Filipin Levels as Potential Predictors of Alzheimer’s Disease Risk

To date, therapies to prevent or treat Alzheimer's disease (AD) have largely focused on removing excess aggregation-prone amyloid peptide Aβ from the brain, an approach that has produced dis-appointing clinical outcomes. An alternative hypothesis proposes that Aβ production and aggrega-tion is a symptom of a larger, systemic disease affecting the regulation of lipids, including choles-terol. In this scenario, lipid dysregulation would likely occur early in the disease process, making it an ideal target for predicting risk of mild cognitive impairment (MCI) to AD conversion. Here, we report that levels of filipin, a fluorescent polyene macrolide widely used as a diagnostic tool for diseases of lipid dysregulation, correlate with cellular damage caused by 27-hydroxycholesterol and with dementia status in human peripheral blood cells. These results provide strong prelimi-nary data suggesting that filipin could be of use in the development of a quick and inexpensive method to measure the risk of AD conversion in patients with MCI, supplementing existing testing strategies that focus on the consequences of Aβ accumulation.