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Stathas S, Alvarez VE, Xia W, Nicks R, Meng G, Daley S, Pothast M, Shah A, Kelley H, Esnault C, McCormack R, Dixon E, Fishbein L, Cherry JD, Huber BR, Tripodis Y, Alosco ML, Mez J, McKee AC, Stein TD. Tau phosphorylation sites serine202 and serine396 are differently altered in chronic traumatic encephalopathy and Alzheimer's disease. Alzheimers Dement 2022; 18:1511-1522. [PMID: 34854540 PMCID: PMC9160206 DOI: 10.1002/alz.12502] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 07/03/2021] [Accepted: 09/22/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Chronic traumatic encephalopathy (CTE) is a neurodegenerative tauopathy associated with repetitive head impacts (RHI) typically sustained by contact sport athletes. Post-translation modifications to tau in CTE have not been well delineated or compared to Alzheimer's disease (AD). METHODS We measured phosphorylated tau epitopes within dorsolateral frontal cortex from post mortem brains with neither CTE nor AD (n = 108), CTE (n = 109), AD (n = 223), and both CTE and AD (n = 33). RESULTS Levels of hyperphosphorylated tau (p-tau)202 , p-tau231 , and p-tau396 were significantly increased in CTE. Total years of RHI exposure was significantly associated with increased p-tau202 levels (P = .001), but not p-tau396 . Instead, p-tau396 was most closely related to amyloid beta (Aβ)1-42 levels (P < .001). The p-tau202 :p-tau396 ratio was significantly increased in early and late CTE compared to AD. DISCUSSION In frontal cortex, p-tau202 is the most upregulated p-tau species in CTE, while p-tau396 is most increased in AD. p-tau202 and p-tau396 measurements may aid in developing biomarkers for disease.
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Affiliation(s)
- SpiroAnthony Stathas
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
- VA Bedford Healthcare System, Bedford, MA, 01730, USA
| | - Victor E. Alvarez
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
- VA Bedford Healthcare System, Bedford, MA, 01730, USA
- Department of Neurology, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 20118, USA
- VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA, 02130, USA
| | - Weiming Xia
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
- VA Bedford Healthcare System, Bedford, MA, 01730, USA
| | - Raymond Nicks
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
- VA Bedford Healthcare System, Bedford, MA, 01730, USA
| | - Gaoyuan Meng
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
- VA Bedford Healthcare System, Bedford, MA, 01730, USA
- VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA, 02130, USA
| | - Sarah Daley
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
- VA Bedford Healthcare System, Bedford, MA, 01730, USA
| | - Morgan Pothast
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
| | - Arsal Shah
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
- VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA, 02130, USA
| | - Hunter Kelley
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
| | - Camille Esnault
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
| | - Robert McCormack
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
| | - Erin Dixon
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
| | - Lucas Fishbein
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
| | - Jonathan D. Cherry
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
- Department of Neurology, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 20118, USA
- VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA, 02130, USA
| | - Bertrand R. Huber
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
- Department of Neurology, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 20118, USA
- VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA, 02130, USA
| | - Yorghos Tripodis
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, 20118, USA
| | - Michael L. Alosco
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
- Department of Neurology, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 20118, USA
| | - Jesse Mez
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
- Department of Neurology, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 20118, USA
| | - Ann C. McKee
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
- VA Bedford Healthcare System, Bedford, MA, 01730, USA
- Department of Neurology, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 20118, USA
- VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA, 02130, USA
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
| | - Thor D. Stein
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
- VA Bedford Healthcare System, Bedford, MA, 01730, USA
- Department of Neurology, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 20118, USA
- VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA, 02130, USA
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, 72 E Concord Street, B7800, Boston, MA, 02118, USA
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Benussi A, Libri I, Premi E, Alberici A, Cantoni V, Gadola Y, Rivolta J, Pengo M, Gazzina S, Calhoun VD, Gasparotti R, Zetterberg H, Ashton NJ, Blennow K, Padovani A, Borroni B. Differences and similarities between familial and sporadic frontotemporal dementia: An Italian single-center cohort study. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12326. [PMID: 35898667 PMCID: PMC9310192 DOI: 10.1002/trc2.12326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/11/2022] [Accepted: 06/17/2022] [Indexed: 06/15/2023]
Abstract
Introduction The possibility to generalize our understandings on treatments and assessments to both familial frontotemporal dementia (f-FTD) and sporadic FTD (s-FTD) is a fundamental perspective for the near future, considering the constant advancement in potential disease-modifying therapies that target particular genetic forms of FTD. We aimed to investigate differences in clinical features, cerebrospinal fluid (CSF), and blood-based biomarkers between f-FTD and s-FTD. Methods In this longitudinal cohort study, we evaluated a consecutive sample of symptomatic FTD patients, classified as f-FTD and s-FTD according to Goldman scores (GS). All patients underwent clinical, behavioral, and neuropsychiatric symptom assessment, CSF biomarkers and serum neurofilament light (NfL) analysis, and brain atrophy evaluation with magnetic resonance imaging. Results Of 570 patients with FTD, 123 were classified as f-FTD, and 447 as s-FTD. In the f-FTD group, 95 had a pathogenic FTD mutation while 28 were classified as GS = 1 or 2; of the s-FTD group, 133 were classified as GS = 3 and 314 with GS = 4. f-FTD and s-FTD cases showed comparable demographic features, except for younger age at disease onset, age at diagnosis, and higher years of education in the f-FTD group (all P < .05). f-FTD showed worse behavioral disturbances as measured with Frontal Behavioral Inventory (FBI) negative behaviors (14.0 ± 7.6 vs. 11.6 ± 7.4, P = .002), and positive behaviors (20.0 ± 11.0 vs. 17.4 ± 11.8, P = .031). Serum NfL concentrations were higher in patients with f-FTD (70.9 ± 37.9 pg/mL) compared to s-FTD patients (37.3 ± 24.2 pg/mL, P < .001), and f-FTD showed greater brain atrophy in the frontal and temporal regions and basal ganglia. Patients with f-FTD had significantly shorter survival than those with s-FTD (P = .004). Discussion f-FTD and s-FTD are very similar clinical entities, but with different biological mechanisms, and different rates of progression. The parallel characterization of both f-FTD and s-FTD will improve our understanding of the disease, and aid in designing future clinical trials for both genetic and sporadic forms of FTD. Highlights Do clinical features and biomarkers differ between patients with familial frontotemporal dementia (f-FTD) and sporadic FTD (s-FTD)?In this cohort study of 570 patients with FTD, f-FTD and s-FTD share similar demographic features, but with younger age at disease onset and diagnosis in the f-FTD group.f-FTD showed higher serum neurofilament light concentrations, greater brain damage, and shorter survival, compared to s-FTD.f-FTD and s-FTD are very similar clinical entities, but with different cognitive reserve mechanisms and different rates of progression.
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Affiliation(s)
- Alberto Benussi
- Neurology UnitDepartment of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
- Neurology UnitDepartment of Neurological and Vision SciencesASST Spedali CiviliBresciaItaly
| | - Ilenia Libri
- Neurology UnitDepartment of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Enrico Premi
- Stroke UnitDepartment of Neurological and Vision SciencesASST Spedali CiviliBresciaItaly
| | - Antonella Alberici
- Neurology UnitDepartment of Neurological and Vision SciencesASST Spedali CiviliBresciaItaly
| | - Valentina Cantoni
- Neurology UnitDepartment of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Yasmine Gadola
- Neurology UnitDepartment of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Jasmine Rivolta
- Neurology UnitDepartment of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Marta Pengo
- Department of Molecular and Translational MedicineUniversity of BresciaBresciaItaly
| | - Stefano Gazzina
- Neurophysiology UnitDepartment of Neurological and Vision SciencesASST Spedali CiviliBresciaItaly
| | - Vince D. Calhoun
- The Mind Research NetworkDepartment of Electrical and Computer EngineeringUniversity of New MexicoAlbuquerqueNew MexicoUSA
| | | | - Henrik Zetterberg
- Institute of Neuroscience and PhysiologyDepartment of Psychiatry and NeurochemistryThe Sahlgrenska Academy at the University of GothenburgMölndalSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- UK Dementia Research Institute at UCLLondonUK
- Department of Neurodegenerative DiseaseUCL Institute of NeurologyLondonUK
- Hong Kong Center for Neurodegenerative DiseasesHong KongChina
| | - Nicholas J. Ashton
- Institute of Neuroscience and PhysiologyDepartment of Psychiatry and NeurochemistryThe Sahlgrenska Academy at the University of GothenburgMölndalSweden
- Wallenberg Centre for Molecular and Translational MedicineUniversity of GothenburgMölndalSweden
- King's College LondonInstitute of PsychiatryPsychology & NeuroscienceMaurice Wohl Clinical Neuroscience InstituteLondonUK
- NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS FoundationLondonUK
| | - Kaj Blennow
- Institute of Neuroscience and PhysiologyDepartment of Psychiatry and NeurochemistryThe Sahlgrenska Academy at the University of GothenburgMölndalSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
| | - Alessandro Padovani
- Neurology UnitDepartment of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
- Neurology UnitDepartment of Neurological and Vision SciencesASST Spedali CiviliBresciaItaly
| | - Barbara Borroni
- Neurology UnitDepartment of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
- Neurology UnitDepartment of Neurological and Vision SciencesASST Spedali CiviliBresciaItaly
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Biomarkers of Neurodegenerative Diseases: Biology, Taxonomy, Clinical Relevance, and Current Research Status. Biomedicines 2022; 10:biomedicines10071760. [PMID: 35885064 PMCID: PMC9313182 DOI: 10.3390/biomedicines10071760] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 01/02/2023] Open
Abstract
The understanding of neurodegenerative diseases, traditionally considered to be well-defined entities with distinguishable clinical phenotypes, has undergone a major shift over the last 20 years. The diagnosis of neurodegenerative diseases primarily requires functional brain imaging techniques or invasive tests such as lumbar puncture to assess cerebrospinal fluid. A new biological approach and research efforts, especially in vivo, have focused on biomarkers indicating underlying proteinopathy in cerebrospinal fluid and blood serum. However, due to the complexity and heterogeneity of neurodegenerative processes within the central nervous system and the large number of overlapping clinical diagnoses, identifying individual proteinopathies is relatively difficult and often not entirely accurate. For this reason, there is an urgent need to develop laboratory methods for identifying specific biomarkers, understand the molecular basis of neurodegenerative disorders and classify the quantifiable and readily available tools that can accelerate efforts to translate the knowledge into disease-modifying therapies that can improve and simplify the areas of differential diagnosis, as well as monitor the disease course with the aim of estimating the prognosis or evaluating the effects of treatment. The aim of this review is to summarize the current knowledge about clinically relevant biomarkers in different neurodegenerative diseases.
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Schindler SE, Karikari TK, Ashton NJ, Henson RL, Yarasheski KE, West T, Meyer MR, Kirmess KM, Li Y, Saef B, Moulder KL, Bradford D, Fagan AM, Gordon BA, Benzinger TLS, Balls-Berry J, Bateman RJ, Xiong C, Zetterberg H, Blennow K, Morris JC. Effect of Race on Prediction of Brain Amyloidosis by Plasma Aβ42/Aβ40, Phosphorylated Tau, and Neurofilament Light. Neurology 2022; 99:e245-e257. [PMID: 35450967 PMCID: PMC9302933 DOI: 10.1212/wnl.0000000000200358] [Citation(s) in RCA: 76] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/22/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To evaluate whether plasma biomarkers of amyloid (Aβ42/Aβ40), tau (p-tau181 and p-tau231), and neuroaxonal injury (neurofilament light chain [NfL]) detect brain amyloidosis consistently across racial groups. METHODS Individuals enrolled in studies of memory and aging who self-identified as African American (AA) were matched 1:1 to self-identified non-Hispanic White (NHW) individuals by age, APOE ε4 carrier status, and cognitive status. Each participant underwent blood and CSF collection, and amyloid PET was performed in 103 participants (68%). Plasma Aβ42/Aβ40 was measured by a high-performance immunoprecipitation-mass spectrometry assay. Plasma p-tau181, p-tau231, and NfL were measured by Simoa immunoassays. CSF Aβ42/Aβ40 and amyloid PET status were used as primary and secondary reference standards of brain amyloidosis, respectively. RESULTS There were 76 matched pairs of AA and NHW participants (n = 152 total). For both AA and NHW groups, the median age was 68.4 years, 42% were APOE ε4 carriers, and 91% were cognitively normal. AA were less likely than NHW participants to have brain amyloidosis by CSF Aβ42/Aβ40 (22% vs 43% positive; p = 0.003). The receiver operating characteristic area under the curve of CSF Aβ42/Aβ40 status with the plasma biomarkers was as follows: Aβ42/Aβ40, 0.86 (95% CI 0.79-0.92); p-tau181, 0.76 (0.68-0.84); p-tau231, 0.69 (0.60-0.78); and NfL, 0.64 (0.55-0.73). In models predicting CSF Aβ42/Aβ40 status with plasma Aβ42/Aβ40 that included covariates (age, sex, APOE ε4 carrier status, race, and cognitive status), race did not affect the probability of CSF Aβ42/Aβ40 positivity. In similar models based on plasma p-tau181, p-tau231, or NfL, AA participants had a lower probability of CSF Aβ42/Aβ40 positivity (odds ratio 0.31 [95% CI 0.13-0.73], 0.30 [0.13-0.71], and 0.27 [0.12-0.64], respectively). Models of amyloid PET status yielded similar findings. DISCUSSION Models predicting brain amyloidosis using a high-performance plasma Aβ42/Aβ40 assay may provide an accurate and consistent measure of brain amyloidosis across AA and NHW groups, but models based on plasma p-tau181, p-tau231, and NfL may perform inconsistently and could result in disproportionate misdiagnosis of AA individuals.
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Affiliation(s)
- Suzanne E Schindler
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China.
| | - Thomas K Karikari
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Nicholas J Ashton
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Rachel L Henson
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Kevin E Yarasheski
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Tim West
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Mathew R Meyer
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Kristopher M Kirmess
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Yan Li
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Benjamin Saef
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Krista L Moulder
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - David Bradford
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Anne M Fagan
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Brian A Gordon
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Tammie L S Benzinger
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Joyce Balls-Berry
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Randall J Bateman
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Chengjie Xiong
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Henrik Zetterberg
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Kaj Blennow
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - John C Morris
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
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Zhang Y, Yang Y, Hu Z, Zhu M, Qin S, Yu P, Li B, Xu J, Ondrejcak T, Klyubin I, Rowan MJ, Hu NW. Long-Term Depression-Inducing Low Frequency Stimulation Enhances p-Tau181 and p-Tau217 in an Age-Dependent Manner in Live Rats. J Alzheimers Dis 2022; 89:335-350. [PMID: 35871344 PMCID: PMC9484260 DOI: 10.3233/jad-220351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Cognitive decline in Alzheimer’s disease (AD) correlates with the extent of tau pathology, in particular tau hyperphosphorylation, which is strongly age-associated. Although elevation of cerebrospinal fluid or blood levels of phosphorylated tau (p-Tau) at residues Thr181 (p-Tau181), Thr217 (p-Tau217), and Thr231 (p-Tau231) are proposed to be particularly sensitive markers of preclinical AD, the generation of p-Tau during brain activity is poorly understood. Objective: To study whether the expression levels of p-Tau181, p-Tau217, and p-Tau231 can be enhanced by physiological synaptic long-term depression (LTD) which has been linked to the enhancement of p-Tau in hippocampus. Methods: In vivo electrophysiology was performed in urethane anesthetized young adult and aged male rats. Low frequency electrical stimulation (LFS) was used to induce LTD at CA3 to CA1 synapses. The expression level of p-Tau and total tau was measured in dorsal hippocampus using immunofluorescent staining and/or western blotting. Results: We found that LFS enhanced p-Tau181 and p-Tau217 in an age-dependent manner in the hippocampus of live rats. In contrast, phosphorylation at residues Thr231, Ser202/Thr205, and Ser396 appeared less sensitive to LFS. Pharmacological antagonism of either N-methyl-D-aspartate or metabotropic glutamate 5 receptors inhibited the elevation of both p-Tau181 and p-Tau217. Targeting the integrated stress response, which increases with aging, using a small molecule inhibitor ISRIB, prevented the enhancement of p-Tau by LFS in aged rats. Conclusion: Together, our data provide a novel in vivo means to uncover brain plasticity-related cellular and molecular processes of tau phosphorylation at key sites in health and aging.
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Affiliation(s)
- Yangyang Zhang
- Department of Physiology and Neurobiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Yin Yang
- Department of Physiology and Neurobiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Zhengtao Hu
- Department of Physiology and Neurobiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
- Department of Gerontology, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Manyi Zhu
- Department of Physiology and Neurobiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Shuangying Qin
- Department of Physiology and Neurobiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Pengpeng Yu
- Department of Physiology and Neurobiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
- Department of Pharmacology & Therapeutics and Institute of Neuroscience, Trinity College, Dublin, Ireland
| | - Bo Li
- Department of Physiology and Neurobiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Jitian Xu
- Department of Physiology and Neurobiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Tomas Ondrejcak
- Department of Pharmacology & Therapeutics and Institute of Neuroscience, Trinity College, Dublin, Ireland
| | - Igor Klyubin
- Department of Pharmacology & Therapeutics and Institute of Neuroscience, Trinity College, Dublin, Ireland
| | - Michael J. Rowan
- Department of Pharmacology & Therapeutics and Institute of Neuroscience, Trinity College, Dublin, Ireland
| | - Neng-Wei Hu
- Department of Physiology and Neurobiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
- Department of Pharmacology & Therapeutics and Institute of Neuroscience, Trinity College, Dublin, Ireland
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356
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Alty J, Bai Q, Li R, Lawler K, St George RJ, Hill E, Bindoff A, Garg S, Wang X, Huang G, Zhang K, Rudd KD, Bartlett L, Goldberg LR, Collins JM, Hinder MR, Naismith SL, Hogg DC, King AE, Vickers JC. The TAS Test project: a prospective longitudinal validation of new online motor-cognitive tests to detect preclinical Alzheimer's disease and estimate 5-year risks of cognitive decline and dementia. BMC Neurol 2022; 22:266. [PMID: 35850660 PMCID: PMC9289357 DOI: 10.1186/s12883-022-02772-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The worldwide prevalence of dementia is rapidly rising. Alzheimer's disease (AD), accounts for 70% of cases and has a 10-20-year preclinical period, when brain pathology covertly progresses before cognitive symptoms appear. The 2020 Lancet Commission estimates that 40% of dementia cases could be prevented by modifying lifestyle/medical risk factors. To optimise dementia prevention effectiveness, there is urgent need to identify individuals with preclinical AD for targeted risk reduction. Current preclinical AD tests are too invasive, specialist or costly for population-level assessments. We have developed a new online test, TAS Test, that assesses a range of motor-cognitive functions and has capacity to be delivered at significant scale. TAS Test combines two innovations: using hand movement analysis to detect preclinical AD, and computer-human interface technologies to enable robust 'self-testing' data collection. The aims are to validate TAS Test to [1] identify preclinical AD, and [2] predict risk of cognitive decline and AD dementia. METHODS Aim 1 will be addressed through a cross-sectional study of 500 cognitively healthy older adults, who will complete TAS Test items comprising measures of motor control, processing speed, attention, visuospatial ability, memory and language. TAS Test measures will be compared to a blood-based AD biomarker, phosphorylated tau 181 (p-tau181). Aim 2 will be addressed through a 5-year prospective cohort study of 10,000 older adults. Participants will complete TAS Test annually and subtests of the Cambridge Neuropsychological Test Battery (CANTAB) biennially. 300 participants will undergo in-person clinical assessments. We will use machine learning of motor-cognitive performance on TAS Test to develop an algorithm that classifies preclinical AD risk (p-tau181-defined) and determine the precision to prospectively estimate 5-year risks of cognitive decline and AD. DISCUSSION This study will establish the precision of TAS Test to identify preclinical AD and estimate risk of cognitive decline and AD. If accurate, TAS Test will provide a low-cost, accessible enrichment strategy to pre-screen individuals for their likelihood of AD pathology prior to more expensive tests such as blood or imaging biomarkers. This would have wide applications in public health initiatives and clinical trials. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05194787 , 18 January 2022. Retrospectively registered.
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Affiliation(s)
- Jane Alty
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia. .,School of Medicine, University of Tasmania, Hobart, Australia. .,Royal Hobart Hospital, Hobart, Tasmania, Australia.
| | - Quan Bai
- School of Information and Communication Technologies, University of Tasmania, Hobart, Australia
| | - Renjie Li
- School of Information and Communication Technologies, University of Tasmania, Hobart, Australia
| | - Katherine Lawler
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia.,Royal Hobart Hospital, Hobart, Tasmania, Australia
| | - Rebecca J St George
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia.,School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Edward Hill
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Aidan Bindoff
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Saurabh Garg
- School of Information and Communication Technologies, University of Tasmania, Hobart, Australia
| | - Xinyi Wang
- School of Information and Communication Technologies, University of Tasmania, Hobart, Australia
| | - Guan Huang
- School of Information and Communication Technologies, University of Tasmania, Hobart, Australia
| | - Kaining Zhang
- School of Information and Communication Technologies, University of Tasmania, Hobart, Australia
| | - Kaylee D Rudd
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Larissa Bartlett
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Lynette R Goldberg
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Jessica M Collins
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Mark R Hinder
- School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Sharon L Naismith
- Healthy Brain Ageing Program, University of Sydney, Sydney, Australia
| | - David C Hogg
- School of Computing, University of Leeds, Leeds, UK
| | - Anna E King
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - James C Vickers
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
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357
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Explore the Therapeutic Composition and Mechanism of Schisandra chinensis-Acorus tatarinowii Schott on Alzheimer’s Disease by Using an Integrated Approach on Chemical Profile, Network Pharmacology, and UPLC-QTOF/MS-Based Metabolomics Analysis. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:6362617. [PMID: 35860432 PMCID: PMC9293517 DOI: 10.1155/2022/6362617] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/21/2022] [Indexed: 11/17/2022]
Abstract
Background. Alzheimer’s disease places a heavy economic burden to healthcare systems around the world. However, the effective treatments are still lacking. Traditional Chinese medicines (TCM) of Schisandra chinensis and Acorus tatarinowii Schott have the pharmacological effects of sedation and neuroprotection and have been clinically proven to be effective in the treatment of AD. However, their main anti-Alzheimer’s compounds and functional mechanisms remain unclear. Purpose. To elucidate the main therapeutic components and possible mechanisms of Sc-At in AD using a comprehensive strategy combining metabolomics and network pharmacology. Methods. First, the UPLC-QTOF/MS method was used to identify the main chemical constituents of Schisandra chinensis and Acorus tatarinowii Schott alcohol extracts in vitro and in vivo. Secondly, the theoretical active ingredients, targets, and pathways of Sc-At for AD treatment were predicted by network pharmacology methods. Finally, plasma metabolomics were detected by UPLC-QTOF/MS to analyze the differential metabolites and metabolic pathways related to Sc-At. Based on the analyses above, the anti-AD mechanism of Sc-At was explored. Results. A total of 95 chemical components were identified in Sc-At extracts in vitro, and 34 prototype drug components were detected in rat plasma; network pharmacology screening identified 14 drug components in line with the principle of Lipinski, of which 10 were present for in vitro drug composition analysis. For these 10 components, 58 AD disease targets were predicted, and 85 AD-related KEGG signaling pathways were enriched. Six core biomarkers of Sc-At (cis-8,11,14,17-eicosatetraenoic acid, prostaglandin H2, sphingosine 1-phosphate, enol-phenylpyruvate, 3-methoxytyrosine, and pristanoyl-CoA) were regulated to a normal state during the treatment of AD. Conclusion. The mechanism of Sc-At for the treatment of AD can be achieved by the effect of the 10 compounds of Sc-At on TNF, MAPK8, MAPK14, PTGS1, and other targets, thereby affecting arachidonic acid metabolism, neurotransmitters, and sphingolipid metabolism.
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358
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Mielke MM, Dage JL, Frank RD, Algeciras-Schimnich A, Knopman DS, Lowe VJ, Bu G, Vemuri P, Graff-Radford J, Jack CR, Petersen RC. Performance of plasma phosphorylated tau 181 and 217 in the community. Nat Med 2022; 28:1398-1405. [PMID: 35618838 PMCID: PMC9329262 DOI: 10.1038/s41591-022-01822-2] [Citation(s) in RCA: 134] [Impact Index Per Article: 67.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/11/2022] [Indexed: 01/03/2023]
Abstract
Plasma phosphorylated tau 181 (P-tau181) and 217 (P-tau217) are indicators of both amyloid and tau pathology in clinical settings, but their performance in heterogeneous community-based populations is unclear. We examined P-tau181 and P-tau217 (n = 1,329, aged 30-98 years), in the population-based Mayo Clinic Study of Aging. Continuous, unadjusted plasma P-tau181 and P-tau217 predicted abnormal amyloid positron-emission tomography (PET) (area under the receiver operating characteristic curve (AUROC) = 0.81-0.86) and tau PET entorhinal cortex (AUROC > 0.80), but was less predictive of a tau PET temporal region of interest (AUROC < 0.70). Multiple comorbidities were associated with higher plasma P-tau181 and P-tau217 levels; the difference between participants with and without chronic kidney disease (CKD) was similar to the difference between participants with and without elevated brain amyloid. The exclusion of participants with CKD and other comorbidities affected the establishment of a normal reference range and cutpoints. Understanding the effect of comorbidities on P-tau181 and P-tau217 levels is important for their future interpretation in the context of clinical screening, diagnosis or prognosis at the population level.
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Affiliation(s)
- Michelle M. Mielke
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA.,Department of Neurology, Mayo Clinic, Rochester, MN, USA.,Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Jeffrey L. Dage
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ryan D. Frank
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | | | - Val J. Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Guojun Bu
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | | | | | | | - Ronald C. Petersen
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA.,Department of Neurology, Mayo Clinic, Rochester, MN, USA
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359
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Jiang Y, Zhou X, Wong HY, Ouyang L, Ip FCF, Chau VMN, Lau SF, Wu W, Wong DYK, Seo H, Fu WY, Lai NCH, Chen Y, Chen Y, Tong EPS, Mok VCT, Kwok TCY, Mok KY, Shoai M, Lehallier B, Losada PM, O'Brien E, Porter T, Laws SM, Hardy J, Wyss-Coray T, Masters CL, Fu AKY, Ip NY. An IL1RL1 genetic variant lowers soluble ST2 levels and the risk effects of APOE-ε4 in female patients with Alzheimer's disease. NATURE AGING 2022; 2:616-634. [PMID: 37117777 PMCID: PMC10154240 DOI: 10.1038/s43587-022-00241-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 05/23/2022] [Indexed: 04/30/2023]
Abstract
Changes in the levels of circulating proteins are associated with Alzheimer's disease (AD), whereas their pathogenic roles in AD are unclear. Here, we identified soluble ST2 (sST2), a decoy receptor of interleukin-33-ST2 signaling, as a new disease-causing factor in AD. Increased circulating sST2 level is associated with more severe pathological changes in female individuals with AD. Genome-wide association analysis and CRISPR-Cas9 genome editing identified rs1921622 , a genetic variant in an enhancer element of IL1RL1, which downregulates gene and protein levels of sST2. Mendelian randomization analysis using genetic variants, including rs1921622 , demonstrated that decreased sST2 levels lower AD risk and related endophenotypes in females carrying the Apolipoprotein E (APOE)-ε4 genotype; the association is stronger in Chinese than in European-descent populations. Human and mouse transcriptome and immunohistochemical studies showed that rs1921622 /sST2 regulates amyloid-beta (Aβ) pathology through the modulation of microglial activation and Aβ clearance. These findings demonstrate how sST2 level is modulated by a genetic variation and plays a disease-causing role in females with AD.
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Affiliation(s)
- Yuanbing Jiang
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China
| | - Xiaopu Zhou
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China
- Guangdong Provincial Key Laboratory of Brain Science, Disease and Drug Development; Shenzhen-Hong Kong Institute of Brain Science, HKUST Shenzhen Research Institute, Shenzhen, China
| | - Hiu Yi Wong
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China
| | - Li Ouyang
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China
| | - Fanny C F Ip
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China
- Guangdong Provincial Key Laboratory of Brain Science, Disease and Drug Development; Shenzhen-Hong Kong Institute of Brain Science, HKUST Shenzhen Research Institute, Shenzhen, China
| | - Vicky M N Chau
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China
| | - Shun-Fat Lau
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China
| | - Wei Wu
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China
| | - Daniel Y K Wong
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China
| | - Heukjin Seo
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
| | - Wing-Yu Fu
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China
| | - Nicole C H Lai
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China
| | - Yuewen Chen
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Guangdong Provincial Key Laboratory of Brain Science, Disease and Drug Development; Shenzhen-Hong Kong Institute of Brain Science, HKUST Shenzhen Research Institute, Shenzhen, China
- The Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences; Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Yu Chen
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Guangdong Provincial Key Laboratory of Brain Science, Disease and Drug Development; Shenzhen-Hong Kong Institute of Brain Science, HKUST Shenzhen Research Institute, Shenzhen, China
- The Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences; Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Estella P S Tong
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China
| | - Vincent C T Mok
- Gerald Choa Neuroscience Centre, Lui Che Woo Institute of Innovative Medicine, Therese Pei Fong Chow Research Centre for Prevention of Dementia, Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Timothy C Y Kwok
- Therese Pei Fong Chow Research Centre for Prevention of Dementia, Division of Geriatrics, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Kin Y Mok
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- UK Dementia Research Institute, University College London, London, UK
| | - Maryam Shoai
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- UK Dementia Research Institute, University College London, London, UK
| | - Benoit Lehallier
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
- Alkahest Inc, San Carlos, California, USA
| | - Patricia Morán Losada
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, California, USA
| | - Eleanor O'Brien
- Centre for Precision Health, Edith Cowan University, Joondalup, Australia
- Collaborative Genomics and Translation Group, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Tenielle Porter
- Centre for Precision Health, Edith Cowan University, Joondalup, Australia
- Collaborative Genomics and Translation Group, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
- School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Bentley, Australia
| | - Simon M Laws
- Centre for Precision Health, Edith Cowan University, Joondalup, Australia
- Collaborative Genomics and Translation Group, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
- School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Bentley, Australia
| | - John Hardy
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- UK Dementia Research Institute, University College London, London, UK
- Institute for Advanced Study, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
| | - Tony Wyss-Coray
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, California, USA
- The Phil and Penny Knight Initiative for Brain Resilience, Stanford University, Stanford, California, USA
| | - Colin L Masters
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Australia
| | - Amy K Y Fu
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China
- Guangdong Provincial Key Laboratory of Brain Science, Disease and Drug Development; Shenzhen-Hong Kong Institute of Brain Science, HKUST Shenzhen Research Institute, Shenzhen, China
| | - Nancy Y Ip
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China.
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China.
- Guangdong Provincial Key Laboratory of Brain Science, Disease and Drug Development; Shenzhen-Hong Kong Institute of Brain Science, HKUST Shenzhen Research Institute, Shenzhen, China.
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360
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Abrahamson EE, Kofler JK, Becker CR, Price JC, Newell KL, Ghetti B, Murrell JR, McLean CA, Lopez OL, Mathis CA, Klunk WE, Villemagne VL, Ikonomovic MD. 11C-PiB PET can underestimate brain amyloid-β burden when cotton wool plaques are numerous. Brain 2022; 145:2161-2176. [PMID: 34918018 PMCID: PMC9630719 DOI: 10.1093/brain/awab434] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 10/02/2021] [Accepted: 10/20/2021] [Indexed: 09/01/2023] Open
Abstract
Individuals with familial Alzheimer's disease due to PSEN1 mutations develop high cortical fibrillar amyloid-β load but often have lower cortical 11C-Pittsburgh compound B (PiB) retention than Individuals with sporadic Alzheimer's disease. We hypothesized this is influenced by limited interactions of Pittsburgh compound B with cotton wool plaques, an amyloid-β plaque type common in familial Alzheimer's disease but rare in sporadic Alzheimer's disease. Histological sections of frontal and temporal cortex, caudate nucleus and cerebellum were obtained from 14 cases with sporadic Alzheimer's disease, 12 cases with familial Alzheimer's disease due to PSEN1 mutations, two relatives of a PSEN1 mutation carrier but without genotype information and three non-Alzheimer's disease cases. Sections were processed immunohistochemically using amyloid-β-targeting antibodies and the fluorescent amyloid stains cyano-PiB and X-34. Plaque load was quantified by percentage area analysis. Frozen homogenates from the same brain regions from five sporadic Alzheimer's disease and three familial Alzheimer's disease cases were analysed for 3H-PiB in vitro binding and concentrations of amyloid-β1-40 and amyloid-β1-42. Nine sporadic Alzheimer's disease, three familial Alzheimer's disease and three non-Alzheimer's disease participants had 11C-PiB PET with standardized uptake value ratios calculated using the cerebellum as the reference region. Cotton wool plaques were present in the neocortex of all familial Alzheimer's disease cases and one sporadic Alzheimer's disease case, in the caudate nucleus from four familial Alzheimer's disease cases, but not in the cerebellum. Cotton wool plaques immunolabelled robustly with 4G8 and amyloid-β42 antibodies but weakly with amyloid-β40 and amyloid-βN3pE antibodies and had only background cyano-PiB fluorescence despite labelling with X-34. Relative to amyloid-β plaque load, cyano-Pittsburgh compound B plaque load was similar in sporadic Alzheimer's disease while in familial Alzheimer's disease it was lower in the neocortex and the caudate nucleus. In both regions, insoluble amyloid-β1-42 and amyloid-β1-40 concentrations were similar in familial Alzheimer's disease and sporadic Alzheimer's disease groups, while 3H-PiB binding was lower in the familial Alzheimer's disease than the sporadic Alzheimer's disease group. Higher amyloid-β1-42 concentration associated with higher 3H-PiB binding in sporadic Alzheimer's disease but not familial Alzheimer's disease. 11C-PiB retention correlated with region-matched post-mortem amyloid-β plaque load; however, familial Alzheimer's disease cases with abundant cotton wool plaques had lower 11C-PiB retention than sporadic Alzheimer's disease cases with similar amyloid-β plaque loads. PiB has limited ability to detect amyloid-β aggregates in cotton wool plaques and may underestimate total amyloid-β plaque burden in brain regions with abundant cotton wool plaques.
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Affiliation(s)
- Eric E Abrahamson
- Department of Neurology, University of Pittsburgh School of Medicine. Pittsburgh, PA, USA
- Geriatric Research Education and Clinical Center, Pittsburgh VA Healthcare System, Pittsburgh, PA, USA
| | - Julia K Kofler
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Carl R Becker
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Julie C Price
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Massachusetts General Hospital, A. A. Martinos Center for Biomedical Imaging, Cambridge, MA, USA
| | - Kathy L Newell
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, IN, USA
| | - Bernardino Ghetti
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, IN, USA
| | - Jill R Murrell
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Catriona A McLean
- Victorian Brain Bank, The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Oscar L Lopez
- Department of Neurology, University of Pittsburgh School of Medicine. Pittsburgh, PA, USA
| | - Chester A Mathis
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - William E Klunk
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Victor L Villemagne
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Milos D Ikonomovic
- Department of Neurology, University of Pittsburgh School of Medicine. Pittsburgh, PA, USA
- Geriatric Research Education and Clinical Center, Pittsburgh VA Healthcare System, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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361
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Chen YH, Lin RR, Huang HF, Xue YY, Tao QQ. Microglial Activation, Tau Pathology, and Neurodegeneration Biomarkers Predict Longitudinal Cognitive Decline in Alzheimer's Disease Continuum. Front Aging Neurosci 2022; 14:848180. [PMID: 35847667 PMCID: PMC9280990 DOI: 10.3389/fnagi.2022.848180] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 05/12/2022] [Indexed: 01/02/2023] Open
Abstract
Purpose Biomarkers used for predicting longitudinal cognitive change in Alzheimer's disease (AD) continuum are still elusive. Tau pathology, neuroinflammation, and neurodegeneration are the leading candidate predictors. We aimed to determine these three aspects of biomarkers in cerebrospinal fluid (CSF) and plasma to predict longitudinal cognition status using Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort. Patients and Methods A total of 430 subjects including, 96 cognitive normal (CN) with amyloid β (Aβ)-negative, 54 CN with Aβ-positive, 195 mild cognitive impairment (MCI) with Aβ-positive, and 85 AD with amyloid-positive (Aβ-positive are identified by CSF Aβ42/Aβ40 < 0.138). Aβ burden was evaluated by CSF and plasma Aβ42/Aβ40 ratio; tau pathology was evaluated by CSF and plasma phosphorylated-tau (p-tau181); microglial activation was measured by CSF soluble TREM2 (sTREM2) and progranulin (PGRN); neurodegeneration was measured by CSF and plasma t-tau and structural magnetic resonance imaging (MRI); cognition was examined annually over the subsequent 8 years using the Alzheimer's Disease Assessment Scale Cognition 13-item scale (ADAS13) and Mini-Mental State Exam (MMSE). Linear mixed-effects models (LME) were applied to assess the correlation between biomarkers and longitudinal cognition decline, as well as their effect size on the prediction of longitudinal cognitive decline. Results Baseline CSF Aβ42/Aβ40 ratio was decreased in MCI and AD compared to CN, while CSF p-tau181 and t-tau increased. Baseline CSF sTREM2 and PGRN did not show any differences in MCI and AD compared to CN. Baseline brain volumes (including the hippocampal, entorhinal, middle temporal lobe, and whole-brain) decreased in MCI and AD groups. For the longitudinal study, there were significant interaction effects of CSF p-tau181 × time, plasma p-tau181 × time, CSF sTREM2 × time, and brain volumes × time, indicating CSF, and plasma p-tau181, CSF sTREM2, and brain volumes could predict longitudinal cognition deterioration rate. CSF sTREM2, CSF, and plasma p-tau181 had similar medium prediction effects, while brain volumes showed stronger effects in predicting cognition decline. Conclusion Our study reported that baseline CSF sTREM2, CSF, and plasma p-tau181, as well as structural MRI, could predict longitudinal cognitive decline in subjects with positive AD pathology. Plasma p-tau181 can be used as a relatively noninvasive reliable biomarker for AD longitudinal cognition decline prediction.
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Affiliation(s)
- Yi-He Chen
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, and Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Rong-Rong Lin
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, and Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Hui-Feng Huang
- Department of Neurology, Lishui Hospital, Zhejiang University School of Medicine, Lishui, China
| | - Yan-Yan Xue
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, and Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Qing-Qing Tao
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, and Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
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Newcombe VFJ, Ashton NJ, Posti JP, Glocker B, Manktelow A, Chatfield DA, Winzeck S, Needham E, Correia MM, Williams GB, Simrén J, Takala RSK, Katila AJ, Maanpää HR, Tallus J, Frantzén J, Blennow K, Tenovuo O, Zetterberg H, Menon DK. Post-acute blood biomarkers and disease progression in traumatic brain injury. Brain 2022; 145:2064-2076. [PMID: 35377407 PMCID: PMC9326940 DOI: 10.1093/brain/awac126] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/09/2022] [Accepted: 02/13/2022] [Indexed: 11/23/2022] Open
Abstract
There is substantial interest in the potential for traumatic brain injury to result in progressive neurological deterioration. While blood biomarkers such as glial fibrillary acid protein (GFAP) and neurofilament light have been widely explored in characterizing acute traumatic brain injury (TBI), their use in the chronic phase is limited. Given increasing evidence that these proteins may be markers of ongoing neurodegeneration in a range of diseases, we examined their relationship to imaging changes and functional outcome in the months to years following TBI. Two-hundred and three patients were recruited in two separate cohorts; 6 months post-injury (n = 165); and >5 years post-injury (n = 38; 12 of whom also provided data ∼8 months post-TBI). Subjects underwent blood biomarker sampling (n = 199) and MRI (n = 172; including diffusion tensor imaging). Data from patient cohorts were compared to 59 healthy volunteers and 21 non-brain injury trauma controls. Mean diffusivity and fractional anisotropy were calculated in cortical grey matter, deep grey matter and whole brain white matter. Accelerated brain ageing was calculated at a whole brain level as the predicted age difference defined using T1-weighted images, and at a voxel-based level as the annualized Jacobian determinants in white matter and grey matter, referenced to a population of 652 healthy control subjects. Serum neurofilament light concentrations were elevated in the early chronic phase. While GFAP values were within the normal range at ∼8 months, many patients showed a secondary and temporally distinct elevations up to >5 years after injury. Biomarker elevation at 6 months was significantly related to metrics of microstructural injury on diffusion tensor imaging. Biomarker levels at ∼8 months predicted white matter volume loss at >5 years, and annualized brain volume loss between ∼8 months and 5 years. Patients who worsened functionally between ∼8 months and >5 years showed higher than predicted brain age and elevated neurofilament light levels. GFAP and neurofilament light levels can remain elevated months to years after TBI, and show distinct temporal profiles. These elevations correlate closely with microstructural injury in both grey and white matter on contemporaneous quantitative diffusion tensor imaging. Neurofilament light elevations at ∼8 months may predict ongoing white matter and brain volume loss over >5 years of follow-up. If confirmed, these findings suggest that blood biomarker levels at late time points could be used to identify TBI survivors who are at high risk of progressive neurological damage.
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Affiliation(s)
| | - Nicholas J Ashton
- Wallenberg Centre for Molecular and Translational Medicine, University of
Gothenburg, Gothenburg, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and
Physiology, The Sahlgrenska Academy at the University of Gothenburg,
Mölndal, Sweden
- King’s College London, Institute of Psychiatry, Psychology and
Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute,
London, UK
- Mental Health and Biomedical Research Unit for Dementia, Maudsley NIHR
Biomedical Research Centre, London, UK
| | - Jussi P Posti
- Neurocenter, Department of Neurosurgery, Turku University Hospital and
University of Turku, Turku, Finland
- Turku Brain Injury Center, Turku University Hospital and University of
Turku, Turku, Finland
| | - Ben Glocker
- Biomedical Image Analysis Group, Department of Computing, Imperial College
London, London, UK
| | - Anne Manktelow
- University Division of Anaesthesia, Department of Medicine, University of
Cambridge, Cambridge, UK
| | - Doris A Chatfield
- University Division of Anaesthesia, Department of Medicine, University of
Cambridge, Cambridge, UK
| | - Stefan Winzeck
- University Division of Anaesthesia, Department of Medicine, University of
Cambridge, Cambridge, UK
- Biomedical Image Analysis Group, Department of Computing, Imperial College
London, London, UK
| | - Edward Needham
- University Division of Anaesthesia, Department of Medicine, University of
Cambridge, Cambridge, UK
| | - Marta M Correia
- MRC (Medical Research Council) Cognition and Brain Sciences Unit,
University of Cambridge, Cambridge, UK
| | - Guy B Williams
- Wolfson Brain Imaging Centre, Department of Clinical
Neurosciences, Cambridge, UK
| | - Joel Simrén
- Institute of Neuroscience and Physiology, Department of Psychiatry and
Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg,
Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University
Hospital, Mölndal, Sweden
| | - Riikka S K Takala
- Perioperative Services, Intensive Care Medicine and Pain Management,
Department of Anesthesiology and Intensive Care, Turku University Hospital, University
of Turku, Turku, Finland
| | - Ari J Katila
- Perioperative Services, Intensive Care Medicine and Pain Management,
Department of Anesthesiology and Intensive Care, Turku University Hospital, University
of Turku, Turku, Finland
| | - Henna Riikka Maanpää
- Neurocenter, Department of Neurosurgery, Turku University Hospital and
University of Turku, Turku, Finland
- Turku Brain Injury Center, Turku University Hospital and University of
Turku, Turku, Finland
| | - Jussi Tallus
- Turku Brain Injury Center, Turku University Hospital and University of
Turku, Turku, Finland
| | - Janek Frantzén
- Neurocenter, Department of Neurosurgery, Turku University Hospital and
University of Turku, Turku, Finland
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and
Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg,
Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University
Hospital, Mölndal, Sweden
| | - Olli Tenovuo
- Turku Brain Injury Center, Turku University Hospital and University of
Turku, Turku, Finland
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and
Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg,
Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University
Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of
Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, University College
London, London, UK
- Hong Kong Center for Neurodegenerative Disease,
Hong Kong, China
| | - David K Menon
- Correspondence to: David Menon University Division of Anaesthesia
University of Cambridge Box 93, Addenbrooke’s Hospital Hills Road, Cambridge CB2 0QQ, UK
E-mail:
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Tau as a Biomarker of Neurodegeneration. Int J Mol Sci 2022; 23:ijms23137307. [PMID: 35806324 PMCID: PMC9266883 DOI: 10.3390/ijms23137307] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 06/29/2022] [Accepted: 06/29/2022] [Indexed: 12/13/2022] Open
Abstract
Less than 50 years since tau was first isolated from a porcine brain, its detection in femtolitre concentrations in biological fluids is revolutionizing the diagnosis of neurodegenerative diseases. This review highlights the molecular and technological advances that have catapulted tau from obscurity to the forefront of biomarker diagnostics. Comprehensive updates are provided describing the burgeoning clinical applications of tau as a biomarker of neurodegeneration. For the clinician, tau not only enhances diagnostic accuracy, but holds promise as a predictor of clinical progression, phenotype, and response to drug therapy. For patients living with neurodegenerative disorders, characterization of tau dysregulation could provide much-needed clarity to a notoriously murky diagnostic landscape.
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364
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Sadlonova M, Vogelgsang J, Lange C, Günther I, Wiesent A, Eberhard C, Ehrentraut J, Kirsch M, Hansen N, Esselmann H, Timäus C, Asendorf T, Breitling B, Chebbok M, Heinemann S, Celano C, Kutschka I, Wiltfang J, Baraki H, von Arnim CAF. Identification of risk factors for delirium, cognitive decline, and dementia after cardiac surgery (FINDERI-find delirium risk factors): a study protocol of a prospective observational study. BMC Cardiovasc Disord 2022; 22:299. [PMID: 35773648 PMCID: PMC9245863 DOI: 10.1186/s12872-022-02732-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/23/2022] [Indexed: 11/10/2022] Open
Abstract
Background Postoperative delirium is a common complication of cardiac surgery associated with higher morbidity, longer hospital stay, risk of cognitive decline, dementia, and mortality. Geriatric patients, patients undergoing cardiac surgery, and intensive care patients are at a high risk of developing postoperative delirium. Gold standard assessments or biomarkers to predict risk factors for delirium, cognitive decline, and dementia in patients undergoing cardiac surgery are not yet available. Methods The FINDERI trial (FINd DElirium RIsk factors) is a prospective, single-center, observational study. In total, 500 patients aged ≥ 50 years undergoing cardiac surgery at the Department of Cardiovascular and Thoracic Surgery of the University of Göttingen Medical Center will be recruited. Our primary aim is to validate a delirium risk assessment in context of cardiac surgery. Our secondary aims are to identify specific preoperative and perioperative factors associated with delirium, cognitive decline, and accelerated dementia after cardiac surgery, and to identify blood-based biomarkers that predict the incidence of postoperative delirium, cognitive decline, or dementia in patients undergoing cardiac surgery. Discussion This prospective, observational study might help to identify patients at high risk for delirium prior to cardiac surgery, and to identify important biological mechanisms by which cardiac surgery is associated with delirium. The predictive value of a delirium screening questionnaire in cardiac surgery might be revealed. Finally, the identification of specific blood biomarkers might help to predict delirium, cognitive decline, and dementia in patients undergoing cardiac surgery. Trial registration: Ethics approval for this study was obtained from the IRB of the University of Göttingen Medical Center. The investigators registered this study in the German Clinical Trials Register (DRKS; https://www.drks.de) (DRKS00025095) on April 19th, 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-022-02732-4.
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Affiliation(s)
- Monika Sadlonova
- Department of Cardiovascular and Thoracic Surgery, University of Göttingen Medical Center, Robert-Koch-Street 40, 37075, Göttingen, Germany. .,Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Center, Göttingen, Germany. .,DZHK (German Center for Cardiovascular Research), Partner Site, Göttingen, Germany. .,Department of Psychiatry, Massachusetts General Hospital, Boston, USA. .,Department of Psychiatry, Harvard Medical School, Boston, USA.
| | - Jonathan Vogelgsang
- Department of Psychiatry, Translational Neuroscience Laboratory, McLean Hospital, Harvard Medical School, Boston, USA
| | - Claudia Lange
- Department of Psychiatry and Psychotherapy, University of Göttingen Medical Center, Göttingen, Germany
| | - Irina Günther
- Department of Psychiatry and Psychotherapy, University of Göttingen Medical Center, Göttingen, Germany
| | - Adriana Wiesent
- Department of Geriatrics, University of Göttingen Medical Center, Göttingen, Germany
| | - Charlotte Eberhard
- Department of Cardiovascular and Thoracic Surgery, University of Göttingen Medical Center, Robert-Koch-Street 40, 37075, Göttingen, Germany
| | - Julia Ehrentraut
- Department of Geriatrics, University of Göttingen Medical Center, Göttingen, Germany
| | - Mareike Kirsch
- Department of Geriatrics, University of Göttingen Medical Center, Göttingen, Germany
| | - Niels Hansen
- Department of Psychiatry and Psychotherapy, University of Göttingen Medical Center, Göttingen, Germany
| | - Hermann Esselmann
- Department of Psychiatry and Psychotherapy, University of Göttingen Medical Center, Göttingen, Germany
| | - Charles Timäus
- Department of Psychiatry and Psychotherapy, University of Göttingen Medical Center, Göttingen, Germany
| | - Thomas Asendorf
- Department of Medical Statistics, University of Göttingen Medical Center, Göttingen, Germany
| | - Benedict Breitling
- Department of Psychiatry and Psychotherapy, University of Göttingen Medical Center, Göttingen, Germany
| | - Mohammed Chebbok
- Department of Geriatrics, University of Göttingen Medical Center, Göttingen, Germany.,Department of Cardiology and Pneumology, University of Göttingen Medical Center, Göttingen, Germany
| | - Stephanie Heinemann
- Department of Geriatrics, University of Göttingen Medical Center, Göttingen, Germany
| | - Christopher Celano
- Department of Psychiatry, Massachusetts General Hospital, Boston, USA.,Department of Psychiatry, Harvard Medical School, Boston, USA
| | - Ingo Kutschka
- Department of Cardiovascular and Thoracic Surgery, University of Göttingen Medical Center, Robert-Koch-Street 40, 37075, Göttingen, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site, Göttingen, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University of Göttingen Medical Center, Göttingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany.,Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Hassina Baraki
- Department of Cardiovascular and Thoracic Surgery, University of Göttingen Medical Center, Robert-Koch-Street 40, 37075, Göttingen, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site, Göttingen, Germany
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365
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Moll A, Ramirez LM, Ninov M, Schwarz J, Urlaub H, Zweckstetter M. Hsp multichaperone complex buffers pathologically modified Tau. Nat Commun 2022; 13:3668. [PMID: 35760815 PMCID: PMC9237115 DOI: 10.1038/s41467-022-31396-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 06/16/2022] [Indexed: 11/23/2022] Open
Abstract
Alzheimer’s disease is a neurodegenerative disorder in which misfolding and aggregation of pathologically modified Tau is critical for neuronal dysfunction and degeneration. The two central chaperones Hsp70 and Hsp90 coordinate protein homeostasis, but the nature of the interaction of Tau with the Hsp70/Hsp90 machinery has remained enigmatic. Here we show that Tau is a high-affinity substrate of the human Hsp70/Hsp90 machinery. Complex formation involves extensive intermolecular contacts, blocks Tau aggregation and depends on Tau’s aggregation-prone repeat region. The Hsp90 co-chaperone p23 directly binds Tau and stabilizes the multichaperone/substrate complex, whereas the E3 ubiquitin-protein ligase CHIP efficiently disassembles the machinery targeting Tau to proteasomal degradation. Because phosphorylated Tau binds the Hsp70/Hsp90 machinery but is not recognized by Hsp90 alone, the data establish the Hsp70/Hsp90 multichaperone complex as a critical regulator of Tau in neurodegenerative diseases. Alzheimer’s disease is characterized by the accumulation of aggregated tau protein. Here the authors find that Hsp chaperones, which normally protect cell homeostasis, can assemble with co-chaperones in a “multichaperone machinery” to target tau aggregation.
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Affiliation(s)
- Antonia Moll
- German Center for Neurodegenerative Diseases (DZNE), Von-Siebold-Str. 3a, 37075, Göttingen, Germany.,Department for NMR-based Structural Biology, Max Planck Institute for Multidisciplinary Sciences, Am Fassberg 11, 37077, Göttingen, Germany
| | - Lisa Marie Ramirez
- German Center for Neurodegenerative Diseases (DZNE), Von-Siebold-Str. 3a, 37075, Göttingen, Germany.,Department for NMR-based Structural Biology, Max Planck Institute for Multidisciplinary Sciences, Am Fassberg 11, 37077, Göttingen, Germany
| | - Momchil Ninov
- Max Planck Institute for Multidisciplinary Sciences, Bioanalytical Mass Spectrometry Group, Am Fassberg 11, 37077, Göttingen, Germany.,University Medical Center Goettingen, Institute of Clinical Chemistry, Bioanalytics, Robert-Koch-Strasse 40, 37075, Göttingen, Germany
| | - Juliane Schwarz
- Max Planck Institute for Multidisciplinary Sciences, Bioanalytical Mass Spectrometry Group, Am Fassberg 11, 37077, Göttingen, Germany.,University Medical Center Goettingen, Institute of Clinical Chemistry, Bioanalytics, Robert-Koch-Strasse 40, 37075, Göttingen, Germany
| | - Henning Urlaub
- Max Planck Institute for Multidisciplinary Sciences, Bioanalytical Mass Spectrometry Group, Am Fassberg 11, 37077, Göttingen, Germany.,University Medical Center Goettingen, Institute of Clinical Chemistry, Bioanalytics, Robert-Koch-Strasse 40, 37075, Göttingen, Germany
| | - Markus Zweckstetter
- German Center for Neurodegenerative Diseases (DZNE), Von-Siebold-Str. 3a, 37075, Göttingen, Germany. .,Department for NMR-based Structural Biology, Max Planck Institute for Multidisciplinary Sciences, Am Fassberg 11, 37077, Göttingen, Germany.
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366
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Investigating the use of plasma pTau181 in retired contact sports athletes. J Neurol 2022; 269:5582-5595. [PMID: 35751688 DOI: 10.1007/s00415-022-11223-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 05/26/2022] [Accepted: 06/09/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Considering the wide range of outcomes following sport-related concussions, biomarkers are needed to detect underlying pathological changes. The objective was to analyze the use of plasma phosphorylated tau 181 (pTau181) as a non-invasive measure of underlying brain changes in a cohort of retired contact sports athletes at risk of neurodegeneration. METHODS Fifty-four retired contact sport athletes and 27 healthy controls whose blood plasma was analyzed for pTau181 were included. A portion (N = 21) of retired athletes had a 2-years follow-up visit. All participants had completed a neuropsychological battery and MRI imaging. RESULTS Plasma pTau181 was significantly higher in retired athletes compared to healthy controls (8.94 ± 5.08 pg/mL vs. 6.00 ± 2.53 pg/mL, respectively; 95% BCa CI 1.38-4.62; p = 0.02); and was significantly associated with fornix fractional anisotropy values only in the athletes group (β = - 0.002; 95% BCa CI - 0.003 to - 0.001; p = 0.002). When the retired athletes cohort was divided into high vs. normal pTau181 groups, the corpus callosum (CC) volume and white-matter integrity was significantly lower in high pTau181 compared to older healthy controls (CC volume: 1.57 ± 0.19 vs. 2.02 ± 0.32, p = 0.002; CC medial diffusivity: 0.96 ± 0.04 × 10-3 mm2/s vs. 0.90 ± 0.03 × 10-3 mm2/s, p = 0.003; CC axial diffusivity: 1.49 ± 0.04 × 10-3 mm2/s vs. 1.41 ± 0.02 × 10-3 mm2/s, p < 0.001, respectively). CONCLUSIONS Although high plasma pTau181 levels were associated with abnormalities in CC and fornix, baseline pTau181 did not predict longitudinal changes in regional brain volumes or white-matter integrity in the athletes. pTau181 may be useful for identifying those with brain abnormalities related to repeated concussion but not for predicting progression.
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Neerland BE, Busund R, Haaverstad R, Helbostad JL, Landsverk SA, Martinaityte I, Norum HM, Ræder J, Selbaek G, Simpson MR, Skaar E, Skjærvold NK, Skovlund E, Slooter AJ, Svendsen ØS, Tønnessen T, Wahba A, Zetterberg H, Wyller TB. Alpha-2-adrenergic receptor agonists for the prevention of delirium and cognitive decline after open heart surgery (ALPHA2PREVENT): protocol for a multicentre randomised controlled trial. BMJ Open 2022; 12:e057460. [PMID: 35725264 PMCID: PMC9214392 DOI: 10.1136/bmjopen-2021-057460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Postoperative delirium is common in older cardiac surgery patients and associated with negative short-term and long-term outcomes. The alpha-2-adrenergic receptor agonist dexmedetomidine shows promise as prophylaxis and treatment for delirium in intensive care units (ICU) and postoperative settings. Clonidine has similar pharmacological properties and can be administered both parenterally and orally. We aim to study whether repurposing of clonidine can represent a novel treatment option for delirium, and the possible effects of dexmedetomidine and clonidine on long-term cognitive trajectories, motor activity patterns and biomarkers of neuronal injury, and whether these effects are associated with frailty status. METHODS AND ANALYSIS This five-centre, double-blind randomised controlled trial will include 900 cardiac surgery patients aged 70+ years. Participants will be randomised 1:1:1 to dexmedetomidine or clonidine or placebo. The study drug will be given as a continuous intravenous infusion from the start of cardiopulmonary bypass, at a rate of 0.4 µg/kg/hour. The infusion rate will be decreased to 0.2 µg/kg/hour postoperatively and be continued until discharge from the ICU or 24 hours postoperatively, whichever happens first.Primary end point is the 7-day cumulative incidence of postoperative delirium (Diagnostic and Statistical Manual of Mental Disorders, fifth edition). Secondary end points include the composite end point of coma, delirium or death, in addition to delirium severity and motor activity patterns, levels of circulating biomarkers of neuronal injury, cognitive function and frailty status 1 and 6 months after surgery. ETHICS AND DISSEMINATION This trial is approved by the Regional Committee for Ethics in Medical Research in Norway (South-East Norway) and by the Norwegian Medicines Agency. Dissemination plans include publication in peer-reviewed medical journals and presentation at scientific meetings. TRIAL REGISTRATION NUMBER NCT05029050.
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Affiliation(s)
| | - Rolf Busund
- Department of Cardiothoracic and Vascular Surgery, University Hospital of North Norway, Tromsø, Norway
- Institute of Clinical Medicine, UiT The Artic University of Norway, Tromsø, Norway
| | - Rune Haaverstad
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
- Institute of Clinical Science, University of Bergen, Bergen, Norway
| | - Jorunn L Helbostad
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Ieva Martinaityte
- Institute of Clinical Medicine, UiT The Artic University of Norway, Tromsø, Norway
- Department of Geriatric Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Hilde Margrethe Norum
- Department of Anaesthesiology, Oslo University Hospital, Oslo, Norway
- Department of Research and Development, Oslo University Hospital, Oslo, Norway
| | - Johan Ræder
- Department of Anaesthesiology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Geir Selbaek
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway
| | - Melanie R Simpson
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Elisabeth Skaar
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Nils Kristian Skjærvold
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Anesthesia and Intensive Care Medicine, Trondheim University Hospital, Trondheim, Norway
| | - Eva Skovlund
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Arjen Jc Slooter
- Department of Intensive Care Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Neurology, UZ Brussel and Vrije Universiteit Brussel, Brussel, Brussel, Belgium
| | - Øyvind Sverre Svendsen
- Department of Anesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Theis Tønnessen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
| | - Alexander Wahba
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Cardiothoracic Surgery, Trondheim University Hospital, Trondheim, Norway
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, University of Gothenburg Sahlgrenska Academy, Goteborg, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- UK Dementia Research Institute, UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, People's Republic of China
| | - Torgeir Bruun Wyller
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Fan DY, Jian JM, Huang S, Li WW, Shen YY, Wang Z, Zeng GH, Yi X, Jin WS, Liu YH, Zeng F, Bu XL, Chen LY, Mao QX, Xu ZQ, Yu JT, Wang J, Wang YJ. Establishment of combined diagnostic models of Alzheimer's disease in a Chinese cohort: the Chongqing Ageing & Dementia Study (CADS). Transl Psychiatry 2022; 12:252. [PMID: 35710549 PMCID: PMC9203516 DOI: 10.1038/s41398-022-02016-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 05/18/2022] [Accepted: 05/31/2022] [Indexed: 11/09/2022] Open
Abstract
Cerebrospinal fluid (CSF) biomarkers are essential for the accurate diagnosis of Alzheimer's disease (AD), yet their measurement levels vary widely across centers and regions, leaving no uniform cutoff values to date. Diagnostic cutoff values of CSF biomarkers for AD are lacking for the Chinese population. As a member of the Alzheimer's Association Quality Control program for CSF biomarkers, we aimed to establish diagnostic models based on CSF biomarkers and risk factors for AD in a Chinese cohort. A total of 64 AD dementia patients and 105 age- and sex-matched cognitively normal (CN) controls from the Chongqing Ageing & Dementia Study cohort were included. CSF Aβ42, P-tau181, and T-tau levels were measured by ELISA. Combined biomarker models and integrative models with demographic characteristics were established by logistic regression. The cutoff values to distinguish AD from CN were 933 pg/mL for Aβ42, 48.7 pg/mL for P-tau181 and 313 pg/mL for T-tau. The AN model, including Aβ42 and T-tau, had a higher diagnostic accuracy of 89.9%. Integrating age and APOE ε4 status to AN model (the ANA'E model) increased the diagnostic accuracy to 90.5% and improved the model performance. This study established cutoff values of CSF biomarkers and optimal combined models for AD diagnosis in a Chinese cohort.
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Affiliation(s)
- Dong-Yu Fan
- grid.410570.70000 0004 1760 6682Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China ,Chongqing Key Laboratory of Ageing and Brain Diseases, Chongqing, China ,grid.410570.70000 0004 1760 6682Shigatse Branch, Xinqiao Hospital, Third Military Medical University, Shigatse, China
| | - Jie-Ming Jian
- grid.410570.70000 0004 1760 6682Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China ,Chongqing Key Laboratory of Ageing and Brain Diseases, Chongqing, China
| | - Shan Huang
- grid.410570.70000 0004 1760 6682Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China ,Chongqing Key Laboratory of Ageing and Brain Diseases, Chongqing, China ,grid.263452.40000 0004 1798 4018First Clinical Medical College, Shanxi Medical University, Taiyuan, China ,grid.263452.40000 0004 1798 4018Department of Neurology, First Affiliated Hospital, Shanxi Medical University, Taiyuan, China
| | - Wei-Wei Li
- grid.410570.70000 0004 1760 6682Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China ,Chongqing Key Laboratory of Ageing and Brain Diseases, Chongqing, China ,Department of Neurology, Western Theater General Hospital, Chengdu, China
| | - Ying-Ying Shen
- grid.410570.70000 0004 1760 6682Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China ,Chongqing Key Laboratory of Ageing and Brain Diseases, Chongqing, China
| | - Zhen Wang
- grid.410570.70000 0004 1760 6682Department of Critical Care Medicine, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Gui-Hua Zeng
- grid.410570.70000 0004 1760 6682Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China ,Chongqing Key Laboratory of Ageing and Brain Diseases, Chongqing, China
| | - Xu Yi
- grid.410570.70000 0004 1760 6682Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China ,Chongqing Key Laboratory of Ageing and Brain Diseases, Chongqing, China
| | - Wang-Sheng Jin
- grid.410570.70000 0004 1760 6682Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China ,Chongqing Key Laboratory of Ageing and Brain Diseases, Chongqing, China
| | - Yu-Hui Liu
- grid.410570.70000 0004 1760 6682Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China ,Chongqing Key Laboratory of Ageing and Brain Diseases, Chongqing, China
| | - Fan Zeng
- grid.410570.70000 0004 1760 6682Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China ,Chongqing Key Laboratory of Ageing and Brain Diseases, Chongqing, China
| | - Xian-Le Bu
- grid.410570.70000 0004 1760 6682Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China ,Chongqing Key Laboratory of Ageing and Brain Diseases, Chongqing, China
| | - Li-Yong Chen
- grid.410570.70000 0004 1760 6682Department of Anaesthesiology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Qing-Xiang Mao
- grid.410570.70000 0004 1760 6682Department of Anaesthesiology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Zhi-Qiang Xu
- grid.410570.70000 0004 1760 6682Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China ,Chongqing Key Laboratory of Ageing and Brain Diseases, Chongqing, China
| | - Jin-Tai Yu
- grid.8547.e0000 0001 0125 2443Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jun Wang
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China. .,Chongqing Key Laboratory of Ageing and Brain Diseases, Chongqing, China.
| | - Yan-Jiang Wang
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China. .,Chongqing Key Laboratory of Ageing and Brain Diseases, Chongqing, China. .,State Key Laboratory of Trauma, Burn and Combined Injury, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China. .,Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China.
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369
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Staging of Alzheimer's disease: past, present, and future perspectives. Trends Mol Med 2022; 28:726-741. [PMID: 35717526 DOI: 10.1016/j.molmed.2022.05.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/15/2022] [Accepted: 05/16/2022] [Indexed: 01/01/2023]
Abstract
For many years Alzheimer's disease (AD) was associated with the dementia stage of the disease, the tail end of a pathophysiological process that lasts approximately two decades. Whereas early disease staging assessments focused on progressive deterioration of clinical functioning, brain imaging with positron emission tomography (PET) and cerebrospinal fluid (CSF) biomarker studies highlighted the long preclinical phase of AD in which a cascade of detectable biological abnormalities precede cognitive decline. The recent proliferation of imaging and fluid biomarkers of AD pathophysiology provide an opportunity for the identification of several biological stages in the preclinical phase of AD. We discuss the use of clinical and biomarker information in past, present, and future staging of AD. We highlight potential applications of PET, CSF, and plasma biomarkers for staging AD severity in vivo.
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370
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Qin W, Li F, Jia L, Wang Q, Li Y, Wei Y, Li Y, Jin H, Jia J. Phosphorylated Tau 181 Serum Levels Predict Alzheimer’s Disease in the Preclinical Stage. Front Aging Neurosci 2022; 14:900773. [PMID: 35769604 PMCID: PMC9234327 DOI: 10.3389/fnagi.2022.900773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background There is an urgent need for cost-effective, easy-to-measure biomarkers to identify subjects who will develop Alzheimer’s disease (AD), especially at the pre-symptomatic stage. This stage can be determined in autosomal dominant AD (ADAD) which offers the opportunity to observe the dynamic biomarker changes during the life-course of AD stages. This study aimed to investigate serum biomarkers during different AD stages and potential novel protein biomarkers of presymptomatic AD. Methods In the first stage, 32 individuals [20 mutation carriers including 10 with AD, and 10 with mild cognitive impairment (MCI), and 12 healthy controls] from ADAD families were analyzed. All subjects underwent a complete clinical evaluation and a comprehensive neuropsychological battery. Serum samples were collected from all subjects, and antibody arrays were used to analyze 170 proteins in these samples. The most promising biomarkers were identified during this screening and were then measured in serum samples of 12 subjects with pre-MCI and 20 controls. Results The serum levels of 13 proteins were significantly different in patients with AD or MCI compared to controls. Of the 13 proteins, cathepsin D, immunoglobulin E, epidermal growth factor receptor (EGFR), matrix metalloproteinase-9 (MMP-9), von Willebrand factor (vWF), haptoglobin, and phosphorylated Tau-181 (p-Tau181) correlated with all cognitive measures (R2 = −0.69–0.76). The areas under the receiver operating characteristic curve of these seven proteins were 0.71–0.93 for the classification of AD and 0.57–0.95 for the classification of MCI. Higher levels of p-Tau181 were found in the serum of pre-MCI subjects than in the serum of controls. The p-Tau181 serum level might detect AD before symptoms occur (area under the curve 0.85, sensitivity 75%, specificity 81.67%). Conclusions A total of 13 serum proteins showed significant differences between subjects with AD and MCI and healthy controls. The p-Tau181 serum level might be a broadly available and cost-effective biomarker to identify individuals with preclinical AD and assess the severity of AD.
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Affiliation(s)
- Wei Qin
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Fangyu Li
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Longfei Jia
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Qi Wang
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Ying Li
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Yiping Wei
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Yan Li
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Hongmei Jin
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Jianping Jia
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
- Beijing Key Laboratory of Geriatric Cognitive Disorders, Capital Medical University, Beijing, China
- Clinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China
- Center of Alzheimer’s Disease, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
- *Correspondence: Jianping Jia
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371
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Chouliaras L, Thomas A, Malpetti M, Donaghy P, Kane J, Mak E, Savulich G, Prats-Sedano MA, Heslegrave AJ, Zetterberg H, Su L, Rowe JB, O'Brien JT. Differential levels of plasma biomarkers of neurodegeneration in Lewy body dementia, Alzheimer's disease, frontotemporal dementia and progressive supranuclear palsy. J Neurol Neurosurg Psychiatry 2022; 93:651-658. [PMID: 35078917 PMCID: PMC9148982 DOI: 10.1136/jnnp-2021-327788] [Citation(s) in RCA: 64] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 12/01/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES This longitudinal study compared emerging plasma biomarkers for neurodegenerative disease between controls, patients with Alzheimer's disease (AD), Lewy body dementia (LBD), frontotemporal dementia (FTD) and progressive supranuclear palsy (PSP). METHODS Plasma phosphorylated tau at threonine-181 (p-tau181), amyloid beta (Αβ)42, Aβ40, neurofilament light (NfL) and glial fibrillar acidic protein (GFAP) were measured using highly sensitive single molecule immunoassays (Simoa) in a multicentre cohort of 300 participants (controls=73, amyloid positive mild cognitive impairment (MCI+) and AD dementia=63, LBD=117, FTD=28, PSP=19). LBD participants had known positron emission tomography (PET)-Aβ status. RESULTS P-tau181 was elevated in MCI+AD compared with all other groups. Aβ42/40 was lower in MCI+AD compared with controls and FTD. NfL was elevated in all dementias compared with controls while GFAP was elevated in MCI+AD and LBD. Plasma biomarkers could classify between MCI+AD and controls, FTD and PSP with high accuracy but showed limited ability in differentiating MCI+AD from LBD. No differences were detected in the levels of plasma biomarkers when comparing PET-Aβ positive and negative LBD. P-tau181, NfL and GFAP were associated with baseline and longitudinal cognitive decline in a disease specific pattern. CONCLUSION This large study shows the role of plasma biomarkers in differentiating patients with different dementias, and at monitoring longitudinal change. We confirm that p-tau181 is elevated in MCI+AD, versus controls, FTD and PSP, but is less accurate in the classification between MCI+AD and LBD or detecting amyloid brain pathology in LBD. NfL was elevated in all dementia groups, while GFAP was elevated in MCI+AD and LBD.
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Affiliation(s)
- Leonidas Chouliaras
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Alan Thomas
- Translational and Clinical Research Institute, Newcastle University, Newcastle, UK
| | - Maura Malpetti
- Department of Clinical Neurosciences, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Paul Donaghy
- Translational and Clinical Research Institute, Newcastle University, Newcastle, UK
| | - Joseph Kane
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Elijah Mak
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - George Savulich
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Maria A Prats-Sedano
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Amanda J Heslegrave
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- Dementia Research Insitute, UCL, London, UK
| | - Henrik Zetterberg
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- Dementia Research Insitute, UCL, London, UK
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Li Su
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - James Benedict Rowe
- Department of Clinical Neurosciences, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - John Tiernan O'Brien
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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372
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Therriault J, Pascoal TA, Lussier FZ, Tissot C, Chamoun M, Bezgin G, Servaes S, Benedet AL, Ashton NJ, Karikari TK, Lantero-Rodriguez J, Kunach P, Wang YT, Fernandez-Arias J, Massarweh G, Vitali P, Soucy JP, Saha-Chaudhuri P, Blennow K, Zetterberg H, Gauthier S, Rosa-Neto P. Biomarker modeling of Alzheimer's disease using PET-based Braak staging. NATURE AGING 2022; 2:526-535. [PMID: 37118445 PMCID: PMC10154209 DOI: 10.1038/s43587-022-00204-0] [Citation(s) in RCA: 88] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 03/08/2022] [Indexed: 04/30/2023]
Abstract
Gold-standard diagnosis of Alzheimer's disease (AD) relies on histopathological staging systems. Using the topographical information from [18F]MK6240 tau positron-emission tomography (PET), we applied the Braak tau staging system to 324 living individuals. We used PET-based Braak stage to model the trajectories of amyloid-β, phosphorylated tau (pTau) in cerebrospinal fluid (pTau181, pTau217, pTau231 and pTau235) and plasma (pTau181 and pTau231), neurodegeneration and cognitive symptoms. We identified nonlinear AD biomarker trajectories corresponding to the spatial extent of tau-PET, with modest biomarker changes detectable by Braak stage II and significant changes occurring at stages III-IV, followed by plateaus. Early Braak stages were associated with isolated memory impairment, whereas Braak stages V-VI were incompatible with normal cognition. In 159 individuals with follow-up tau-PET, progression beyond stage III took place uniquely in the presence of amyloid-β positivity. Our findings support PET-based Braak staging as a framework to model the natural history of AD and monitor AD severity in living humans.
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Affiliation(s)
- Joseph Therriault
- Translational Neuroimaging Laboratory, McGill Research Centre for Studies in Aging, Douglas Mental Health Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest de l'Île de Montréal, Montreal, Quebec, Canada.
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
| | - Tharick A Pascoal
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Firoza Z Lussier
- Translational Neuroimaging Laboratory, McGill Research Centre for Studies in Aging, Douglas Mental Health Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest de l'Île de Montréal, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Cécile Tissot
- Translational Neuroimaging Laboratory, McGill Research Centre for Studies in Aging, Douglas Mental Health Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest de l'Île de Montréal, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Mira Chamoun
- Translational Neuroimaging Laboratory, McGill Research Centre for Studies in Aging, Douglas Mental Health Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest de l'Île de Montréal, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Gleb Bezgin
- Translational Neuroimaging Laboratory, McGill Research Centre for Studies in Aging, Douglas Mental Health Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest de l'Île de Montréal, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Stijn Servaes
- Translational Neuroimaging Laboratory, McGill Research Centre for Studies in Aging, Douglas Mental Health Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest de l'Île de Montréal, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Andrea L Benedet
- Translational Neuroimaging Laboratory, McGill Research Centre for Studies in Aging, Douglas Mental Health Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest de l'Île de Montréal, Montreal, Quebec, Canada
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Nicholas J Ashton
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute, London, UK
- Biomedical Research Unit for Dementia at South London, NIHR Biomedical Research Centre for Mental Health and Maudsley NHS Foundation, London, UK
| | - Thomas K Karikari
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Juan Lantero-Rodriguez
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Peter Kunach
- Translational Neuroimaging Laboratory, McGill Research Centre for Studies in Aging, Douglas Mental Health Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest de l'Île de Montréal, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Yi-Ting Wang
- Translational Neuroimaging Laboratory, McGill Research Centre for Studies in Aging, Douglas Mental Health Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest de l'Île de Montréal, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Jaime Fernandez-Arias
- Translational Neuroimaging Laboratory, McGill Research Centre for Studies in Aging, Douglas Mental Health Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest de l'Île de Montréal, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Gassan Massarweh
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Paolo Vitali
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Jean-Paul Soucy
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | | | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
| | - Serge Gauthier
- Translational Neuroimaging Laboratory, McGill Research Centre for Studies in Aging, Douglas Mental Health Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest de l'Île de Montréal, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Pedro Rosa-Neto
- Translational Neuroimaging Laboratory, McGill Research Centre for Studies in Aging, Douglas Mental Health Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest de l'Île de Montréal, Montreal, Quebec, Canada.
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
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373
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Schindler SE. Fluid Biomarkers in Dementia Diagnosis. Continuum (Minneap Minn) 2022; 28:822-833. [PMID: 35678404 DOI: 10.1212/con.0000000000001083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE OF REVIEW This article discusses how fluid biomarkers can augment the routine dementia evaluation and improve diagnostic accuracy. The tests that are currently available and the indications for their use are described. Further, tests that are under development and likely to be used in the future are identified. RECENT FINDINGS Technical improvements in assay sensitivity and precision have led to the rapid development of blood-based biomarkers for Alzheimer disease (AD) over the past several years. Studies have found that the ratio of amyloid-β (Aβ) peptides (Aβ42/Aβ40) and concentrations of phosphorylated tau isoforms in plasma can identify individuals with AD brain pathology. Blood-based tests may enable much broader use of AD biomarkers in the evaluation of patients with cognitive impairment. SUMMARY Even after a detailed history, examination, routine laboratory testing, and brain imaging, the cause of dementia sometimes remains unclear. CSF and blood-based biomarkers can evaluate for a range of neurologic disorders that are associated with dementia, including AD. Integrating data from fluid biomarker tests and the routine dementia evaluation may improve the accuracy of dementia diagnosis.
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374
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Thijssen EH, Verberk IMW, Kindermans J, Abramian A, Vanbrabant J, Ball AJ, Pijnenburg Y, Lemstra AW, van der Flier WM, Stoops E, Hirtz C, Teunissen CE. Differential diagnostic performance of a panel of plasma biomarkers for different types of dementia. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12285. [PMID: 35603139 PMCID: PMC9107685 DOI: 10.1002/dad2.12285] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/07/2021] [Accepted: 12/07/2021] [Indexed: 12/12/2022]
Abstract
Introduction We explored what combination of blood‐based biomarkers (amyloid beta [Aβ]1‐42/1‐40, phosphorylated tau [p‐tau]181, neurofilament light [NfL], glial fibrillary acidic protein [GFAP]) differentiates Alzheimer's disease (AD) dementia, frontotemporal dementia (FTD), and dementia with Lewy bodies (DLB). Methods We measured the biomarkers with Simoa in two separate cohorts (n = 160 and n = 152). In one cohort, Aβ1‐42/1‐40 was also measured with mass spectrometry (MS). We assessed the differential diagnostic value of the markers, by logistic regression with Wald's backward selection. Results MS and Simoa Aβ1‐42/1‐40 similarly differentiated AD from controls. The Simoa panel that optimally differentiated AD from FTD consisted of NfL and p‐tau181 (area under the curve [AUC] = 0.94; cohort 1) or NfL, GFAP, and p‐tau181 (AUC = 0.90; cohort 2). For AD from DLB, the panel consisted of NfL, p‐tau181, and GFAP (AUC = 0.88; cohort 1), and only p‐tau181 (AUC = 0.81; cohort 2). Discussion A combination of plasma p‐tau181, NfL, and GFAP, but not Aβ1‐42/1‐40, might be useful to discriminate AD, FTD, and DLB.
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Affiliation(s)
- Elisabeth H Thijssen
- Neurochemistry Laboratory Department of Clinical Chemistry Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam the Netherlands
| | - Inge M W Verberk
- Neurochemistry Laboratory Department of Clinical Chemistry Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam the Netherlands
| | - Jana Kindermans
- IRMB-PPC, INM, Univ Montpellier, CHU Montpellier, INSERM CNRS Montpellier France
| | - Adlin Abramian
- Neurochemistry Laboratory Department of Clinical Chemistry Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam the Netherlands
| | | | | | - Yolande Pijnenburg
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam the Netherlands
| | - Afina W Lemstra
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam the Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam the Netherlands
| | | | - Christophe Hirtz
- IRMB-PPC, INM, Univ Montpellier, CHU Montpellier, INSERM CNRS Montpellier France
| | - Charlotte E Teunissen
- Neurochemistry Laboratory Department of Clinical Chemistry Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam the Netherlands
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Vrillon A, Mouton-Liger F, Martinet M, Cognat E, Hourregue C, Dumurgier J, Bouaziz-Amar E, Brinkmalm A, Blennow K, Zetterberg H, Hugon J, Paquet C. Plasma neuregulin 1 as a synaptic biomarker in Alzheimer's disease: a discovery cohort study. Alzheimers Res Ther 2022; 14:71. [PMID: 35606871 PMCID: PMC9125890 DOI: 10.1186/s13195-022-01014-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 04/27/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Synaptic dysfunction is an early core feature of Alzheimer's disease (AD), closely associated with cognitive symptoms. Neuregulin 1 (NRG1) is a growth and differentiation factor with a key role in the development and maintenance of synaptic transmission. Previous reports have shown that changes in cerebrospinal fluid (CSF) NRG1 concentration are associated with cognitive status and biomarker evidence of AD pathology. Plasma biomarkers reflecting synaptic impairment would be of great clinical interest. OBJECTIVE To measure plasma NRG1 concentration in AD patients in comparison with other neurodegenerative disorders and neurological controls (NC) and to study its association with cerebrospinal fluid (CSF) core AD and synaptic biomarkers. METHODS This retrospective study enrolled 127 participants including patients with AD at mild cognitive impairment stage (AD-MCI, n = 27) and at dementia stage (n = 35), non-AD dementia (n = 26, Aβ-negative), non-AD MCI (n = 19), and neurological controls (n=20). Plasma and CSF NRG1, as well as CSF core AD biomarkers (Aβ 42/Aβ 40 ratio, phospho-tau, and total tau), were measured using ELISA. CSF synaptic markers were measured using ELISA for GAP-43 and neurogranin and through immunoprecipitation mass spectrometry for SNAP-25. RESULTS Plasma NRG1 concentration was higher in AD-MCI and AD dementia patients compared with neurological controls (respectively P = 0.005 and P < 0.001). Plasma NRG1 differentiated AD MCI patients from neurological controls with an area under the curve of 88.3%, and AD dementia patients from NC with an area under the curve of 87.3%. Plasma NRG1 correlated with CSF NRG1 (β = 0.372, P = 0.0056, adjusted on age and sex). Plasma NRG1 was associated with AD CSF core biomarkers in the whole cohort and in Aβ-positive patients (β = -0.197-0.423). Plasma NRG1 correlated with CSF GAP-43, neurogranin, and SNAP-25 (β = 0.278-0.355). Plasma NRG1 concentration correlated inversely with MMSE in the whole cohort and in Aβ-positive patients (all, β = -0.188, P = 0.038; Aβ+: β = -0.255, P = 0.038). CONCLUSION Plasma NRG1 concentration is increased in AD patients and correlates with CSF core AD and synaptic biomarkers and cognitive status. Thus, plasma NRG1 is a promising non-invasive biomarker to monitor synaptic impairment in AD.
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Affiliation(s)
- Agathe Vrillon
- Université Paris Cité, Inserm U1144, Paris, France.
- Université Paris Cité, Center of Cognitive Neurology, Lariboisière Fernand-Widal Hospital, APHP, 200 rue du Faubourg Saint-Denis, 75010, Paris, France.
| | | | - Matthieu Martinet
- Université Paris Cité, Inserm U1144, Paris, France
- Université Paris Cité, Center of Cognitive Neurology, Lariboisière Fernand-Widal Hospital, APHP, 200 rue du Faubourg Saint-Denis, 75010, Paris, France
| | - Emmanuel Cognat
- Université Paris Cité, Inserm U1144, Paris, France
- Université Paris Cité, Center of Cognitive Neurology, Lariboisière Fernand-Widal Hospital, APHP, 200 rue du Faubourg Saint-Denis, 75010, Paris, France
| | - Claire Hourregue
- Université Paris Cité, Center of Cognitive Neurology, Lariboisière Fernand-Widal Hospital, APHP, 200 rue du Faubourg Saint-Denis, 75010, Paris, France
| | - Julien Dumurgier
- Université Paris Cité, Center of Cognitive Neurology, Lariboisière Fernand-Widal Hospital, APHP, 200 rue du Faubourg Saint-Denis, 75010, Paris, France
| | - Elodie Bouaziz-Amar
- Université Paris Cité, Inserm U1144, Paris, France
- Université Paris Cité, Department of Biochemistry, APHP GHU Nord Lariboisière-Fernand Widal, Paris, France
| | - Ann Brinkmalm
- Institute of Neuroscience and Physiology, The Salhgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, The Salhgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, The Salhgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- UK Dementia Research Institute at UCL, London, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Jacques Hugon
- Université Paris Cité, Inserm U1144, Paris, France
- Université Paris Cité, Center of Cognitive Neurology, Lariboisière Fernand-Widal Hospital, APHP, 200 rue du Faubourg Saint-Denis, 75010, Paris, France
| | - Claire Paquet
- Université Paris Cité, Inserm U1144, Paris, France
- Université Paris Cité, Center of Cognitive Neurology, Lariboisière Fernand-Widal Hospital, APHP, 200 rue du Faubourg Saint-Denis, 75010, Paris, France
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377
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Girolamo F, Errede M, Bizzoca A, Virgintino D, Ribatti D. Central Nervous System Pericytes Contribute to Health and Disease. Cells 2022; 11:1707. [PMID: 35626743 PMCID: PMC9139243 DOI: 10.3390/cells11101707] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/16/2022] [Accepted: 05/18/2022] [Indexed: 12/11/2022] Open
Abstract
Successful neuroprotection is only possible with contemporary microvascular protection. The prevention of disease-induced vascular modifications that accelerate brain damage remains largely elusive. An improved understanding of pericyte (PC) signalling could provide important insight into the function of the neurovascular unit (NVU), and into the injury-provoked responses that modify cell-cell interactions and crosstalk. Due to sharing the same basement membrane with endothelial cells, PCs have a crucial role in the control of endothelial, astrocyte, and oligodendrocyte precursor functions and hence blood-brain barrier stability. Both cerebrovascular and neurodegenerative diseases impair oxygen delivery and functionally impair the NVU. In this review, the role of PCs in central nervous system health and disease is discussed, considering their origin, multipotency, functions and also dysfunction, focusing on new possible avenues to modulate neuroprotection. Dysfunctional PC signalling could also be considered as a potential biomarker of NVU pathology, allowing us to individualize therapeutic interventions, monitor responses, or predict outcomes.
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Affiliation(s)
- Francesco Girolamo
- Unit of Human Anatomy and Histology, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari ‘Aldo Moro’, 70124 Bari, Italy; (M.E.); (D.V.); (D.R.)
| | - Mariella Errede
- Unit of Human Anatomy and Histology, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari ‘Aldo Moro’, 70124 Bari, Italy; (M.E.); (D.V.); (D.R.)
| | - Antonella Bizzoca
- Physiology Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari ‘Aldo Moro’, 70124 Bari, Italy;
| | - Daniela Virgintino
- Unit of Human Anatomy and Histology, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari ‘Aldo Moro’, 70124 Bari, Italy; (M.E.); (D.V.); (D.R.)
| | - Domenico Ribatti
- Unit of Human Anatomy and Histology, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari ‘Aldo Moro’, 70124 Bari, Italy; (M.E.); (D.V.); (D.R.)
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378
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Blood phospho-tau in Alzheimer disease: analysis, interpretation, and clinical utility. Nat Rev Neurol 2022; 18:400-418. [PMID: 35585226 DOI: 10.1038/s41582-022-00665-2] [Citation(s) in RCA: 102] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2022] [Indexed: 12/11/2022]
Abstract
Well-authenticated biomarkers can provide critical insights into the biological basis of Alzheimer disease (AD) to enable timely and accurate diagnosis, estimate future burden and support therapeutic trials. Current cerebrospinal fluid and molecular neuroimaging biomarkers fulfil these criteria but lack the scalability and simplicity necessary for widespread application. Blood biomarkers of adequate effectiveness have the potential to act as first-line diagnostic and prognostic tools, and offer the possibility of extensive population screening and use that is not limited to specialized centres. Accelerated progress in our understanding of the biochemistry of brain-derived tau protein and advances in ultrasensitive technologies have enabled the development of AD-specific phosphorylated tau (p-tau) biomarkers in blood. In this Review we discuss how new information on the molecular processing of brain p-tau and secretion of specific fragments into biofluids is informing blood biomarker development, enabling the evaluation of preanalytical factors that affect quantification, and informing harmonized protocols for blood handling. We also review the performance of blood p-tau biomarkers in the context of AD and discuss their potential contexts of use for clinical and research purposes. Finally, we highlight outstanding ethical, clinical and analytical challenges, and outline the steps that need to be taken to standardize inter-laboratory and inter-assay measurements.
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379
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Zeng Q, Li K, Luo X, Wang S, Xu X, Jiaerken Y, Liu X, Hong L, Hong H, Li Z, Fu Y, Zhang T, Chen Y, Liu Z, Huang P, Zhang M. The association of enlarged perivascular space with microglia-related inflammation and Alzheimer's pathology in cognitively normal elderly. Neurobiol Dis 2022; 170:105755. [PMID: 35577066 DOI: 10.1016/j.nbd.2022.105755] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/15/2022] [Accepted: 05/10/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Glymphatic dysfunction may contribute to the accumulation of Alzheimer's disease (AD) pathologies. Conversely, AD pathologic change might also cause neuroinflammation and aggravate glymphatic dysfunction, forming a loop that accelerates AD progression. In vivo validations are needed to confirm their relationships. METHODS In this study, we included 144 cognitively normal participants with AD pathological biomarker data (baseline CSF Aβ1-42, T-Tau, P-Tau181; plasma P-Tau181 at baseline and at least one follow-up) from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Each subject had completed structural MRI scans. Among them, 117 subjects have available neuroinflammatory biomarker (soluble triggering receptor expressed on myeloid cells 2 (sTREM2), and 123 subjects have completed two times [18F]-florbetapir PET. The enlarged PVS (EPVS) visual rating scores in basal ganglia (BG) and centrum semiovale (CS) were assessed on T1-weighted images to reflect glymphatic dysfunction. Intracranial volume and white matter hyperintensities (WMH) volume were also calculated for further analysis. We performed stepwise linear regression models and mediation analyses to estimate the association between EPVS severity, sTREM2, and AD biomarkers. RESULTS CS-EPVS degree was associated with CSF sTREM2, annual change of plasma P-tau181 and total WMH volume, whereas BG-EPVS severity was associated with age, gender and intracranial volume. The sTREM2 mediated the association between CSF P-tau181 and CS-EPVS. CONCLUSION Impaired glymphatic dysfunction could contribute to the accumulation of pathological tau protein. The association between tauopathy and glymphatic dysfunction was mediated by the microglia inflammatory process. These findings may provide evidence for novel treatment strategies of anti-neuroinflammation therapy in the early stage.
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Affiliation(s)
- Qingze Zeng
- Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Kaicheng Li
- Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao Luo
- Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Shuyue Wang
- Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaopei Xu
- Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yeerfan Jiaerken
- Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaocao Liu
- Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Luwei Hong
- Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Hui Hong
- Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Zheyu Li
- Department of Neurology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yanv Fu
- Department of Neurology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Tianyi Zhang
- Department of Neurology, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Yanxing Chen
- Department of Neurology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Zhirong Liu
- Department of Neurology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Peiyu Huang
- Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
| | - Minming Zhang
- Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
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380
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Li TR, Yao YX, Jiang XY, Dong QY, Yu XF, Wang T, Cai YN, Han Y. β-Amyloid in blood neuronal-derived extracellular vesicles is elevated in cognitively normal adults at risk of Alzheimer's disease and predicts cerebral amyloidosis. Alzheimers Res Ther 2022; 14:66. [PMID: 35550625 PMCID: PMC9097146 DOI: 10.1186/s13195-022-01010-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/27/2022] [Indexed: 02/08/2023]
Abstract
Background Blood biomarkers that can be used for preclinical Alzheimer’s disease (AD) diagnosis would enable trial enrollment at a time when the disease is potentially reversible. Here, we investigated plasma neuronal-derived extracellular vesicle (nEV) cargo in patients along the Alzheimer’s continuum, focusing on cognitively normal controls (NCs) with high brain β-amyloid (Aβ) loads (Aβ+). Methods The study was based on the Sino Longitudinal Study on Cognitive Decline project. We enrolled 246 participants, including 156 NCs, 45 amnestic mild cognitive impairment (aMCI) patients, and 45 AD dementia (ADD) patients. Brain Aβ loads were determined using positron emission tomography. NCs were classified into 84 Aβ− NCs and 72 Aβ+ NCs. Baseline plasma nEVs were isolated by immunoprecipitation with an anti-CD171 antibody. After verification, their cargos, including Aβ, tau phosphorylated at threonine 181, and neurofilament light, were quantified using a single-molecule array. Concentrations of these cargos were compared among the groups, and their receiver operating characteristic (ROC) curves were constructed. A subset of participants underwent follow-up cognitive assessment and magnetic resonance imaging. The relationships of nEV cargo levels with amyloid deposition, longitudinal changes in cognition, and brain regional volume were explored using correlation analysis. Additionally, 458 subjects in the project had previously undergone plasma Aβ quantification. Results Only nEV Aβ was included in the subsequent analysis. We focused on Aβ42 in the current study. After normalization of nEVs, the levels of Aβ42 were found to increase gradually across the cognitive continuum, with the lowest in the Aβ− NC group, an increase in the Aβ+ NC group, a further increase in the aMCI group, and the highest in the ADD group, contributing to their diagnoses (Aβ− NCs vs. Aβ+ NCs, area under the ROC curve values of 0.663; vs. aMCI, 0.857; vs. ADD, 0.957). Furthermore, nEV Aβ42 was significantly correlated with amyloid deposition, as well as longitudinal changes in cognition and entorhinal volume. There were no differences in plasma Aβ levels among NCs, aMCI, and ADD individuals. Conclusions Our findings suggest the potential use of plasma nEV Aβ42 levels in diagnosing AD-induced cognitive impairment and Aβ+ NCs. This biomarker reflects cortical amyloid deposition and predicts cognitive decline and entorhinal atrophy. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-01010-x.
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Affiliation(s)
- Tao-Ran Li
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
| | - Yun-Xia Yao
- Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
| | - Xue-Yan Jiang
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China.,School of Biomedical Engineering, Hainan University, Haikou, 570228, China
| | - Qiu-Yue Dong
- Key Laboratory of Specialty Fiber Optics and Optical Access Networks, Joint International Research Laboratory of Specialty Fiber Optics and Advanced Communication, School of Information and Communication Engineering, Shanghai University, Shanghai, 200444, China
| | - Xian-Feng Yu
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
| | - Ting Wang
- Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
| | - Yan-Ning Cai
- Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China.
| | - Ying Han
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China. .,School of Biomedical Engineering, Hainan University, Haikou, 570228, China. .,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, 100053, China. .,National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China.
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381
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Pradhan LK, Sahoo PK, Chauhan S, Das SK. Recent Advances Towards Diagnosis and Therapeutic Fingerprinting for Alzheimer's Disease. J Mol Neurosci 2022; 72:1143-1165. [PMID: 35553375 DOI: 10.1007/s12031-022-02009-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/02/2022] [Indexed: 12/12/2022]
Abstract
Since the report of "a peculiar severe disease process of the cerebral cortex" by Alois Alzheimer in 1906, it was considered to be a rare condition characterized by loss of cognition, memory impairment, and pathological markers such as senile plaques or neurofibrillary tangles (NFTs). Later on, the report was published in the textbook "Psychiatrie" and the disease was named as Alzheimer's disease (AD) and was known to be the consequences of aging; however, owing to its complex etiology, there is no cure for the progressive neurodegenerative disorder. Our current understanding of the mechanisms involved in the pathogenesis of AD is still at the mechanistic level. The treatment strategies applied currently only alleviate the symptoms and co-morbidities. For instance, the available treatments such as the usage of acetylcholinesterase inhibitors and N-methyl D-aspartate antagonists have minimal impact on the disease progression and target the later aspects of the disease. The recent advancements in the last two decades have made us more clearly understand the pathophysiology of the disease which has led to the development of novel therapeutic strategies. This review gives a brief idea about the various facets of AD pathophysiology and its management through modern investigational therapies to give a new direction for development of targeted therapeutic measures.
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Affiliation(s)
- Lilesh Kumar Pradhan
- Neurobiology Laboratory, Centre for Biotechnology, Siksha 'O' Anusandhan (Deemed to Be University), Kalinga Nagar, Bhubaneswar-751003, India
| | - Pradyumna Kumar Sahoo
- Neurobiology Laboratory, Centre for Biotechnology, Siksha 'O' Anusandhan (Deemed to Be University), Kalinga Nagar, Bhubaneswar-751003, India
| | - Santosh Chauhan
- Autophagy Laboratory, Infectious Disease Biology Division, Institute of Life Sciences, Bhubaneswar-751023, India.
| | - Saroj Kumar Das
- Neurobiology Laboratory, Centre for Biotechnology, Siksha 'O' Anusandhan (Deemed to Be University), Kalinga Nagar, Bhubaneswar-751003, India.
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382
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Kac PR, Gonzalez-Ortiz F, Simrén J, Dewit N, Vanmechelen E, Zetterberg H, Blennow K, Ashton NJ, Karikari TK. Diagnostic value of serum versus plasma phospho-tau for Alzheimer's disease. Alzheimers Res Ther 2022; 14:65. [PMID: 35545792 PMCID: PMC9097064 DOI: 10.1186/s13195-022-01011-w] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/27/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Blood phosphorylated tau (p-tau) forms are promising Alzheimer's disease (AD) biomarkers, but validation in matrices other than ethylenediaminetetraacetic acid (EDTA) plasma is limited. Firstly, we assessed the diagnostic potential of p-tau231 and p-tau181 in paired plasma and serum samples. Secondly, we compared serum and cerebrospinal fluid (CSF) samples from biomarker-positive AD and biomarker-negative control participants. METHODS We studied three independent cohorts (n=115 total): cohorts 1 and 2 included individuals with paired plasma and serum, while cohort 3 included paired serum and CSF. Blood-based p-tau231 and p-tau181 were measured using in-house or commercial single molecule array (Simoa) methods. RESULTS Serum and plasma p-tau231 and p-tau181 were two- to three-fold increased in biomarker-positive AD versus biomarker-negative controls (P≤0.0008). Serum p-tau231 separated diagnostic groups with area under the curve (AUC) of 82.2% (cohort 3) to 88.2% (cohort 1) compared with 90.2% (cohort 1) for plasma. Similarly, p-tau181 showed AUC of 89.6% (cohort 1) to 89.8% (cohort 3) in serum versus 85.4% in plasma (cohort 1). P-tau231 and p-tau181 correlated slightly better in serum (rho=0.92 for cohort 1, 0.93 for cohort 3) than in plasma (rho=0.88, cohort 1). Within-individual p-tau181 (Quanterix) and p-tau231 concentrations were twice higher in plasma versus serum, but p-tau181 (in-house, Gothenburg) levels were not statistically different. Bland-Altman plots revealed that the relative difference between serum/plasma was larger in the lower range. P-tau levels in paired plasma and serum correlated strongly with each other (rho=0.75-0.93) as well as with CSF Aβ42 (rho= -0.56 to -0.59), p-tau and total-tau (rho=0.53-0.73). Based on the results, it seems possible that serum p-tau reflects the same pool of brain-secreted p-tau as in CSF; we estimated that less than 2% of CSF p-tau is found in serum, being same for both controls and AD. CONCLUSIONS Comparable diagnostic performances and strong correlations between serum versus plasma pairs suggest that p-tau analyses can be expanded to research cohorts and hospital systems that prefer serum to other blood matrices. However, absolute biomarker concentrations may not be interchangeable, indicating that plasma and serum samples should be used independently. These results should be validated in independent cohorts.
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Affiliation(s)
- Przemysław R Kac
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Fernando Gonzalez-Ortiz
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Joel Simrén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Nele Dewit
- ADx NeuroSciences, Technologiepark 94, Ghent, Belgium
| | | | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.,UK Dementia Research Institute at UCL, London, UK.,Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.,King's College London, Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute, London, UK.,NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS Foundation, London, UK
| | - Thomas K Karikari
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. .,Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
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Down-Regulation of Insulin Like Growth Factor 1 Involved in Alzheimer’s Disease via MAPK, Ras, and FoxO Signaling Pathways. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:8169981. [PMID: 35571248 PMCID: PMC9096571 DOI: 10.1155/2022/8169981] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/07/2022] [Accepted: 04/19/2022] [Indexed: 11/18/2022]
Abstract
The inability to halt or even delay the course of Alzheimer's disease (AD) forces the development of new molecular signatures and therapeutic strategies. Insulin like growth factor 1 (IGF1) is a promising target for AD treatment, yet exact mechanisms of AD ascribed to IGF1 remain elusive. Herein, gene expression profiles of 195 samples were analyzed and 19,245 background genes were generated, among which 4,424 differentially expressed genes (DEGs) were overlapped between AD/control and IGF1-low/high groups. Based on such DEGs, seven co-expression modules were established by weight gene correlation network analysis (WGCNA). The turquoise module had the strongest correlation with AD and IGF1-low expression, the DEGs of which were enriched in GABAergic synapse, long-term potentiation, mitogen-activated protein kinase (MAPK), Ras, and forkhead box O (FoxO) signaling pathways. Furthermore, cross-talking pathways of IGF1, including MAPK, Ras, and FoxO signaling pathways were identified in the protein-protein interaction network. According to the area under the curve (AUC) analysis, down-regulation of IGF1 exhibited good diagnostic performance in AD prediction. Collectively, our findings highlight the involvement of low IGF1 in AD pathogenesis via MAPK, Ras, and FoxO signaling pathways, which might advance strategies for the prevention and therapy of AD based on IGF1 target.
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384
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Ossenkoppele R, van der Kant R, Hansson O. Tau biomarkers in Alzheimer's disease: towards implementation in clinical practice and trials. Lancet Neurol 2022; 21:726-734. [DOI: 10.1016/s1474-4422(22)00168-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 03/30/2022] [Accepted: 04/04/2022] [Indexed: 10/18/2022]
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385
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De Meyer S, Vanbrabant J, Schaeverbeke JM, Reinartz M, Luckett ES, Dupont P, Van Laere K, Stoops E, Vanmechelen E, Poesen K, Vandenberghe R. Phospho-specific plasma p-tau181 assay detects clinical as well as asymptomatic Alzheimer's disease. Ann Clin Transl Neurol 2022; 9:734-746. [PMID: 35502634 PMCID: PMC9082389 DOI: 10.1002/acn3.51553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Plasma phosphorylated-tau-181 (p-tau181) reliably detects clinical Alzheimer's disease (AD) as well as asymptomatic amyloid-β (Aβ) pathology, but is consistently quantified with assays using antibody AT270, which cross-reacts with p-tau175. This study investigates two novel phospho-specific assays for plasma p-tau181 and p-tau231 in clinical and asymptomatic AD. METHODS Plasma p-tau species were quantified with Simoa in 44 AD patients, 40 spouse controls and an independent cohort of 151 cognitively unimpaired (CU) elderly who underwent Aβ-PET. Simoa plasma Aβ42 measurements were available in a CU subset (N = 69). Receiver operating characteristics and Aβ-PET associations were used to evaluate biomarker validity. RESULTS The novel plasma p-tau181 and p-tau231 assays did not show cross-reactivity. Plasma p-tau181 accurately detected clinical AD (area under the curve (AUC) = 0.98, 95% CI 0.95-1.00) as well as asymptomatic Aβ pathology (AUC = 0.84, 95% CI 0.76-0.92), while plasma p-tau231 did not (AUC = 0.74, 95% CI 0.63-0.85 and 0.61, 95% CI 0.52-0.71, respectively). Plasma p-tau181, but not p-tau231, detected asymptomatic Aβ pathology more accurately than age, sex and APOE combined (AUC = 0.64). In asymptomatic elderly, correlations between plasma p-tau181 and Aβ pathology were observed throughout the cerebral cortex (ρ = 0.40, p < 0.0001), with focal associations within AD-vulnerable regions, particularly the precuneus. The plasma Aβ42/p-tau181 ratio did not reflect asymptomatic Aβ pathology better than p-tau181 alone. INTERPRETATION The novel plasma p-tau181 assay is an accurate tool to detect clinical as well as asymptomatic AD and provides a phospho-specific alternative to currently employed immunoassays.
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Affiliation(s)
- Steffi De Meyer
- Laboratory for Cognitive Neurology, Department of NeurosciencesKU LeuvenLeuvenBelgium
- Laboratory for Molecular Neurobiomarker Research, Department of NeurosciencesKU LeuvenLeuvenBelgium
- Laboratory Medicine DepartmentUZ LeuvenLeuvenBelgium
- Alzheimer Research CentreLeuven Brain Institute (LBI), KU LeuvenLeuvenBelgium
| | | | - Jolien M. Schaeverbeke
- Laboratory for Cognitive Neurology, Department of NeurosciencesKU LeuvenLeuvenBelgium
- Alzheimer Research CentreLeuven Brain Institute (LBI), KU LeuvenLeuvenBelgium
| | - Mariska Reinartz
- Laboratory for Cognitive Neurology, Department of NeurosciencesKU LeuvenLeuvenBelgium
- Alzheimer Research CentreLeuven Brain Institute (LBI), KU LeuvenLeuvenBelgium
| | - Emma S. Luckett
- Laboratory for Cognitive Neurology, Department of NeurosciencesKU LeuvenLeuvenBelgium
- Alzheimer Research CentreLeuven Brain Institute (LBI), KU LeuvenLeuvenBelgium
| | - Patrick Dupont
- Laboratory for Cognitive Neurology, Department of NeurosciencesKU LeuvenLeuvenBelgium
- Alzheimer Research CentreLeuven Brain Institute (LBI), KU LeuvenLeuvenBelgium
| | - Koen Van Laere
- Alzheimer Research CentreLeuven Brain Institute (LBI), KU LeuvenLeuvenBelgium
- Nuclear Medicine and Molecular Imaging, Department of Imaging and PathologyKU LeuvenLeuvenBelgium
- Division of Nuclear MedicineUZ LeuvenLeuvenBelgium
| | | | | | - Koen Poesen
- Laboratory for Molecular Neurobiomarker Research, Department of NeurosciencesKU LeuvenLeuvenBelgium
- Laboratory Medicine DepartmentUZ LeuvenLeuvenBelgium
- Alzheimer Research CentreLeuven Brain Institute (LBI), KU LeuvenLeuvenBelgium
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of NeurosciencesKU LeuvenLeuvenBelgium
- Alzheimer Research CentreLeuven Brain Institute (LBI), KU LeuvenLeuvenBelgium
- Neurology DepartmentUZ LeuvenLeuvenBelgium
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386
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Windon C, Iaccarino L, Mundada N, Allen I, Boxer AL, Byrd D, Rivera‐Mindt M, Rabinovici GD. Comparison of plasma and CSF biomarkers across ethnoracial groups in the ADNI. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12315. [PMID: 35510092 PMCID: PMC9057320 DOI: 10.1002/dad2.12315] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 02/06/2023]
Abstract
Introduction Ethnoracial differences in cerebrospinal fluid (CSF; amyloid beta 42 [Aβ42], total tau [t-tau], phosphorylated tau 181 [p-tau181], and plasma (p-tau181, neurofilament light [NfL]) biomarkers of Alzheimer's disease (AD) are incompletely understood. Methods We performed cross-sectional analyses with and without adjustment for covariates comparing baseline CSF (Aβ42, t-tau, p-tau181) and plasma (p-tau181, NfL) values in 47 African Americans (AAs) matched to 141 non-Hispanic Whites (NHWs) and 43 Latinos (LAs) matched to 129 NHWs from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Results Unadjusted comparisons revealed no significant differences in plasma or CSF biomarkers between AAs and NHWs. A trend toward a lower CSF t-tau and p-tau181 in LAs compared to NHWs was observed, without significant differences in plasma biomarkers. After adjusting for covariates, there were no significant differences in CSF or plasma biomarkers between AAs and NHWs or between LAs and NHWs. Discussion Plasma and CSF AD biomarkers may perform similarly across diverse populations but future studies in large, diverse cohorts are needed.
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Affiliation(s)
- Charles Windon
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Leonardo Iaccarino
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Nidhi Mundada
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Isabel Allen
- Department of Epidemiology and BiostatisticsUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Adam L. Boxer
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Desiree Byrd
- Department of PsychologyQueens CollegeThe City University of New YorkQueensNew YorkUSA
| | - Monica Rivera‐Mindt
- Department of PsychologyFordham UniversityFordham University Dept. of PsychologyBronxNew YorkUSA
| | - Gil D. Rabinovici
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Department of Radiology and Biomedical ImagingUniversity of CaliforniaSan FranciscoCaliforniaUSA
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387
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Lagarde J, Olivieri P, Tonietto M, Tissot C, Rivals I, Gervais P, Caillé F, Moussion M, Bottlaender M, Sarazin M. Tau-PET imaging predicts cognitive decline and brain atrophy progression in early Alzheimer's disease. J Neurol Neurosurg Psychiatry 2022; 93:459-467. [PMID: 35228270 DOI: 10.1136/jnnp-2021-328623] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 01/31/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To explore whether regional tau binding measured at baseline is associated with the rapidity of Alzheimer's disease (AD) progression over 2 years, as assessed by the decline in specified cognitive domains, and the progression of regional brain atrophy, in comparison with amyloid-positron emission tomography (PET), MRI and cerebrospinal fluid (CSF) biomarkers. METHODS Thirty-six patients with AD (positive CSF biomarkers and amyloid-PET) and 15 controls underwent a complete neuropsychological assessment, 3T brain MRI, [11C]-PiB and [18F]-flortaucipir PET imaging, and were monitored annually over 2 years, with a second brain MRI after 2 years. We used mixed effects models to explore the relations between tau-PET, amyloid-PET, CSF biomarkers and MRI at baseline and cognitive decline and the progression of brain atrophy over 2 years in patients with AD. RESULTS Baseline tau-PET was strongly associated with the subsequent cognitive decline in regions that are usually associated with each cognitive domain. No significant relationship was observed between the cognitive decline and initial amyloid load, regional cortical atrophy or CSF biomarkers. Baseline tau tracer binding in the superior temporal gyrus was associated with subsequent atrophy in an inferomedial temporal volume of interest, as was the voxelwise tau tracer binding with subsequent cortical atrophy in the superior temporal, parietal and frontal association cortices. CONCLUSIONS These results suggest that tau tracer binding is predictive of cognitive decline in AD in domain-specific brain areas, which provides important insights into the interaction between tau burden and neurodegeneration, and is of the utmost importance to develop new prognostic markers that will help improve the design of therapeutic trials.
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Affiliation(s)
- Julien Lagarde
- Department of Neurology of Memory and Language, GHU Paris Psychiatrie & Neurosciences, Hôpital Sainte-Anne, Paris, France .,Université de Paris, Paris, France.,Université Paris-Saclay, BioMaps, Service Hospitalier Frédéric Joliot CEA, CNRS, Inserm, Orsay, France
| | - Pauline Olivieri
- Department of Neurology of Memory and Language, GHU Paris Psychiatrie & Neurosciences, Hôpital Sainte-Anne, Paris, France.,Université de Paris, Paris, France.,Université Paris-Saclay, BioMaps, Service Hospitalier Frédéric Joliot CEA, CNRS, Inserm, Orsay, France
| | - Matteo Tonietto
- Université Paris-Saclay, BioMaps, Service Hospitalier Frédéric Joliot CEA, CNRS, Inserm, Orsay, France
| | - Cecile Tissot
- McGill University Research Centre for Studies in Aging, Montreal, Quebec, Canada
| | - Isabelle Rivals
- Equipe de Statistique Appliquée, ESPCI Paris, PSL Research University, INSERM, UMRS 1158 Neurophysiologie Respiratoire Expérimentale et Clinique, 10 rue Vauquelin, Paris, France
| | - Philippe Gervais
- Université Paris-Saclay, BioMaps, Service Hospitalier Frédéric Joliot CEA, CNRS, Inserm, Orsay, France
| | - Fabien Caillé
- Université Paris-Saclay, BioMaps, Service Hospitalier Frédéric Joliot CEA, CNRS, Inserm, Orsay, France
| | - Martin Moussion
- Department of Neurology of Memory and Language, GHU Paris Psychiatrie & Neurosciences, Hôpital Sainte-Anne, Paris, France.,Centre d'évaluation Troubles Psychiques et Vieillissement, GHU Paris Psychiatrie & Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Michel Bottlaender
- Université Paris-Saclay, BioMaps, Service Hospitalier Frédéric Joliot CEA, CNRS, Inserm, Orsay, France.,Université Paris-Saclay, UNIACT, Neurospin, Joliot Institute, CEA, Gif sur Yvette, France
| | - Marie Sarazin
- Department of Neurology of Memory and Language, GHU Paris Psychiatrie & Neurosciences, Hôpital Sainte-Anne, Paris, France.,Université de Paris, Paris, France.,Université Paris-Saclay, BioMaps, Service Hospitalier Frédéric Joliot CEA, CNRS, Inserm, Orsay, France
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388
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Frontera JA, Boutajangout A, Masurkar AV, Betensky RA, Ge Y, Vedvyas A, Debure L, Moreira A, Lewis A, Huang J, Thawani S, Balcer L, Galetta S, Wisniewski T. Comparison of serum neurodegenerative biomarkers among hospitalized COVID-19 patients versus non-COVID subjects with normal cognition, mild cognitive impairment, or Alzheimer's dementia. Alzheimers Dement 2022; 18:899-910. [PMID: 35023610 PMCID: PMC9011610 DOI: 10.1002/alz.12556] [Citation(s) in RCA: 76] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Neurological complications among hospitalized COVID-19 patients may be associated with elevated neurodegenerative biomarkers. METHODS Among hospitalized COVID-19 patients without a history of dementia (N = 251), we compared serum total tau (t-tau), phosphorylated tau-181 (p-tau181), glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL), ubiquitin carboxy-terminal hydrolase L1 (UCHL1), and amyloid beta (Aβ40,42) between patients with or without encephalopathy, in-hospital death versus survival, and discharge home versus other dispositions. COVID-19 patient biomarker levels were also compared to non-COVID cognitively normal, mild cognitive impairment (MCI), and Alzheimer's disease (AD) dementia controls (N = 161). RESULTS Admission t-tau, p-tau181, GFAP, and NfL were significantly elevated in patients with encephalopathy and in those who died in-hospital, while t-tau, GFAP, and NfL were significantly lower in those discharged home. These markers correlated with severity of COVID illness. NfL, GFAP, and UCHL1 were higher in COVID patients than in non-COVID controls with MCI or AD. DISCUSSION Neurodegenerative biomarkers were elevated to levels observed in AD dementia and associated with encephalopathy and worse outcomes among hospitalized COVID-19 patients.
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Affiliation(s)
| | | | | | | | - Yulin Ge
- New York University Grossman School of MedicineNew YorkNew YorkUSA
| | - Alok Vedvyas
- New York University Grossman School of MedicineNew YorkNew YorkUSA
| | - Ludovic Debure
- New York University Grossman School of MedicineNew YorkNew YorkUSA
| | - Andre Moreira
- New York University Grossman School of MedicineNew YorkNew YorkUSA
| | - Ariane Lewis
- New York University Grossman School of MedicineNew YorkNew YorkUSA
| | - Joshua Huang
- New York University Grossman School of MedicineNew YorkNew YorkUSA
| | - Sujata Thawani
- New York University Grossman School of MedicineNew YorkNew YorkUSA
| | - Laura Balcer
- New York University Grossman School of MedicineNew YorkNew YorkUSA
| | - Steven Galetta
- New York University Grossman School of MedicineNew YorkNew YorkUSA
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389
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Huang LK, Chao SP, Hu CJ, Chien LN, Chiou HY, Lo YC, Hsieh YC. Plasma Phosphorylated-tau181 Is a Predictor of Post-stroke Cognitive Impairment: A Longitudinal Study. Front Aging Neurosci 2022; 14:889101. [PMID: 35572134 PMCID: PMC9099290 DOI: 10.3389/fnagi.2022.889101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 03/24/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Post-stroke cognitive impairment (PSCI) cannot be neglected because it drastically influences the daily life of patients and their families. However, there are no studies exploring the association between preclinical blood biomarkers of neurodegeneration including plasma amyloid-β (Aβ), tau, and brain-derived neurotrophic factor (BDNF) together with the risk of PSCI. This longitudinal study was to investigate whether these blood biomarkers with imaging markers of cerebral small vessel disease can improve the prediction for PSCI. In addition, we also explored the association between blood biomarkers with the trajectories of PSCI. Methods Adult patients with first-ever acute ischemic stroke were recruited, and the cognitive and functional abilities of these patients were evaluated. Furthermore, blood biomarkers of neurodegeneration including plasma Aβ-40, Aβ-42, total tau, phosphorylated tau 181 (p-tau181), and BDNF levels and image markers of cerebral small vessel disease were measured. Each patient was followed up at 3 and 12 months at the outpatient department. Results Of 136 patients, 40 and 50 patients developed PSCI at 3 and 12 months after stroke, respectively. In functional trajectories, 27 patients did not have PSCI at 3 months but did at 12 months. By contrast, the PSCI status of 17 patients at 3 months was reversed at 12 months. Patients with high-acute plasma p-tau181 had a significantly lower PSCI risk at 3 months (odds ratio [OR] = 0.62, 95% CI = 0.40-0.94, p = 0.0243) and 12 months (OR = 0.69, 95% CI = 0.47-0.99, p = 0.0443) after adjustment for covariates and image biomarkers. Discrimination and reclassification statistics indicated that the p-tau181 level can improve discrimination ability for PSCI at 3 and 12 months, respectively. In addition, the plasma p-tau181 level was the highest in subjects without PSCI followed by those with delayed-onset PSCI and early-onset PSCI with reversal, whereas the lowest plasma p-tau181 level was found among those with persistent PSCI, showing a significant trend test (p = 0.0081). Conclusion Plasma p-tau181 is a potential biomarker for predicting early- and delayed-onset PSCI. Future studies should incorporate plasma p-tau181 as an indicator for timely cognitive intervention in the follow-up of patients with stroke.
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Affiliation(s)
- Li-Kai Huang
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan
- Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University and National Health Research Institutes, Taipei, Taiwan
| | - Shu-Ping Chao
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan
| | - Chaur-Jong Hu
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Li-Nien Chien
- Graduate Institution of Data Science, College of Management, Taipei Medical University, Taipei, Taiwan
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan
- Health Data Analytics and Statistics Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan
| | - Hung-Yi Chiou
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
- Master Program in Applied Epidemiology, College of Public Health, Taipei Medical University, Taipei, Taiwan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Yu-Chun Lo
- Graduate Institute of Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Yi-Chen Hsieh
- Graduate Institute of Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Master Program in Applied Epidemiology, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Ph.D. Program in Biotechnology Research and Development, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
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390
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Choi H, Lee D, Mook-Jung I. Gut Microbiota as a Hidden Player in the Pathogenesis of Alzheimer's Disease. J Alzheimers Dis 2022; 86:1501-1526. [PMID: 35213369 DOI: 10.3233/jad-215235] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Alzheimer's disease (AD), the most common neurodegenerative disorder, is accompanied by cognitive impairment and shows representative pathological features, including senile plaques and neurofibrillary tangles in the brain. Recent evidence suggests that several systemic changes outside the brain are associated with AD and may contribute to its pathogenesis. Among the factors that induce systemic changes in AD, the gut microbiota is increasingly drawing attention. Modulation of gut microbiome, along with continuous attempts to remove pathogenic proteins directly from the brain, is a viable strategy to cure AD. Seeking a holistic understanding of the pathways throughout the body that can affect the pathogenesis, rather than regarding AD solely as a brain disease, may be key to successful therapy. In this review, we focus on the role of the gut microbiota in causing systemic manifestations of AD. The review integrates recently emerging concepts and provides potential mechanisms about the involvement of the gut-brain axis in AD, ranging from gut permeability and inflammation to bacterial translocation and cross-seeding.
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Affiliation(s)
- Hyunjung Choi
- Genomic Medicine Institute, Medical Research Center, Seoul National University, Seoul, Republic of Korea.,SNU Dementia Research Center, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Dongjoon Lee
- Department of Biochemistry and Biomedical Sciences, College of Medicine, Seoul National University, Seoul, Republic of Korea.,SNU Dementia Research Center, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Inhee Mook-Jung
- Genomic Medicine Institute, Medical Research Center, Seoul National University, Seoul, Republic of Korea.,Department of Biochemistry and Biomedical Sciences, College of Medicine, Seoul National University, Seoul, Republic of Korea.,SNU Dementia Research Center, College of Medicine, Seoul National University, Seoul, Republic of Korea
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391
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Alawode DOT, Fox NC, Zetterberg H, Heslegrave AJ. Alzheimer’s Disease Biomarkers Revisited From the Amyloid Cascade Hypothesis Standpoint. Front Neurosci 2022; 16:837390. [PMID: 35573283 PMCID: PMC9091905 DOI: 10.3389/fnins.2022.837390] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/04/2022] [Indexed: 11/25/2022] Open
Abstract
Alzheimer’s disease (AD) is the most common neurodegenerative disease worldwide. Amyloid beta (Aβ) is one of the proteins which aggregate in AD, and its key role in the disease pathogenesis is highlighted in the amyloid cascade hypothesis, which states that the deposition of Aβ in the brain parenchyma is a crucial initiating step in the future development of AD. The sensitivity of instruments used to measure proteins in blood and cerebrospinal fluid has significantly improved, such that Aβ can now successfully be measured in plasma. However, due to the peripheral production of Aβ, there is significant overlap between diagnostic groups. The presence of pathological Aβ within the AD brain has several effects on the cells and surrounding tissue. Therefore, there is a possibility that using markers of tissue responses to Aβ may reveal more information about Aβ pathology and pathogenesis than looking at plasma Aβ alone. In this manuscript, using the amyloid cascade hypothesis as a starting point, we will delve into how the effect of Aβ on the surrounding tissue can be monitored using biomarkers. In particular, we will consider whether glial fibrillary acidic protein, triggering receptor expressed on myeloid cells 2, phosphorylated tau, and neurofilament light chain could be used to phenotype and quantify the tissue response against Aβ pathology in AD.
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Affiliation(s)
- Deborah O. T. Alawode
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom
- UK Dementia Research Institute at UCL, London, United Kingdom
- *Correspondence: Deborah O. T. Alawode,
| | - Nick C. Fox
- UK Dementia Research Institute at UCL, London, United Kingdom
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Henrik Zetterberg
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom
- UK Dementia Research Institute at UCL, London, United Kingdom
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Amanda J. Heslegrave
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom
- UK Dementia Research Institute at UCL, London, United Kingdom
- Amanda J. Heslegrave,
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392
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Zetterberg H, Schott JM. Blood biomarkers for Alzheimer's disease and related disorders. Acta Neurol Scand 2022; 146:51-55. [PMID: 35470421 DOI: 10.1111/ane.13628] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/03/2022] [Accepted: 04/18/2022] [Indexed: 12/13/2022]
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disease and the single commonest cause of dementia. Many other diseases can, however, cause dementia, and differential diagnosis can be challenging, especially in early disease stages. For most neurodegenerative dementias, accumulation of brain pathologies starts many years before clinical onset; the ability to detect these pathologies paves the way for targeted disease-modifying prevention trials. AD is associated with β-amyloid and tau pathologies, which can be quantified using cerebrospinal fluid and imaging biomarkers and, more recently, using highly sensitive blood tests. While for the most part, specific biomarkers of non-AD neurodegenerative dementias are lacking, non-specific biomarkers of neurodegeneration are available. This review summarizes recent advances in the neurodegenerative dementia blood biomarker research and discusses the next steps required for clinical implementation.
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Affiliation(s)
- Henrik Zetterberg
- Department of Psychiatry and Neurochemistry Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg Mölndal Sweden
- Clinical Neurochemistry Laboratory Sahlgrenska University Hospital Mölndal Sweden
- Department of Neurodegenerative Disease UCL Institute of Neurology Queen Square London UK
- UK Dementia Research Institute at UCL London UK
- Hong Kong Center for Neurodegenerative Diseases Hong Kong China
| | - Jonathan M. Schott
- UK Dementia Research Institute at UCL London UK
- Dementia Research Centre UCL Queen Square Institute of Neurology University College London London UK
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393
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Multiple Roles of Paeoniflorin in Alzheimer's Disease. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:2464163. [PMID: 35449815 PMCID: PMC9017479 DOI: 10.1155/2022/2464163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/09/2022] [Indexed: 12/18/2022]
Abstract
Alzheimer's disease (AD) is a geriatric disease with the morbidity and mortality continuing to grow, partly due to the aging of the world population. As one of the most common types of primary neurodegenerative dementia, it is mainly due to environmental, epigenetic, immunological, and genetic factors. Paeoniflorin (PF), the main component of paeony extract, plays a more and more important role in the prevention and treatment of AD, including regulating protein, anti-inflammation, antioxidation, and antiapoptosis, protecting glial cells, regulating neurotransmitters and related enzymes and receptors, and inhibiting or activating related signal pathways. This article summarizes the latest researches on the multiple effects and the mechanisms of PF in the treatment to cure AD, providing new insights and research basis for further clinical application of traditional Chinese medicine (TCM) in the treatment of AD.
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394
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Klyucherev TO, Olszewski P, Shalimova AA, Chubarev VN, Tarasov VV, Attwood MM, Syvänen S, Schiöth HB. Advances in the development of new biomarkers for Alzheimer's disease. Transl Neurodegener 2022; 11:25. [PMID: 35449079 PMCID: PMC9027827 DOI: 10.1186/s40035-022-00296-z] [Citation(s) in RCA: 75] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 03/28/2022] [Indexed: 12/16/2022] Open
Abstract
Alzheimer's disease (AD) is a complex, heterogeneous, progressive disease and is the most common type of neurodegenerative dementia. The prevalence of AD is expected to increase as the population ages, placing an additional burden on national healthcare systems. There is a large need for new diagnostic tests that can detect AD at an early stage with high specificity at relatively low cost. The development of modern analytical diagnostic tools has made it possible to determine several biomarkers of AD with high specificity, including pathogenic proteins, markers of synaptic dysfunction, and markers of inflammation in the blood. There is a considerable potential in using microRNA (miRNA) as markers of AD, and diagnostic studies based on miRNA panels suggest that AD could potentially be determined with high accuracy for individual patients. Studies of the retina with improved methods of visualization of the fundus are also showing promising results for the potential diagnosis of the disease. This review focuses on the recent developments of blood, plasma, and ocular biomarkers for the diagnosis of AD.
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Affiliation(s)
- Timofey O Klyucherev
- Department of Neuroscience, Functional Pharmacology, University of Uppsala, Uppsala, Sweden.,Department of Pharmacology, Institute of Pharmacy, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Pawel Olszewski
- Department of Neuroscience, Functional Pharmacology, University of Uppsala, Uppsala, Sweden
| | - Alena A Shalimova
- Department of Neuroscience, Functional Pharmacology, University of Uppsala, Uppsala, Sweden.,Department of Pharmacology, Institute of Pharmacy, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Vladimir N Chubarev
- Institute of Translational Medicine and Biotechnology, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Vadim V Tarasov
- Department of Pharmacology, Institute of Pharmacy, I. M. Sechenov First Moscow State Medical University, Moscow, Russia.,Institute of Translational Medicine and Biotechnology, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Misty M Attwood
- Department of Neuroscience, Functional Pharmacology, University of Uppsala, Uppsala, Sweden
| | - Stina Syvänen
- Department of Public Health and Caring Sciences, Rudbeck Laboratory, Uppsala University, Uppsala, Sweden
| | - Helgi B Schiöth
- Department of Neuroscience, Functional Pharmacology, University of Uppsala, Uppsala, Sweden.
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395
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Liu L, Cai Y, Lauro BM, Meunier AL, Chhatwal J, Selkoe DJ. Generation and application of semi-synthetic p-Tau181 calibrator for immunoassay calibration. Biochem Biophys Res Commun 2022; 611:85-90. [PMID: 35483223 DOI: 10.1016/j.bbrc.2022.04.077] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/08/2022] [Accepted: 04/17/2022] [Indexed: 12/28/2022]
Abstract
Evidence suggests that plasma levels of tau protein phosphorylated at specific residues such as p-T181, p-T217, and p-T231 can be used as biomarkers for Alzheimer's disease (AD) diagnosis and prognosis. Accurate tools to calibrate immunoassays (calibrators) to precisely detect phosphorylated residues on tau protein will provide important gains in reliability and specificity. This study sought to establish a method to generate those accurate calibrators. We generated a semi-synthetic (chimeric) p-Tau181 calibrator by coupling a recombinant tau fragment (residues 1-174) with a synthetic peptide containing a single phosphorylated residue (p-T181) via thioester bond formation. The generation of a semi-synthetic protein containing both the N-terminal region of tau and the pT181 epitope was demonstrated by mobility shift assays using CBB staining and immunoblotting with N-terminal and pT181-specific antibodies. p-Tau 181 assays performed with the novel calibrator on multiple platforms revealed LLoQs as low as 0.14 pg/ml. Our facile and inexpensive method generates a semi-synthetic tau pT181 calibrator suitable for different immunoassay platforms. The same method can easily be adapted to other AD-relevant phospho-epitopes such as pT217 and pT231.
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Affiliation(s)
- Lei Liu
- Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.
| | - Yuqi Cai
- Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Bianca M Lauro
- Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Angela L Meunier
- Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Jasmeer Chhatwal
- Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Dennis J Selkoe
- Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
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396
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Varesi A, Carrara A, Pires VG, Floris V, Pierella E, Savioli G, Prasad S, Esposito C, Ricevuti G, Chirumbolo S, Pascale A. Blood-Based Biomarkers for Alzheimer's Disease Diagnosis and Progression: An Overview. Cells 2022; 11:1367. [PMID: 35456047 PMCID: PMC9044750 DOI: 10.3390/cells11081367] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/12/2022] [Accepted: 04/15/2022] [Indexed: 01/10/2023] Open
Abstract
Alzheimer's Disease (AD) is a progressive neurodegenerative disease characterized by amyloid-β (Aβ) plaque deposition and neurofibrillary tangle accumulation in the brain. Although several studies have been conducted to unravel the complex and interconnected pathophysiology of AD, clinical trial failure rates have been high, and no disease-modifying therapies are presently available. Fluid biomarker discovery for AD is a rapidly expanding field of research aimed at anticipating disease diagnosis and following disease progression over time. Currently, Aβ1-42, phosphorylated tau, and total tau levels in the cerebrospinal fluid are the best-studied fluid biomarkers for AD, but the need for novel, cheap, less-invasive, easily detectable, and more-accessible markers has recently led to the search for new blood-based molecules. However, despite considerable research activity, a comprehensive and up-to-date overview of the main blood-based biomarker candidates is still lacking. In this narrative review, we discuss the role of proteins, lipids, metabolites, oxidative-stress-related molecules, and cytokines as possible disease biomarkers. Furthermore, we highlight the potential of the emerging miRNAs and long non-coding RNAs (lncRNAs) as diagnostic tools, and we briefly present the role of vitamins and gut-microbiome-related molecules as novel candidates for AD detection and monitoring, thus offering new insights into the diagnosis and progression of this devastating disease.
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Affiliation(s)
- Angelica Varesi
- Department of Biology and Biotechnology, University of Pavia, 27100 Pavia, Italy
- Almo Collegio Borromeo, 27100 Pavia, Italy
| | - Adelaide Carrara
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy; (A.C.); (V.F.)
| | - Vitor Gomes Pires
- Department of Biological Sciences, Columbia University, New York, NY 10027, USA;
| | - Valentina Floris
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy; (A.C.); (V.F.)
| | - Elisa Pierella
- School of Medicine, Faculty of Clinical and Biomedical Sciences, University of Central Lancashire, Preston PR1 2HE, UK;
| | - Gabriele Savioli
- Emergency Department, IRCCS Policlinico San Matteo, 27100 Pavia, Italy;
| | - Sakshi Prasad
- Faculty of Medicine, National Pirogov Memorial Medical University, 21018 Vinnytsya, Ukraine;
| | - Ciro Esposito
- Unit of Nephrology and Dialysis, ICS Maugeri, University of Pavia, 27100 Pavia, Italy;
| | - Giovanni Ricevuti
- Department of Drug Sciences, University of Pavia, 27100 Pavia, Italy
| | - Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37129 Verona, Italy;
| | - Alessia Pascale
- Department of Drug Sciences, Section of Pharmacology, University of Pavia, 27100 Pavia, Italy;
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397
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Pomilio AB, Vitale AA, Lazarowski AJ. Neuroproteomics Chip-Based Mass Spectrometry and Other Techniques for Alzheimer´S Disease Biomarkers – Update. Curr Pharm Des 2022; 28:1124-1151. [DOI: 10.2174/1381612828666220413094918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/25/2022] [Indexed: 11/22/2022]
Abstract
Background:
Alzheimer's disease (AD) is a progressive neurodegenerative disease of growing interest given that there is cognitive damage and symptom onset acceleration. Therefore, it is important to find AD biomarkers for early diagnosis, disease progression, and discrimination of AD and other diseases.
Objective:
To update the relevance of mass spectrometry for the identification of peptides and proteins involved in AD useful as discriminating biomarkers.
Methods:
Proteomics and peptidomics technologies that show the highest possible specificity and selectivity for AD biomarkers are analyzed, together with the biological fluids used. In addition to positron emission tomography and magnetic resonance imaging, MALDI-TOF mass spectrometry is widely used to identify proteins and peptides involved in AD. The use of protein chips in SELDI technology and electroblotting chips for peptides makes feasible small amounts (L) of samples for analysis.
Results:
Suitable biomarkers are related to AD pathology, such as intracellular neurofibrillary tangles; extraneuronal senile plaques; neuronal and axonal degeneration; inflammation and oxidative stress. Recently, peptides were added to the candidate list, which are not amyloid-b or tau fragments, but are related to coagulation, brain plasticity, and complement/neuroinflammation systems involving the neurovascular unit.
Conclusion:
The progress made in the application of mass spectrometry and recent chip techniques is promising for discriminating between AD, mild cognitive impairment, and matched healthy controls. The application of this technique to blood samples from patients with AD has shown to be less invasive and fast enough to determine the diagnosis, stage of the disease, prognosis, and follow-up of the therapeutic response.
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Affiliation(s)
- Alicia B. Pomilio
- Departamento de Bioquímica Clínica, Área Hematología, Hospital de Clínicas “José de San Martín”, Universidad de Buenos Aires, Av. Córdoba 2351, C1120AAF Buenos Aires, Argentina
| | - Arturo A. Vitale
- Departamento de Bioquímica Clínica, Área Hematología, Hospital de Clínicas “José de San Martín”, Universidad de Buenos Aires, Av. Córdoba 2351, C1120AAF Buenos Aires, Argentina
| | - Alberto J. Lazarowski
- Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Universidad de Buenos Aires, Córdoba 2351, C1120AAF Buenos Aires, Argentina
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398
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Lim J, Kim S, Oh SJ, Han SM, Moon SY, Kang B, Seo SB, Jang S, Son SU, Jung J, Kang T, Park SA, Moon M, Lim EK. miRNA sensing hydrogels capable of self-signal amplification for early diagnosis of Alzheimer's disease. Biosens Bioelectron 2022; 209:114279. [PMID: 35447599 DOI: 10.1016/j.bios.2022.114279] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/21/2022] [Accepted: 04/09/2022] [Indexed: 11/02/2022]
Abstract
Alzheimer's disease (AD), one of the leading senile disorders in the world, causes severe memory loss and cognitive impairment. To date, there is no clear cure for AD. However, early diagnosis and monitoring can help mitigate the effects of this disease. In this study, we reported a platform for diagnosing early-stage AD using microRNAs (miRNAs) in the blood as biomarkers. First, we selected an appropriate target miRNA (miR-574-5p) using AD model mice (4-month-old 5XFAD mice) and developed a hydrogel-based sensor that enabled high-sensitivity detection of the target miRNA. This hydrogel contained catalytic hairpin assembly (CHA) reaction-based probes, leading to fluorescence signal amplification without enzymes and temperature changes, at room temperature. This sensor exhibited high sensitivity and selectivity, as evidenced by its picomolar-level detection limit (limit of detection: 1.29 pM). Additionally, this sensor was evaluated using the plasma of AD patients and non-AD control to validate its clinical applicability. Finally, to use this sensor as a point-of-care-testing (POCT) diagnostic system, a portable fluorometer was developed and verified for feasibility of application.
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Affiliation(s)
- Jaewoo Lim
- Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, South Korea; Department of Nanobiotechnology, KRIBB School of Biotechnology, University of Science and Technology, 125 Gwahak-ro, Yuseong-gu, Daejeon, 34113, South Korea
| | - Sujin Kim
- Department of Biochemistry, College of Medicine, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon, 35365, South Korea
| | - Seung Jae Oh
- YUHS-KRIBB Medical Convergence Research Institute, College of Medicine, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Song Mi Han
- Lab for Neurodegenerative Dementia, Department of Anatomy, Ajou University School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon, 16499, South Korea; Department of Neurology, Ajou University School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon, 16499, South Korea; Neuroscience Graduate Program, Department of Biomedical Sciences, Ajou University Graduate School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon, 16499, South Korea
| | - So Young Moon
- Department of Neurology, Ajou University School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon, 16499, South Korea
| | - Byunghoon Kang
- Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, South Korea
| | - Seung Beom Seo
- Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, South Korea; Department of Cogno-Mechatronics Engineering, Pusan National University, 2 Busandaehak-ro 63beon-gil, Geumjeong-gu, Busan, 46241, South Korea
| | - Soojin Jang
- Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, South Korea; Department of Nanobiotechnology, KRIBB School of Biotechnology, University of Science and Technology, 125 Gwahak-ro, Yuseong-gu, Daejeon, 34113, South Korea
| | - Seong Uk Son
- Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, South Korea; Department of Nanobiotechnology, KRIBB School of Biotechnology, University of Science and Technology, 125 Gwahak-ro, Yuseong-gu, Daejeon, 34113, South Korea
| | - Juyeon Jung
- Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, South Korea; Department of Nanobiotechnology, KRIBB School of Biotechnology, University of Science and Technology, 125 Gwahak-ro, Yuseong-gu, Daejeon, 34113, South Korea
| | - Taejoon Kang
- Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, South Korea
| | - Sun Ah Park
- Lab for Neurodegenerative Dementia, Department of Anatomy, Ajou University School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon, 16499, South Korea; Department of Neurology, Ajou University School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon, 16499, South Korea; Neuroscience Graduate Program, Department of Biomedical Sciences, Ajou University Graduate School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon, 16499, South Korea
| | - Minho Moon
- Department of Biochemistry, College of Medicine, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon, 35365, South Korea.
| | - Eun-Kyung Lim
- Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, South Korea; Department of Nanobiotechnology, KRIBB School of Biotechnology, University of Science and Technology, 125 Gwahak-ro, Yuseong-gu, Daejeon, 34113, South Korea.
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399
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Manzine PR, Vatanabe IP, Grigoli MM, Pedroso RV, de Almeida MPOMEP, de Oliveira DDSMS, Crispim Nascimento CM, Peron R, de Souza Orlandi F, Cominetti MR. Potential Protein Blood-Based Biomarkers in Different Types of Dementia: A Therapeutic Overview. Curr Pharm Des 2022; 28:1170-1186. [DOI: 10.2174/1381612828666220408124809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 02/24/2022] [Indexed: 11/22/2022]
Abstract
Abstract:
Biomarkers capable of identifying and distinguishing types of dementia such as Alzheimer's disease (AD), Parkinson's disease dementia (PDD), Lewy body dementia (LBD), and frontotemporal dementia (FTD) have been become increasingly relentless. Studies of possible biomarker proteins in the blood that can help formulate new diagnostic proposals and therapeutic visions of different types of dementia are needed. However, due to several limitations of these biomarkers, especially in discerning dementia, their clinical applications are still undetermined. Thus, the updating of biomarker blood proteins that can help in the diagnosis and discrimination of these main dementia conditions is essential to enable new pharmacological and clinical management strategies, with specificities for each type of dementia. To review the literature concerning protein blood-based AD and non-AD biomarkers as new pharmacological targets and/or therapeutic strategies. Recent findings for protein-based AD, PDD, LBD, and FTD biomarkers are focused on in this review. Protein biomarkers were classified according to the pathophysiology of the dementia types. The diagnosis and distinction of dementia through protein biomarkers is still a challenge. The lack of exclusive biomarkers for each type of dementia highlights the need for further studies in this field. Only after this, blood biomarkers may have a valid use in clinical practice as they are promising to help in diagnosis and in the differentiation of diseases.
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Affiliation(s)
- Patricia Regina Manzine
- Department of Gerontology, Federal University of Sao Carlos, Brazil. Highway Washington Luis, Km 235. Monjolinho
| | - Izabela Pereira Vatanabe
- Department of Gerontology, Federal University of Sao Carlos, Brazil. Highway Washington Luis, Km 235. Monjolinho
| | - Marina Mantellatto Grigoli
- Department of Gerontology, Federal University of Sao Carlos, Brazil. Highway Washington Luis, Km 235. Monjolinho
| | - Renata Valle Pedroso
- Department of Gerontology, Federal University of Sao Carlos, Brazil. Highway Washington Luis, Km 235. Monjolinho
| | | | | | | | - Rafaela Peron
- Department of Gerontology, Federal University of Sao Carlos, Brazil. Highway Washington Luis, Km 235. Monjolinho
| | - Fabiana de Souza Orlandi
- Department of Gerontology, Federal University of Sao Carlos, Brazil. Highway Washington Luis, Km 235. Monjolinho
| | - Márcia Regina Cominetti
- Department of Gerontology, Federal University of Sao Carlos, Brazil. Highway Washington Luis, Km 235. Monjolinho
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400
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Goyzueta-Mamani LD, Chávez-Fumagalli MA, Alvarez-Fernandez K, Aguilar-Pineda JA, Nieto-Montesinos R, Davila Del-Carpio G, Vera-Lopez KJ, Lino Cardenas CL. Alzheimer's Disease: A Silent Pandemic - A Systematic Review on the Situation and Patent Landscape of the Diagnosis. Recent Pat Biotechnol 2022; 16:355-378. [PMID: 35400333 DOI: 10.2174/1872208316666220408114129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 01/13/2022] [Accepted: 02/17/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is characterized by cognitive impairment, tau protein deposits, and amyloid beta plaques. AD impacted 44 million people in 2016, and it is estimated to affect 100 million people by 2050. AD is disregarded as a pandemic compared with other diseases. To date, there is no effective treatment or diagnosis. OBJECTIVE We aimed to discuss the current tools used to diagnose COVID-19, to point out their potential to be adapted for AD diagnosis, and to review the landscape of existing patents in the AD field and future perspectives for AD diagnosis. METHOD We carried out a scientific screening following a research strategy in PubMed; Web of Science; the Derwent Innovation Index; the KCI-Korean Journal Database; SciELO; the Russian Science Citation index; and the CDerwent, EDerwent, and MDerwent index databases. RESULTS A total of 326 from 6,446 articles about AD and 376 from 4,595 articles about COVID-19 were analyzed. Of these, AD patents were focused on biomarkers and neuroimaging with no accurate, validated diagnostic methods, and only 7% of kit development patents were found. In comparison, COVID-19 patents were 60% about kit development for diagnosis; they are highly accurate and are now commercialized. CONCLUSION AD is still neglected and not recognized as a pandemic that affects the people and economies of all nations. There is a gap in the development of AD diagnostic tools that could be filled if the interest and effort that has been invested to tackle the COVID-19 emergency could also be applied for innovation.
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Affiliation(s)
- Luis Daniel Goyzueta-Mamani
- Laboratory of Genomics and Neurovascular Diseases, Vicerrectorado de investigacion, Universidad Catolica de Santa Maria, Arequipa, Peru
| | - Miguel Angel Chávez-Fumagalli
- Laboratory of Genomics and Neurovascular Diseases, Vicerrectorado de investigacion, Universidad Catolica de Santa Maria, Arequipa, Peru
| | - Karla Alvarez-Fernandez
- Laboratory of Genomics and Neurovascular Diseases, Vicerrectorado de investigacion, Universidad Catolica de Santa Maria, Arequipa, Peru
| | - Jorge A Aguilar-Pineda
- Laboratory of Genomics and Neurovascular Diseases, Vicerrectorado de investigacion, Universidad Catolica de Santa Maria, Arequipa, Peru
| | - Rita Nieto-Montesinos
- Laboratory of Genomics and Neurovascular Diseases, Vicerrectorado de investigacion, Universidad Catolica de Santa Maria, Arequipa, Peru
| | - Gonzalo Davila Del-Carpio
- Laboratory of Genomics and Neurovascular Diseases, Vicerrectorado de investigacion, Universidad Catolica de Santa Maria, Arequipa, Peru
| | - Karin J Vera-Lopez
- Laboratory of Genomics and Neurovascular Diseases, Vicerrectorado de investigacion, Universidad Catolica de Santa Maria, Arequipa, Peru
| | - Christian L Lino Cardenas
- Cardiovascular Research Center, Cardiology Division, Massachusetts General Hospital, Boston, MA, USA
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