A nasal swab taking only a few minutes may reveal the biological beginnings of Alzheimer's disease before memory and thinking problems appear. Duke School of Medicine researchers led by Bradley Goldstein, with first author Vincent D'Anniballe, report in Nature Communications that cells gently brushed from the upper nose carry gene-activity signatures that distinguish people with early or diagnosed Alzheimer's from those ageing healthily.
The team sampled the olfactory lining, home to the smell-detecting nerve cells, in 22 participants, using a small brush after numbing spray, and measured gene activity across hundreds of thousands of individual cells. Nerve and immune cells showed distinct patterns separating early and clinical Alzheimer's cases from healthy controls, and a combined nasal gene score made that separation correctly about 81 per cent of the time.
Strikingly, the swab flagged changes in people who had laboratory evidence of Alzheimer's but no symptoms yet, hinting that it could offer an earlier window on the disease than current blood tests, which detect later-stage markers. Working with the Duke and UNC Alzheimer's Disease Research Center, the team is now expanding the research to larger groups and testing whether the swab can track response to treatment.