Large-scale proteome and metabolome analysis of CSF implicates altered glucose and carbon metabolism and succinylcarnitine in Alzheimer's disease

Daniel J. Panyard, Justin McKetney, Yuetiva K. Deming, Autumn R. Morrow, Gilda E. Ennis, Erin M. Jonaitis, Carol A. Van Hulle, Chengran Yang, Yun Ju Sung, Muhammad Ali, Gwendlyn Kollmorgen, Ivonne Suridjan, Anna Bayfield, Barbara B. Bendlin, Henrik Zetterberg, Kaj Blennow, Carlos Cruchaga, Cynthia M. Carlsson, Sterling C. Johnson, Sanjay AsthanaJoshua J. Coon, Corinne D. Engelman

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


INTRODUCTION: A hallmark of Alzheimer's disease (AD) is the aggregation of proteins (amyloid beta [A] and hyperphosphorylated tau [T]) in the brain, making cerebrospinal fluid (CSF) proteins of particular interest. METHODS: We conducted a CSF proteome-wide analysis among participants of varying AT pathology (n = 137 participants; 915 proteins) with nine CSF biomarkers of neurodegeneration and neuroinflammation. RESULTS: We identified 61 proteins significantly associated with the AT category (P < 5.46 × 10−5) and 636 significant protein-biomarker associations (P < 6.07 × 10−6). Proteins from glucose and carbon metabolism pathways were enriched among amyloid- and tau-associated proteins, including malate dehydrogenase and aldolase A, whose associations with tau were replicated in an independent cohort (n = 717). CSF metabolomics identified and replicated an association of succinylcarnitine with phosphorylated tau and other biomarkers. DISCUSSION: These results implicate glucose and carbon metabolic dysregulation and increased CSF succinylcarnitine levels with amyloid and tau pathology in AD. Highlights: Cerebrospinal fluid (CSF) proteome enriched for extracellular, neuronal, immune, and protein processing. Glucose/carbon metabolic pathways enriched among amyloid/tau-associated proteins. Key glucose/carbon metabolism protein associations independently replicated. CSF proteome outperformed other omics data in predicting amyloid/tau positivity. CSF metabolomics identified and replicated a succinylcarnitine–phosphorylated tau association.

Original languageEnglish
Pages (from-to)5447-5470
Number of pages24
JournalAlzheimer's and Dementia
Issue number12
StatePublished - Dec 2023


  • Alzheimer's disease
  • acylcarnitines
  • amyloid
  • biomarkers
  • carbon metabolism
  • glucose metabolism
  • metabolism
  • metabolomics
  • multiomics
  • neurodegeneration
  • neuroinflammation
  • proteomics
  • tau


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