Abstract
BACKGROUND: Cuproptosis is increasingly recognized as an essential factor in the pathological process of Alzheimer's disease (AD). However, the specific role of cuproptosis-related genes in AD remains poorly understood. METHODS: Our first step was to obtain gene expression data from the GEO database and identify differentially expressed cuproptosis-associated genes (DECAGs) in AD. GO, KEGG, and GSEA analyses were then conducted on these genes. Subsequently, we attempted to classify AD patients by unsupervised clustering. Then, four machine-learning models were used to screen hub-genes from the DECAGs. We also explored the immune features of these genes and predicted target drugs. Molecular docking analysis was then performed on the predicted drugs and their corresponding hub-gene related proteins. Candidate markers were then validated by single-cell analysis and intracellular communication was investigated in a GEO scRNA-seq dataset. Lastly, we examined the expression levels of the hub-genes in peripheral blood cells using real-time quantitative PCR. RESULTS: 19 DECAGs were found in AD and the key biological processes and molecular functions associated with AD were further determined. Two subtypes of peripheral blood cells showed significant alternations in AD: Cluster1 and Cluster2. Five hub-genes including FDX1, GLS, PDK1, MAP2K1, and SOD1 were then screened out from the machine-learning study. All of the five hub-genes were significantly correlated with various immunocytes. We discovered compounds targeting hub-gene related proteins and forecasted multiple strong hydrogen bonding interactions between the picked predicted drugs and the target proteins by molecular docking analysis. Subsequently, in the single-cell analysis of AD peripheral blood, all hub-genes except SOD1 were found to be up-regulated in B cells, NK cells, and CD4+ T cells, possibly acting on the MIF pathway. Finally, we discovered that the levels of PDK1 expression in AD patients were remarkably upregulated, while FDX1 and GLS were significantly decreased using qPCR. CONCLUSION: This study examined changes in intercellular communication between immune cells in the peripheral blood and identified five novel feature genes associated with cuproptosis in AD patients. These results facilitated a deeper understanding of the molecular mechanisms of AD and suggested novel therapeutic targets.