Title Plasma Repressor Element 1-Silencing Transcription Factor Levels Decrease in Patients With Alzheimer's Disease
Abstract Background: Repressor element 1-silencing transcription/neuron-restrictive silencer factor (REST) was considered as a new therapeutic target for neurodegenerative disorders like Alzheimer’s disease (AD). However, the relationships between AD and REST remain unclear. This study aimed to 1) examine plasma REST levels and REST gene AD patients, and 2) further explore the pathological relationships between REST protein levels and cognition decline in clinic, including medial temporal-lobe atrophy. Methods: Subjects (n=252, mean age 68.95±8.78 years old) were recruited in Beijing, China, and then divided into normal cognition (NC) group (n=89), amnestic mild cognitive impairment (aMCI) group (n=79) and AD group (n=84) according to diagnostic criteria. All subjects received neuropsychological assessments, laboratory tests and neuroimaging scans (MRI) at baseline. Plasma REST protein levels and distribution of the single-nucleotide polymorphisms (SNPs) of REST were compared across the three groups. Correlation between cognitive function, neuro-image and REST level was calculated using multi-linear-regression analysis. medial temporal-lobe atrophy (need to add this method). Results: The plasma REST levels in both NC group (430.30±303.43) and aMCI group (414.27±263.39) were significantly higher than AD group ( NC vs AD, p=0.034; aMCI vs AD, p=0.033). There was no significant difference between NC and aMCI group (p=0.948). There was no significant difference among three groups on the distribution of the genotype distribution of Rs2227902 and Rs3976529 of REST gene. The REST level was correlated to left medial temporal-lobe atrophy index (r=0.306, p=0.023). After 6-month follow up, the REST level in NC group was positively related to the change scores of mini-mental state examination scale (MMSE) (r=0.289, p=0.02). Conclusion: Plasma REST protein declines in AD patients, which also associated with memory impairment and left temporal-lobe atrophy, which may have potential value for clinical diagnosis of AD.