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Llorens F, Kruse N, Karch A, Schmitz M, Zafar S, Gotzmann N, Sun T, Köchy S, Knipper T, Cramm M, Golanska E, Sikorska B, Liberski PP, Sánchez-Valle R, Fischer A, Mollenhauer B, Zerr I. Validation of α-Synuclein as a CSF Biomarker for Sporadic Creutzfeldt-Jakob Disease. Mol Neurobiol 2017; 55:2249-2257. [PMID: 28321768 PMCID: PMC5840235 DOI: 10.1007/s12035-017-0479-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 03/02/2017] [Indexed: 01/15/2023]
Abstract
The analysis of cerebrospinal fluid (CSF) biomarkers gains importance in the differential diagnosis of prion diseases. However, no single diagnostic tool or combination of them can unequivocally confirm prion disease diagnosis. Electrochemiluminescence (ECL)-based immunoassays have demonstrated to achieve high diagnostic accuracy in a variety of sample types due to their high sensitivity and dynamic range. Quantification of CSF α-synuclein (a-syn) by an in-house ECL-based ELISA assay has been recently reported as an excellent approach for the diagnosis of sporadic Creutzfeldt-Jakob disease (sCJD), the most prevalent form of human prion disease. In the present study, we validated a commercially available ECL-based a-syn ELISA platform as a diagnostic test for correct classification of sCJD cases. CSF a-syn was analysed in 203 sCJD cases with definite diagnosis and in 445 non-CJD cases. We investigated reproducibility and stability of CSF a-syn and made recommendations for its analysis in the sCJD diagnostic workup. A sensitivity of 98% and a specificity of 97% were achieved when using an optimal cut-off of 820 pg/mL a-syn. Moreover, we were able to show a negative correlation between a-syn levels and disease duration suggesting that CSF a-syn may be a good prognostic marker for sCJD patients. The present study validates the use of a-syn as a CSF biomarker of sCJD and establishes the clinical and pre-analytical parameters for its use in differential diagnosis in clinical routine. Additionally, the current test presents some advantages compared to other diagnostic approaches: it is fast, economic, requires minimal amount of CSF and a-syn levels are stable along disease progression.
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Affiliation(s)
- Franc Llorens
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany. .,German Center for Neurodegenerative Diseases (DZNE), Site Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany.
| | - Niels Kruse
- Institute for Neuropathology, University Medical Center Göttingen, Göttingen, Germany
| | - André Karch
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Matthias Schmitz
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Site Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany
| | - Saima Zafar
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Site Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany
| | - Nadine Gotzmann
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Site Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany
| | - Ting Sun
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Site Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany
| | - Silja Köchy
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Site Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany
| | - Tobias Knipper
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany
| | - Maria Cramm
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Site Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany
| | - Ewa Golanska
- Department of Molecular Pathology and Neuropathology, Medical University of Lodz, Lodz, Poland
| | - Beata Sikorska
- Department of Molecular Pathology and Neuropathology, Medical University of Lodz, Lodz, Poland
| | - Pawel P Liberski
- Department of Molecular Pathology and Neuropathology, Medical University of Lodz, Lodz, Poland
| | - Raquel Sánchez-Valle
- Creutzfeldt-Jakob disease unit. Alzheimer's disease and other cognitive disorders unit. Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andre Fischer
- German Center for Neurodegenerative Diseases (DZNE), Site Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany
| | - Brit Mollenhauer
- Institute for Neuropathology, University Medical Center Göttingen, Göttingen, Germany.,Paracelsus-Elena Klinik, Center for Parkinsonism and Movement Disorders, Kassel, Germany.,Department of Neurosurgery, University Medical Center Göttingen, Göttingen, Germany
| | - Inga Zerr
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Site Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany
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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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Foutz A, Appleby BS, Hamlin C, Liu X, Yang S, Cohen Y, Chen W, Blevins J, Fausett C, Wang H, Gambetti P, Zhang S, Hughson A, Tatsuoka C, Schonberger LB, Cohen ML, Caughey B, Safar JG. Diagnostic and prognostic value of human prion detection in cerebrospinal fluid. Ann Neurol 2017; 81:79-92. [PMID: 27893164 PMCID: PMC5266667 DOI: 10.1002/ana.24833] [Citation(s) in RCA: 151] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 11/23/2016] [Accepted: 11/23/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Several prion amplification systems have been proposed for detection of prions in cerebrospinal fluid (CSF), most recently, the measurements of prion seeding activity with second-generation real-time quaking-induced conversion (RT-QuIC). The objective of this study was to investigate the diagnostic performance of the RT-QuIC prion test in the broad phenotypic spectrum of prion diseases. METHODS We performed CSF RT-QuIC testing in 2,141 patients who had rapidly progressive neurological disorders, determined diagnostic sensitivity and specificity in 272 cases that were autopsied, and evaluated the impact of mutations and polymorphisms in the PRNP gene, and type 1 or type 2 human prions on diagnostic performance. RESULTS The 98.5% diagnostic specificity and 92% sensitivity of CSF RT-QuIC in a blinded retrospective analysis matched the 100% specificity and 95% sensitivity of a blind prospective study. The CSF RT-QuIC differentiated 94% of cases of sporadic Creutzfeldt-Jakob disease (sCJD) MM1 from the sCJD MM2 phenotype, and 80% of sCJD VV2 from sCJD VV1. The mixed prion type 1-2 and cases heterozygous for codon 129 generated intermediate CSF RT-QuIC patterns, whereas genetic prion diseases revealed distinct profiles for each PRNP gene mutation. INTERPRETATION The diagnostic performance of the improved CSF RT-QuIC is superior to surrogate marker tests for prion diseases such as 14-3-3 and tau proteins, and together with PRNP gene sequencing the test allows the major prion subtypes to be differentiated in vivo. This differentiation facilitates prediction of the clinicopathological phenotype and duration of the disease-two important considerations for envisioned therapeutic interventions. ANN NEUROL 2017;81:79-92.
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Affiliation(s)
- Aaron Foutz
- National Prion Disease Pathology Surveillance Center; Case Western Reserve University School of Medicine, Cleveland, OH
| | - Brian S. Appleby
- National Prion Disease Pathology Surveillance Center; Case Western Reserve University School of Medicine, Cleveland, OH
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH
- Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH
- Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Clive Hamlin
- National Prion Disease Pathology Surveillance Center; Case Western Reserve University School of Medicine, Cleveland, OH
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Xiaoqin Liu
- National Prion Disease Pathology Surveillance Center; Case Western Reserve University School of Medicine, Cleveland, OH
| | - Sheng Yang
- Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Yvonne Cohen
- National Prion Disease Pathology Surveillance Center; Case Western Reserve University School of Medicine, Cleveland, OH
| | - Wei Chen
- National Prion Disease Pathology Surveillance Center; Case Western Reserve University School of Medicine, Cleveland, OH
| | - Janis Blevins
- National Prion Disease Pathology Surveillance Center; Case Western Reserve University School of Medicine, Cleveland, OH
| | - Cameron Fausett
- Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Han Wang
- Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Pierluigi Gambetti
- National Prion Disease Pathology Surveillance Center; Case Western Reserve University School of Medicine, Cleveland, OH
| | - Shulin Zhang
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Andrew Hughson
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT
| | - Curtis Tatsuoka
- Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Lawrence B. Schonberger
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Mark L. Cohen
- National Prion Disease Pathology Surveillance Center; Case Western Reserve University School of Medicine, Cleveland, OH
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Byron Caughey
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT
| | - Jiri G. Safar
- National Prion Disease Pathology Surveillance Center; Case Western Reserve University School of Medicine, Cleveland, OH
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH
- Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH
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55
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Llorens F, Kruse N, Schmitz M, Gotzmann N, Golanska E, Thüne K, Zejneli O, Kanata E, Knipper T, Cramm M, Lange P, Zafar S, Sikorska B, Liberski PP, Mitrova E, Varges D, Schmidt C, Sklaviadis T, Mollenhauer B, Zerr I. Evaluation of α‐synuclein as a novel cerebrospinal fluid biomarker in different forms of prion diseases. Alzheimers Dement 2016; 13:710-719. [DOI: 10.1016/j.jalz.2016.09.013] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 08/15/2016] [Accepted: 09/29/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Franc Llorens
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
- German Center for Neurodegenerative Diseases (DZNE) Site Göttingen Germany
| | - Niels Kruse
- Institute for Neuropathology University Medical Center Göttingen Göttingen Germany
| | - Matthias Schmitz
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
- German Center for Neurodegenerative Diseases (DZNE) Site Göttingen Germany
| | - Nadine Gotzmann
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
- German Center for Neurodegenerative Diseases (DZNE) Site Göttingen Germany
| | - Ewa Golanska
- Department of Molecular Pathology and Neuropathology Medical University of Lodz Lodz Poland
| | - Katrin Thüne
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
- German Center for Neurodegenerative Diseases (DZNE) Site Göttingen Germany
| | - Orgeta Zejneli
- Laboratory of Pharmacology, School of Health Sciences, Department of Pharmacy Aristotle University of Thessaloniki Thessaloniki Greece
| | - Eirini Kanata
- Laboratory of Pharmacology, School of Health Sciences, Department of Pharmacy Aristotle University of Thessaloniki Thessaloniki Greece
| | - Tobias Knipper
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
| | - Maria Cramm
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
- German Center for Neurodegenerative Diseases (DZNE) Site Göttingen Germany
| | - Peter Lange
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
| | - Saima Zafar
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
- German Center for Neurodegenerative Diseases (DZNE) Site Göttingen Germany
| | - Beata Sikorska
- Department of Molecular Pathology and Neuropathology Medical University of Lodz Lodz Poland
| | - Pawel P. Liberski
- Department of Molecular Pathology and Neuropathology Medical University of Lodz Lodz Poland
| | - Eva Mitrova
- Department of Prion Diseases Slovak Medical University Bratislava Bratislava Slovakia
| | - Daniela Varges
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
| | - Christian Schmidt
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
| | - Theodoros Sklaviadis
- Laboratory of Pharmacology, School of Health Sciences, Department of Pharmacy Aristotle University of Thessaloniki Thessaloniki Greece
| | - Brit Mollenhauer
- Institute for Neuropathology University Medical Center Göttingen Göttingen Germany
- Paracelsus‐Elena Klinik Center for Parkinsonism and Movement Disorders Kassel Germany
- Department of Neurosurgery University Medical Center Göttingen Göttingen Germany
| | - Inga Zerr
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
- German Center for Neurodegenerative Diseases (DZNE) Site Göttingen Germany
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Cerebrospinal Fluid Biomarkers in the Diagnosis of Creutzfeldt-Jakob Disease in Slovak Patients: over 10-Year Period Review. Mol Neurobiol 2016; 54:5919-5927. [PMID: 27665282 DOI: 10.1007/s12035-016-0128-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 09/12/2016] [Indexed: 10/21/2022]
Abstract
Creutzfeldt-Jakob disease is a rare, but rapidly progressive, up to now untreatable and fatal neurodegenerative disorder. Clinical diagnosis of Creutzfeldt-Jakob disease (CJD) is difficult; however, it can be facilitated by suitable biomarkers. Aim of the present study is to compare levels of cerebrospinal fluid biomarkers (total tau protein, phosphorylated-tau protein, protein 14-3-3 and amyloid beta) in Slovak population of CJD suspect cases, retrospectively in over a 10-year period. One thousand three hundred sixty-four CSF samples from patients with suspect CJD, forming a homogenous group in terms of geographical as well as of equal transport conditions, storage and laboratory processing, were analysed. Definite diagnosis of Creutzfeldt-Jakob disease was confirmed in 101 patients with genetic form, and 60 patients with its sporadic form of the disease. Specificity of protein 14-3-3 and total tau in both forms CJD was similar (87 % for P14-3-3/85 % for total tau), sensitivity to P 14-3-3 and total tau was higher in sporadic Creutzfeldt-Jakob disease (sCJD) (90/95 %) than in genetic Creutzfeldt-Jakob disease (gCJD) (89/74 %). As expected, the total tau levels were significantly higher in CJD patients than in controls, but there was also significant difference between gCJD and sCJD (levels in gCJD were lower; p = 0.003). There was no significant difference in p-tau and Aβ 1-42 levels neither between both CJD forms nor between CJD patients and control group.
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Zerr I, Bähr M. Is there a role of Tau in Huntington′s disease? J Neurochem 2016; 139:9-10. [DOI: 10.1111/jnc.13762] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 08/08/2016] [Accepted: 08/08/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Inga Zerr
- Department of Neurology; University Medicine Göttingen; Göttingen Germany
| | - Mathias Bähr
- Department of Neurology; University Medicine Göttingen; Göttingen Germany
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Abstract
PURPOSE OF REVIEW This article presents an update on the clinical aspects of human prion disease, including the wide spectrum of their presentations. RECENT FINDINGS Prion diseases, a group of disorders caused by abnormally shaped proteins called prions, occur in sporadic (Jakob-Creutzfeldt disease), genetic (genetic Jakob-Creutzfeldt disease, Gerstmann-Sträussler-Scheinker syndrome, and fatal familial insomnia), and acquired (kuru, variant Jakob-Creutzfeldt disease, and iatrogenic Jakob-Creutzfeldt disease) forms. This article presents updated information on the clinical features and diagnostic methods for human prion diseases. New antemortem potential diagnostic tests based on amplifying prions in order to detect them are showing very high specificity. Understanding of the diversity of possible presentations of human prion diseases continues to evolve, with some genetic forms progressing slowly over decades, beginning with dysautonomia and neuropathy and progressing to a frontal-executive dementia with pathology of combined prionopathy and tauopathy. Unfortunately, to date, all human prion disease clinical trials have failed to show survival benefit. A very rare polymorphism in the prion protein gene recently has been identified that appears to protect against prion disease; this finding, in addition to providing greater understanding of the prionlike mechanisms of neurodegenerative disorders, might lead to potential treatments. SUMMARY Sporadic Jakob-Creutzfeldt disease is the most common form of human prion disease. Genetic prion diseases, resulting from mutations in the prion-related protein gene (PRNP), are classified based on the mutation, clinical phenotype, and neuropathologic features and can be difficult to diagnose because of their varied presentations. Perhaps most relevant to this Continuum issue on neuroinfectious diseases, acquired prion diseases are caused by accidental transmission to humans, but fortunately, they are the least common form and are becoming rarer as awareness of transmission risk has led to implementation of measures to prevent such occurrences.
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CSF Tau proteins reduce misdiagnosis of sporadic Creutzfeldt–Jakob disease suspected cases with inconclusive 14-3-3 result. J Neurol 2016; 263:1847-61. [DOI: 10.1007/s00415-016-8209-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 06/13/2016] [Accepted: 06/14/2016] [Indexed: 10/21/2022]
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Soomro S, Mohan C. Biomarkers for sporadic Creutzfeldt-Jakob disease. Ann Clin Transl Neurol 2016; 3:465-72. [PMID: 27547775 PMCID: PMC4892001 DOI: 10.1002/acn3.304] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 02/26/2016] [Accepted: 02/26/2016] [Indexed: 01/27/2023] Open
Abstract
Sporadic Creutzfeldt-Jakob disease (sCJD) is a rare but fatal type of spongiform encephalopathy with unknown cause. Unfortunately, definitive diagnosis of this disease can only be done by examination of postmortem brain tissue. Presumptive diagnosis is done through a combination of clinical manifestations, radiology results, and cerebrospinal fluid (CSF) testing for CSF 14-3-3. Even with these guidelines, premortem diagnosis of sCJD can be unreliable with high rates of misdiagnosis. This calls for more reliable biomarkers of the disease, allowing for better diagnosis as well as understanding the pathogenesis of sCJD. This review compiles potential genetic, protein, biomolecular, and imaging biomarker studies for sCJD since 2010, highlighting the promise of proteins, cytokines, and composite biomarkers for improving the diagnosis as well as understanding the pathogenesis of this mysterious ailment.
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Affiliation(s)
- Sanam Soomro
- Department of Biomedical EngineeringUniversity of HoustonHoustonTexas77204
| | - Chandra Mohan
- Department of Biomedical EngineeringUniversity of HoustonHoustonTexas77204
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Leitão MJ, Baldeiras I, Almeida MR, Ribeiro MH, Santos AC, Ribeiro M, Tomás J, Rocha S, Santana I, Oliveira CR. Sporadic Creutzfeldt-Jakob disease diagnostic accuracy is improved by a new CSF ELISA 14-3-3γ assay. Neuroscience 2016; 322:398-407. [PMID: 26940479 DOI: 10.1016/j.neuroscience.2016.02.057] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 02/22/2016] [Accepted: 02/23/2016] [Indexed: 10/22/2022]
Abstract
Protein 14-3-3 is a reliable marker of rapid neuronal damage, specifically increased in cerebrospinal fluid (CSF) of sporadic Creutzfeldt-Jakob disease (sCJD) patients. Its detection is usually performed by Western Blot (WB), prone to methodological issues. Our aim was to evaluate the diagnostic performance of a recently developed quantitative enzyme-linked immunosorbent (ELISA) assay for 14-3-3γ, in comparison with WB and other neurodegeneration markers. CSF samples from 145 patients with suspicion of prion disease, later classified as definite sCJD (n=72) or Non-prion diseases (Non-CJD; n=73) comprised our population. 14-3-3 protein was determined by WB and ELISA. Total Tau (t-Tau) and phosphorylated Tau (p-Tau) were also evaluated. Apolipoprotein E gene (ApoE) and prionic protein gene (PRNP) genotyping was assessed. ELISA 14-3-3γ levels were significantly increased in sCJD compared to Non-CJD patients (p<0.001), showing very good accuracy (AUC=0.982; sensitivity=97%; specificity=94%), and matching WB results in 81% of all cases. It strongly correlated with t-Tau and p-Tau (p<0.0001), showing slightly higher specificity (14-3-3 WB - 63%; Tau - 90%; p-Tau/t-Tau ratio - 88%). From WB inconclusive results (n=44), ELISA 14-3-3γ correctly classified 41 patients. Additionally, logistic regression analysis selected ELISA 14-3-3γ as the best single predictive marker for sCJD (overall accuracy=93%). ApoE and PRNP genotypes did not influence ELISA 14-3-3γ levels. Despite specificity for 14-3-3γ isoform, ELISA results not only match WB evaluation but also help discrimination of inconclusive results. Our results therefore reinforce this assay as a single screening test, allowing higher sample throughput and unequivocal results.
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Affiliation(s)
- M J Leitão
- Neurochemistry Laboratory, Neurology Department, University Hospital Coimbra, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, 3000-075 Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Portugal; CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Rua Larga, Faculty of Medicine, Pólo I, 1st Floor, 3004-504 Coimbra, Portugal.
| | - I Baldeiras
- Neurochemistry Laboratory, Neurology Department, University Hospital Coimbra, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, 3000-075 Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Portugal; CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Rua Larga, Faculty of Medicine, Pólo I, 1st Floor, 3004-504 Coimbra, Portugal
| | - M R Almeida
- CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Rua Larga, Faculty of Medicine, Pólo I, 1st Floor, 3004-504 Coimbra, Portugal
| | - M H Ribeiro
- Neurochemistry Laboratory, Neurology Department, University Hospital Coimbra, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, 3000-075 Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Portugal
| | - A C Santos
- CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Rua Larga, Faculty of Medicine, Pólo I, 1st Floor, 3004-504 Coimbra, Portugal
| | - M Ribeiro
- CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Rua Larga, Faculty of Medicine, Pólo I, 1st Floor, 3004-504 Coimbra, Portugal
| | - J Tomás
- Neurology Department, University Hospital Coimbra, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, 3000-075 Coimbra, Portugal
| | - S Rocha
- Neurology Department, St Marcos Hospital, Braga, Portugal
| | - I Santana
- Neurology Department, University Hospital Coimbra, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, 3000-075 Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Portugal; CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Rua Larga, Faculty of Medicine, Pólo I, 1st Floor, 3004-504 Coimbra, Portugal
| | - C R Oliveira
- Neurochemistry Laboratory, Neurology Department, University Hospital Coimbra, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, 3000-075 Coimbra, Portugal; Neurology Department, University Hospital Coimbra, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, 3000-075 Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Portugal; CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Rua Larga, Faculty of Medicine, Pólo I, 1st Floor, 3004-504 Coimbra, Portugal
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CSF biomarkers in neurodegenerative and vascular dementias. Prog Neurobiol 2016; 138-140:36-53. [DOI: 10.1016/j.pneurobio.2016.03.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 03/12/2016] [Accepted: 03/14/2016] [Indexed: 12/14/2022]
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Bai HX, Zou Y, Lee AM, Lancaster E, Yang L. Diagnostic Value and Safety of Brain Biopsy in Patients With Cryptogenic Neurological Disease: A Systematic Review and Meta-analysis of 831 Cases. Neurosurgery 2016; 77:283-95; discussion 295. [PMID: 25856111 DOI: 10.1227/neu.0000000000000756] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The role of brain biopsy in patients with cryptogenic neurological disease is uncertain. OBJECTIVE To determine the risks and benefits of diagnostic brain biopsy for nonneoplastic indications in immunocompetent patients. METHODS Appropriate studies were identified by searching electronic databases. RESULTS We screened 3645 abstracts and included 20 studies with a total of 831 patients. Indications for biopsy were: (1a) severe neurological disease of unknown etiology in adults (n = 7) and (1b) in children (n = 2); (2) suspected primary angiitis of the central nervous system (PACNS) (n = 3); (3) chronic meningitis of unknown cause (n = 3); (4) atypical dementia (n = 4); and (5) nonneoplastic disease (n = 1). Diagnostic success rates calculated for subgroups were 51.3% (34.5-68.1) for 1a, 53.8% (42.9-64.5) for 1b, 74.7% (64.0-84.1) for 2, 30.3% (17.2-45.4) for 3, and 60.8% (41.2-78.8) for 4. Clinical impact rates were 30.5% (13.6-50.6) for 1a (n = 6), 67.1% (42.8-87.3) for 1b (n = 2), 8.3% (2.3-20.0) for 3 (n = 1), and 14.2% (6.5-24.3) for 4 (n = 2). Lymphoma (n = 32) and Creutzfeldt-Jakob disease (n = 30) were the most common diagnoses on the final histopathology reports of positive brain biopsies in 1a. In 1b, encephalitis (n = 7), PACNS (n = 6), and demyelination (n = 6) were the most common. The odds ratio for achieving a diagnostic biopsy when there was a radiological target was 3.70 (P = .014, 95% confidence interval, 1.31-10.42). CONCLUSION Brain biopsy in cryptogenic neurological disease was associated with the highest diagnostic yield in patients with suspected PACNS. The greatest clinical impact was seen in children with cryptogenic neurological disease. The presence of a radiological target was associated with a higher diagnostic yield.
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Affiliation(s)
- Harrison Xiao Bai
- ‡Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; §Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia; ¶Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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Mitochondrial DNA differentiates Alzheimer's disease from Creutzfeldt-Jakob disease. Alzheimers Dement 2016; 12:546-55. [PMID: 26806388 DOI: 10.1016/j.jalz.2015.12.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 11/25/2015] [Accepted: 12/16/2015] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Low content of cell-free mitochondrial DNA (mtDNA) in cerebrospinal fluid (CSF) is a biomarker of early stage Alzheimer's disease (AD), but whether mtDNA is altered in a rapid neurodegenerative dementia such as Creutzfeldt-Jakob disease is unknown. METHODS CSF mtDNA was measured using digital polymerase chain reaction (dPCR) in two independent cohorts comprising a total of 112 patients diagnosed with sporadic Creutzfeldt-Jakob disease (sCJD), probable AD, or non-Alzheimer's type dementia. RESULTS Patients with AD exhibit low mtDNA content in CSF compared with patients diagnosed with sCJD or with non-Alzheimer's type dementias. The CSF concentration of mtDNA does not correlate with Aβ, t-tau, p-tau, and 14-3-3 protein levels in CSF. DISCUSSION Low-CSF mtDNA is not a consequence of brain damage and allows the differential diagnosis of AD from sCJD and other dementias. These results support the hypothesis that mtDNA in CSF is a pathophysiological biomarker of AD.
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Dulamea A, Solomon E. Role of the biomarkers for the diagnosis of Creutzfeldt-Jakob disease. J Med Life 2016; 9:211-5. [PMID: 27453757 PMCID: PMC4863517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Sporadic Creutzfeldt-Jakob disease (CJD) is a human prion disease, rapidly progressive and fatal, characterized by spongiform encephalopathy. The characteristic triad of signs - rapidly progressive dementia, myoclonus and periodic sharp wave complexes (PSWC) on electroencephalography (EEG) - usually appear in the late stages of the disease. The clinical diagnosis of CJD ante-mortem involves the exclusion of the rapidly progressive non-prionic dementias, the definitive diagnosis requiring brain tissue confirmation. Authors evaluated the methods of clinical diagnosis for sporadic CJD. METHODS This study retrospectively reviewed the medical records of patients diagnosed with probable sporadic CJD, based on brain magnetic resonance imaging (MRI), EEG, cerebrospinal fluid (CSF) analysis and extensive laboratory work-up. RESULTS Four patients with a mean age of 67 years were included in our study. The mean duration from diagnosis until death was of 3.2 weeks. The clinical features of the disease at onset were atypical. In the final stage of the disease, all patients presented rapidly progressive dementia and myoclonus. High levels of 14-3-3 protein and tau protein and normal levels of amyloid β1-42 were found at CSF analysis, in all patients. PSWC on EEG were present in 3 out of 4 patients at different moments of the disease. MRI showed hyperintense lesions in brain cortex, caudate nucleus, and putamen on T2, FLAIR, and DWI. CONCLUSION CJD may present various clinical features and, since brain biopsy is usually difficult to perform, a combination of biomarkers is useful in order to establish the diagnosis in the early phase of the disease.
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Affiliation(s)
- A Dulamea
- ”Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania,Department of Neurology, Fundeni Clinical Institute, Bucharest, Romania
| | - E Solomon
- Department of Neurology, Fundeni Clinical Institute, Bucharest, Romania
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Llorens F, Schmitz M, Karch A, Cramm M, Lange P, Gherib K, Varges D, Schmidt C, Zerr I, Stoeck K. Comparative analysis of cerebrospinal fluid biomarkers in the differential diagnosis of neurodegenerative dementia. Alzheimers Dement 2015; 12:577-89. [PMID: 26718584 DOI: 10.1016/j.jalz.2015.10.009] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 09/02/2015] [Accepted: 10/27/2015] [Indexed: 11/18/2022]
Affiliation(s)
- Franc Llorens
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Göttingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany.
| | - Matthias Schmitz
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - André Karch
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Maria Cramm
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Göttingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | - Peter Lange
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Kerim Gherib
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Daniela Varges
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Christian Schmidt
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Inga Zerr
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Göttingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | - Katharina Stoeck
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
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Abstract
Prion diseases are a heterogeneous class of fatal neurodegenerative disorders associated with misfolding of host cellular prion protein (PrP(C)) into a pathological isoform, termed PrP(Sc). Prion diseases affect various mammals, including humans, and effective treatments are not available. Prion diseases are distinguished from other protein misfolding disorders - such as Alzheimer's or Parkinson's disease - in that they are infectious. Prion diseases occur sporadically without any known exposure to infected material, and hereditary cases resulting from rare mutations in the prion protein have also been documented. The mechanistic underpinnings of prion and other neurodegenerative disorders remain poorly understood. Various proteomics techniques have been instrumental in early PrP(Sc) detection, biomarker discovery, elucidation of PrP(Sc) structure and mapping of biochemical pathways affected by pathogenesis. Moving forward, proteomics approaches will likely become more integrated into the clinical and research settings for the rapid diagnosis and characterization of prion pathogenesis.
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Affiliation(s)
- Roger A Moore
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, NIH,NIAID, Hamilton, MT 59840, USA
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Chen CJ, Chen CM, Pai TW, Chang HT, Hwang CS. A genome-wide association study on amyotrophic lateral sclerosis in the Taiwanese Han population. Biomark Med 2015; 10:597-611. [PMID: 26580837 DOI: 10.2217/bmm.15.115] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Identification of mutations in patients with amyotrophic lateral sclerosis (ALS) in a genome-wide association study can reveal possible biomarkers of such a rapidly progressive and fatal neurodegenerative disease. It was observed that significant single nucleotide polymorphisms vary when the tested population changes from one ethnic group to another. To identify new loci associated with ALS susceptibility in the Taiwanese Han population, we performed a genome-wide association study on 94 patients with sporadic ALS and 376 matched controls. We uncovered two new susceptibility loci at 13q14.3 (rs2785946) and 11q25 (rs11224052). In addition, we analyzed the functions of all the associated genes among 54 significant single nucleotide polymorphisms using Gene Ontology annotations, and the results showed several statistically significant neural- and muscle-related Gene Ontology terms and the associated diseases.
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Affiliation(s)
- Chi-Jim Chen
- Department of Computer Science & Engineering, National Taiwan Ocean University, Keelung, Taiwan
| | - Chien-Ming Chen
- Department of Computer Science & Engineering, National Taiwan Ocean University, Keelung, Taiwan
| | - Tun-Wen Pai
- Department of Computer Science & Engineering, National Taiwan Ocean University, Keelung, Taiwan
| | - Hao-Teng Chang
- Graduate Institute of Basic Medical Sciences, China Medical University, Taichung, Taiwan.,Department of Computer Science & Information Engineering, Asia University, Taichung, Taiwan
| | - Chi-Shin Hwang
- Department of Neurology, Taipei City Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Park JH, Choi YG, Lee YJ, Park SJ, Choi HS, Choi KC, Choi EK, Kim YS. Real-Time Quaking-Induced Conversion Analysis for the Diagnosis of Sporadic Creutzfeldt-Jakob Disease in Korea. J Clin Neurol 2015; 12:101-6. [PMID: 26541494 PMCID: PMC4712274 DOI: 10.3988/jcn.2016.12.1.101] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 08/19/2015] [Accepted: 08/20/2015] [Indexed: 11/27/2022] Open
Abstract
Background and Purpose The level of 14-3-3 protein in the cerebrospinal fluid (CSF) is increased in Creutzfeldt-Jakob disease (CJD) patients, which has led to it being used as a clinical biomarker for the ante-mortem diagnosis of human prion diseases. However, the specificity of the 14-3-3 protein is less reliable for CJD diagnosis. Newly developed assays including real-time quaking-induced conversion (RT-QuIC) have made it possible to detect the PrPSc-like abnormal prion isoform with a high sensitivity in animal and human specimens that might contain a minute amount of PrPSc due to in vitro prion replication. Methods This study applied a highly sensitive RT-QuIC assay using recombinant human PrP to detect PrPSc in the CSF of 81 patients with sporadic CJD (sCJD) in Korea. Results RT-QuIC analysis of the CSF samples based on the expression levels of 14-3-3 and total tau proteins revealed positivity in 62 of 81 sCJD patients (sensitivity of 76.5%) but no positive results in the 100 non-CJD patients. Conclusions The sensitivity of the RT-QuIC in this study was similar to that in some previous reports, and the specificity of RT-QuIC was higher than that of 14-3-3 in CSF, suggesting that RT-QuIC analysis can complement the weakness of the specificity of 14-3-3 for the diagnosis of sCJD. These results indicate that RT-QuIC might be very useful for the rapid and specific diagnosis of sCJD and provide a practical novel method for the ante-mortem diagnosis of human prion diseases.
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Affiliation(s)
- Jeong Ho Park
- Korea CJD Diagnostic Center, Hallym University, Anyang, Korea.,Laboratory of Transmissible Spongiform Encephalopathy, Ilsong Institute of Life Science, Hallym University, Anyang, Korea
| | - Yeong Gon Choi
- Laboratory of Transmissible Spongiform Encephalopathy, Ilsong Institute of Life Science, Hallym University, Anyang, Korea
| | - Yun Jung Lee
- Laboratory of Transmissible Spongiform Encephalopathy, Ilsong Institute of Life Science, Hallym University, Anyang, Korea
| | - Seok Joo Park
- Laboratory of Transmissible Spongiform Encephalopathy, Ilsong Institute of Life Science, Hallym University, Anyang, Korea
| | - Hong Seok Choi
- Laboratory of Transmissible Spongiform Encephalopathy, Ilsong Institute of Life Science, Hallym University, Anyang, Korea
| | - Kyung Chan Choi
- Department of Pathology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.,Korea CJD Autopsy Center, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Eun Kyoung Choi
- Department of Biomedical Gerontology, Graduate School of Hallym University, Chuncheon, Korea.,Laboratory of Cellular Aging and Neurodegeneration, Ilsong Institute of Life Science, Hallym University, Anyang, Korea.
| | - Yong Sun Kim
- Korea CJD Diagnostic Center, Hallym University, Anyang, Korea.,Laboratory of Transmissible Spongiform Encephalopathy, Ilsong Institute of Life Science, Hallym University, Anyang, Korea.
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Assato PA, da Silva JDF, de Oliveira HC, Marcos CM, Rossi D, Valentini SR, Mendes-Giannini MJS, Zanelli CF, Fusco-Almeida AM. Functional analysis of Paracoccidioides brasiliensis 14-3-3 adhesin expressed in Saccharomyces cerevisiae. BMC Microbiol 2015; 15:256. [PMID: 26537993 PMCID: PMC4634143 DOI: 10.1186/s12866-015-0586-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 10/23/2015] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND 14-3-3 proteins comprise a family of eukaryotic multifunctional proteins involved in several cellular processes. The Pb14-3-3 of Paracoccidioides brasiliensis seems to play an important role in the Paracoccidioides-host interaction. Paracoccidioides brasiliensis is an etiological agent of paracoccidioidomycosis, which is a systemic mycosis that is endemic in Latin America. In the initial steps of the infection, Paracoccidioides spp. synthetizes adhesins that allow it to adhere and invade host cells. Therefore, the aim of this work was to perform a functional analysis of Pb14-3-3 using Saccharomyces cerevisiae as a model. RESULTS The functional analysis of Pb14-3-3 was performed in S. cerevisiae, and it was found that Pb14-3-3 partially complemented S. cerevisiae proteins Bmh1p and Bmh2p, which are recognized as two yeast 14-3-3 homologues. When we evaluated the adhesion profile of S. cerevisiae transformants, Pb14-3-3 acted as an adhesin in S. cerevisiae; however, Bmh1p did not show this function. The influence of Pb14-3-3 in S. cerevisiae ergosterol pathway was also evaluated and our results showed that Pb14-3-3 up-regulates genes involved in ergosterol biosynthesis. CONCLUSIONS Our data showed that Pb14-3-3 was able to partially complement Bmh1p and Bmh2p proteins in S. cerevisiae; however, we suggest that Pb14-3-3 has a differential role as an adhesin. In addition, Pb-14-3-3 may be involved in Paracoccidioides spp. ergosterol biosynthesis which makes it an interest as a therapeutic target.
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Affiliation(s)
- Patricia Akemi Assato
- Laboratório de Micologia Clínica - Núcleo de Proteômica - Faculdade de Ciências Farmacêuticas- Unesp - Campus Araraquara, Rodovia Araraquara - Jaú Km 1, 14801-902, Araraquara, SP, Brazil.
| | - Julhiany de Fátima da Silva
- Laboratório de Micologia Clínica - Núcleo de Proteômica - Faculdade de Ciências Farmacêuticas- Unesp - Campus Araraquara, Rodovia Araraquara - Jaú Km 1, 14801-902, Araraquara, SP, Brazil.
| | - Haroldo Cesar de Oliveira
- Laboratório de Micologia Clínica - Núcleo de Proteômica - Faculdade de Ciências Farmacêuticas- Unesp - Campus Araraquara, Rodovia Araraquara - Jaú Km 1, 14801-902, Araraquara, SP, Brazil.
| | - Caroline Maria Marcos
- Laboratório de Micologia Clínica - Núcleo de Proteômica - Faculdade de Ciências Farmacêuticas- Unesp - Campus Araraquara, Rodovia Araraquara - Jaú Km 1, 14801-902, Araraquara, SP, Brazil.
| | - Danuza Rossi
- Laboratório de Biologia Molecular - Faculdade de Ciências Farmacêuticas- Unesp - Campus Araraquara, Rodovia Araraquara - Jaú Km 1, 14801-902, Araraquara, SP, Brazil.
| | - Sandro Roberto Valentini
- Laboratório de Biologia Molecular - Faculdade de Ciências Farmacêuticas- Unesp - Campus Araraquara, Rodovia Araraquara - Jaú Km 1, 14801-902, Araraquara, SP, Brazil.
| | - Maria José Soares Mendes-Giannini
- Laboratório de Micologia Clínica - Núcleo de Proteômica - Faculdade de Ciências Farmacêuticas- Unesp - Campus Araraquara, Rodovia Araraquara - Jaú Km 1, 14801-902, Araraquara, SP, Brazil.
| | - Cleslei Fernando Zanelli
- Laboratório de Biologia Molecular - Faculdade de Ciências Farmacêuticas- Unesp - Campus Araraquara, Rodovia Araraquara - Jaú Km 1, 14801-902, Araraquara, SP, Brazil.
| | - Ana Marisa Fusco-Almeida
- Laboratório de Micologia Clínica - Núcleo de Proteômica - Faculdade de Ciências Farmacêuticas- Unesp - Campus Araraquara, Rodovia Araraquara - Jaú Km 1, 14801-902, Araraquara, SP, Brazil.
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[Clinically validated molecular biomarkers of neurodegenerative dementia]. DER NERVENARZT 2015; 85:1372-81. [PMID: 25331214 DOI: 10.1007/s00115-014-4086-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
As cerebrospinal fluid-based neurochemical dementia diagnostics (CSF-NDD) has now been validated at the S3 evidence level, the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) and the German Society for Neurology (DGN) recommend CSF-NDD in the recent joint dementia guidelines for improved early and differential diagnostics of multigenic (sporadic) Alzheimer's dementia (AD). The CSF-NDD also provides a predictive diagnosis of incipient AD for high-risk patients when they are still in the prodromal stage of mild cognitive impairment (MCI) but as no (secondary) preventive therapy of AD is currently available, the use of CSF-NDD for the predictive molecular diagnosis of AD is not recommended in the neuropsychiatry guidelines (http://www.DGPPN.de). However, molecular diagnostics of preclinical AD by CSF-NDD and/or [18F]-amyloid positron emission tomography (PET) has meanwhile gained high clinical relevance for therapeutic clinical research, as this novel clinical model allows systematic screening for promising (secondary) preventive therapy options. Moreover, it has now become apparent that blood-based neurochemical diagnostics of preclinical and early AD will be possible by means of various formats of multiplex assays. However, so far promising blood assays have not been consistently validated by independent research groups and in contrast to CSF-NDD a blood-based diagnosis of AD is not yet available.
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Manix M, Kalakoti P, Henry M, Thakur J, Menger R, Guthikonda B, Nanda A. Creutzfeldt-Jakob disease: updated diagnostic criteria, treatment algorithm, and the utility of brain biopsy. Neurosurg Focus 2015; 39:E2. [DOI: 10.3171/2015.8.focus15328] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Creutzfeldt-Jakob disease (CJD) is a rare neurodegenerative condition with a rapid disease course and a mortality rate of 100%. Several forms of the disease have been described, and the most common is the sporadic type. The most challenging aspect of this disease is its diagnosis—the gold standard for definitive diagnosis is considered to be histopatho-logical confirmation—but newer tests are providing means for an antemortem diagnosis in ways less invasive than brain biopsy. Imaging studies, electroencephalography, and biomarkers are used in conjunction with the clinical picture to try to make the diagnosis of CJD without brain tissue samples, and all of these are reviewed in this article. The current diagnostic criteria are limited; test sensitivity and specificity varies with the genetics of the disease as well as the clinical stage. Physicians may be unsure of all diagnostic testing available, and may order outdated tests or prematurely request a brain biopsy when the diagnostic workup is incomplete. The authors review CJD, discuss the role of brain biopsy in this patient population, provide a diagnostic pathway for the patient presenting with rapidly progressive dementia, and propose newer diagnostic criteria.
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Llorens F, Schmitz M, Gloeckner SF, Kaerst L, Hermann P, Schmidt C, Varges D, Zerr I. Increased albumin CSF/serum ratio in dementia with Lewy bodies. J Neurol Sci 2015; 358:398-403. [PMID: 26476775 DOI: 10.1016/j.jns.2015.10.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 10/02/2015] [Accepted: 10/06/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Alterations in the CSF/serum albumin ratio (Qalb) is currently recognized as one of the most reliable markers of blood-brain barrier impairment and blood-CSF barrier permeability, but its potential role as a biomarker in the differential diagnosis of neurological diseases has been poorly analysed. METHODS We evaluated Qalb and core CSF biomarkers (Tau, p-Tau and Aβ42) in a large patient population of neurological and neurodegenerative cases. Diagnostic test evaluation was assessed by ROC-AUC analysis. RESULTS In the differential diagnostic analysis, increased Qalb was found in dementia with Lewy bodies (DLB) patients compared to other diseases, either individually or stratified in non-dementia and dementia groups. When clinical groups were analysed individually and compared to controls, Qalb was also increased in stroke and Parkinson's disease dementia (PDD) cases, but not in Parkinson's disease (PD). Qalb in DLB cases correlate with CSF Aβ42 levels but not with Tau and p-Tau levels. Due to the lower CSF Aβ42 levels in DLB compared to PD and PDD, the potential clinical applicability of Qalb with respect to the DLB diagnosis is increased in combination with CSF Aβ42 analysis. CONCLUSIONS The present study demonstrates increased Qalb in synucleinopathies associated with dementia revealing a potential new clinical approach for the differential diagnosis of DLB.
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Affiliation(s)
- Franc Llorens
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany.
| | - Matthias Schmitz
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | | | - Lisa Kaerst
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany
| | - Peter Hermann
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany
| | - Christian Schmidt
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany
| | - Daniela Varges
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany
| | - Inga Zerr
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
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Sancesario GM, Bernardini S. How many biomarkers to discriminate neurodegenerative dementia? Crit Rev Clin Lab Sci 2015; 52:314-26. [PMID: 26292074 DOI: 10.3109/10408363.2015.1051658] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A number of cerebrospinal fluid (CSF) biomarkers are currently used for the diagnosis of dementia. Opposite changes in the level of amyloid-β(1-42) versus total tau and phosphorylated-tau181 in the CSF reflect the specific pathology of Alzheimer's disease (AD) in the brain. This panel of biomarkers has proven to be effective to differentiate AD from controls and from the major types of neurodegenerative dementia, and to evaluate the progression from mild cognitive impairment to AD. In the absence of specific biomarkers reflecting the pathologies of the other most common forms of dementia, such as Lewy Body disease, Frontotemporal lobar degeneration, Creutzfeldt-Jakob disease, etc., the evaluation of biomarkers of AD pathology is used, attempting to exclude rather than to confirm AD. Other biomarkers included in the common clinical practice do not clearly relate to the underlying pathology: progranulin (PGRN) is a selective marker of frontotemporal dementia with mutations in the PGRN gene; the 14-3-3 protein is a highly sensitive and specific marker for Creutzfeldt-Jakob disease, but has to be used carefully in differentiating rapid progressive dementia; and α-synuclein is an emerging candidate biomarker of the different forms of synucleinopathy. This review summarizes several biomarkers of neurodegenerative dementia validated based on the neuropathological processes occurring in brain tissue. Notwithstanding the paucity of pathologically validated biomarkers and their high analytical variability, the combinations of these biomarkers may well represent a key and more precise analytical and diagnostic tool in the complex plethora of degenerative dementia.
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Affiliation(s)
- Giulia M Sancesario
- a Department of Clinical and Behavioural Neurology , Santa Lucia Foundation, IRCCS , Rome , Italy and
| | - Sergio Bernardini
- b Department of Experimental Medicine and Surgery , Tor Vergata University of Rome , Rome , Italy
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Llorens F, Kruse N, Schmitz M, Shafiq M, da Cunha JEG, Gotzman N, Zafar S, Thune K, de Oliveira JRM, Mollenhauer B, Zerr I. Quantification of CSF biomarkers using an electrochemiluminescence-based detection system in the differential diagnosis of AD and sCJD. J Neurol 2015; 262:2305-11. [DOI: 10.1007/s00415-015-7837-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 06/24/2015] [Accepted: 06/24/2015] [Indexed: 01/26/2023]
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Krzyzanowska A, García-Consuegra I, Pascual C, Antequera D, Ferrer I, Carro E. Expression of regulatory proteins in choroid plexus changes in early stages of Alzheimer disease. J Neuropathol Exp Neurol 2015; 74:359-69. [PMID: 25756589 DOI: 10.1097/nen.0000000000000181] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Recent studies indicate that the choroid plexus has important physiologic and pathologic roles in Alzheimer disease (AD). To obtain additional insight on choroid plexus function, we performed a proteomic analysis of choroid plexus samples from patients with AD stages I to II (n = 16), III to IV (n = 16), and V to VI (n = 11) and 7 age-matched control subjects. We used 2-dimensional differential gel electrophoresis coupled with mass spectrometry to generate a complete picture of changes in choroid plexus protein expression occurring in AD patients. We identified 6 proteins: 14-3-3 β/α, 14-3-3 ε, moesin, proteasome activator complex subunit 1, annexin V, and aldehyde dehydrogenase, which were significantly regulated in AD patient samples (p < 0.05, >1.5-fold variation in expression vs control samples). These proteins are implicated in major physiologic functions including mitochondrial dysfunction and apoptosis regulation. These findings contribute additional significance to the emerging importance of molecular and functional changes of choroid plexus function in the pathophysiology of AD.
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Affiliation(s)
- Agnieszka Krzyzanowska
- From the Neuroscience Group, Research Institute Hospital; Biomedical Research Networking Center on Neurodegenerative Diseases (CIBERNED); and Proteomic Unit, Research Institute Hospital, Madrid; and Institut de Neuropatologia, IDIBELL-Hospital Universitari de Bellvitge; and Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
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Validation of 14-3-3 Protein as a Marker in Sporadic Creutzfeldt-Jakob Disease Diagnostic. Mol Neurobiol 2015; 53:2189-99. [DOI: 10.1007/s12035-015-9167-5] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 03/31/2015] [Indexed: 11/26/2022]
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A Practical Approach to Avoiding Iatrogenic Creutzfeldt-Jakob Disease (CJD) from Invasive Instruments. Infect Control Hosp Epidemiol 2015; 36:844-8. [DOI: 10.1017/ice.2015.53] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Potential Creutzfeldt-Jakob disease instrument-contamination events continue to occur, causing widespread hospital and patient concern. We propose the use of a combination of diagnostic tests (ie, spinal fluid for 14-3-3 protein or nasal brushing for misfolded prion protein) and instrument handling procedures (ie, using a regional set of dedicated instruments), which if applied to all patients admitted with symptoms of either dementia or cerebellar disease, should eliminate the risk of iatrogenic instrument infection.Infect Control Hosp Epidemiol 2015;36(7):844–848
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Rohan Z, Smetakova M, Kukal J, Rusina R, Matej R. Proteinase-activated receptor 2 and disease biomarkers in cerebrospinal fluid in cases with autopsy-confirmed prion diseases and other neurodegenerative diseases. BMC Neurol 2015; 15:50. [PMID: 25886404 PMCID: PMC4392746 DOI: 10.1186/s12883-015-0300-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 03/11/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Proteinase-activated receptor 2 (PAR-2) has been shown to promote both neurotoxic and neuroprotective effects. Similarly, other routinely used nonspecific markers of neuronal damage can be found in cerebrospinal fluid (CSF) and can be used as biomarkers for different neurodegenerative disorders. METHODS Using enzyme-linked immunosorbent assays and western blotting we assessed PAR-2, total-tau, phospho-tau, beta-amyloid levels, and protein 14-3-3 in the CSF of former patients who had undergone a neuropathological autopsy after death and who had been definitively diagnosed with a prion or other neurodegenerative disease. RESULTS We did not find any significant correlation between levels of PAR-2 and other biomarkers, nor did we find any differences in PAR-2 levels between prion diseases and other neurodegenerative conditions. However, we confirmed that very high total-tau levels were significantly associated with definitive prion diagnoses and exhibited greater sensitivity and specificity than protein 14-3-3, which is routinely used as a marker. CONCLUSIONS Our study showed that PAR-2, in CSF, was not specifically altered in prion diseases compared to other neurodegenerative conditions. Our results also confirmed that very high total-tau protein CSF levels were significantly associated with a definitive Creutzfeldt-Jakob disease (CJD) diagnosis and should be routinely tested as a diagnostic marker. Observed individual variability in CSF biomarkers provide invaluable feedback from neuropathological examinations even in "clinically certain" cases.
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Affiliation(s)
- Zdenek Rohan
- Department of Pathology and Molecular Medicine, National Reference Laboratory for Diagnostics of Human Prion Diseases, Thomayer Hospital, Prague, Czech Republic. .,Institute of Pathology, Third Medical Faculty of Charles University in Prague and Kralovske Vinohrady Teaching Hospital, Prague, Czech Republic.
| | - Magdalena Smetakova
- Department of Pathology and Molecular Medicine, National Reference Laboratory for Diagnostics of Human Prion Diseases, Thomayer Hospital, Prague, Czech Republic. .,Institute of Pathology, Third Medical Faculty of Charles University in Prague and Kralovske Vinohrady Teaching Hospital, Prague, Czech Republic.
| | - Jaromir Kukal
- Department of Software Engineering, Faculty of Nuclear Science and Physical Engineering, Czech Technical University, Prague, Czech Republic.
| | - Robert Rusina
- Thomayer Hospital, Department of Neurology, Prague, Czech Republic. .,Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague, and General University Hospital in Prague, Prague, Czech Republic.
| | - Radoslav Matej
- Department of Pathology and Molecular Medicine, National Reference Laboratory for Diagnostics of Human Prion Diseases, Thomayer Hospital, Prague, Czech Republic. .,Institute of Pathology, Third Medical Faculty of Charles University in Prague and Kralovske Vinohrady Teaching Hospital, Prague, Czech Republic. .,Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague, and General University Hospital in Prague, Prague, Czech Republic.
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81
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Forner SA, Takada LT, Bettcher BM, Lobach IV, Tartaglia MC, Torres-Chae C, Haman A, Thai J, Vitali P, Neuhaus J, Bostrom A, Miller BL, Rosen HJ, Geschwind MD. Comparing CSF biomarkers and brain MRI in the diagnosis of sporadic Creutzfeldt-Jakob disease. Neurol Clin Pract 2015; 5:116-125. [PMID: 26137420 DOI: 10.1212/cpj.0000000000000111] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We assessed the diagnostic utility of 3 CSF biomarkers-14-3-3 protein, total tau (T-tau), and neuron-specific enolase (NSE)-from the same lumbar puncture to distinguish between participants with neuropathologically confirmed sporadic Creutzfeldt-Jakob disease (sCJD, n = 57) and controls with nonprion rapidly progressive dementia (npRPD, n = 41). Measures of diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value, as well as logistic regression and area under the receiver operator curve (AUC), were used to assess the ability of these CSF biomarkers, alone or concomitantly, to predict diagnosis. In a subcohort with available MRI (sCJD n = 57, npRPD = 32), we compared visual assessment of diffusion-weighted imaging MRI sequences to these CSF biomarkers. MRI was the best predictor, with an AUC of 0.97 (confidence interval [CI] 0.92-1.00) and a diagnostic accuracy of 97% (CI 90%-100%). Of the CSF biomarkers, T-tau had a higher diagnostic accuracy (79.6%) than 14-3-3 (70.4%, CI for difference 8.7%, 9.7%; p = 0.048) or NSE (71.4%, CI for difference 7.6%, 8.7%; p = 0.03).
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Affiliation(s)
- Sven A Forner
- Memory and Aging Center (SAF, BMB, IVL, CT-C, AH, JN, AB, BLM, HLR, MDG), Department of Neurology, University of California San Francisco; Department of Neurology (LTT), Hospital das Clinicas, University of Sao Paulo Medical School, Brazil; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Canada; Division of Geriatrics (JT), San Francisco Veterans Affairs Medical Center and University of California at San Francisco; and the Brain MRI 3T Mondino Research Center (PV), C. Mondino National Neurological Institute, Pavia, Italy
| | - Leonel T Takada
- Memory and Aging Center (SAF, BMB, IVL, CT-C, AH, JN, AB, BLM, HLR, MDG), Department of Neurology, University of California San Francisco; Department of Neurology (LTT), Hospital das Clinicas, University of Sao Paulo Medical School, Brazil; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Canada; Division of Geriatrics (JT), San Francisco Veterans Affairs Medical Center and University of California at San Francisco; and the Brain MRI 3T Mondino Research Center (PV), C. Mondino National Neurological Institute, Pavia, Italy
| | - Brianne M Bettcher
- Memory and Aging Center (SAF, BMB, IVL, CT-C, AH, JN, AB, BLM, HLR, MDG), Department of Neurology, University of California San Francisco; Department of Neurology (LTT), Hospital das Clinicas, University of Sao Paulo Medical School, Brazil; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Canada; Division of Geriatrics (JT), San Francisco Veterans Affairs Medical Center and University of California at San Francisco; and the Brain MRI 3T Mondino Research Center (PV), C. Mondino National Neurological Institute, Pavia, Italy
| | - Iryna V Lobach
- Memory and Aging Center (SAF, BMB, IVL, CT-C, AH, JN, AB, BLM, HLR, MDG), Department of Neurology, University of California San Francisco; Department of Neurology (LTT), Hospital das Clinicas, University of Sao Paulo Medical School, Brazil; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Canada; Division of Geriatrics (JT), San Francisco Veterans Affairs Medical Center and University of California at San Francisco; and the Brain MRI 3T Mondino Research Center (PV), C. Mondino National Neurological Institute, Pavia, Italy
| | - Maria Carmela Tartaglia
- Memory and Aging Center (SAF, BMB, IVL, CT-C, AH, JN, AB, BLM, HLR, MDG), Department of Neurology, University of California San Francisco; Department of Neurology (LTT), Hospital das Clinicas, University of Sao Paulo Medical School, Brazil; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Canada; Division of Geriatrics (JT), San Francisco Veterans Affairs Medical Center and University of California at San Francisco; and the Brain MRI 3T Mondino Research Center (PV), C. Mondino National Neurological Institute, Pavia, Italy
| | - Charles Torres-Chae
- Memory and Aging Center (SAF, BMB, IVL, CT-C, AH, JN, AB, BLM, HLR, MDG), Department of Neurology, University of California San Francisco; Department of Neurology (LTT), Hospital das Clinicas, University of Sao Paulo Medical School, Brazil; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Canada; Division of Geriatrics (JT), San Francisco Veterans Affairs Medical Center and University of California at San Francisco; and the Brain MRI 3T Mondino Research Center (PV), C. Mondino National Neurological Institute, Pavia, Italy
| | - Aissatou Haman
- Memory and Aging Center (SAF, BMB, IVL, CT-C, AH, JN, AB, BLM, HLR, MDG), Department of Neurology, University of California San Francisco; Department of Neurology (LTT), Hospital das Clinicas, University of Sao Paulo Medical School, Brazil; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Canada; Division of Geriatrics (JT), San Francisco Veterans Affairs Medical Center and University of California at San Francisco; and the Brain MRI 3T Mondino Research Center (PV), C. Mondino National Neurological Institute, Pavia, Italy
| | - Julie Thai
- Memory and Aging Center (SAF, BMB, IVL, CT-C, AH, JN, AB, BLM, HLR, MDG), Department of Neurology, University of California San Francisco; Department of Neurology (LTT), Hospital das Clinicas, University of Sao Paulo Medical School, Brazil; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Canada; Division of Geriatrics (JT), San Francisco Veterans Affairs Medical Center and University of California at San Francisco; and the Brain MRI 3T Mondino Research Center (PV), C. Mondino National Neurological Institute, Pavia, Italy
| | - Paolo Vitali
- Memory and Aging Center (SAF, BMB, IVL, CT-C, AH, JN, AB, BLM, HLR, MDG), Department of Neurology, University of California San Francisco; Department of Neurology (LTT), Hospital das Clinicas, University of Sao Paulo Medical School, Brazil; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Canada; Division of Geriatrics (JT), San Francisco Veterans Affairs Medical Center and University of California at San Francisco; and the Brain MRI 3T Mondino Research Center (PV), C. Mondino National Neurological Institute, Pavia, Italy
| | - John Neuhaus
- Memory and Aging Center (SAF, BMB, IVL, CT-C, AH, JN, AB, BLM, HLR, MDG), Department of Neurology, University of California San Francisco; Department of Neurology (LTT), Hospital das Clinicas, University of Sao Paulo Medical School, Brazil; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Canada; Division of Geriatrics (JT), San Francisco Veterans Affairs Medical Center and University of California at San Francisco; and the Brain MRI 3T Mondino Research Center (PV), C. Mondino National Neurological Institute, Pavia, Italy
| | - Alan Bostrom
- Memory and Aging Center (SAF, BMB, IVL, CT-C, AH, JN, AB, BLM, HLR, MDG), Department of Neurology, University of California San Francisco; Department of Neurology (LTT), Hospital das Clinicas, University of Sao Paulo Medical School, Brazil; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Canada; Division of Geriatrics (JT), San Francisco Veterans Affairs Medical Center and University of California at San Francisco; and the Brain MRI 3T Mondino Research Center (PV), C. Mondino National Neurological Institute, Pavia, Italy
| | - Bruce L Miller
- Memory and Aging Center (SAF, BMB, IVL, CT-C, AH, JN, AB, BLM, HLR, MDG), Department of Neurology, University of California San Francisco; Department of Neurology (LTT), Hospital das Clinicas, University of Sao Paulo Medical School, Brazil; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Canada; Division of Geriatrics (JT), San Francisco Veterans Affairs Medical Center and University of California at San Francisco; and the Brain MRI 3T Mondino Research Center (PV), C. Mondino National Neurological Institute, Pavia, Italy
| | - Howard J Rosen
- Memory and Aging Center (SAF, BMB, IVL, CT-C, AH, JN, AB, BLM, HLR, MDG), Department of Neurology, University of California San Francisco; Department of Neurology (LTT), Hospital das Clinicas, University of Sao Paulo Medical School, Brazil; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Canada; Division of Geriatrics (JT), San Francisco Veterans Affairs Medical Center and University of California at San Francisco; and the Brain MRI 3T Mondino Research Center (PV), C. Mondino National Neurological Institute, Pavia, Italy
| | - Michael D Geschwind
- Memory and Aging Center (SAF, BMB, IVL, CT-C, AH, JN, AB, BLM, HLR, MDG), Department of Neurology, University of California San Francisco; Department of Neurology (LTT), Hospital das Clinicas, University of Sao Paulo Medical School, Brazil; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Canada; Division of Geriatrics (JT), San Francisco Veterans Affairs Medical Center and University of California at San Francisco; and the Brain MRI 3T Mondino Research Center (PV), C. Mondino National Neurological Institute, Pavia, Italy
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82
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Detection of the disease-associated form of the prion protein in biological samples. Bioanalysis 2015; 7:253-61. [PMID: 25587841 DOI: 10.4155/bio.14.301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Transmissible spongiform encephalopathies (TSEs) are neurodegenerative diseases that occur in a variety of mammals. In TSEs, a chromosomally encoded protein (PrPC) undergoes a conformational change to the disease-associated form (PrPd). PrPd is capable of inducing a change in additional molecules of PrPC to the PrPd conformation. TSEs are inevitably fatal and cross-species transmission is known to occur, and there is potential for transmission via blood transfusion and organ transplantation in humans. Thus, there is interest in high-quality diagnostics for both humans and animals. This review summarizes methods of TSE detection currently in use in diagnostic settings and discusses recent advances in PrPd detection that afford substantial enhancements in sensitivity over currently approved methods for use in clinical settings.
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83
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Zerr I, Polyakova TA. [Creutzfeldt-Jakob disease: clinical and diagnostic aspects]. Zh Nevrol Psikhiatr Im S S Korsakova 2015. [PMID: 28635779 DOI: 10.17116/jnevro2015115629-16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
In this article, authors analyzed a modern approach to the diagnosis of Creutzfeldt-Jakob disease (CJD) based on the clinical signs, cerebrospinal fluid markers, electroencephalography and magnetic resonance imaging. It was demonstrated for the first time that patients with late-onset CJD differed from younger CJD patients with respect to MRI profiles and initial clinical presentation. To date, cerebrospinal fluid (CSF) analysis, particularly protein 14-3-3 testing, presents an important approach to the identification of disease cases. A spectrum of differential diagnosis of rapid progressive dementia varied from neurodegenerative dementias to dementia due to acute neurological conditions. Real-time quaking-induced conversion (RT-QuIC) allows the amplification of miniscule amounts of scrapie prion protein. Recent studies applied the RT-QuIC methodology to CSF for the diagnosis of human prion diseases.
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Affiliation(s)
- I Zerr
- National Center of Neurodegenerative and Prion Diseases, Georg-August Gottingen University, Gottingen, Germany
| | - T A Polyakova
- Russian Medical Academy of Postgraduate Education, Moscow
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84
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Raphael I, Webb J, Stuve O, Haskins W, Forsthuber T. Body fluid biomarkers in multiple sclerosis: how far we have come and how they could affect the clinic now and in the future. Expert Rev Clin Immunol 2014; 11:69-91. [PMID: 25523168 DOI: 10.1586/1744666x.2015.991315] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Multiple sclerosis (MS) is an autoimmune inflammatory disease of the central nervous system, which affects over 2.5 million people worldwide. Although MS has been extensively studied, many challenges still remain in regards to treatment, diagnosis and prognosis. Typically, prognosis and individual responses to treatment are evaluated by clinical tests such as the expanded disability status scale, MRI and presence of oligoclonal bands in the cerebrospinal fluid. However, none of these measures correlates strongly with treatment efficacy or disease progression across heterogeneous patient populations and subtypes of MS. Numerous studies over the past decades have attempted to identify sensitive and specific biomarkers for diagnosis, prognosis and treatment efficacy of MS. The objective of this article is to review and discuss the current literature on body fluid biomarkers in MS, including research on potential biomarker candidates in the areas of miRNA, mRNA, lipids and proteins.
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Affiliation(s)
- Itay Raphael
- University of Texas San Antonio - Biology, San Antonio, TX, USA
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85
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Day GS, Tang-Wai DF. When dementia progresses quickly: a practical approach to the diagnosis and management of rapidly progressive dementia. Neurodegener Dis Manag 2014; 4:41-56. [PMID: 24640978 DOI: 10.2217/nmt.13.75] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Making a diagnosis of rapidly progressive dementia requires practical adaptation of the skills used to assess patients with chronic causes of cognitive impairment. An expedited assessment, commensurate with the accelerated pace of the disease, is required to identify the cause of symptoms amidst a myriad of possibilities. Features upon history, physical examination and cognitive assessment that support specific diagnoses are reviewed, and a stratified approach to testing is presented. The use of readily-accessible investigations is prioritized, acknowledging the implications and applications of novel diagnostic tests. The coordinated use of clinical and laboratory measures are promoted as a means of facilitating rapid evaluation, with the ultimate goal of identifying patients with potentially reversible causes of rapidly progressive dementia.
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Affiliation(s)
- Gregory S Day
- University of Toronto, Division of Neurology, University Health Network Memory Clinic, Toronto Western Hospital, Toronto, ON, Canada
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86
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Molinuevo JL, Blennow K, Dubois B, Engelborghs S, Lewczuk P, Perret-Liaudet A, Teunissen CE, Parnetti L. The clinical use of cerebrospinal fluid biomarker testing for Alzheimer's disease diagnosis: A consensus paper from the Alzheimer's Biomarkers Standardization Initiative. Alzheimers Dement 2014; 10:808-17. [DOI: 10.1016/j.jalz.2014.03.003] [Citation(s) in RCA: 140] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 02/28/2014] [Accepted: 03/18/2014] [Indexed: 11/16/2022]
Affiliation(s)
- José Luis Molinuevo
- Alzheimer's Disease and Other Cognitive Disorders Unit; Hospital Clinic i Universitari, IDIBAPS and Barcelona Beta Research Centre; Pasqual Maragall Foundation Barcelona Spain
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry; Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg; Mölndal Sweden
| | - Bruno Dubois
- Centre des Maladies Cognitives et Comportementales, Hôpital de la Salpêtrière, AP-HP; Institute of Brain and Spinal Cord (ICM), UMR-S975; Université Pierre et Marie Curie-Paris 6 Paris France
| | - Sebastiaan Engelborghs
- Department of Neurology and Memory Clinic; Hospital Network Antwerp (ZNA); Middelheim and Hoge Beuken Antwerp Belgium
- Reference Centre for Biological Markers of Dementia (BIODEM); Institute Born-Bunge, University of Antwerp; Antwerp Belgium
| | - Piotr Lewczuk
- Department of Psychiatry and Psychotherapy; Universitätsklinikum Erlangen and Friedrich-Alexander Universität Erlangen-Nürnberg; Erlangen Germany
| | - Armand Perret-Liaudet
- Centre for Memory Resources and Research (CMRR); Neurobiology Laboratory, GHE, Hôpitaux de Lyon; Université Lyon 1, CNRS UMR5292, INSERM U1028 Lyon France
| | - Charlotte E. Teunissen
- Neurochemistry Laboratory and Biobank; Department of Clinical Chemistry, VU University Medical Center; Amsterdam The Netherlands
| | - Lucilla Parnetti
- Centre for Memory Disturbances and Alzheimer's Centre, Section of Neurology; University of Perugia; Perugia Italy
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Di Gangi S, Bertin M, Noventa M, Cagnin A, Cosmi E, Gizzo S. Obstetric dilemma on the most appropriate management of Creutzfeldt-Jakob disease in pregnancy: seventh case presentation, literature review and new insight. J Matern Fetal Neonatal Med 2014; 28:254-61. [PMID: 24749800 DOI: 10.3109/14767058.2014.916678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Prion diseases (PDs) are fatal neurological disorders that are thought to be caused by the accumulation of an altered variant of a benign, widely expressed protein (PrPC) into a distinct pathological conformation(s) (PrPSc). The PDs are so rare but lethal pathologies that need an early diagnosis to adequately support the infected patient. A maternal-fetal transmission during pregnancy has been supposed to be on the basis of animal studies, but till now the effective vertical transmission in humans has not been proved. We present a case of infected pregnant woman with a peculiar pregnancy course and outcome. We also provided a systematic literature review to find the best obstetrical management of women affected by prionic disease during pregnancy. The available data underline the potential risk of prenatal and postnatal transmission of the disease but do not permit to define the exact molecular mechanism of transmission, the best follow-up and recommendations that are useful in both obstetrical and neonatal practice. At present awaiting for further clarifications about this topic, it is mandatory to personalize the management of this rare pregnancy complication according to the maternal-fetal well-being status.
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Abstract
Human prion diseases are fatal neurodegenerative disorders that are characterized by spongiform changes, astrogliosis, and the accumulation of an abnormal prion protein (PrP(Sc)). Approximately 10%-15% of human prion diseases are familial variants that are caused by pathogenic mutations in the prion protein gene (PRNP). Point mutations or the insertions of one or more copies of a 24 bp repeat are associated with familial human prion diseases including familial Creutzfeldt-Jakob disease (CJD), Gerstmann-Sträussler-Scheinker syndrome, and fatal familial insomnia. These mutations vary significantly in frequency between countries. Here, we compare the frequency of PRNP mutations between European countries and East Asians. Associations between single nucleotide polymorphisms (SNPs) of several candidate genes including PRNP and CJD have been reported. The SNP of PRNP at codon 129 has been shown to be associated with sporadic, iatrogenic, and variant CJD. The SNPs of several genes other than PRNP have been showed contradictory results. Case-control studies and genome-wide association studies have also been performed to identify candidate genes correlated with variant and/or sporadic CJD. This review provides a general overview of the genetic mutations and polymorphisms that have been analyzed in association with human prion diseases to date.
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Affiliation(s)
- Byung-Hoon Jeong
- Korea Zoonosis Research Institute, Chonbuk National University, Jeonju, Korea
| | - Yong-Sun Kim
- Ilsong Institute of Life Science, Hallym University, Anyang, Korea
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Shiner E, Taylor L, Mohan A, Watson S, Sachdev PS. Severe depression masquerading as Creutzfeldt-Jakob disease. BMJ Case Rep 2014; 2014:bcr-2013-203352. [PMID: 24748140 DOI: 10.1136/bcr-2013-203352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
We report a case of melancholic depression with catatonic features presenting as a rapidly progressive organic brain syndrome, initially thought to be probable Creutzfeldt-Jakob disease. The case highlights the fundamental importance of thorough exclusion of treatable pathology masquerading as an irreversible syndrome.
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Affiliation(s)
- Elizabeth Shiner
- Institute of Neurological Sciences, Prince of Wales Hospital, Sydney, Australia
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90
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Unusual features of Creutzfeldt–Jakob disease followed-up in a memory clinic. J Neurol 2014; 261:696-701. [DOI: 10.1007/s00415-014-7246-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 01/08/2014] [Indexed: 10/25/2022]
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91
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Satoh K. [CSF analysis of patients with prion disease by biomarkers and real-time qucking-induced conversion (RT-QUIC) method]. Rinsho Shinkeigaku 2013; 23:1252-4. [PMID: 24291947 DOI: 10.5692/clinicalneurol.53.1252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Hsich et al reported 14-3-3 protein in CSF supports a diagnosis of human prion disease, and 14-3-3 protein is one of supportive diagnostic criteria on WHO (1998). In the presence of 14-3-3 protein and total tau protein is widely used as a surrogate marker in the pre-mortem diagnosis of human prion disease and other rapidly progressive dementia. Most recent research report that the sensitivity of 14-3-3 protein was 43%-100%, and the specificity of 14-3-3 protein was 47%-97%. And the sensitivity of total tau protein was 43%-100%, and the specificity of total tau protein was 47%-97%. In other hand we recently developed a new in vitro amplification technology, designated "RT-QUIC assay", for the detection of PrP(Sc) in CSF of sCJD. Other group reported that CSF RT-QUIC method analysis has the potential to be a more specific diagnostic test for sCJD than current CSF tests, but their method is different from our method and their study was not enough. Now we are analyzing for the sensitivity and specificity of biomarkers and RT-QUIC method in CSF of definite cases of human prion disease, the number of definite cases of human prion disease is larger than that of other studies.
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Affiliation(s)
- Katsuya Satoh
- Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences
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Belay ED, Blase J, Sehulster LM, Maddox RA, Schonberger LB. Management of neurosurgical instruments and patients exposed to Creutzfeldt-Jakob disease. Infect Control Hosp Epidemiol 2013; 34:1272-80. [PMID: 24225612 PMCID: PMC4748700 DOI: 10.1086/673986] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To summarize the approaches used to manage exposure of patients to inadequately sterilized neurosurgical instruments contaminated as a result of Creutzfeldt-Jakob disease (CJD). METHODS Information on past CJD exposure incidents reported to the Centers for Disease Control and Prevention (CDC) was aggregated and summarized. In addition, inactivation studies were reviewed, and data from selected publications were provided for reference. RESULTS Nineteen incidents of patient exposure to potentially CJD-contaminated instruments were reported to the CDC, including 17 that involved intracranial procedures and 2 that involved ophthalmologic procedures. In more than 50% of incidents, the neurosurgical procedures were performed for diagnostic work up of the index patients. At least 12 of the hospitals had multiple neurosurgical sets, and the CJD-contaminated instruments could not be identified in 11 of 19 hospitals. In 12 of 15 hospitals with neurosurgical incidents, a decision was made to notify patients of their potential exposure. CONCLUSIONS Neurosurgical instruments used for treatment of patients with suspected or diagnosed CJD or patients whose diagnosis is unclear should be promptly identified and sterilized using recommended CJD decontamination protocols. Inability to trace instruments complicates appropriate management of exposure incidents. The feasibility of instituting instrument tracking procedures should be considered.
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Affiliation(s)
- Ermias D Belay
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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TSE diagnostics: recent advances in immunoassaying prions. Clin Dev Immunol 2013; 2013:360604. [PMID: 23970925 PMCID: PMC3732588 DOI: 10.1155/2013/360604] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 05/27/2013] [Accepted: 07/02/2013] [Indexed: 02/05/2023]
Abstract
Transmissible spongiform encephalopathies (TSEs) or prion diseases are a group of rare fatal neurodegenerative diseases, affecting humans and animals. They are believed to be the consequence of the conversion of the cellular prion protein to its aggregation-prone, β-sheet-rich isoform, named prion. Definite diagnosis of TSEs is determined post mortem. For this purpose, immunoassays for analyzing brain tissue have been developed. However, the ultimate goal of TSE diagnostics is an ante mortem test, which would be sensitive enough to detect prions in body fluids, that is, in blood, cerebrospinal fluid, or urine. Such a test would be of paramount importance also for screening of asymptomatic carriers of the disease with the aim of increasing food, drugs, and blood-derived products safety. In the present paper, we have reviewed recent advances in the development of immunoassays for the detection of prions.
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Davies NWS. Subacute onset encephalopathy: a rare clinical syndrome with many aetiologies. Br J Hosp Med (Lond) 2013; 74:126-7. [DOI: 10.12968/hmed.2013.74.3.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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