Personalized Medicine Approach in Alzheimer’s Disease: A Review

Alzheimer’s disease (AD), a polygenic and multifactorial disease, is a progressive neurodegenerative disorder and the most commoncause of dementia. Amyloid deposition, neurofibrillary tangle formation and premature neuronal death are the major neuropathological hallmarks of AD. Personalized medicine is an approach aims to maximize the effectiveness of disease diagnosis, prevention and treatment and to minimize side effects of drugs in different patients with the help of high-throughput OMICS technologies. Although AD Drugs such asDonepezil, Rivastigmine, Galantamine, and Memantine have been developed but their effectiveness is directly related to early-stage AD diagnosis. However, these disease-modifying treatments were not fully satisfactory.Therefore, early-stage diagnosis and prevention of ADare of high importance. So genomics, proteomics and metabolomics studies are essential to identify reliable biomarkers for AD early-stage diagnosis. Genome wide association studies (GWAS), whole genome sequencing (WGS) and whole exome sequencing (WES) showedthat Genetic variations in apolipoprotein E (APOE) and proximal genes (PVRL2, TOMM40, and APOC1) are associated with dementia, particularly AD. Epigenetic mechanisms such as DNA methylation and miRNAs may play a central role in the regulation of related geneexpression. For instance, miRNA expression can impact the regulation of APP (amyloid beta A4 precursor protein). Also, polymorphisms in the apolipoprotein E and CYP2D6 genes are widely reported to predict therapeutic responses to Donepezil therapy. Conclusion: Taken all together, precision medicine approach in AD aims to design the best personalized therapeutic intervention by identifying a person’s specific pattern of risk factors, related biomarkers and by administering a preventive or therapeutic intervention that is specifically personalized and optimized to the patient.