Biotechnology Lead Wendy Nelson on coexistence with ApoE4, the Alzheimer’s disease gene

Written by Katie Cobb | January 20, 2023

By way of a 23andMe take a look at, Wendy Nelson, PhD, found that she carried two copies of the Alzheimer’s illness biomarker ApoE4 – the “Alzheimer’s gene”. It has modified the best way she thinks about mind well being.

When Wendy Nelson, Ph. D., found she carried two copies of the Alzheimer’s illness biomarker ApoE4, a genetic variant related to an elevated threat of Alzheimer’s illness, she drew on her profession in biotechnology to determine what to do subsequent.

When Nelson was older, her grandfather and mom had Alzheimer’s illness, as did her maternal aunt.

“So, my mother was at all times very afraid of getting Alzheimer’s, and he or she positively had it when she was very younger,” she stated, “Being affected person.” The truth is, Nelson’s mom was identified with Alzheimer’s illness in her mid-60s, and Nelson remembers seeing indicators of Alzheimer’s signs earlier than that.

This was her mom’s aspect of the household – however what about her father’s aspect? After her mom dies of Alzheimer’s illness in 2022, Nelson decides to pursue genetic testing. She was curious as as to if she carried any of the genetic biomarkers for Alzheimer’s illness.

There are dozens of genes which were linked to an elevated threat of Alzheimer’s illness. A few of these genes have little impact on an individual’s chance of creating Alzheimer’s illness. Others have so much. One particular genetic variant, referred to as APOE4, has gained a repute because the “Alzheimer’s gene.”

This APOE4 variant doesn’t carry the Alzheimer’s gene. At all times Get sick—however due to a deep skilled background in biotechnology, Nelson felt that the extra she knew about Alzheimer’s dangers, the higher ready she was to make life-style modifications that might stave off Alzheimer’s illness or its signs.

Irrespective of how ready she was for the outcomes, it nonetheless rocked her world. She discovered that not solely had she inherited one copy of the APOE4 variant from her mom’s aspect of the household – she had additionally inherited one copy from her father, making her symmetric APOE4 service.

“I did 23andMe, as lots of people do nowadays, and sadly, it sort of confirmed my worst fears as a substitute of assuaging them,” she instructed Being Affected person on LiveTalk just lately. “I suppose it took me some time to swallow that tablet. However then, I am a scientist, so I am not going to take a seat again and settle for my potential destiny. I wished to know what I might do about it.”

Study extra about how she determined to pursue genetic testing, what the method was like, how she felt when she received her outcomes, and most significantly, what she did subsequent. Watch the complete dialog right hereOr learn a transcript of the dialog under:

Be affected person: I’ve intentionally sought to grasp your genetic situation. Inform us a bit bit about that. What went into this determination?

Nelson: Nicely, I am within the biotech business, I’ve a Ph.D. in science, and I have been working within the biotech business for nearly 30 years now. Now, there are issues you are able to do — there are scientific trials and stuff. 5 or 6 years in the past, I did not need to know as a result of there was nothing you would do in case you discovered you had it or had been liable to getting it. They are saying you’ll be able to eat wholesome and you’ll train. I do, however so does my mother. I’ve watched the scientific trial house and I do know that they are attempting to get individuals into scientific trials early on and that being pregnant qualifies you for some scientific trials now. So, that is a part of the explanation I made a decision to seek out out, but it surely was additionally partly as a result of I hoped to solely carry one. I hoped it might assist relieve a number of the stress and concern I carried with me, and sadly, it backfired. I discovered I used to be carrying two, and that was earlier than my dad went down that street. I did 23andMe, as lots of people do nowadays, and sadly, it sort of confirmed my worst fears as a substitute of assuaging them.

Be affected person: For individuals who have not had their genetic testing, how did you discover this info on 23andMe?

Nelson: they ship you an incredible report with every kind of attention-grabbing details about 1,000,000 different issues then it has an ApoE4 variant. You say you carry ApoE4 and have a considerably elevated threat of creating Alzheimer’s illness, and I am like, “Uh, crap.” It is as clear as day, and there is a complete massive web page on it.

Be affected person: Being in biotech, you might be nicely versed in genetics, maybe greater than the common individual. However, you had two copies of ApoE4, not one, and also you did not count on that. So how did you course of that info, and the way did you cope with it?

Nelson: It is very irritating and irritating and irritating at first. I suppose it took me some time to swallow that tablet. However then, I am a scientist, so I am not going to take a seat again and settle for my potential destiny. I wished to know what I might do about it. So, I did some extra analysis alone, on what you are able to do. I went on a low stage of rosuvastatin to cut back my ldl cholesterol. There are increasingly hyperlinks between ldl cholesterol buildup and Alzheimer’s illness, which is understood to be extra helpful for youthful individuals. Simply issues like that.

I suppose it took me some time to swallow that tablet.
However then, I am a scientist, so I am not simply going to take a seat round
Return and settle for my potential destiny. I wished to
Discover out what I can do about it.”

Be affected person: You talked about scientific trials — have you ever joined any scientific trials for individuals who do not have Alzheimer’s illness however have a genetic variant?

Nelson: I’ve received my eyes on some corporations. There’s a very attention-grabbing firm referred to as Alzheon. Right here within the Boston space, they’ve glorious knowledge on stage 2 Alzheimer’s sufferers for what oral tablet would assist in the early levels. It helps forestall oligomerization from occurring within the first place and, hopefully, prevents tau tangles and amyloid plaque buildup from occurring within the first place. They only signed up for his or her Section 3 trial in sufferers, and the primary learn must be in mid-2024. If they’ve good strong knowledge, they will open it as much as carriers like me in 2025. So I am watching corporations like which have potential new issues coming their means. To work. There’s additionally an organization referred to as Cognito Therapeutics that I am watching in San Francisco. That is fully completely different – it is like a digital actuality headset that stimulates the auditory and sensory results of seen mild. It appears to interrupt down these build-ups in your thoughts. So, I’ve received my eyes set on the issues I might be very happy to strive. So, I will be completely concerned when corporations like this open up their experiences to carriers.

Be affected person: Sure, we have already coated these two corporations. I need to discuss to you a bit bit extra in regards to the science behind this as a result of, as a PhD, you clearly know greater than the common individual. Are you able to inform us a bit bit about what you recognize about ApoE4, its interplay with ldl cholesterol, and why individuals with this gene variant are likely to do issues unsuitable versus somebody who would not have this gene?

Nelson: It is a recognized biomarker, proper? That is positively an indication of a transparent hyperlink between excessive ldl cholesterol and Alzheimer’s illness. Subsequently, nobody is aware of the precise biology of Alzheimer’s illness, so loads of it’s hypothesis. However, issues just like the biomarker ApoE4 have been discovered time and time once more to be an apparent hyperlink. So, for this reason something you are able to do to maintain your ldl cholesterol low, which is clearly heart problems as nicely, can solely be good for you and your mind.

Be affected person: Studying about mind well being additionally means understanding how organic methods are related. That is most likely the best option to perceive what threat elements are in your thoughts, proper?

Nelson: Every part within the human physique is related in a technique or one other. You are able to do all the fitting issues and nonetheless get a illness like Alzheimer’s due to a bunch of unhealthy genetic playing cards you had been dealt.

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There are loads of correlations and indicators that issues are threat elements. However even when you do not have these threat elements, you would develop Alzheimer’s illness. And even when you’ve got all the threat elements, you will not essentially develop Alzheimer’s illness. So, there may be additionally some genetic predisposition and luck thrown into the combo.

Be affected person: Discovering out whether or not plaque could also be current within the mind is a step additional than discovering your genetic situation. Wish to strive the blood checks coming to market to seek out out?

Nelson: Actually, I do not know if I need to know but. I have never performed it but as a result of, as everyone knows, harm to your mind begins 15 or extra years earlier than you’ve got signs. I do not need to know if my years actually counted. If I needed to discover out if I needed to take this take a look at to get right into a scientific trial that I assumed was actually promising, that is after I would discover out.

Be affected person: inform us a bit bit about how issues have modified. Are you doing issues in another way than you probably did prior to now that you recognize you’ve got ApoE4?

Nelson: To some extent, however no more than we must always all be doing anyway, and that’s residing every day to its best potential. I’ve seen my dad and mom make the error of placing the whole lot off till their retirement. You already know, I’ve heard this excuse over and over: “Oh, I might prefer to go there. We’ll do this once we retire.” Then, by the point my dad retired, he’d retired to deal with my mother, so it was too late. So, I can’t make this error. I am simply attempting to do what I need to do now as time permits. I am additionally attempting to observe the Alzheimer’s illness house extra actively and see what I can do for myself and my household. However once more, all of us need to stay as wholesome a life as doable. So, I might say it is a bit bit completely different, however not that a lot.

Be affected person: what would you say to these people who find themselves already contemplating genetic testing? Do you advise them to take action or not?

Nelson: It depends upon their character. Some individuals, when you’ve got the mindset that it’ll allow you to analysis potential scientific trials or assist your self, then by all means, go and do it. If it’ll sit in your shoulders and burden you for the remainder of your years, cease till there’s one thing you recognize and extra medication are available on the market. Folks ought to wait till they’re in the fitting mindset and really feel there may be sufficient hope to know that there isn’t a such burden for them and attempt to do one thing about it.

This interview has been edited for size and readability.

Katie Cobb is a author and theater artist primarily based in Raleigh, NC.

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