bioRxiv · 10.1101/2025.01.02.631098
Sex-specific Associations of Gene Expression with Alzheimer's Disease Neuropathology and Ante-mortem Cognitive Performance
Abstract
The biological mechanisms underlying womens increased Alzheimers disease (AD) prevalence remain undefined. Previous case/control studies have identified sex-biased molecular pathways, but sex-specific relationships between gene expression and AD endophenotypes, particularly sex chromosomes, are underexplored. With bulk transcriptomic data across 3 brain regions from 767 decedents, we investigated sex-specific associations between gene expression and post-mortem {beta}-amyloid and tau as well as antemortem longitudinal cognition. Of 23,118 significant gene associations, 10% were significant in one sex and not the other (sex-specific). Most sex-specific gene associations were identified in females (73%) and associated with tau tangles and longitudinal cognition (90%). Four X-linked genes, MCF2, HDAC8, FTX, and SLC10A3, demonstrated significant sex differences in their associations with AD endophenotypes (i.e., significant sex x gene interaction). Our results also uncovered sex-specific biological pathways, including a female-specific role of neuroinflammation and neuronal development, reinforcing the potential for sex-aware analyses to enhance precision medicine approaches in AD.
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Seto, M., Clifton, M., Gomez, M. L., Coughlan, G., Gifford, K. A., Jefferson, A. L., De Jager, P., Bennett, D. A., Wang, Y., Barnes, L. L., Schneider, J. A., Hohman, T. J., Buckley, R. F., Dumitrescu, L.. 2025-01-02. Sex-specific Associations of Gene Expression with Alzheimer's Disease Neuropathology and Ante-mortem Cognitive Performance. https://doi.org/10.1101/2025.01.02.631098
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