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Pilz G, Sakic I, Wipfler P, Kraus J, Haschke-Becher E, Hitzl W, Trinka E, Harrer A. Chemokine CXCL13 in serum, CSF and blood-CSF barrier function: evidence of compartment restriction. Fluids Barriers CNS 2020; 17:7. [PMID: 32089130 PMCID: PMC7038591 DOI: 10.1186/s12987-020-0170-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 01/16/2020] [Indexed: 01/02/2023] Open
Abstract
Background and purpose Elevation of the chemokine CXCL13 in CSF frequently occurs during active and acute CNS inflammatory processes and presumably is associated with B cell-related immune activation. Elevation levels, however, vary a lot and “leaking” of CXCL13 from blood across dysfunctional brain barriers is a possible source. The aim was to clarify the relation between CXCL13 concentrations in CSF, CXCL13 concentrations in serum and blood–CSF barrier (BCSFB) function for a correct interpretation of the intrathecal origin of CXCL13. Methods We retrospectively analyzed CXCL13 of banked CSF/serum samples (n = 69) selected from patient records and categorized the CSF CXCL13 elevations as CXCL13 negative (< 30 pg/ml), low (30–100 pg/ml), medium (101–250 pg/ml), or high (> 250 pg/ml). CXCL13 concentrations in CSF and serum and the corresponding CSF/serum CXCL13 quotients (Qcxcl13) were compared to CSF/serum albumin quotients (QAlb) as a measure for BCSFB function. The CXCL13 negative category included two subgroups with normal and dysfunctional BCSFB. Results Serum CXCL13 concentrations were similar across categories with median levels around 100 pg/ml but differed between individuals (29 to > 505 pg/ml). Despite clear evidence in serum, CXCL13 was detectable only at trace amounts (medians 3.5 and 7.5 pg/ml) in CSF of the two CXCL13 negative subgroups irrespective of a normal or pathological QAlb. Moreover, we found no association between CSF and serum CXCL13 levels or between QAlb and CSF CXCL13 levels in any of the CSF CXCL13-delineated categories. CXCL13 apparently does not “leak” from blood into CSF. This implies an intrathecal origin also for low CSF CXCL13 levels and a caveat for analyzing the Qcxcl13, because higher serum than CSF concentrations arithmetically depress the Qcxcl13 resulting in misleadingly low CSF/serum quotients. Conclusion We demonstrated that CXCL13 does not cross from blood into CSF, not even during severe BCSFB dysfunction. CSF CXCL13 elevations therefore most likely always are CNS-derived, which highlights their relevance as indicator of inflammatory CNS processes. We recommend data should not be corrected for BCSFB permeability (QAlb) and not to calculate CSF/serum quotients for CXCL13 as these may introduce error.
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Affiliation(s)
- Georg Pilz
- Department of Neurology, Paracelsus Medical University, Ignaz-Harrer-Str 79, Salzburg, 5020, Austria
| | - Irma Sakic
- Department of Neurology, Paracelsus Medical University, Ignaz-Harrer-Str 79, Salzburg, 5020, Austria
| | - Peter Wipfler
- Department of Neurology, Paracelsus Medical University, Ignaz-Harrer-Str 79, Salzburg, 5020, Austria
| | - Jörg Kraus
- Department of Laboratory Medicine, Paracelsus Medical University, Salzburg, Austria.,Departent of Neurology, Medical Faculty, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany
| | | | - Wolfgang Hitzl
- Research Office, Biostatistics, Paracelsus Medical University, Salzburg, Austria.,Department of Ophthalmology and Optometry, Paracelsus Medical University, Salzburg, Austria.,Research Program Experimental Ophthalmology and Glaucoma Research, Paracelsus Medical University, Salzburg, Austria
| | - Eugen Trinka
- Department of Neurology, Paracelsus Medical University, Ignaz-Harrer-Str 79, Salzburg, 5020, Austria
| | - Andrea Harrer
- Department of Neurology, Paracelsus Medical University, Ignaz-Harrer-Str 79, Salzburg, 5020, Austria.
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52
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Ziemssen T, Akgün K, Brück W. Molecular biomarkers in multiple sclerosis. J Neuroinflammation 2019; 16:272. [PMID: 31870389 PMCID: PMC6929340 DOI: 10.1186/s12974-019-1674-2] [Citation(s) in RCA: 130] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 12/16/2019] [Indexed: 11/30/2022] Open
Abstract
Multiple sclerosis (MS) is an inflammatory-neurodegenerative disease of the central nervous system presenting with significant inter- and intraindividual heterogeneity. However, the application of clinical and imaging biomarkers is currently not able to allow individual characterization and prediction. Complementary, molecular biomarkers which are easily quantifiable come from the areas of immunology and neurobiology due to the causal pathomechanisms and can excellently complement other disease characteristics. Only a few molecular biomarkers have so far been routinely used in clinical practice as their validation and transfer take a long time. This review describes the characteristics that an ideal MS biomarker should have and the challenges of establishing new biomarkers. In addition, clinically relevant and promising biomarkers from the blood and cerebrospinal fluid are presented which are useful for MS diagnosis and prognosis as well as for the assessment of therapy response and side effects.
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Affiliation(s)
- Tjalf Ziemssen
- MS center, Center of Clinical Neuroscience, University Clinic Carl-Gustav Carus, Dresden University of Technology, Dresden, Germany.
| | - Katja Akgün
- MS center, Center of Clinical Neuroscience, University Clinic Carl-Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Wolfgang Brück
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
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53
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Silajdžić E, Björkqvist M. A Critical Evaluation of Wet Biomarkers for Huntington's Disease: Current Status and Ways Forward. J Huntingtons Dis 2019; 7:109-135. [PMID: 29614689 PMCID: PMC6004896 DOI: 10.3233/jhd-170273] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
There is an unmet clinical need for objective biomarkers to monitor disease progression and treatment response in Huntington's disease (HD). The aim of this review is, therefore, to provide practical advice for biomarker discovery and to summarise studies on biofluid markers for HD. A PubMed search was performed to review literature with regard to candidate saliva, urine, blood and cerebrospinal fluid biomarkers for HD. Information has been organised into tables to allow a pragmatic approach to the discussion of the evidence and generation of practical recommendations for future studies. Many of the markers published converge on metabolic and inflammatory pathways, although changes in other analytes representing antioxidant and growth factor pathways have also been found. The most promising markers reflect neuronal and glial degeneration, particularly neurofilament light chain. International collaboration to standardise assays and study protocols, as well as to recruit sufficiently large cohorts, will facilitate future biomarker discovery and development.
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Affiliation(s)
- Edina Silajdžić
- Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Maria Björkqvist
- Department of Experimental Medical Science, Brain Disease Biomarker Unit, Wallenberg Neuroscience Center, Lund University, Lund, Sweden
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54
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Folke J, Rydbirk R, Løkkegaard A, Salvesen L, Hejl AM, Starhof C, Bech S, Winge K, Christensen S, Pedersen LØ, Aznar S, Pakkenberg B, Brudek T. Distinct Autoimmune Anti-α-Synuclein Antibody Patterns in Multiple System Atrophy and Parkinson's Disease. Front Immunol 2019; 10:2253. [PMID: 31616427 PMCID: PMC6769034 DOI: 10.3389/fimmu.2019.02253] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 09/05/2019] [Indexed: 11/16/2022] Open
Abstract
Aggregation of alpha-synuclein (α-syn) is considered to be the major pathological hallmark and driving force of Multiple System Atrophy (MSA) and Parkinson's disease (PD). Immune dysfunctions have been associated with both MSA and PD and recently we reported that the levels of natural occurring autoantibodies (NAbs) with high-affinity/avidity toward α-synuclein are reduced in MSA and PD patients. Here, we aimed to evaluate the plasma immunoglobulin (Ig) composition binding α-syn and other amyloidogenic neuropathological proteins, and to correlate them with disease severity and duration in MSA and PD patients. All participants were recruited from a single neurological unit and the plasma samples were stored for later research at the Bispebjerg Movement Disorder Biobank. All patients were diagnosed according to current consensus criteria. Using multiple variable linear regression analyses, we observed higher levels of anti-α-syn IgG1 and IgG3 NAbs in MSA vs. PD, higher levels of anti-α-syn IgG2 NAbs in PD compared to controls, whereas anti-α-syn IgG4 NAbs were reduced in PD compared to MSA and controls. Anti-α-syn IgM levels were decreased in both MSA and PD. Further our data supported that MSA patients' immune system was affected with reduced IgG1 and IgM global levels compared to PD and controls, with further reduced global IgG2 levels compared to PD. These results suggest distinct autoimmune patterns in MSA and PD. These findings suggest a specific autoimmune physiological mechanism involving responses toward α-syn, differing in neurodegenerative disease with overlapping α-syn pathology.
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Affiliation(s)
- Jonas Folke
- Research Laboratory for Stereology and Neuroscience, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Rasmus Rydbirk
- Research Laboratory for Stereology and Neuroscience, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Annemette Løkkegaard
- Department of Neurology, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Lisette Salvesen
- Department of Neurology, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Anne-Mette Hejl
- Department of Neurology, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Charlotte Starhof
- Department of Neurology, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Sára Bech
- Department of Neurology, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Kristian Winge
- Novo Nordisk Foundation, Hellerup, Denmark.,Bispebjerg Movement Disorders Biobank, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
| | | | - Lars Østergaard Pedersen
- Department of Immunology and Microbiology, Faculty of Health, University of Copenhagen, Copenhagen, Denmark
| | - Susana Aznar
- Research Laboratory for Stereology and Neuroscience, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Bente Pakkenberg
- Research Laboratory for Stereology and Neuroscience, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health, University of Copenhagen, Copenhagen, Denmark
| | - Tomasz Brudek
- Research Laboratory for Stereology and Neuroscience, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
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VGF Peptides in Cerebrospinal Fluid of Patients with Dementia with Lewy Bodies. Int J Mol Sci 2019; 20:ijms20194674. [PMID: 31547145 PMCID: PMC6801397 DOI: 10.3390/ijms20194674] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 09/10/2019] [Accepted: 09/16/2019] [Indexed: 12/13/2022] Open
Abstract
In a previous proteomic study, we identified the neurosecretory protein VGF (VGF) as a potential biomarker for dementia with Lewy bodies (DLB). Here, we extended the study of VGF by comparing levels in cerebrospinal fluid (CSF) from 44 DLB patients, 20 Alzheimer’s disease (AD) patients, and 22 cognitively normal controls selected from the Amsterdam Dementia Cohort. CSF was analyzed using two orthogonal analytical methods: (1) In-house-developed quantitative ELISA and (2) selected reaction monitoring (SRM). We further addressed associations of VGF with other CSF biomarkers and cognition. VGF levels were lower in CSF from patients with DLB compared to either AD patients or controls. VGF was positively correlated with CSF tau and α-synuclein (0.55 < r < 0.75), but not with Aβ1-42. In DLB patients, low VGF levels were related to a more advanced cognitive decline at time of first presentation, whereas high levels of VGF were associated with steeper subsequent longitudinal cognitive decline. Hence, CSF VGF levels were lower in DLB compared to both AD and controls across different analytical methods. The strong associations with cognitive decline further points out VGF as a possible disease stage or prognostic marker for DLB.
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56
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Kalligerou F, Ntanasi E, Voskou P, Velonakis G, Karavasilis E, Mamalaki E, Kyrozis A, Sigala E, Economou NT, Patas K, Yannakoulia M, Scarmeas N. Aiginition Longitudinal Biomarker Investigation Of Neurodegeneration (ALBION): study design, cohort description, and preliminary data. Postgrad Med 2019; 131:501-508. [PMID: 31483196 DOI: 10.1080/00325481.2019.1663708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objectives: Aiginition Longitudinal Biomarker Investigation Of Neurodegeneration (ALBION) is a longitudinal ongoing study initiated in 2018 that takes place in the Cognitive Disorders Clinic of Aiginition Hospital of the National and Kapodistrian University of Athens. Its aim is to address several research questions concerning the preclinical and prodromal stage of Alzheimer's disease and explore potential markers for early detection, prediction, and primary prevention of dementia. Methods: We here present the design and the preliminary baseline characteristics of ALBION. The sample of our study consists of people aged over 50 who are concerned about their memory but are cognitively normal (CN) or have mild cognitive deficits. Each participant undergoes an extensive assessment including several demographic, medical, social, environmental, clinical, nutritional, neuropsychological determinants and lifestyle activities. Furthermore, we are collecting data from portable devices, neuroimaging techniques and biological samples (blood, stools, CSF). All participants are assessed annually for a period of 10 years. Results: In total, 47 participants have completed the initial evaluation up to date and are divided in two groups, CN individuals (N = 26) and MCI patients (N = 21), based on their cognitive status. The participants are, on average, 64 years old, 46.3% of the sample is male with an average of 12.73 years of education. MCI patients report more comorbidities and have a lower score in the MMSE test. Regarding APOE status, 2 participants are ε4 homozygotes and 10 ε4 heterozygotes. CSF analyses (Aβ42, Τ-tau, P-tau) revealed no differences between the two groups. Conclusion: The ALBION study offers an opportunity to explore preclinical dementia and identify new and tailored markers, particularly relating to lifestyle. Further investigation of these populations may provide a wider profile of the changes taking place in the preclinical phase of dementia, leading to potentially effective therapeutic and preventive strategies.
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Affiliation(s)
- F Kalligerou
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School , Athens , Greece
| | - E Ntanasi
- Department of Nutrition and Diatetics, Harokopio University , Athens , Greece
| | - P Voskou
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School , Athens , Greece
| | - G Velonakis
- 2nd department of Radliology, University General Hospital "Attikon", National and Kapodistrian University of Athens, Medical School , Athens , Greece
| | - E Karavasilis
- 2nd department of Radliology, University General Hospital "Attikon", National and Kapodistrian University of Athens, Medical School , Athens , Greece
| | - E Mamalaki
- Department of Nutrition and Diatetics, Harokopio University , Athens , Greece
| | - A Kyrozis
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School , Athens , Greece
| | - E Sigala
- Department of Nutrition and Diatetics, Harokopio University , Athens , Greece
| | - N T Economou
- Sleep Study Unit, Department of Psychiatry, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School , Athens , Greece
| | - K Patas
- Laboratory of Biopathology, Aiginition Hospital , Athens , Greece
| | - M Yannakoulia
- Department of Nutrition and Diatetics, Harokopio University , Athens , Greece
| | - N Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School , Athens , Greece
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Cameron S, Gillio-Meina C, Ranger A, Choong K, Fraser DD. Collection and Analyses of Cerebrospinal Fluid for Pediatric Translational Research. Pediatr Neurol 2019; 98:3-17. [PMID: 31280949 DOI: 10.1016/j.pediatrneurol.2019.05.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 05/23/2019] [Accepted: 05/27/2019] [Indexed: 12/18/2022]
Abstract
Cerebrospinal fluid sample collection and analysis is imperative to better elucidate central nervous system injury and disease in children. Sample collection methods are varied and carry with them certain ethical and biologic considerations, complications, and contraindications. Establishing best practices for sample collection, processing, storage, and transport will ensure optimal sample quality. Cerebrospinal fluid samples can be affected by a number of factors including subject age, sampling method, sampling location, volume extracted, fraction, blood contamination, storage methods, and freeze-thaw cycles. Indicators of sample quality can be assessed by matrix-associated laser desorption/ionization time-of-flight mass spectrometry and include cystatin C fragments, oxidized proteins, prostaglandin D synthase, and evidence of blood contamination. Precise documentation of sample collection processes and the establishment of meticulous handling procedures are essential for the creation of clinically relevant biospecimen repositories. In this review we discuss the ethical considerations and best practices for cerebrospinal fluid collection, as well as the influence of preanalytical factors on cerebrospinal fluid analyses. Cerebrospinal fluid biomarkers in highly researched pediatric diseases or disorders are discussed.
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Affiliation(s)
| | | | - Adrianna Ranger
- Pediatrics, Western University, London, Ontario, Canada; Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Karen Choong
- Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Douglas D Fraser
- Pediatrics, Western University, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Clinical Neurological Sciences, Western University, London, Ontario, Canada; Physiology and Pharmacology, Western University, London, Ontario, Canada; Translational Research Centre, London, Ontario, Canada.
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58
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Mendes T, Cardoso S, Guerreiro M, Maroco J, Silva D, Alves L, Schmand B, Gerardo B, Lima M, Santana I, de Mendonça A. Can Subjective Memory Complaints Identify Aβ Positive and Aβ Negative Amnestic Mild Cognitive Impairment Patients? J Alzheimers Dis 2019; 70:1103-1111. [DOI: 10.3233/jad-190414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Tiago Mendes
- Faculty of Medicine, University of Lisboa, Lisbon, Portugal
- Department of Psychiatry and Mental Health, Santa Maria Hospital, Lisbon, Portugal
| | - Sandra Cardoso
- Faculty of Medicine, University of Lisboa, Lisbon, Portugal
| | | | - João Maroco
- Instituto Superior de Psicologia Aplicada, Lisbon, Portugal
| | - Dina Silva
- Faculty of Medicine, University of Lisboa, Lisbon, Portugal
- Department of Psychology and Educational Sciences and Centre for Biomedical Research (CBMR), Cognitive Neuroscience Research Group, Universidade do Algarve, Faro, Portugal
| | - Luísa Alves
- Chronic Diseases Research Centre, NOVA Medical School, NOVA University of Lisbon, Portugal
| | - Ben Schmand
- Faculty of Social and Behavioral Sciences, University of Amsterdam, the Netherlands
| | - Bianca Gerardo
- Neuropsychology Unit, Centro Hospitalar e Universitário de Coimbra, Portugal
| | - Marisa Lima
- Neuropsychology Unit, Centro Hospitalar e Universitário de Coimbra, Portugal
| | - Isabel Santana
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Portugal
- Neuropsychology Unit, Centro Hospitalar e Universitário de Coimbra, Portugal
- Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
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59
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Unequivocal Biomarker for Parkinson’s Disease: A Hunt that Remains a Pester. Neurotox Res 2019; 36:627-644. [DOI: 10.1007/s12640-019-00080-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/17/2019] [Accepted: 06/19/2019] [Indexed: 12/14/2022]
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60
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Spitzer P, Weinbeer J, Herrmann M, Oberstein TJ, Condic M, Lewczuk P, Kornhuber J, Maler JM. Analysis of Surface Levels of IL-1 Receptors and Macrophage Scavenger Receptor I in Peripheral Immune Cells of Patients With Alzheimer Disease. J Geriatr Psychiatry Neurol 2019; 32:211-220. [PMID: 31018751 PMCID: PMC6552296 DOI: 10.1177/0891988719841728] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Increased concentrations of interleukin 1 (IL-1) in the cerebrospinal fluid and serum of patients with Alzheimer disease (AD) reduced phagocytic capacity point to an inflammatory activation of mononuclear phagocytes in AD. Interleukin 1 receptors (IL-1R) and the macrophage scavenger receptor I (MSRI) are important players in IL-1 signaling and phagocytosis. In 20 patients with AD and 17 controls, IL-1RI, IL-1RII, and MSRI were assessed on peripheral blood mononuclear cells by flow cytometry. IL-1β, soluble IL-1 receptors, and IL-1R antagonist (IL-1Ra) were measured by enzyme-linked immunosorbent assay. The fraction of IL-1RI+ monocytes was increased by 10% and the expression of MSRI was reduced by 12% in AD. A 3.6% increased fraction of IL-1RI+ lymphocytes was accompanied by a 6.1% reduced expression of IL-1RII. The IL-1RI on monocytes and lymphocytes discriminated patients with AD with an accuracy of 0.79 and 0.75, respectively. The IL-1Ra was elevated in AD. Changes in the expression of IL-1 receptors and MSRI on peripheral blood cells fit to the concept of a proinflammatory state of the peripheral immune system. However, the observed differences are not strong enough to suggest their application as biomarkers for AD.
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Affiliation(s)
- Philipp Spitzer
- Department of Psychiatry and Psychotherapy, Friedrich–Alexander University Erlangen–Nuremberg, University Hospital Erlangen, Erlangen, Germany,Philipp Spitzer, Department of Psychiatry and Psychotherapy, Friedrich–Alexander University Erlangen–Nuremberg, Schwabachanlage 6, D-91054 Erlangen, Germany.
| | - Johannes Weinbeer
- Department of Psychiatry and Psychotherapy, Friedrich–Alexander University Erlangen–Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Martin Herrmann
- Department of Medicine III, Institute for Clinical Immunology, Friedrich–Alexander University Erlangen–Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Timo Jan Oberstein
- Department of Psychiatry and Psychotherapy, Friedrich–Alexander University Erlangen–Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Mateja Condic
- Department of Psychiatry and Psychotherapy, Friedrich–Alexander University Erlangen–Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, Friedrich–Alexander University Erlangen–Nuremberg, University Hospital Erlangen, Erlangen, Germany,Department of Neurodegeneration Diagnostics, Medical University of Bialystok, Bialystok, Poland
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich–Alexander University Erlangen–Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Juan Manuel Maler
- Department of Psychiatry and Psychotherapy, Friedrich–Alexander University Erlangen–Nuremberg, University Hospital Erlangen, Erlangen, Germany
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Koch BC, Daniels LO, Thomsen LT, Nielsen MBM, Berendt M, Gredal H. Collection of cerebrospinal fluid into EDTA versus plain tubes does not affect the standard analysis in dogs. Acta Vet Scand 2019; 61:23. [PMID: 31060616 PMCID: PMC6503347 DOI: 10.1186/s13028-019-0457-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 04/23/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cerebrospinal fluid (CSF) can be collected into ethylenediaminetetraacetic acid (EDTA) or plain tubes. The EDTA content presumably contributes to a better cell preservation. EDTA, however, is reported to cause a false elevation in the total protein concentration and to dilute the CSF sample, thereby affecting the diagnostic interpretation. To the authors' knowledge, no validated studies support this view. The aim of this study was therefore to determine if the choice of tube (EDTA or plain) influences the results of the standard CSF analysis. RESULTS Thirty-two paired EDTA stabilised and plain CSF samples were included. There was no statistically significant difference in the semi-quantitative protein concentrations when comparing CSF samples from EDTA and plain plastic tubes (P > 0.99). The total nucleated cell count did not differ significantly between EDTA and plain tube samples (P = 0.85). There were no significant differences in the differential cell counts between the two tubes when evaluating polymorphonuclear cells (P = 0.90), lymphocytes (P = 0.84) and monocytes/macrophages (P = 0.86). Also, there was no significant difference in the preservation of cell morphology when evaluating cytological preparations from EDTA stabilised and plain tube samples (P = 0.45). CONCLUSIONS The collection of CSF into EDTA tubes does not influence the result of the standard CSF analysis. However, a presumed positive effect of EDTA on cell preservation could not be shown in the present study.
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Jensen CS, Bahl JM, Østergaard LB, Høgh P, Wermuth L, Heslegrave A, Zetterberg H, Heegaard NHH, Hasselbalch SG, Simonsen AH. Exercise as a potential modulator of inflammation in patients with Alzheimer's disease measured in cerebrospinal fluid and plasma. Exp Gerontol 2019; 121:91-98. [PMID: 30980923 DOI: 10.1016/j.exger.2019.04.003] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 02/04/2019] [Accepted: 04/08/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND Neuroinflammation is recognized as part of the pathological progression of Alzheimer's disease (AD), but the molecular mechanisms are still not entirely clear. Systemically, physical exercise has shown to have a positive modulating effect on markers of inflammation. It is not known if this general effect also takes place in the central nervous system in AD. The aim of this study was to investigate the effect of 16 weeks of moderate to high-intensity physical exercise on selected biomarkers of inflammation both systemically and in the CNS, in patients with AD. METHODS Plasma and cerebrospinal fluid (CSF) from 198 patients with Alzheimer's disease participating in the Preserving Cognition, Quality of Life, Physical Health and Functional Ability in Alzheimer's Disease: The Effect of Physical Exercise (ADEX) study were analyzed for concentrations of 8‑isoprostane, soluble trigger receptor expressed on myeloid cells 2 (sTREM2), and the MSD v-plex proinflammation panel 1 human containing interferon gamma (IFNγ), Interleukin-10 (IL10), IL12p70, IL13, IL1β, IL2, IL4, IL6, IL8, and tumor necrosis factor alpha (TNFα), before and after a 16-week intervention with physical exercise, and we studied whether changes were modulated by the patients' APOE genotype. RESULTS Most inflammatory markers remained unchanged after exercise. We found an increasing effect of 16 weeks of physical exercise on sTREM2 measured in CSF. Further, IL6 in plasma increased in the exercise group after physical exercise (mean relative change 41.03, SD 76.7), compared to controls (-0.97, SD 49.4). In a sub-analysis according to APOE genotype, we found that in ε4 carriers, exercise had a stabilizing effect on IFNγ concentration with a mean relative change of 7.84 (SD 42.6), as compared to controls (114.7 (SD 188.3), p = 0.038. CONCLUSION Our findings indicate an effect of physical exercise on markers of neuroinflammation in CSF measured by an increase in sTREM2 in patients with AD. Further, there may be a small inflammatory systemic effect related to physical exercise in patients with AD.
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Affiliation(s)
- Camilla Steen Jensen
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet University of Copenhagen, DK-2100 Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark.
| | | | - Lærke Borg Østergaard
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet University of Copenhagen, DK-2100 Copenhagen, Denmark.
| | - Peter Høgh
- Department of Clinical Medicine, University of Copenhagen, Denmark; Regional Dementia Research Centre, Department of Neurology, Zealand University Hospital, DK-4000 Roskilde, Denmark.
| | - Lene Wermuth
- Dementia Clinic, Department of Neurology, Odense University Hospital, DK-5000 Odense, Denmark.
| | - Amanda Heslegrave
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, WC1N London, UK; UK Dementia Research Institute at UCL, London WC1E 6BT, UK.
| | - Henrik Zetterberg
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, WC1N London, UK; UK Dementia Research Institute at UCL, London WC1E 6BT, UK; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, S-431 80 Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, S-431 80 Mölndal, Sweden.
| | - Niels H H Heegaard
- Department of Clinical Biochemistry, Immunology and Genetics, Statens Serum Institut, Copenhagen, Denmark; Department of Clinical Biochemistry, University of Southern Denmark, Odense, Denmark
| | - Steen Gregers Hasselbalch
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet University of Copenhagen, DK-2100 Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark.
| | - Anja Hviid Simonsen
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet University of Copenhagen, DK-2100 Copenhagen, Denmark.
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Novel Immunotherapeutic Approaches to Target Alpha-Synuclein and Related Neuroinflammation in Parkinson's Disease. Cells 2019; 8:cells8020105. [PMID: 30708997 PMCID: PMC6406239 DOI: 10.3390/cells8020105] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 01/23/2019] [Accepted: 01/29/2019] [Indexed: 12/12/2022] Open
Abstract
The etiology of Parkinson’s disease (PD) is significantly influenced by disease-causing changes in the protein alpha-Synuclein (aSyn). It can trigger and promote intracellular stress and thereby impair the function of dopaminergic neurons. However, these damage mechanisms do not only extend to neuronal cells, but also affect most glial cell populations, such as astroglia and microglia, but also T lymphocytes, which can no longer maintain the homeostatic CNS milieu because they produce neuroinflammatory responses to aSyn pathology. Through precise neuropathological examination, molecular characterization of biomaterials, and the use of PET technology, it has been clearly demonstrated that neuroinflammation is involved in human PD. In this review, we provide an in-depth overview of the pathomechanisms that aSyn elicits in models of disease and focus on the affected glial cell and lymphocyte populations and their interaction with pathogenic aSyn species. The interplay between aSyn and glial cells is analyzed both in the basic research setting and in the context of human neuropathology. Ultimately, a strong rationale builds up to therapeutically reduce the burden of pathological aSyn in the CNS. The current antibody-based approaches to lower the amount of aSyn and thereby alleviate neuroinflammatory responses is finally discussed as novel therapeutic strategies for PD.
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Menéndez-Valladares P, García-Sánchez MI, Adorna Martínez M, García De Veas Silva JL, Bermudo Guitarte C, Izquierdo Ayuso G. Validation and meta-analysis of kappa index biomarker in multiple sclerosis diagnosis. Autoimmun Rev 2019; 18:43-49. [DOI: 10.1016/j.autrev.2018.07.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 07/19/2018] [Indexed: 01/23/2023]
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Hok-A-Hin YS, Willemse EAJ, Teunissen CE, Del Campo M. Guidelines for CSF Processing and Biobanking: Impact on the Identification and Development of Optimal CSF Protein Biomarkers. Methods Mol Biol 2019; 2044:27-50. [PMID: 31432404 DOI: 10.1007/978-1-4939-9706-0_2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The field of neurological diseases strongly needs biomarkers for early diagnosis and optimal stratification of patients in clinical trials or to monitor disease progression. Cerebrospinal fluid (CSF) is one of the main sources for the identification of novel protein biomarkers for neurological diseases. Despite the enormous efforts employed to identify novel CSF biomarkers, the high variability observed across different studies has hampered their validation and implementation in clinical practice. Such variability is partly caused by the effect of different pre-analytical confounding factors on protein stability, highlighting the importance to develop and comply with standardized operating procedures. In this chapter, we describe the international consensus pre-analytical guidelines for CSF processing and biobanking that have been established during the last decade, with a special focus on the influence of pre-analytical confounders on the global CSF proteome. In addition, we provide novel results on the influence of different delayed storage and freeze/thaw conditions on the CSF proteome using two novel large multiplex protein arrays (SOMAscan and Olink). Compliance to consensus guidelines will likely facilitate the successful development and implementation of CSF protein biomarkers in both research and clinical settings, ultimately facilitating the successful development of disease-modifying therapies.
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Affiliation(s)
- Yanaika S Hok-A-Hin
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center, Amsterdam UMC, Amsterdam, The Netherlands.
| | - Eline A J Willemse
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center, Amsterdam UMC, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center, Amsterdam UMC, Amsterdam, The Netherlands
| | - Marta Del Campo
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center, Amsterdam UMC, Amsterdam, The Netherlands
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66
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Starhof C, Hejl A, Heegaard NH, Carlsen AL, Burton M, Lilje B, Winge K. The biomarker potential of cell‐free microRNA from cerebrospinal fluid in Parkinsonian Syndromes. Mov Disord 2018; 34:246-254. [DOI: 10.1002/mds.27542] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 08/27/2018] [Accepted: 08/30/2018] [Indexed: 12/11/2022] Open
Affiliation(s)
- Charlotte Starhof
- Department of NeurologyBispebjerg University Hospital Copenhagen Denmark
| | - Anne‐Mette Hejl
- Department of NeurologyBispebjerg University Hospital Copenhagen Denmark
| | - Niels H.H. Heegaard
- Department of Autoimmunology and BiomarkersStatens Serum Institute Copenhagen Denmark
- Department of Clinical BiochemistryUniversity of Southern Denmark Odense Denmark
| | - Anting L. Carlsen
- Department of Autoimmunology and BiomarkersStatens Serum Institute Copenhagen Denmark
| | - Mark Burton
- Department of Clinical GeneticsOdense University Hospital Odense Denmark
| | - Berit Lilje
- Department of Microbiology and Infection ControlStatens Serum Institute Copenhagen Denmark
| | - Kristian Winge
- Department of NeurologyBispebjerg University Hospital Copenhagen Denmark
- Department of NeurologyZealand University Hospital Roskilde Denmark
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67
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Pachner AR, DiSano K, Royce DB, Gilli F. Clinical utility of a molecular signature in inflammatory demyelinating disease. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2018; 6:e520. [PMID: 30568998 PMCID: PMC6278854 DOI: 10.1212/nxi.0000000000000520] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 10/02/2018] [Indexed: 12/25/2022]
Abstract
Objective We sought to develop molecular biomarkers of intrathecal inflammation to assist neurologists in identifying patients most likely to benefit from a range of immune therapies. Methods We used Luminex technology and index determination to search for an inflammatory activity molecular signature (IAMS) in patients with inflammatory demyelinating disease (IDD), other neuroinflammatory diagnoses, and noninflammatory controls. We then followed the clinical characteristics of these patients to find how the presence of the signature might assist in diagnosis and prognosis. Results A CSF molecular signature consisting of elevated CXCL13, elevated immunoglobulins, normal albumin CSF/serum ratio (Qalbumin), and minimal elevation of cytokines other than CXCL13 provided diagnostic and prognostic value; absence of the signature in IDD predicted lack of subsequent inflammatory events. The signature outperformed oligoclonal bands, which were frequently false positive for active neuroinflammation. Conclusions A CSF IAMS may prove useful in the diagnosis and management of patients with IDD and other neuroinflammatory syndromes. Classification of evidence This study provides Class IV evidence that a CSF IAMS identifies patients with IDD.
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Affiliation(s)
- Andrew R Pachner
- Department of Neurology, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH
| | - Krista DiSano
- Department of Neurology, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH
| | - Darlene B Royce
- Department of Neurology, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH
| | - Francesca Gilli
- Department of Neurology, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH
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68
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Starhof C, Winge K, Heegaard NHH, Skogstrand K, Friis S, Hejl A. Cerebrospinal fluid pro-inflammatory cytokines differentiate parkinsonian syndromes. J Neuroinflammation 2018; 15:305. [PMID: 30390673 PMCID: PMC6215346 DOI: 10.1186/s12974-018-1339-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 10/19/2018] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Neuroinflammation has been established to be part of the neuropathological changes in Parkinson's disease (PD) and atypical parkinsonism (APD). Activated microglia play a key role in neuroinflammation by release of cytokines. Evidence of the disparity, if any, in the neuroinflammatory response between PD and APD is sparse. In this study, we investigated CSF cytokine profiles in patients with PD, multiple system atrophy (MSA), or progressive supranuclear palsy (PSP). METHODS On a sensitive electrochemiluminescence-based platform (Quickplex, Meso Scale Discovery®), we examined a panel of C-reactive protein (CRP) and eight selected cytokines, IFN-γ, IL-10, IL-18, IL-1β, IL-4, IL-6, TGF-β1, and TNF-α, among patients with PD (n = 46), MSA (n = 35), and PSP (n = 39) or controls (n = 31). Additionally, CSF total tau protein levels were measured as a marker of nonspecific neurodegeneration for correlation estimates. RESULTS CRP and the pro-inflammatory cytokines TNF-α, IL-1β, and Il-6 were statistically significantly elevated in MSA and PSP patients compared to PD patients but not compared to control patients. No analytes differed statistically significantly between MSA and PSP patients. The best diagnostic discrimination, evaluated by ROC curve (AUC 0.77, p = 007, 95% CI 0.660-0.867), between PD and MSA patients was seen for a subset of analytes: CRP, TNF-α, IL-1β, and IFN-γ. CONCLUSION Among the investigated cytokines and CRP, we found a statistically significant increase of microglia-derived cytokines in MSA and PSP patients compared to PD patients.
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Affiliation(s)
- C Starhof
- Department of Neurology, Bispebjerg University Hospital, Bispebjerg Bakke 23, Copenhagen, Denmark.
| | - K Winge
- Department of Neurology, Bispebjerg University Hospital, Bispebjerg Bakke 23, Copenhagen, Denmark.,Department of Neurology, Roskilde University Hospital, Roskilde, Denmark
| | - N H H Heegaard
- Department of Clinical Biochemistry, University of Southern Denmark, Odense, Denmark.,Department of Autoimmunology and Biomarkers, Statens Serum Institute, Copenhagen, Denmark
| | - K Skogstrand
- Center for Neonatal Screening, Department of Congenital Disorders, Statens Serum Institute, Copenhagen, Denmark
| | - S Friis
- Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark.,Department of Public Health, Copenhagen University, Copenhagen, Denmark
| | - A Hejl
- Department of Neurology, Bispebjerg University Hospital, Bispebjerg Bakke 23, Copenhagen, Denmark
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69
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Konijnenberg E, Carter SF, Ten Kate M, den Braber A, Tomassen J, Amadi C, Wesselman L, Nguyen HT, van de Kreeke JA, Yaqub M, Demuru M, Mulder SD, Hillebrand A, Bouwman FH, Teunissen CE, Serné EH, Moll AC, Verbraak FD, Hinz R, Pendleton N, Lammertsma AA, van Berckel BNM, Barkhof F, Boomsma DI, Scheltens P, Herholz K, Visser PJ. The EMIF-AD PreclinAD study: study design and baseline cohort overview. ALZHEIMERS RESEARCH & THERAPY 2018; 10:75. [PMID: 30075734 PMCID: PMC6091034 DOI: 10.1186/s13195-018-0406-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 07/12/2018] [Indexed: 12/26/2022]
Abstract
Background Amyloid pathology is the pathological hallmark in Alzheimer’s disease (AD) and can precede clinical dementia by decades. So far it remains unclear how amyloid pathology leads to cognitive impairment and dementia. To design AD prevention trials it is key to include cognitively normal subjects at high risk for amyloid pathology and to find predictors of cognitive decline in these subjects. These goals can be accomplished by targeting twins, with additional benefits to identify genetic and environmental pathways for amyloid pathology, other AD biomarkers, and cognitive decline. Methods From December 2014 to October 2017 we enrolled cognitively normal participants aged 60 years and older from the ongoing Manchester and Newcastle Age and Cognitive Performance Research Cohort and the Netherlands Twins Register. In Manchester we included single individuals, and in Amsterdam monozygotic twin pairs. At baseline, participants completed neuropsychological tests and questionnaires, and underwent physical examination, blood sampling, ultrasound of the carotid arteries, structural and resting state functional brain magnetic resonance imaging, and dynamic amyloid positron emission tomography (PET) scanning with [18F]flutemetamol. In addition, the twin cohort underwent lumbar puncture for cerebrospinal fluid collection, buccal cell collection, magnetoencephalography, optical coherence tomography, and retinal imaging. Results We included 285 participants, who were on average 74.8 ± 9.7 years old, 64% female. Fifty-eight participants (22%) had an abnormal amyloid PET scan. Conclusions A rich baseline dataset of cognitively normal elderly individuals has been established to estimate risk factors and biomarkers for amyloid pathology and future cognitive decline. Electronic supplementary material The online version of this article (10.1186/s13195-018-0406-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elles Konijnenberg
- Alzheimer Center, Department of Neurology, VU University Medical Center, Neuroscience Amsterdam, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - Stephen F Carter
- Wolfson Molecular Imaging Centre, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Mara Ten Kate
- Alzheimer Center, Department of Neurology, VU University Medical Center, Neuroscience Amsterdam, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Anouk den Braber
- Alzheimer Center, Department of Neurology, VU University Medical Center, Neuroscience Amsterdam, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.,Department of Biological Psychology, VU University, Neuroscience Amsterdam, Amsterdam, The Netherlands
| | - Jori Tomassen
- Alzheimer Center, Department of Neurology, VU University Medical Center, Neuroscience Amsterdam, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Chinenye Amadi
- Wolfson Molecular Imaging Centre, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Linda Wesselman
- Alzheimer Center, Department of Neurology, VU University Medical Center, Neuroscience Amsterdam, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Hoang-Ton Nguyen
- Department of Ophthalmology, VU University Medical Center, Neuroscience Amsterdam, Amsterdam, The Netherlands
| | - Jacoba A van de Kreeke
- Department of Ophthalmology, VU University Medical Center, Neuroscience Amsterdam, Amsterdam, The Netherlands
| | - Maqsood Yaqub
- Department of Radiology & Nuclear Medicine, VU University Medical Center, Neuroscience Amsterdam, Amsterdam, The Netherlands
| | - Matteo Demuru
- Alzheimer Center, Department of Neurology, VU University Medical Center, Neuroscience Amsterdam, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Sandra D Mulder
- Neurochemistry Laboratory, Department of Clinical Chemistry, VU University Medical Center, Neuroscience Amsterdam, Amsterdam, The Netherlands
| | - Arjan Hillebrand
- Department of Clinical Neurophysiology, VU University Medical Center, Neuroscience Amsterdam, Amsterdam, The Netherlands
| | - Femke H Bouwman
- Alzheimer Center, Department of Neurology, VU University Medical Center, Neuroscience Amsterdam, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, VU University Medical Center, Neuroscience Amsterdam, Amsterdam, The Netherlands
| | - Erik H Serné
- Department of Internal Medicine, VU University Medical Center, Neuroscience Amsterdam, Amsterdam, The Netherlands
| | - Annette C Moll
- Department of Ophthalmology, VU University Medical Center, Neuroscience Amsterdam, Amsterdam, The Netherlands
| | - Frank D Verbraak
- Department of Ophthalmology, VU University Medical Center, Neuroscience Amsterdam, Amsterdam, The Netherlands
| | - Rainer Hinz
- Wolfson Molecular Imaging Centre, Division of Informatics, Imaging and Data Sciences, Faculty of Medicine, Biology and Health, University of Manchester, Manchester, UK
| | - Neil Pendleton
- Wolfson Molecular Imaging Centre, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Adriaan A Lammertsma
- Department of Radiology & Nuclear Medicine, VU University Medical Center, Neuroscience Amsterdam, Amsterdam, The Netherlands
| | - Bart N M van Berckel
- Department of Radiology & Nuclear Medicine, VU University Medical Center, Neuroscience Amsterdam, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology & Nuclear Medicine, VU University Medical Center, Neuroscience Amsterdam, Amsterdam, The Netherlands.,Institutes of Neurology & Healthcare Engineering, UCL, London, UK
| | - Dorret I Boomsma
- Department of Biological Psychology, VU University, Neuroscience Amsterdam, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center, Department of Neurology, VU University Medical Center, Neuroscience Amsterdam, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Karl Herholz
- Wolfson Molecular Imaging Centre, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Pieter Jelle Visser
- Alzheimer Center, Department of Neurology, VU University Medical Center, Neuroscience Amsterdam, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
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70
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Hansson O, Mikulskis A, Fagan AM, Teunissen C, Zetterberg H, Vanderstichele H, Molinuevo JL, Shaw LM, Vandijck M, Verbeek MM, Savage M, Mattsson N, Lewczuk P, Batrla R, Rutz S, Dean RA, Blennow K. The impact of preanalytical variables on measuring cerebrospinal fluid biomarkers for Alzheimer's disease diagnosis: A review. Alzheimers Dement 2018; 14:1313-1333. [DOI: 10.1016/j.jalz.2018.05.008] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 04/20/2018] [Accepted: 05/03/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Oskar Hansson
- Department of Neurology; Skåne University Hospital; Lund Sweden
- Memory Clinic; Skåne University Hospital; Malmö Sweden
| | | | - Anne M. Fagan
- Department of Neurology; Washington University School of Medicine; St Louis MO USA
| | | | - Henrik Zetterberg
- UK Dementia Research Institute; London UK
- Department of Molecular Neuroscience; UCL Institute of Neurology; London UK
- Clinical Neurochemistry Laboratory; Sahlgrenska University Hospital; Mölndal Sweden
- Department of Psychiatry and Neurochemistry; Sahlgrenska Academy at the University of Gothenburg; Mölndal Sweden
| | | | - Jose Luis Molinuevo
- BarcelonaBeta Brain Research Center; Pasqual Maragall Foundation; Barcelona Spain
| | - Leslie M. Shaw
- Department of Pathology and Laboratory Medicine; Perelman School of Medicine; University of Pennsylvania; Philadelphia PA USA
| | | | - Marcel M. Verbeek
- Radboud University Medical Center; Departments of Neurology and Laboratory Medicine; Donders Institute for Brain; Cognition and Behaviour; Nijmegen The Netherlands
| | | | - Niklas Mattsson
- Department of Neurology; Skåne University Hospital; Lund Sweden
| | - Piotr Lewczuk
- Department of Psychiatry and Psychotherapy; Universitätsklinikum Erlangen; Friedrich-Alexander Universität Erlangen-Nürnberg; Germany
- Department of Neurodegeneration Diagnostics; Medical University of Bialystok; Poland
| | | | | | - Robert A. Dean
- Department of Pathology and Laboratory Medicine; Indiana University School of Medicine; Indianapolis IN USA
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory; Sahlgrenska University Hospital; Mölndal Sweden
- Department of Psychiatry and Neurochemistry; Sahlgrenska Academy at the University of Gothenburg; Mölndal Sweden
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71
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Lewczuk P, Riederer P, O’Bryant SE, Verbeek MM, Dubois B, Visser PJ, Jellinger KA, Engelborghs S, Ramirez A, Parnetti L, Jack CR, Teunissen CE, Hampel H, Lleó A, Jessen F, Glodzik L, de Leon MJ, Fagan AM, Molinuevo JL, Jansen WJ, Winblad B, Shaw LM, Andreasson U, Otto M, Mollenhauer B, Wiltfang J, Turner MR, Zerr I, Handels R, Thompson AG, Johansson G, Ermann N, Trojanowski JQ, Karaca I, Wagner H, Oeckl P, van Waalwijk van Doorn L, Bjerke M, Kapogiannis D, Kuiperij HB, Farotti L, Li Y, Gordon BA, Epelbaum S, Vos SJB, Klijn CJM, Van Nostrand WE, Minguillon C, Schmitz M, Gallo C, Mato AL, Thibaut F, Lista S, Alcolea D, Zetterberg H, Blennow K, Kornhuber J, Riederer P, Gallo C, Kapogiannis D, Mato AL, Thibaut F. Cerebrospinal fluid and blood biomarkers for neurodegenerative dementias: An update of the Consensus of the Task Force on Biological Markers in Psychiatry of the World Federation of Societies of Biological Psychiatry. World J Biol Psychiatry 2018; 19:244-328. [PMID: 29076399 PMCID: PMC5916324 DOI: 10.1080/15622975.2017.1375556] [Citation(s) in RCA: 183] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In the 12 years since the publication of the first Consensus Paper of the WFSBP on biomarkers of neurodegenerative dementias, enormous advancement has taken place in the field, and the Task Force takes now the opportunity to extend and update the original paper. New concepts of Alzheimer's disease (AD) and the conceptual interactions between AD and dementia due to AD were developed, resulting in two sets for diagnostic/research criteria. Procedures for pre-analytical sample handling, biobanking, analyses and post-analytical interpretation of the results were intensively studied and optimised. A global quality control project was introduced to evaluate and monitor the inter-centre variability in measurements with the goal of harmonisation of results. Contexts of use and how to approach candidate biomarkers in biological specimens other than cerebrospinal fluid (CSF), e.g. blood, were precisely defined. Important development was achieved in neuroimaging techniques, including studies comparing amyloid-β positron emission tomography results to fluid-based modalities. Similarly, development in research laboratory technologies, such as ultra-sensitive methods, raises our hopes to further improve analytical and diagnostic accuracy of classic and novel candidate biomarkers. Synergistically, advancement in clinical trials of anti-dementia therapies energises and motivates the efforts to find and optimise the most reliable early diagnostic modalities. Finally, the first studies were published addressing the potential of cost-effectiveness of the biomarkers-based diagnosis of neurodegenerative disorders.
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Affiliation(s)
- Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, and Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
- Department of Neurodegeneration Diagnostics, Medical University of Białystok, and Department of Biochemical Diagnostics, University Hospital of Białystok, Białystok, Poland
| | - Peter Riederer
- Center of Mental Health, Clinic and Policlinic of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Sid E. O’Bryant
- Institute for Healthy Aging, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Marcel M. Verbeek
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Nijmegen, The Netherlands
- Department of Laboratory Medicine, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer center, Nijmegen, The Netherlands
| | - Bruno Dubois
- Institut de la Mémoire et de la Maladie d’Alzheimer (IM2A), Salpêtrièrie Hospital, INSERM UMR-S 975 (ICM), Paris 6 University, Paris, France
| | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
- Department of Neurology, Alzheimer Centre, Amsterdam Neuroscience VU University Medical Centre, Amsterdam, The Netherlands
| | | | - Sebastiaan Engelborghs
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium
- Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium
| | - Alfredo Ramirez
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Lucilla Parnetti
- Section of Neurology, Center for Memory Disturbances, Lab of Clinical Neurochemistry, University of Perugia, Perugia, Italy
| | | | - Charlotte E. Teunissen
- Neurochemistry Lab and Biobank, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Harald Hampel
- AXA Research Fund & UPMC Chair, Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Paris 06, Inserm, CNRS, Institut du Cerveau et de la Moelle Épinière (ICM), Département de Neurologie, Institut de la Mémoire et de la Maladie d’Alzheimer (IM2A), Hôpital Pitié-Salpêtrière, Boulevard de l’hôpital, Paris, France
| | - Alberto Lleó
- Department of Neurology, Institut d’Investigacions Biomèdiques Sant Pau - Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED, Spain
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
- German Center for Neurodegenerative Disorders (DZNE), Bonn, Germany
| | - Lidia Glodzik
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY, USA
| | - Mony J. de Leon
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY, USA
| | - Anne M. Fagan
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - José Luis Molinuevo
- Barcelonabeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Willemijn J. Jansen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Bengt Winblad
- Karolinska Institutet, Department NVS, Center for Alzheimer Research, Division of Neurogeriatrics, Huddinge, Sweden
| | - Leslie M. Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ulf Andreasson
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Brit Mollenhauer
- Paracelsus-Elena-Klinik, Kassel and University Medical Center Göttingen, Department of Neurology, Göttingen, Germany
| | - Jens Wiltfang
- Department of Psychiatry & Psychotherapy, University of Göttingen, Göttingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- iBiMED, Medical Sciences Department, University of Aveiro, Aveiro, Portugal
| | - Martin R. Turner
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Inga Zerr
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Clinical Dementia Centre, Department of Neurology, University Medical School, Göttingen, Germany
| | - Ron Handels
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
- Karolinska Institutet, Department NVS, Center for Alzheimer Research, Division of Neurogeriatrics, Huddinge, Sweden
| | | | - Gunilla Johansson
- Karolinska Institutet, Department NVS, Center for Alzheimer Research, Division of Neurogeriatrics, Huddinge, Sweden
| | - Natalia Ermann
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, and Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - John Q. Trojanowski
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ilker Karaca
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Holger Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Patrick Oeckl
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Linda van Waalwijk van Doorn
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Nijmegen, The Netherlands
- Department of Laboratory Medicine, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer center, Nijmegen, The Netherlands
| | - Maria Bjerke
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium
| | - Dimitrios Kapogiannis
- Laboratory of Neurosciences, National Institute on Aging/National Institutes of Health (NIA/NIH), Baltimore, MD, USA
| | - H. Bea Kuiperij
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Nijmegen, The Netherlands
- Department of Laboratory Medicine, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer center, Nijmegen, The Netherlands
| | - Lucia Farotti
- Section of Neurology, Center for Memory Disturbances, Lab of Clinical Neurochemistry, University of Perugia, Perugia, Italy
| | - Yi Li
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY, USA
| | - Brian A. Gordon
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Stéphane Epelbaum
- Institut de la Mémoire et de la Maladie d’Alzheimer (IM2A), Salpêtrièrie Hospital, INSERM UMR-S 975 (ICM), Paris 6 University, Paris, France
| | - Stephanie J. B. Vos
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Catharina J. M. Klijn
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Nijmegen, The Netherlands
| | | | - Carolina Minguillon
- Barcelonabeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Matthias Schmitz
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Clinical Dementia Centre, Department of Neurology, University Medical School, Göttingen, Germany
| | - Carla Gallo
- Departamento de Ciencias Celulares y Moleculares/Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Andrea Lopez Mato
- Chair of Psychoneuroimmunoendocrinology, Maimonides University, Buenos Aires, Argentina
| | - Florence Thibaut
- Department of Psychiatry, University Hospital Cochin-Site Tarnier 89 rue d’Assas, INSERM 894, Faculty of Medicine Paris Descartes, Paris, France
| | - Simone Lista
- AXA Research Fund & UPMC Chair, Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Paris 06, Inserm, CNRS, Institut du Cerveau et de la Moelle Épinière (ICM), Département de Neurologie, Institut de la Mémoire et de la Maladie d’Alzheimer (IM2A), Hôpital Pitié-Salpêtrière, Boulevard de l’hôpital, Paris, France
| | - Daniel Alcolea
- Department of Neurology, Institut d’Investigacions Biomèdiques Sant Pau - Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED, Spain
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, and Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
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Thompson AG, Gray E, Thézénas ML, Charles PD, Evetts S, Hu MT, Talbot K, Fischer R, Kessler BM, Turner MR. Cerebrospinal fluid macrophage biomarkers in amyotrophic lateral sclerosis. Ann Neurol 2018; 83:258-268. [PMID: 29331073 DOI: 10.1002/ana.25143] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 01/04/2018] [Accepted: 01/09/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The neurodegenerative disease, amyotrophic lateral sclerosis (ALS), is a heterogeneous clinical syndrome involving multiple molecular pathways. The development of biomarkers for use in therapeutic trials is a priority. We sought to use a high-throughput proteomic method to identify novel biomarkers in individual cerebrospinal fluid (CSF) samples. METHODS Liquid chromatography/tandem mass spectrometry with label-free quantification was used to identify CSF proteins using samples from a well-characterized longitudinal cohort comprising patients with ALS (n = 43), the upper motor neuron variant, primary lateral sclerosis (PLS; n = 6), and cross-sectional healthy (n = 20) and disease controls (Parkinsons' disease, n = 20; ALS mimic disorders, n = 12). RESULTS Three macrophage-derived chitinases showed increased abundance in ALS: chitotriosidase (CHIT1), chitinase-3-like protein 1 (CHI3L1), and chitinase-3-like protein 2 (CHI3L2). Elevated CHI3L1 was common to ALS and PLS, whereas CHIT1 and CHI3L2 levels differed. Chitinase levels correlated with disease progression rate (CHIT1, r = 0.56, p < 0.001; CHI3L1, r = 0.31; p = 0.028; CHI3L2, r = 0.29, p = 0.044). CHIT1, CHI3L1, and CHI3L2 levels correlated with phosphorylated neurofilament heavy chain (pNFH; r = 0.62, p < 0.001; r = 0.49, p < 0.001; r = 0.41, p < 0.001). CHI3L1 levels, but not CHIT1 or CHI3L2, increased over time in those with low initial levels (gradient = 0.005 log abundance units/month, p = 0.001). High CHIT1 was associated with shortened survival (hazard ratio [HR] 2.84; p = 0.009). Inclusion of pNFH in survival models left only an association of pNFH and survival (HR 1.26; p = 0.019). INTERPRETATION Neuroinflammatory mechanisms have been consistently implicated through various experimental paradigms. These results support a key role for macrophage activity in ALS pathogenesis, offering novel target engagement and pharmacodynamic biomarkers for neuroinflammation-focused ALS therapy. Ann Neurol 2018;83:258-268.
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Affiliation(s)
- Alexander G Thompson
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - Elizabeth Gray
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | | | - Philip D Charles
- Target Discovery Institute, University of Oxford, Oxford, United Kingdom
| | - Samuel Evetts
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - Michele T Hu
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - Kevin Talbot
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - Roman Fischer
- Target Discovery Institute, University of Oxford, Oxford, United Kingdom
| | - Benedikt M Kessler
- Target Discovery Institute, University of Oxford, Oxford, United Kingdom
| | - Martin R Turner
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
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Teunissen CE, Verheul C, Willemse EAJ. The use of cerebrospinal fluid in biomarker studies. HANDBOOK OF CLINICAL NEUROLOGY 2018; 146:3-20. [PMID: 29110777 DOI: 10.1016/b978-0-12-804279-3.00001-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Cerebrospinal fluid (CSF) is an extremely useful matrix for biomarker research for several purposes, such as diagnosis, prognosis, monitoring, and identification of prominent leads in pathways of neurologic diseases. Such biomarkers can be identified based on a priori hypotheses around prominent protein changes, but also by applying -omics technologies. Proteomics is widely used, but metabolomics and transcriptomics are rapidly revealing their potential for CSF studies. The basis of such studies is the availability of high-quality biobanks. Furthermore, profound knowledge and consequent optimization of all aspects in biomarker development are needed. Here we discuss current knowledge and recently developed protocols for successful biomarker studies, from collection of CSF by lumbar puncture, processing, and biobanking protocols, preanalytic confounding factors, and cost-efficient development and validation of assays for implementation into clinical practice or research.
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Affiliation(s)
- C E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands.
| | - C Verheul
- Department of Neurosurgery, Brain Tumor Center, Erasmus Medical Center, Rotterdam, the Netherlands
| | - E A J Willemse
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
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Promise, Progress, and Pitfalls in the Search for Central Nervous System Biomarkers in Neuroimmunological Diseases: A Role for Cerebrospinal Fluid Immunophenotyping. Semin Pediatr Neurol 2017; 24:229-239. [PMID: 29103430 PMCID: PMC5697729 DOI: 10.1016/j.spen.2017.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Biomarkers are central to the translational medicine strategic focus, though strict criteria need to be applied to their designation and utility. They are one of the most promising areas of medical research, but the "biomarker life-cycle" must be understood to avoid false-positive and false-negative results. Molecular biomarkers will revolutionize the treatment of neurological diseases, but the rate of progress depends on a bold, visionary stance by neurologists, as well as scientists, biotech and pharmaceutical industries, funding agencies, and regulators. One important tool in studying cell-specific biomarkers is multiparameter flow cytometry. Cerebrospinal fluid immunophenotyping, or immune phenotypic subsets, captures the biology of intrathecal inflammatory processes, and has the potential to guide personalized immunotherapeutic selection and monitor treatment efficacy. Though data exist for some disorders, they are surprisingly lacking in many others, identifying a serious deficit to be overcome. Flow cytometric immunophenotyping provides a valuable, available, and feasible "window" into both adaptive and innate components of neuroinflammation that is currently underutilized.
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75
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Nuvolone M, Schmid N, Miele G, Sorce S, Moos R, Schori C, Beerli RR, Bauer M, Saudan P, Dietmeier K, Lachmann I, Linnebank M, Martin R, Kallweit U, Kana V, Rushing EJ, Budka H, Aguzzi A. Cystatin F is a biomarker of prion pathogenesis in mice. PLoS One 2017; 12:e0171923. [PMID: 28178353 PMCID: PMC5298286 DOI: 10.1371/journal.pone.0171923] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 01/29/2017] [Indexed: 01/21/2023] Open
Abstract
Misfolding of the cellular prion protein (PrPC) into the scrapie prion protein (PrPSc) results in progressive, fatal, transmissible neurodegenerative conditions termed prion diseases. Experimental and epidemiological evidence point toward a protracted, clinically silent phase in prion diseases, yet there is no diagnostic test capable of identifying asymptomatic individuals incubating prions. In an effort to identify early biomarkers of prion diseases, we have compared global transcriptional profiles in brains from pre-symptomatic prion-infected mice and controls. We identified Cst7, which encodes cystatin F, as the most strongly upregulated transcript in this model. Early and robust upregulation of Cst7 mRNA levels and of its cognate protein was validated in additional mouse models of prion disease. Surprisingly, we found no significant increase in cystatin F levels in both cerebrospinal fluid or brain parenchyma of patients with Creutzfeldt-Jakob disease compared to Alzheimer’s disease or non-demented controls. Our results validate cystatin F as a useful biomarker of early pathogenesis in experimental models of prion disease, and point to unexpected species-specific differences in the transcriptional responses to prion infections.
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Affiliation(s)
- Mario Nuvolone
- Institute of Neuropathology, University Hospital of Zurich, Zurich, Switzerland
| | - Nicolas Schmid
- Institute of Neuropathology, University Hospital of Zurich, Zurich, Switzerland
| | - Gino Miele
- Institute of Neuropathology, University Hospital of Zurich, Zurich, Switzerland
| | - Silvia Sorce
- Institute of Neuropathology, University Hospital of Zurich, Zurich, Switzerland
| | - Rita Moos
- Institute of Neuropathology, University Hospital of Zurich, Zurich, Switzerland
| | | | | | - Monika Bauer
- Cytos Biotechnology AG, Zurich-Schlieren, Switzerland
| | | | | | | | - Michael Linnebank
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Roland Martin
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Ulf Kallweit
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
- Department of Neurology; Bern University Hospital and University of Bern, Bern, Switzerland
| | - Veronika Kana
- Institute of Neuropathology, University Hospital of Zurich, Zurich, Switzerland
| | | | - Herbert Budka
- Institute of Neuropathology, University Hospital of Zurich, Zurich, Switzerland
| | - Adriano Aguzzi
- Institute of Neuropathology, University Hospital of Zurich, Zurich, Switzerland
- * E-mail:
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El Ayoubi NK, Khoury SJ. Blood Biomarkers as Outcome Measures in Inflammatory Neurologic Diseases. Neurotherapeutics 2017; 14:135-147. [PMID: 27757816 PMCID: PMC5233628 DOI: 10.1007/s13311-016-0486-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Multiple sclerosis (MS) is an autoimmune demyelinating disorder of the central nervous system. Only a few biomarkers are available in MS clinical practice, such as cerebrospinal fluid oligoclonal bands and immunoglobulin index, serum anti-aquaporin 4 antibodies, and serum anti-John Cunningham virus antibodies. Thus, there is a significant unmet need for biomarkers to assess prognosis, response to therapy, or potential treatment complications. Here we describe emerging biomarkers that are in development, focusing on those from peripheral blood. There are several limitations in the process of discovery and validation of a good biomarker, such as the pathophysiological complexity of MS and the technical difficulties in globally standardizing methods for sampling, processing, and conserving biological specimens. In spite of these limitations, ongoing international collaborations allow the exploration of many interesting molecules and markers to validate diagnostic, prognostic, and therapeutic-response biomarkers.
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Affiliation(s)
- Nabil K El Ayoubi
- American University of Beirut and Medical Center, Nehme and Therese Tohme Multiple Sclerosis Center, Riad El Solh, Beirut, 1107 2020, Lebanon
| | - Samia J Khoury
- American University of Beirut and Medical Center, Nehme and Therese Tohme Multiple Sclerosis Center, Riad El Solh, Beirut, 1107 2020, Lebanon.
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Guldbrandsen A, Farag Y, Kroksveen AC, Oveland E, Lereim RR, Opsahl JA, Myhr KM, Berven FS, Barsnes H. CSF-PR 2.0: An Interactive Literature Guide to Quantitative Cerebrospinal Fluid Mass Spectrometry Data from Neurodegenerative Disorders. Mol Cell Proteomics 2016; 16:300-309. [PMID: 27890865 DOI: 10.1074/mcp.o116.064477] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 11/18/2016] [Indexed: 01/23/2023] Open
Abstract
The rapidly growing number of biomedical studies supported by mass spectrometry based quantitative proteomics data has made it increasingly difficult to obtain an overview of the current status of the research field. A better way of organizing the biomedical proteomics information from these studies and making it available to the research community is therefore called for. In the presented work, we have investigated scientific publications describing the analysis of the cerebrospinal fluid proteome in relation to multiple sclerosis, Parkinson's disease and Alzheimer's disease. Based on a detailed set of filtering criteria we extracted 85 data sets containing quantitative information for close to 2000 proteins. This information was made available in CSF-PR 2.0 (http://probe.uib.no/csf-pr-2.0), which includes novel approaches for filtering, visualizing and comparing quantitative proteomics information in an interactive and user-friendly environment. CSF-PR 2.0 will be an invaluable resource for anyone interested in quantitative proteomics on cerebrospinal fluid.
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Affiliation(s)
- Astrid Guldbrandsen
- From the ‡Proteomics Unit (PROBE), Department of Biomedicine, University of Bergen, 5009 Bergen, Norway.,§KG Jebsen Centre for Multiple Sclerosis Research, Department of Clinical Medicine, University of Bergen, 5020 Bergen, Norway
| | - Yehia Farag
- From the ‡Proteomics Unit (PROBE), Department of Biomedicine, University of Bergen, 5009 Bergen, Norway.,§KG Jebsen Centre for Multiple Sclerosis Research, Department of Clinical Medicine, University of Bergen, 5020 Bergen, Norway
| | - Ann Cathrine Kroksveen
- From the ‡Proteomics Unit (PROBE), Department of Biomedicine, University of Bergen, 5009 Bergen, Norway.,§KG Jebsen Centre for Multiple Sclerosis Research, Department of Clinical Medicine, University of Bergen, 5020 Bergen, Norway
| | - Eystein Oveland
- From the ‡Proteomics Unit (PROBE), Department of Biomedicine, University of Bergen, 5009 Bergen, Norway.,§KG Jebsen Centre for Multiple Sclerosis Research, Department of Clinical Medicine, University of Bergen, 5020 Bergen, Norway
| | - Ragnhild R Lereim
- From the ‡Proteomics Unit (PROBE), Department of Biomedicine, University of Bergen, 5009 Bergen, Norway.,§KG Jebsen Centre for Multiple Sclerosis Research, Department of Clinical Medicine, University of Bergen, 5020 Bergen, Norway
| | - Jill A Opsahl
- From the ‡Proteomics Unit (PROBE), Department of Biomedicine, University of Bergen, 5009 Bergen, Norway.,§KG Jebsen Centre for Multiple Sclerosis Research, Department of Clinical Medicine, University of Bergen, 5020 Bergen, Norway
| | - Kjell-Morten Myhr
- §KG Jebsen Centre for Multiple Sclerosis Research, Department of Clinical Medicine, University of Bergen, 5020 Bergen, Norway.,¶Norwegian Multiple Sclerosis Registry and Biobank, Haukeland University Hospital, 5021 Bergen, Norway
| | - Frode S Berven
- From the ‡Proteomics Unit (PROBE), Department of Biomedicine, University of Bergen, 5009 Bergen, Norway; .,§KG Jebsen Centre for Multiple Sclerosis Research, Department of Clinical Medicine, University of Bergen, 5020 Bergen, Norway.,‖Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, 5021 Bergen, Norway
| | - Harald Barsnes
- From the ‡Proteomics Unit (PROBE), Department of Biomedicine, University of Bergen, 5009 Bergen, Norway.,**Department of Clinical Science, University of Bergen, 5020 Bergen, Norway.,‡‡Computational Biology Unit, Department of Informatics, University of Bergen, 5020 Bergen, Norway
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Benigni M, Ricci C, Jones AR, Giannini F, Al-Chalabi A, Battistini S. Identification of miRNAs as Potential Biomarkers in Cerebrospinal Fluid from Amyotrophic Lateral Sclerosis Patients. Neuromolecular Med 2016; 18:551-560. [PMID: 27119371 DOI: 10.1007/s12017-016-8396-8] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 04/15/2016] [Indexed: 12/31/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) is a progressive, fatal neurodegenerative disorder. Since no diagnostic laboratory test exists, the identification of specific biomarkers could be fundamental in clinical practice. microRNAs (miRNAs) are considered promising biomarkers for neurodegenerative diseases. The aim of the study was to identify a CSF miRNA set that could differentiate ALS from non-ALS condition. miRNA profiling in CSF from ALS patients (n = 24; eight with C9orf72 expansion) and unaffected control subjects (n = 24) by quantitative reverse transcription PCR identified fourteen deregulated miRNAs. Validation experiments confirmed eight miRNAs as significantly deregulated in ALS. No significant differences were observed between ALS patients with or without C9orf72 expansion. The receiver operator characteristic (ROC) curve analyses revealed the highest diagnostic accuracy for the upregulated miR181a-5p and the downregulated miR21-5p and miR15b-5p. The miR181a-5p/miR21-5p and miR181a-5p/miR15b-5p ratios detected ALS with 90 and 85 % sensitivity and 87 and 91 % specificity, respectively, confirming the application potential as disease biomarkers. These deregulated miRNAs are implicated in apoptotic way and provide insight into processes responsible for motor neuron degeneration.
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Affiliation(s)
- Michele Benigni
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Claudia Ricci
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy.
| | - Ashley R Jones
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Fabio Giannini
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Ammar Al-Chalabi
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Stefania Battistini
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
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Hellwig K, Kvartsberg H, Portelius E, Andreasson U, Oberstein TJ, Lewczuk P, Blennow K, Kornhuber J, Maler JM, Zetterberg H, Spitzer P. Neurogranin and YKL-40: independent markers of synaptic degeneration and neuroinflammation in Alzheimer's disease. ALZHEIMERS RESEARCH & THERAPY 2015; 7:74. [PMID: 26698298 PMCID: PMC4690296 DOI: 10.1186/s13195-015-0161-y] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 10/28/2015] [Indexed: 12/17/2022]
Abstract
Introduction Neuroinflammation and synaptic degeneration are major neuropathological hallmarks in Alzheimer’s disease (AD). Neurogranin and YKL-40 in cerebrospinal fluid (CSF) are newly discovered markers indicating synaptic damage and microglial activation, respectively. Methods CSF samples from 95 individuals including 39 patients with AD dementia (AD-D), 13 with mild cognitive impairment (MCI) due to AD (MCI-AD), 29 with MCI not due to AD (MCI-o) and 14 patients with non-AD dementias (non-AD-D) were analyzed for neurogranin and YKL-40. Results Patients with dementia or MCI due to AD showed elevated levels of CSF neurogranin (p < 0.001 for AD-D and p < 0.05 for MCI-AD) and YKL-40 (p < 0.05 for AD-D and p = 0.15 for MCI-AD) compared to mildly cognitively impaired subjects not diagnosed with AD. CSF levels of neurogranin and YKL-40 did not differ between MCI not due to AD and non-AD dementias. In AD subjects no correlation between YKL-40 and neurogranin was found. The CSF neurogranin levels correlated moderately with tau and p-tau but not with Aβ42 or the MMSE in AD samples. No relevant associations between YKL-40 and MMSE or the core AD biomarkers, Aβ42, t-tau and p-tau were found in AD subjects. Conclusions Neurogranin and YKL-40 are promising AD biomarkers, independent of and complementary to the established core AD biomarkers, reflecting additional pathological changes in the course of AD. Electronic supplementary material The online version of this article (doi:10.1186/s13195-015-0161-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Konstantin Hellwig
- Department of Psychiatry and Psychotherapy, University clinic Erlangen and Friedrich-Alexander University Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany.
| | - Hlin Kvartsberg
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden. .,AlzeCure Foundation, Karolinska Institutet Science Park, Huddinge, Sweden.
| | - Erik Portelius
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.
| | - Ulf Andreasson
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.
| | - Timo Jan Oberstein
- Department of Psychiatry and Psychotherapy, University clinic Erlangen and Friedrich-Alexander University Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany.
| | - Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, University clinic Erlangen and Friedrich-Alexander University Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany. .,Department of Neurodegeneration Diagnostics, Medical University of Białystok, Białystok, Poland.
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University clinic Erlangen and Friedrich-Alexander University Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany.
| | - Juan Manuel Maler
- Department of Psychiatry and Psychotherapy, University clinic Erlangen and Friedrich-Alexander University Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany.
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden. .,Department of Molecular Neuroscience, UCL Institute of Neurology, London, WC1N 3BG, UK.
| | - Philipp Spitzer
- Department of Psychiatry and Psychotherapy, University clinic Erlangen and Friedrich-Alexander University Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany.
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Abstract
Existing clinical outcomes of disease activity, including relapse rates, are inherently insensitive to the underlying pathological process in MS. Moreover, it is extremely difficult to measure clinical disability in patients, which is often a retrospective assessment, and definitely not within the time frame of a clinical trial. Biomarkers , conversely are more specific for a pathologic process and if used correctly can prove invaluable in the diagnosis, stratification and monitoring of disease activity, including any subclinical activity which is not visible to the naked eye. In this chapter, we discuss the development of neurofilaments as surrogate outcomes of disability in MS. The validation and qualification are vital steps in biomarker development and to gaining acceptance in scientific community, and the pitfalls leading up to this are also discussed.
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Reijs BLR, Teunissen CE, Goncharenko N, Betsou F, Blennow K, Baldeiras I, Brosseron F, Cavedo E, Fladby T, Froelich L, Gabryelewicz T, Gurvit H, Kapaki E, Koson P, Kulic L, Lehmann S, Lewczuk P, Lleó A, Maetzler W, de Mendonça A, Miller AM, Molinuevo JL, Mollenhauer B, Parnetti L, Rot U, Schneider A, Simonsen AH, Tagliavini F, Tsolaki M, Verbeek MM, Verhey FRJ, Zboch M, Winblad B, Scheltens P, Zetterberg H, Visser PJ. The Central Biobank and Virtual Biobank of BIOMARKAPD: A Resource for Studies on Neurodegenerative Diseases. Front Neurol 2015; 6:216. [PMID: 26528237 PMCID: PMC4606063 DOI: 10.3389/fneur.2015.00216] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 09/22/2015] [Indexed: 11/28/2022] Open
Abstract
Biobanks are important resources for biomarker discovery and assay development. Biomarkers for Alzheimer’s and Parkinson’s disease (BIOMARKAPD) is a European multicenter study, funded by the EU Joint Programme-Neurodegenerative Disease Research, which aims to improve the clinical use of body fluid markers for the diagnosis and prognosis of Alzheimer’s disease (AD) and Parkinson’s disease (PD). The objective was to standardize the assessment of existing assays and to validate novel fluid biomarkers for AD and PD. To support the validation of novel biomarkers and assays, a central and a virtual biobank for body fluids and associated data from subjects with neurodegenerative diseases have been established. In the central biobank, cerebrospinal fluid (CSF) and blood samples were collected according to the BIOMARKAPD standardized pre-analytical procedures and stored at Integrated BioBank of Luxembourg. The virtual biobank provides an overview of available CSF, plasma, serum, and DNA samples at each site. Currently, at the central biobank of BIOMARKAPD samples are available from over 400 subjects with normal cognition, mild cognitive impairment (MCI), AD, frontotemporal dementia (FTD), vascular dementia, multiple system atrophy, progressive supranuclear palsy, PD, PD with dementia, and dementia with Lewy bodies. The virtual biobank contains information on over 8,600 subjects with varying diagnoses from 21 local biobanks. A website has been launched to enable sample requests from the central biobank and virtual biobank.
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Affiliation(s)
- Babette L R Reijs
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center , Maastricht , Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, VU University Medical Center , Amsterdam , Netherlands
| | | | - Fay Betsou
- Integrated Biobank of Luxembourg , Luxembourg , Luxembourg
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Department of Neuroscience and Physiology, Sahlgrenska University Hospital, The Sahlgrenska Academy at University of Gothenburg , Mölndal , Sweden
| | - Inês Baldeiras
- Center for Neuroscience and Cell Biology, Institute for Biomedical Imaging and Life Sciences, Faculty of Medicine, University of Coimbra , Coimbra , Portugal
| | - Frederic Brosseron
- German Center for Neurodegenerative Diseases (DZNE) e.V. Clinical Neuroscience and Biomarkers , Bonn , Germany
| | - Enrica Cavedo
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Fatebenefratelli , Brescia , Italy
| | - Tormod Fladby
- Department of Neurology, Akershus University Hospital , Lørenskog , Norway ; Institute of Clinical Medicine, University of Oslo , Oslo , Norway
| | - Lutz Froelich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg , Mannheim , Germany
| | - Tomasz Gabryelewicz
- Department of Neurodegenerative Disorders, Mossakowski Medical Research Centre, Polish Academy of Sciences , Warsaw , Poland
| | - Hakan Gurvit
- Behavioural Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University , Istanbul , Turkey
| | - Elisabeth Kapaki
- Neurochemistry Unit, Division of Cognitive and Movement Disorders, 1st Department of Neurology, National and Kapodistrian University of Athens , Athens , Greece
| | - Peter Koson
- Department of Neurology, Slovak Medical University, University Hospital Bratislava , Bratislava , Slovakia ; Institute of Neuroimmunology, Slovak Academy of Sciences , Bratislava , Slovakia
| | - Luka Kulic
- Division of Psychiatry Research, University of Zurich , Schlieren , Switzerland
| | - Sylvain Lehmann
- Laboratoire de Biochimie Protéomique Clinique, INSERM U1183, Institut de Médecine Régénérative et Biothérapies, CHRU de Montpellier, Université de Montpellier , Montpellier , France
| | - Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen and Friedrich-Alexander Universität Erlangen-Nürnberg , Erlangen , Germany ; Department of Neurodegeneration Diagnostics, Medical University of Bialystok , Bialystok , Poland
| | - Alberto Lleó
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau-Biomedical Research Institute Sant Pau , Barcelona , Spain ; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED) , Madrid , Spain
| | - Walter Maetzler
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen , Tübingen , Germany ; German Center for Neurodegenerative Diseases (DZNE), University of Tübingen , Tübingen , Germany
| | | | - Anne-Marie Miller
- Medical Gerontology, School of Medicine, Trinity College Dublin , Dublin , Ireland
| | - José L Molinuevo
- ICN Hospital Clinic i Universitari, Institut d'Investigacions Biomèdiques August Pi i Sunyer , Barcelona , Spain
| | - Brit Mollenhauer
- Paracelsus-Elena-Klinik , Kassel , Germany ; Department of Neurosurgery and Institute of Neuropathology, University Medical Center Göttingen , Göttingen , Germany
| | - Lucilla Parnetti
- Section of Neurology, Centre for Memory Disturbances, University of Perugia , Perugia , Italy
| | - Uros Rot
- Laboratory for CSF Diagnostics, Department of Neurology, University Medical Centre , Ljubljana , Slovenia
| | - Anja Schneider
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen and Translational Dementia Research Group, German Center for Neurodegenerative Diseases (DZNE) , Göttingen , Germany
| | - Anja Hviid Simonsen
- Danish Dementia Research Centre, Rigshospitalet, Copenhagen University Hospital , Copenhagen , Denmark
| | - Fabrizio Tagliavini
- Unit of Neuropathology, Department of Diagnostics and Technology, IRCCS Foundation "Carlo Besta" Neurological Institute , Milan , Italy
| | - Magda Tsolaki
- 3rd Department of Neurology, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Marcel M Verbeek
- Department of Neurology, Radboud Alzheimer Centre, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre , Nijmegen , Netherlands ; Department of Laboratory Medicine, Radboud Alzheimer Centre, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre , Nijmegen , Netherlands
| | - Frans R J Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center , Maastricht , Netherlands
| | - Marzena Zboch
- Research-Scientific-Didactic Centre of Dementia-Related Diseases, Wrocław Medical University , Scinawa , Poland
| | - Bengt Winblad
- Division of Neurogeriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Huddinge , Sweden
| | - Philip Scheltens
- Department of Neurology, Alzheimer Center, VU University Medical Center , Amsterdam , Netherlands
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg , Mölndal , Sweden ; UCL Institute of Neurology , London , UK
| | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center , Maastricht , Netherlands ; Department of Neurology, Alzheimer Center, VU University Medical Center , Amsterdam , Netherlands
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Del Campo M, Jongbloed W, Twaalfhoven HAM, Veerhuis R, Blankenstein MA, Teunissen CE. Facilitating the Validation of Novel Protein Biomarkers for Dementia: An Optimal Workflow for the Development of Sandwich Immunoassays. Front Neurol 2015; 6:202. [PMID: 26483753 PMCID: PMC4586418 DOI: 10.3389/fneur.2015.00202] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 08/31/2015] [Indexed: 01/11/2023] Open
Abstract
Different neurodegenerative disorders, such as Alzheimer’s disease (AD) and frontotemporal dementia (FTD), lead to dementia syndromes. Dementia will pose a huge impact on society and thus it is essential to develop novel tools that are able to detect the earliest, most sensitive, discriminative, and dynamic biomarkers for each of the disorders. To date, the most common assays used in large-scale protein biomarker analysis are enzyme-linked immunosorbent assays (ELISA), such as the sandwich immunoassays, which are sensitive, practical, and easily implemented. However, due to the novelty of many candidate biomarkers identified during proteomics screening, such assays or the antibodies that specifically recognize the desired marker are often not available. The development and optimization of a new ELISA should be carried out with considerable caution since a poor planning can be costly, ineffective, time consuming, and it may lead to a misinterpretation of the findings. Previous guidelines described either the overall biomarker development in more general terms (i.e., the process from biomarker discovery to validation) or the specific steps of performing an ELISA procedure. However, a workflow describing and guiding the main issues in the development of a novel ELISA is missing. Here, we describe a specific and detailed workflow to develop and validate new ELISA for a successful and reliable validation of novel dementia biomarkers. The proposed workflow highlights the main issues in the development of an ELISA and covers several critical aspects, including production, screening, and selection of specific antibodies until optimal fine-tuning of the assay. Although these recommendations are designed to analyze novel biomarkers for dementia in cerebrospinal fluid, they are generally applicable for the development of immunoassays for biomarkers in other human body fluids or tissues. This workflow is designed to maximize the quality of the developed ELISA using a time- and cost-efficient strategy. This will facilitate the validation of the dementia biomarker candidates ultimately allowing accurate diagnostic conclusions.
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Affiliation(s)
- Marta Del Campo
- Neurochemistry Laboratory, VU University Medical Center , Amsterdam , Netherlands ; Department of Clinical Chemistry, VU University Medical Center , Amsterdam , Netherlands
| | - Wesley Jongbloed
- Department of Clinical Chemistry, VU University Medical Center , Amsterdam , Netherlands
| | - Harry A M Twaalfhoven
- Neurochemistry Laboratory, VU University Medical Center , Amsterdam , Netherlands ; Department of Clinical Chemistry, VU University Medical Center , Amsterdam , Netherlands
| | - Robert Veerhuis
- Neurochemistry Laboratory, VU University Medical Center , Amsterdam , Netherlands ; Department of Psychiatry, VU University Medical Center , Amsterdam , Netherlands
| | - Marinus A Blankenstein
- Department of Clinical Chemistry, VU University Medical Center , Amsterdam , Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, VU University Medical Center , Amsterdam , Netherlands ; Department of Clinical Chemistry, VU University Medical Center , Amsterdam , Netherlands
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Teunissen CE, Malekzadeh A, Leurs C, Bridel C, Killestein J. Body fluid biomarkers for multiple sclerosis--the long road to clinical application. Nat Rev Neurol 2015; 11:585-96. [PMID: 26392381 DOI: 10.1038/nrneurol.2015.173] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
There is a strong unmet clinical need for objective body fluid biomarkers to assist early diagnosis and estimate long-term prognosis, monitor treatment response and predict potential adverse effects in multiple sclerosis (MS). Here, we review recent studies (focusing on 2012 to early 2015) on body fluid markers in MS from the perspective of their clinical utility. Because the first step towards clinical implementation of a newly discovered biomarker is independent replication, we focus on biomarkers that have been validated in at least two independent cohorts. We also discuss recent data challenging earlier findings, and biomarkers for which new clinical uses are suggested. For early MS diagnosis and prediction of conversion from clinically isolated syndrome to MS, several new B-cell-associated candidate blood biomarkers have emerged. For prognosis, several novel axonal damage markers should be adopted to biomarker panels. The number of disease-modifying treatments for MS has increased sharply, but biomarkers for treatment response monitoring and adverse effect prediction are scarce, and markers for subtyping and staging of MS are still lacking. In view of the availability and implementation of several standardized protocols to optimize biomarker studies, we expect biomarker development for MS to be improved and accelerated, with clinical implementation in the near future.
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Affiliation(s)
- Charlotte E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Centre, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands
| | - Arjan Malekzadeh
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Centre, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands
| | - Cyra Leurs
- Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands
| | - Claire Bridel
- Department of Clinical Neurosciences, Division of Neurology, Unit of Neuroimmunology and Multiple Sclerosis, Geneva University Hospital, Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Joep Killestein
- Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands
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84
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Hutchinson M. The only certain measure of the effectiveness of multiple sclerosis therapy is cerebrospinal neurofilament level: Commentary. Mult Scler 2015; 21:1242-3. [PMID: 26242693 DOI: 10.1177/1352458515599682] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Leitão MJ, Baldeiras I, Herukka SK, Pikkarainen M, Leinonen V, Simonsen AH, Perret-Liaudet A, Fourier A, Quadrio I, Veiga PM, de Oliveira CR. Chasing the Effects of Pre-Analytical Confounders - A Multicenter Study on CSF-AD Biomarkers. Front Neurol 2015. [PMID: 26217300 PMCID: PMC4495343 DOI: 10.3389/fneur.2015.00153] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Core cerebrospinal fluid (CSF) biomarkers – Aβ42, Tau, and phosphorylated Tau (pTau) – have been recently incorporated in the revised criteria for Alzheimer’s disease (AD). However, their widespread clinical application lacks standardization. Pre-analytical sample handling and storage play an important role in the reliable measurement of these biomarkers across laboratories. Aim In this study, we aim to surpass the efforts from previous studies, by employing a multicenter approach to assess the impact of less studied CSF pre-analytical confounders in AD-biomarkers quantification. Methods Four different centers participated in this study and followed the same established protocol. CSF samples were analyzed for three biomarkers (Aβ42, Tau, and pTau) and tested for different spinning conditions [temperature: room temperature (RT) vs. 4°C; speed: 500 vs. 2000 vs. 3000 g], storage volume variations (25, 50, and 75% of tube total volume), as well as freezing-thaw cycles (up to five cycles). The influence of sample routine parameters, inter-center variability, and relative value of each biomarker (reported as normal/abnormal) was analyzed. Results Centrifugation conditions did not influence biomarkers levels, except for samples with a high CSF total protein content, where either non-centrifugation or centrifugation at RT, compared to 4°C, led to higher Aβ42 levels. Reducing CSF storage volume from 75 to 50% of total tube capacity decreased Aβ42 concentration (within analytical CV of the assay), whereas no change in Tau or pTau was observed. Moreover, the concentration of Tau and pTau appears to be stable up to five freeze–thaw cycles, whereas Aβ42 levels decrease if CSF is freeze-thawed more than three times. Conclusion This systematic study reinforces the need for CSF centrifugation at 4°C prior to storage and highlights the influence of storage conditions in Aβ42 levels. This study contributes to the establishment of harmonized standard operating procedures that will help reducing inter-lab variability of CSF-AD biomarkers evaluation.
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Affiliation(s)
- Maria João Leitão
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra , Coimbra , Portugal
| | - Inês Baldeiras
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra , Coimbra , Portugal ; Neurochemistry Laboratory, Neurology Department, Coimbra University Hospital , Coimbra , Portugal ; Faculty of Medicine, University of Coimbra , Coimbra , Portugal
| | - Sanna-Kaisa Herukka
- Neurology Department, Institute of Clinical Medicine, Kuopio University Hospital, University of Eastern Finland , Kuopio , Finland
| | - Maria Pikkarainen
- Neurology Department, Institute of Clinical Medicine, Kuopio University Hospital, University of Eastern Finland , Kuopio , Finland
| | - Ville Leinonen
- Neurosurgery of NeuroCenter, Kuopio University Hospital , Kuopio , Finland
| | - Anja Hviid Simonsen
- Danish Dementia Research Centre, Copenhagen University Hospital Rigshospitalet , Copenhagen , Denmark
| | - Armand Perret-Liaudet
- Neurobiology, Biochemistry and Molecular Biology Department, University Hospital of Lyon , Lyon , France ; UMR5292, BioRan, CNRS, INSERM U1028, University of Lyon 1 , Lyon , France ; Société Française de Biologie Clinique (SFBC), Alzheimer Biomarkers Group Co-Coordination , Lyon , France
| | - Anthony Fourier
- Neurobiology, Biochemistry and Molecular Biology Department, University Hospital of Lyon , Lyon , France ; UMR5292, BioRan, CNRS, INSERM U1028, University of Lyon 1 , Lyon , France
| | - Isabelle Quadrio
- Neurobiology, Biochemistry and Molecular Biology Department, University Hospital of Lyon , Lyon , France ; UMR5292, BioRan, CNRS, INSERM U1028, University of Lyon 1 , Lyon , France
| | - Pedro Mota Veiga
- Statistics and Research - Curva de Gauss, Training and Consulting , Canas de Senhorim , Portugal
| | - Catarina Resende de Oliveira
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra , Coimbra , Portugal ; Neurochemistry Laboratory, Neurology Department, Coimbra University Hospital , Coimbra , Portugal ; Faculty of Medicine, University of Coimbra , Coimbra , Portugal
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Spellman DS, Wildsmith KR, Honigberg LA, Tuefferd M, Baker D, Raghavan N, Nairn AC, Croteau P, Schirm M, Allard R, Lamontagne J, Chelsky D, Hoffmann S, Potter WZ. Development and evaluation of a multiplexed mass spectrometry based assay for measuring candidate peptide biomarkers in Alzheimer's Disease Neuroimaging Initiative (ADNI) CSF. Proteomics Clin Appl 2015; 9:715-31. [PMID: 25676562 DOI: 10.1002/prca.201400178] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 12/19/2014] [Accepted: 02/05/2015] [Indexed: 11/09/2022]
Abstract
PURPOSE We describe the outcome of the Biomarkers Consortium CSF Proteomics Project (where CSF is cerebral spinal fluid), a public-private partnership of government, academia, nonprofit, and industry. The goal of this study was to evaluate a multiplexed MS-based approach for the qualification of candidate Alzheimer's disease (AD) biomarkers using CSF samples from the AD Neuroimaging Initiative. EXPERIMENTAL DESIGN Reproducibility of sample processing, analytic variability, and ability to detect a variety of analytes of interest were thoroughly investigated. Multiple approaches to statistical analyses assessed whether panel analytes were associated with baseline pathology (mild cognitive impairment (MCI), AD) versus healthy controls or associated with progression for MCI patients, and included (i) univariate association analyses, (ii) univariate prediction models, (iii) exploratory multivariate analyses, and (iv) supervised multivariate analysis. RESULTS A robust targeted MS-based approach for the qualification of candidate AD biomarkers was developed. The results identified several peptides with potential diagnostic or predictive utility, with the most significant differences observed for the following peptides for differentiating (including peptides from hemoglobin A, hemoglobin B, and superoxide dismutase) or predicting (including peptides from neuronal pentraxin-2, neurosecretory protein VGF (VGF), and secretogranin-2) progression versus nonprogression from MCI to AD. CONCLUSIONS AND CLINICAL RELEVANCE These data provide potential insights into the biology of CSF in AD and MCI progression and provide a novel tool for AD researchers and clinicians working to improve diagnostic accuracy, evaluation of treatment efficacy, and early diagnosis.
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Affiliation(s)
- Daniel S Spellman
- Department of Pharmacokinetics, Pharmacodynamics and Drug Metabolism, Merck Research Laboratories, Pennsylvania, PA, USA
| | - Kristin R Wildsmith
- Department of Pharmacodynamic Biomarkers within Development Sciences, Genentech, Inc (a member of the Roche Group), South San Francisco, CA, USA
| | - Lee A Honigberg
- Department of Pharmacodynamic Biomarkers within Development Sciences, Genentech, Inc (a member of the Roche Group), South San Francisco, CA, USA
| | - Marianne Tuefferd
- Discovery Sciences, Janssen Research & Development LLC, Pharmaceutical Companies of Johnson & Johnson, Beerse, Belgium
| | - David Baker
- Janssen Research & Development LLC, Titusville, NJ, USA
| | | | - Angus C Nairn
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | | | | | - Rene Allard
- Caprion Pharmaceuticals, Montreal, QC, Canada
| | | | | | - Steven Hoffmann
- Foundation for the National Institutes of Health, Inc, Bethesda, MD, USA
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Biobanking of Cerebrospinal Fluid for Biomarker Analysis in Neurological Diseases. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 864:79-93. [PMID: 26420615 DOI: 10.1007/978-3-319-20579-3_7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Cerebrospinal fluid (CSF) reflects pathophysiological aspects of neurological diseases, where neuroprotective strategies and biomarkers are urgently needed. Therefore, biobanking is very relevant for biomarker discovery and evaluation for these neurological diseases.An important aspect of CSF biobanking is quality control, needed for e.g. consistent patient follow-up and the exchange of patient samples between research centers. Systematic studies to address effects of pre-analytical and storage variation on a broad range of CSF proteins are needed and initiated.Important features of CSF biobanking are intensive collaboration in international networks and the tight application of standardized protocols. The current adoption of standardized protocols for CSF and blood collection and for biobanking of these samples, as presented in this chapter, enables biomarker studies in large cohorts of patients and controls.In conclusion, biomarker research in neurodegenerative diseases has entered a new era due to the collaborative and multicenter efforts of many groups. The streamlining of biobanking procedures, including sample collection, quality control, and the selection of optimal control groups for investigating biomarkers is an important improvement to perform high quality biomarker studies.
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Integration, Networking, and Global Biobanking in the Age of New Biology. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 864:1-9. [DOI: 10.1007/978-3-319-20579-3_1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Clinical Biochemistry year in review — The clinical “good”, the analytical “bad”, and the “ugly” laboratory practices. Clin Biochem 2014; 47:255-6. [DOI: 10.1016/j.clinbiochem.2014.11.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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