticolimbic patterns of neurofibrillary tangles to capture extreme and representative phenotypes. We combined bulk RNA sequencing with digital pathology to examine hippocampal vulnerability in AD. Using a multidisciplinary approach, we uncovered disease-relevant hippocampal gene expression changes. Biological relevance was prioritized using machine learning and several levels of human validation. This resulted in five genes highly predictive of neuropathologically diagnosed AD: SERPINA5, RYBP, SLC38A2, FEM1B, and PYDC1. Deeper investigation revealed SERPINA5 to be a novel tau binding partner that may represent a “tipping point” in the dynamic maturity of neurofibrillary tangles. Our study highlights the importance of embracing heterogeneity of the human brain to yield promising gene candidates as exampled by SERPINA5.Competing Interest StatementR.C.P. is a consultant for Hoffman-La Roche, Merck, Biogen, Eisai. R.C.P. is on the Data safety and monitoring board for Genentech. N.G.R. takes part in multi-center studies funded by Lilly, Biogen and Abbvie. M.E.M is a consultant for AVID Radiopharmaceuticals.ADAlzheimer’s DiseaseANOVAAnalysis of varianceAUCArea under the curveAβAmyloid-βBpBasepairsBMEbeta-MercaptoethanolCIConfidence intervalDAB3,3′-DiaminobenzidineDAPI4′,6-diamidino-2-phenylindoleFCFold changeFDRFalse discovery rateGOGene ontologyHpSp ADHippocampal sparing subtype of Alzheimer’s DiseaseH&EHematoxylin and eosinLimbic ADLimbic predominant subtype of Alzheimer’s DiseaseMSBBMount Sinai VA Medical Center Brain BankMMSEMini mental state examNFTNeurofibrillary tangleOROdds ratioPBSPhosphate-buffered salinePMSFphenylmethylsulfonyl fluorideRINRNA integrity numberRNA-SeqRNA sequencingROCreceiver operating characteristicTBSTtris-buffered saline with Tween-20Thio-SThioflavin-STypical ADTypical Alzheimer’s Disease