Alzheimer disease (AD) is the most common neurodegenerative disease worldwide and cases are expected to increase 3-fold over the next 40 years.
1 The most common form of AD is the late-onset form, which typically develops after 60 years of age. The etiological factors of late-onset AD are not yet completely understood but include genetic, environmental, and lifestyle factors that influence a person’s risk for developing the disease.
2 Although there is a growing list of AD susceptibility genes, only having an apolipoprotein E4 (
APOE4) allele has a relatively strong effect (relative risk approximately 2-3), and, cumulatively, the more than 10 genes identified thus far account for only less than half of AD cases.
3 To our knowledge, few studies have explored the potential of environmental exposures to contribute to AD, but occupational exposure to metals, solvents, and pesticide is reported to be a potential environmental contributor.
4,5 Previously, we reported that serum levels of p,p’-dichlorodiphenyldichloroethylene (DDE), a metabolite of the organochlorine pesticide dichlorodiphenyltrichloroethane (DDT), were significantly higher in a small cohort (n = 20) of patients with AD compared with control participants, and that there was a significant association between DDE levels and a diagnosis of AD.
6 In the present study, we evaluated the associations between serum DDE levels, AD, and Mini-Mental State Examination (MMSE) scores in a larger number of cases and control participants from 2 geographical sites, and we explored differential susceptibility by
APOE4 genotype status. We also examined the relationship between brain and serum levels of DDE and whether DDT or DDE alters the expression of the amyloid precursor protein (APP) in cultured neuronal cells.