Evidence map›Paper›PMID 42315799›Full record

Observational studyNeuromolecular medicine2026

Association of Cathepsin Proteins with Alzheimer's Disease Risk: An Integrated Observational and Genetic Analysis.

Qianlong Zhang, Qingyang Li, Zisheng Ai, Fei Li, Yi Wang, Wei Zhou

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Neuromolecular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Qianlong ZhangTongji University School of Medicine, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center) affiliated to Tongji University, Shanghai, China.
Qingyang LiMinistry of Education-Shanghai Key Laboratory of Children's Environmental Health, Department of Developmental and Behavioural Paediatrics & Child Primary Care, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Zisheng AiDepartment of Medical Statistics, Tongji University School of Medicine, Shanghai, China.
Fei LiMinistry of Education-Shanghai Key Laboratory of Children's Environmental Health, Department of Developmental and Behavioural Paediatrics & Child Primary Care, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Yi WangTongji University School of Medicine, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center) affiliated to Tongji University, Shanghai, China. yiwang87@tongji.edu.cn.
Wei ZhouMinistry of Education-Shanghai Key Laboratory of Children's Environmental Health, Department of Developmental and Behavioural Paediatrics & Child Primary Care, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. weizhousjtu@sjtu.edu.cn.

Funding

the China Brain Initiative Grant STI2030-Major Projects 2021ZD0200800the National Natural Science Foundation of China 82430104, 82125032, 82404755the National Science and Technology Major Project 2025ZD0214700, 2023ZD0121300the Science and Technology Commission of Shanghai Municipality YDZX20253100003001, 23Y21900500, 23DZ2291100, 2018SHZDZX01the Shanghai Science and Technology Innovation Plan, Rising Star Program A 23QA1408400
6 · The paper itself

Abstract

Alzheimer's disease (AD) involves complex lysosomal proteolytic dysfunction, but the specific roles of cathepsin family proteins remain unclear. This study aimed to systematically evaluate the association of cathepsins with AD risk and to explore underlying mechanistic pathways integrating neuroimaging, cognitive, and genetic evidence. We analyzed data from 52,988 UK Biobank participants. Plasma levels of 11 cathepsins were measured via Olink proteomics. Associations with AD diagnosis, cognitive performance, and brain structural measures were assessed using multivariable regression. Mediation analysis tested pathways through cognition and brain structure. Bidirectional two-sample Mendelian randomization (MR) was used to assess potential directional associations, and colocalization analysis was performed to identify shared genetic signals. Among the cathepsins analyzed, CTSL was the most coherent signal across observational analyses, showing associations with AD diagnosis, poorer cognitive performance, and reduced volume in AD-vulnerable regions including the hippocampus. Exploratory mediation analyses identified indirect associational patterns involving cognition and brain structure. Bidirectional MR provided genetic evidence for a positive directional association of genetically predicted CTSL with AD diagnosis (β = 1.2666 on the log-odds scale, p < 0.001) and for a reverse association of AD liability with higher CTSL levels (β = 0.5556, p < 0.001). Colocalization initially suggested a shared signal in the APOE/ZNF285 region, but this signal was not independent of APOE after sensitivity analysis. CTSL emerged as a candidate plasma molecule associated with AD across observational and genetic analyses. These findings support further longitudinal and experimental evaluation of CTSL, while the mechanistic interpretation remains preliminary.

Indexed as

Alzheimer DiseaseCathepsin LCathepsinsAgedBrainCognitionFemaleGenetic Predisposition to DiseaseHippocampusHumansMagnetic Resonance ImagingMaleMendelian Randomization AnalysisPolymorphism, Single NucleotideProteomicsUK BiobankCathepsin LCathepsinsAlzheimer’s diseaseCathepsin L (CTSL)CognitionMendelian randomizationNeuroimaging

Identifiers

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.