the disease by a series of motor deficits that manifest over years or decades. It is characterized by degeneration of mid-brain dopaminergic neurons with a high prevalence of dementia associated with the spread of pathology to cortical regions. Patients exhibiting symptoms have already undergone significant neuronal loss without chance for recovery. Analysis of disease specific changes in gene expression directly from human patients can uncover invaluable clues about a still unknown etiology, the potential of which grows exponentially as additional gene regulatory measures are questioned. Epigenetic mechanisms are emerging as important components of neurodegeneration, including PD; the extent to which methylation changes correlate with disease progression has not yet been reported. This collection of work aims to define multiple layers of PD that will work toward developing biomarkers that not only could improve diagnostic accuracy, but also push the boundaries of the disease detection timeline. I examined changes in gene expression, alternative splicing of those gene products, and the regulatory mechanism of DNA methylation in the Parkinson’s disease system, as well as the pathologically related Alzheimer’s disease (AD). I first used RNA sequencing (RNAseq) to evaluate differential gene expression and alternative splicing in the posterior cingulate cortex of patients with PD and PD with dementia (PDD). Next, I performed a longitudinal genome-wide methylation study surveying ~850K CpG methylation sites in whole blood from 189 PD patients and 191 control individuals obtained at both a baseline and at a follow-up visit after 2 years. I also considered how symptom management medications could affect the regulatory mechanism of DNA methylation. In the last chapter of this work, I intersected RNAseq and DNA methylation array datasets from whole blood patient samples for integrated differential analyses of both PD and AD. Changes in gene expression and DNA methylation reveal clear patterns of pathway dysregulation that can be seen across brain and blood, from one study to the next. I present a thorough survey of molecular changes occurring within the idiopathic Parkinson’s disease patient and propose candidate targets for potential molecular biomarkers.
Alzheimer’s disease is a disease that can affect cognition, perception and behavior and is currently untreatable. It was discovered in the early 20th century and while significant scientific advancements have occurred, there is ambiguity that remains to be researched and understood. Latinos are the largest ethnic minority in the United States and while data still needs to be uncovered, possible risk factors for developing Alzheimer’s include heart issues, poverty and obesity, age and education level, to name a few. Poverty is linked to obesity, diabetes and a low education level, which in turn have been found to have an impact on Alzheimer’s and all factors impact cardiovascular and vascular health. Due to the collectivistic culture that is deeply rooted in Latinos, there is a strong sense of family that is upheld when caring for relatives who are afflicted and may be hesitant to receive the care that is needed. Other barriers include financial stability, linguistic and cultural barriers, underutilizing resources and health literacy. There are still research gaps that are yet to be filled like brain health and longitudinal studies for Latinos, but current treatments like diet and culturally competent professionals can help with the prognosis. Alzheimer’s is a complex disease, but with the numerous efforts made thus far, such as creating the LatinosAgainstAlzheimer’s Network, it will soon be able to be understood and hopefully eradicated.
Mayer-Rokitansky-Küster-Hauser (MRKH) is a rare Disorder of Sexual Development (DSD) that results in the lack of a uterus and vagina in women. Receiving this diagnosis during adolescence can cause various forms of psychological distress in patients and families.<br/>Specifically, this condition could affect a women’s gender identity, body image, romantic relationships, family relationships, and psychological wellbeing. Parents are also put in a stressful<br/>position as they now have to navigate the healthcare system, disclosure, and the relationship with their child. This study aims to expand the knowledge of psychosocial adjustment by studying body<br/>image, gender identity, and mental health in individuals living with MRKH as well as parental disclosure, parental support systems, and parental perceptions of their child’s mental health.
Hepatocellular Carcinoma (HCC) is one of the main types of liver cancer accounting for 75% of cases and is the second deadliest cancer worldwide. Chronic Hepatitis B (HBV) and Hepatitis C (HCV) remain one of the most important global risk factors and account for 80% of all HCC cases. HCC also exhibits sex-differences with significantly higher incidence and worse prognosis in males. The mechanistic basis of these sex-differences is poorly understood. To identify genes and pathways that are sex-differentially expressed in viral-mediated HCC, we performed differential expression analysis on tumor vs. tumor adjacent samples that were stratified based on sex, viral etiology, and both. The differentially expressed genes were then used in a pathway enrichment analysis to identify potential pathways of interest. We found differentially expressed genes in both sexes and both etiologies. 65 genes were unique to females and 184 genes unique to males. 381 genes are unique to HBV and 195 genes are unique to HCV. We also found pathways that were significantly enriched by the differentially expressed genes. Ten pathways unique to the female tumor tumor-adjacent comparison and a majority of those pathways were a part of the cell cycle. Four enriched pathways unique to male tumor tumor-adjacent and three of them were a part of the immune system. There were no pathways unique to either etiology, but seven pathways shared by both etiologies. Two were a part of the cell cycle and one involved lipid metabolism. These differentially expressed genes and significant pathways are potential targets for individualized therapeutics and diagnostics for HCC.
Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease (ILD) that results in the permanent scarring and damage of lung tissue. Currently, there is no known cause or viable treatment for this disease, and the majority of patients either receive a lung transplant or succumb to the disease within five years of diagnosis. This project centers around studying IPF through analyzing gene expression patterns in healthy vs. diseased lung tissue via spatial transcriptomics. Spatial transcriptomics is the study of individual RNA transcripts within cells on a spatial level. With the novel technology MERFISH, we can detect gene expression in a spatial context with single-cell resolution, allowing us to make inferences about certain patterns of gene expression that are solely driven by the pathology of the disease. A total of 120 cells were selected from 21 different lung samples - 6 healthy; 15 ILD. Within those lung samples, selected from 4 different tissue features - control, less fibrotic, more fibrotic, and cystic. We built an analysis pipeline in R to analyze cell type composition around these features at different distances from the center cell (0-75, 76-150, and 150-225 μm). Cell types were annotated at both a broad (less specific) and fine (more specific) level. Upon analyzing the relationship between the proportions of various cell types and distance from tissue features, we found that within the broad cell type annotation level, airway epithelium cells had a negative relationship with distance and were statistically significant through linear regression models. Within the fine cell type annotation level, ciliated/secretory cells displayed this same trend. The results above support our current understanding of cystic tissue in lung tissue, and is a foundation for understanding disease pathology as a whole.
