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Zhang Q, Duan Q, Gao Y, He P, Huang R, Huang H, Li Y, Ma G, Zhang Y, Nie K, Wang L. Cerebral Microvascular Injury Induced by Lag3-Dependent α-Synuclein Fibril Endocytosis Exacerbates Cognitive Impairment in a Mouse Model of α-Synucleinopathies. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2301903. [PMID: 37381656 PMCID: PMC10477873 DOI: 10.1002/advs.202301903] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/26/2023] [Indexed: 06/30/2023]
Abstract
The pathological accumulation of α-synuclein (α-Syn) and the transmission of misfolded α-Syn underlie α-synucleinopathies. Increased plasma α-Syn levels are associated with cognitive impairment in Parkinson's disease, multiple system atrophy, and dementia with Lewy bodies, but it is still unknown whether the cognitive deficits in α-synucleinopathies have a common vascular pathological origin. Here, it is reported that combined injection of α-Syn preformed fibrils (PFFs) in the unilateral substantia nigra pars compacta, hippocampus, and cerebral cortex results in impaired spatial learning and memory abilities at 6 months post-injection and that this cognitive decline is related to cerebral microvascular injury. Moreover, insoluble α-Syn inclusions are found to form in primary mouse brain microvascular endothelial cells (BMVECs) through lymphocyte-activation gene 3 (Lag3)-dependent α-Syn PFFs endocytosis, causing poly(ADP-ribose)-driven cell death and reducing the expression of tight junction proteins in BMVECs. Knockout of Lag3 in vitro prevents α-Syn PFFs from entering BMVECs, thereby reducing the abovementioned response induced by α-Syn PFFs. Deletion of endothelial cell-specific Lag3 in vivo reverses the negative effects of α-Syn PFFs on cerebral microvessels and cognitive function. In short, this study reveals the effectiveness of targeting Lag3 to block the spread of α-Syn fibrils to endothelial cells in order to improve cognition.
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Affiliation(s)
- Qingxi Zhang
- Department of NeurologyGuangdong Neuroscience InstituteGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
- Guangdong Cardiovascular InstituteGuangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhou510100China
- Guangzhou Key Laboratory of Diagnosis and Treatment for Neurodegenerative DiseasesGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
| | - Qingrui Duan
- Department of NeurologyGuangdong Neuroscience InstituteGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
- Guangzhou Key Laboratory of Diagnosis and Treatment for Neurodegenerative DiseasesGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
| | - Yuyuan Gao
- Department of NeurologyGuangdong Neuroscience InstituteGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
- Guangzhou Key Laboratory of Diagnosis and Treatment for Neurodegenerative DiseasesGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
| | - Peikun He
- Department of NeurologyGuangdong Neuroscience InstituteGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
- Guangzhou Key Laboratory of Diagnosis and Treatment for Neurodegenerative DiseasesGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
| | - Rui Huang
- Department of NeurologyGuangdong Neuroscience InstituteGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
- Guangzhou Key Laboratory of Diagnosis and Treatment for Neurodegenerative DiseasesGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
| | - Haifeng Huang
- Department of NeurologyGuangdong Neuroscience InstituteGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
- Guangzhou Key Laboratory of Diagnosis and Treatment for Neurodegenerative DiseasesGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
| | - Yanyi Li
- Department of NeurologyGuangdong Neuroscience InstituteGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
- Guangzhou Key Laboratory of Diagnosis and Treatment for Neurodegenerative DiseasesGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
| | - Guixian Ma
- Department of NeurologyGuangdong Neuroscience InstituteGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
- Guangzhou Key Laboratory of Diagnosis and Treatment for Neurodegenerative DiseasesGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
| | - Yuhu Zhang
- Department of NeurologyGuangdong Neuroscience InstituteGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
- Guangzhou Key Laboratory of Diagnosis and Treatment for Neurodegenerative DiseasesGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
| | - Kun Nie
- Department of NeurologyGuangdong Neuroscience InstituteGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
- Guangzhou Key Laboratory of Diagnosis and Treatment for Neurodegenerative DiseasesGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
| | - Lijuan Wang
- Department of NeurologyGuangdong Neuroscience InstituteGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
- Guangzhou Key Laboratory of Diagnosis and Treatment for Neurodegenerative DiseasesGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080China
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Wan L, Zhu S, Chen Z, Qiu R, Tang B, Jiang H. Multidimensional biomarkers for multiple system atrophy: an update and future directions. Transl Neurodegener 2023; 12:38. [PMID: 37501056 PMCID: PMC10375766 DOI: 10.1186/s40035-023-00370-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/11/2023] [Indexed: 07/29/2023] Open
Abstract
Multiple system atrophy (MSA) is a fatal progressive neurodegenerative disease. Biomarkers are urgently required for MSA to improve the diagnostic and prognostic accuracy in clinic and facilitate the development and monitoring of disease-modifying therapies. In recent years, significant research efforts have been made in exploring multidimensional biomarkers for MSA. However, currently few biomarkers are available in clinic. In this review, we systematically summarize the latest advances in multidimensional biomarkers for MSA, including biomarkers in fluids, tissues and gut microbiota as well as imaging biomarkers. Future directions for exploration of novel biomarkers and promotion of implementation in clinic are also discussed.
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Affiliation(s)
- Linlin Wan
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, China
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, 410008, China
- National International Collaborative Research Center for Medical Metabolomics, Central South University, Changsha, 410008, China
| | - Sudan Zhu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Zhao Chen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, 410008, China
| | - Rong Qiu
- School of Computer Science and Engineering, Central South University, Changsha, 410083, China
| | - Beisha Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, 410008, China
| | - Hong Jiang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, China.
- Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, 410013, China.
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, 410008, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, China.
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, 410008, China.
- National International Collaborative Research Center for Medical Metabolomics, Central South University, Changsha, 410008, China.
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Zheng Y, Cai H, Zhao J, Yu Z, Feng T. Alpha-Synuclein species in oral mucosa as potential biomarkers for multiple system atrophy. Front Aging Neurosci 2022; 14:1010064. [PMID: 36304930 PMCID: PMC9592697 DOI: 10.3389/fnagi.2022.1010064] [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: 08/02/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background The definitive diagnosis of Multiple system atrophy (MSA) requires the evidence of abnormal deposition of α-Synuclein (α-Syn) through brain pathology which is unable to achieve in vivo. Deposition of α-Syn is not limited to the central nervous system (CNS), but also extended to peripheral tissues. Detection of pathological α-Syn deposition in extracerebral tissues also contributes to the diagnosis of MSA. We recently reported the increased expressions of α-Syn, phosphorylated α-Synuclein at Ser129 (pS129), and α-Syn aggregates in oral mucosal cells of Parkinson’s disease (PD), which serve as potential biomarkers for PD. To date, little is known about the α-Syn expression pattern in oral mucosa of MSA which is also a synucleinopathy. Here, we intend to investigate whether abnormal α-Syn deposition occurs in oral mucosal cells of MSA, and to determine whether α-Syn, pS129, and α-Syn aggregates in oral mucosa are potential biomarkers for MSA. Methods The oral mucosal cells were collected by using cytobrush from 42 MSA patients (23 MSA-P and 19 MSA-C) and 47 age-matched healthy controls (HCs). Immunofluorescence analysis was used to investigate the presence of α-Syn, pS129, and α-Syn aggregates in the oral mucosal cells. Then, the concentrations of α-Syn species in oral mucosa samples were measured using electrochemiluminescence assays. Results Immunofluorescence images indicated elevated α-Syn, pS129, and α-Syn aggregates levels in oral mucosal cells of MSA than HCs. The concentrations of three α-Syn species were significantly higher in oral mucosal cells of MSA than HCs (α-Syn, p < 0.001; pS129, p = 0.042; α-Syn aggregates, p < 0.0001). In MSA patients, the oral mucosa α-Syn levels negatively correlated with disease duration (r = −0.398, p = 0.009). The area under curve (AUC) of receiver operating characteristic (ROC) analysis using an integrative model including age, gender, α-Syn, pS129, and α-Syn aggregates for MSA diagnosis was 0.825, with 73.8% sensitivity and 78.7% specificity. Conclusion The α-Syn levels in oral mucosal cells elevated in patients with MSA, which may be promising biomarkers for MSA.
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Affiliation(s)
- Yuanchu Zheng
- Department of Neurology, Center for Movement Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Huihui Cai
- Department of Neurology, Center for Movement Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jiajia Zhao
- Department of Neurology, Center for Movement Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhenwei Yu
- Department of Pathophysiology, Beijing Neurosurgical Institute, Beijing, China
- *Correspondence: Zhenwei Yu,
| | - Tao Feng
- Department of Neurology, Center for Movement Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Tao Feng,
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Zhang X, Wang S, Li X, Li X, Ran W, Liu C, Tian W, Yu X, Wu C, Li P, Li N, Wei Y, Wang Y, Yu S, Chen Z. Hemoglobin-binding α-synuclein levels in erythrocytes are elevated in patients with multiple system atrophy. Neurosci Lett 2022; 789:136868. [PMID: 36087813 DOI: 10.1016/j.neulet.2022.136868] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 08/24/2022] [Accepted: 09/05/2022] [Indexed: 11/29/2022]
Abstract
Previous studies have shown that α-synuclein (α-syn) accumulation in the normal aging brain is associated with a parallel increase in hemoglobin-binding α-syn (Hb-α-syn) in the brain and peripheral erythrocytes (ERCs), indicating that Hb-α-syn levels in ERCs may reflect the α-syn changes in the brain. However, if there is any change in ERC Hb-α-syn levels in disease condition is unclear. In this study, Hb-α-syn levels in ERCs from 149 Patients with multiple system atrophy (MSA) and 149 healthy controls (HCs) were measured by enzyme linked immunosorbent assay (ELISA). The results showed that Hb-α-syn levels in ERCs were significantly increased in MSA patients in comparison with those in HCs (777.84 ± 240.82 ng/mg vs 508.84 ± 162.57 ng/mg, P < 0.001). Receiver operating characteristic curve (ROC) indicated that increased Hb-α-syn in ERCs could discriminate MSA patients from HCs, with a sensitivity of 71.8%, a specificity of 80.5%, and an area under the curve (AUC) of 0.837. The positive and negative predictive values at a cut-off value of 616.12 ng/mg were 78.7% and 74.1%, respectively. However, the increase in Hb-α-syn levels did not show any association with the age of onset and consultation, disease duration, and UMSARS (I-IV) score. This pilot study suggests that ERC Hb-α-syn is increased in MSA patients and could evaluate α-syn accumulation in the brain of patients.
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Affiliation(s)
- Xinning Zhang
- Department of Neurology, Dongfang Hospital, Beijing University of Chinese Medicine, No. 6 Fangxingyuan 1st Block, Fengtai District, Beijing 100078, China China
| | - Sushi Wang
- Department of Neurology, Dongfang Hospital, Beijing University of Chinese Medicine, No. 6 Fangxingyuan 1st Block, Fengtai District, Beijing 100078, China China
| | - Xuran Li
- Department of Neurobiology, Xuanwu Hospital of Capital Medical University, 45 Changchun Street, Xicheng District, Beijing 100053, China
| | - Xin Li
- Department of Neurobiology, Xuanwu Hospital of Capital Medical University, 45 Changchun Street, Xicheng District, Beijing 100053, China
| | - Weizheng Ran
- Department of Acupuncture, General Hospital of the People's Liberation Army, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
| | - Chengwei Liu
- Affiliated Hospital of Guilin Medical University, No. 15, Lequn Road, Guilin, Guangxi 541001, China
| | - Wenyang Tian
- China Academy of Chinese Medical Sciences Guang'anmen Hospital, No. 5, North Line Pavilion, Xicheng District, Beijing 100053, China
| | - Xiaohan Yu
- Beijing Parkcare Technology Co Ltd, No. 18, Xihuan South Road, Beijing Economic and Technological Development Zone, Beijing 100176, China
| | - Chunlei Wu
- Beijing Parkcare Technology Co Ltd, No. 18, Xihuan South Road, Beijing Economic and Technological Development Zone, Beijing 100176, China
| | - Pengjie Li
- Beijing Parkcare Technology Co Ltd, No. 18, Xihuan South Road, Beijing Economic and Technological Development Zone, Beijing 100176, China
| | - Nannan Li
- Department of Neurology, Dongfang Hospital, Beijing University of Chinese Medicine, No. 6 Fangxingyuan 1st Block, Fengtai District, Beijing 100078, China China
| | - Yifo Wei
- Department of Neurology, Xi'an Traditional Chinese Medicine Hospital, No. 69, Fengcheng Eighth Road, Xi'an, Shaanxi 710021, China
| | - Yao Wang
- Department of Neurology, Dongfang Hospital, Beijing University of Chinese Medicine, No. 6 Fangxingyuan 1st Block, Fengtai District, Beijing 100078, China China
| | - Shun Yu
- Department of Neurobiology, Xuanwu Hospital of Capital Medical University, 45 Changchun Street, Xicheng District, Beijing 100053, China; Beijing Parkcare Technology Co Ltd, No. 18, Xihuan South Road, Beijing Economic and Technological Development Zone, Beijing 100176, China.
| | - Zhigang Chen
- Department of Neurology, Dongfang Hospital, Beijing University of Chinese Medicine, No. 6 Fangxingyuan 1st Block, Fengtai District, Beijing 100078, China China.
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Diagnosing multiple system atrophy at the prodromal stage. Clin Auton Res 2020; 30:197-205. [PMID: 32232688 DOI: 10.1007/s10286-020-00682-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 03/16/2020] [Indexed: 02/07/2023]
Abstract
Identifying individuals at the earliest disease stage becomes crucial as we aim to develop disease-modifying treatments for neurodegenerative disorders. Prodromal diagnostic criteria were recently developed for Parkinson's disease (PD) and are forthcoming for dementia with Lewy bodies (DLB). The latest 2008 version of diagnostic criteria for multiple system atrophy (MSA) have improved diagnostic accuracy in early disease stages compared to previous criteria, but we do not yet have formal criteria for prodromal MSA. Building on similar approaches as for PD and DLB, we can identify features on history-taking, clinical examination, and ancillary clinical testing that can predict the likelihood of an individual developing MSA, while also distinguishing it from PD and DLB. The main clinical hallmarks of MSA are REM sleep behavior disorder (RBD) and autonomic dysfunction (particularly orthostatic hypotension and urogenital symptoms), and may be the primary means by which patients with potential prodromal MSA are identified. Preserved olfaction, absence of significant cognitive deficits, urinary retention, and respiratory symptoms such as stridor and respiratory insufficiency can be clinical features that help distinguish MSA from PD and DLB. Finally, ancillary test results including neuroimaging as well as serological and cerebrospinal fluid (CSF) biomarkers may lend further weight to quantifying the likelihood of phenoconversion into MSA. For prodromal criteria, the primary challenges are MSA's lower prevalence, shorter lead time to diagnosis, and strong overlap with other synucleinopathies. Future prodromal criteria may need to first embed the diagnosis into a general umbrella of prodromal alpha-synucleinopathies, followed by identification of features that suggest prodromal MSA as the specific cause.
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Diagnostic utility of fluid biomarkers in multiple system atrophy: a systematic review and meta-analysis. J Neurol 2020; 268:2703-2712. [PMID: 32162061 DOI: 10.1007/s00415-020-09781-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 03/02/2020] [Accepted: 03/03/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Multiple system atrophy (MSA) is an adult onset, fatal neurodegenerative disease. However, no reliable biomarker is currently available to guide clinical diagnosis and help to determine the prognosis. Thus, a comprehensive meta-analysis is warranted to determine effective biomarkers for MSA and provide useful guidance for clinical diagnosis. METHODS A comprehensive literature search was made of the PubMed, Embase, Cochrane and Web of Science databases for relevant clinical trial articles for 1984-2019. Two review authors examined the full-text records, respectively, and determined which studies met the inclusion criteria. We estimated the mean difference, standard deviation and 95% confidence intervals. RESULTS A total of 28 studies and 11 biomarkers were included in our analysis. Several biomarkers were found to be useful to distinguish MSA patients from healthy controls, including the reduction of phosphorylated tau, α-synuclein (α-syn), 42-amino-acid form of Aβ and total tau (t-tau), the elevation of neurofilament light-chain protein (NFL) in cerebrospinal fluid, the elevation of uric acid and reduction of homocysteine and coenzyme Q10 in plasma. Importantly, α-syn, NFL and t-tau could be used to distinguish MSA from Parkinson's disease (PD), indicating that these three biomarkers could be useful biomarkers in MSA diagnosis. CONCLUSION The findings of our meta-analysis demonstrated diagnostic biomarkers for MSA. Moreover, three biomarkers could be used in differential diagnosis of MSA and PD. The results could be helpful for the early diagnosis of MSA and the accuracy of MSA diagnosis.
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Folke J, Rydbirk R, Løkkegaard A, Salvesen L, Hejl AM, Starhof C, Bech S, Winge K, Christensen S, Pedersen LØ, Aznar S, Pakkenberg B, Brudek T. Distinct Autoimmune Anti-α-Synuclein Antibody Patterns in Multiple System Atrophy and Parkinson's Disease. Front Immunol 2019; 10:2253. [PMID: 31616427 PMCID: PMC6769034 DOI: 10.3389/fimmu.2019.02253] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 09/05/2019] [Indexed: 11/16/2022] Open
Abstract
Aggregation of alpha-synuclein (α-syn) is considered to be the major pathological hallmark and driving force of Multiple System Atrophy (MSA) and Parkinson's disease (PD). Immune dysfunctions have been associated with both MSA and PD and recently we reported that the levels of natural occurring autoantibodies (NAbs) with high-affinity/avidity toward α-synuclein are reduced in MSA and PD patients. Here, we aimed to evaluate the plasma immunoglobulin (Ig) composition binding α-syn and other amyloidogenic neuropathological proteins, and to correlate them with disease severity and duration in MSA and PD patients. All participants were recruited from a single neurological unit and the plasma samples were stored for later research at the Bispebjerg Movement Disorder Biobank. All patients were diagnosed according to current consensus criteria. Using multiple variable linear regression analyses, we observed higher levels of anti-α-syn IgG1 and IgG3 NAbs in MSA vs. PD, higher levels of anti-α-syn IgG2 NAbs in PD compared to controls, whereas anti-α-syn IgG4 NAbs were reduced in PD compared to MSA and controls. Anti-α-syn IgM levels were decreased in both MSA and PD. Further our data supported that MSA patients' immune system was affected with reduced IgG1 and IgM global levels compared to PD and controls, with further reduced global IgG2 levels compared to PD. These results suggest distinct autoimmune patterns in MSA and PD. These findings suggest a specific autoimmune physiological mechanism involving responses toward α-syn, differing in neurodegenerative disease with overlapping α-syn pathology.
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Affiliation(s)
- Jonas Folke
- Research Laboratory for Stereology and Neuroscience, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Rasmus Rydbirk
- Research Laboratory for Stereology and Neuroscience, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Annemette Løkkegaard
- Department of Neurology, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Lisette Salvesen
- Department of Neurology, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Anne-Mette Hejl
- Department of Neurology, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Charlotte Starhof
- Department of Neurology, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Sára Bech
- Department of Neurology, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Kristian Winge
- Novo Nordisk Foundation, Hellerup, Denmark.,Bispebjerg Movement Disorders Biobank, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
| | | | - Lars Østergaard Pedersen
- Department of Immunology and Microbiology, Faculty of Health, University of Copenhagen, Copenhagen, Denmark
| | - Susana Aznar
- Research Laboratory for Stereology and Neuroscience, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Bente Pakkenberg
- Research Laboratory for Stereology and Neuroscience, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health, University of Copenhagen, Copenhagen, Denmark
| | - Tomasz Brudek
- Research Laboratory for Stereology and Neuroscience, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
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Alpha-synuclein in erythrocyte membrane of patients with multiple system atrophy: A pilot study. Parkinsonism Relat Disord 2019; 60:105-110. [DOI: 10.1016/j.parkreldis.2018.09.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 09/05/2018] [Accepted: 09/10/2018] [Indexed: 11/21/2022]
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Cao Z, Wu Y, Liu G, Jiang Y, Wang X, Wang Z, Feng T. α-Synuclein in salivary extracellular vesicles as a potential biomarker of Parkinson's disease. Neurosci Lett 2018; 696:114-120. [PMID: 30579996 DOI: 10.1016/j.neulet.2018.12.030] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/19/2018] [Accepted: 12/19/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Detection of α-synuclein (α-syn) in biological fluids such as saliva may serve as potential biomarker of PD. α-syn pertaining to extracellular vesicles (EVs) has been recently studied in plasma, but not in other biological fluids such as saliva. AIM 1) To investigate the presence of exosomes in PD saliva; 2) to explore the value of α-syn in salivary EVs as potential biomarker in PD. METHODS Saliva samples were obtained from 74 PD and 60 healthy controls (HCs). The EVs were extracted from saliva by XYCQ EV Enrichment KIT. Western blot and Nanosight 300 were used to validate the existence of exosomes in EVs and to analyze the size of salivary EVs. Salivary EVs α-syn levels, including total α-syn (α-synTotal), oligomeric α-syn (α-synOlig) and phosphorylated-ser129 α-syn (α-synPS129), were measured by Electrochemiluminescence (ECL) assays. Diagnostic value and clinical relevance of salivary EVs α-syn were assessed by Receiver Operator Characteristic (ROC) curve and Spearman correlation. RESULTS Alix and CD9 positive EVs, representing the presence of exosomes, was detected in PD salivary samples. Size of salivary EVs was about 30-400 nm. The levels of α-synOlig and α-synOlig/α-synTotal in the salivary EVs were higher in PD than in HCs (10.39 ± 1.46 pg/ng vs.1.37 ± 0.24 pg/ng, p<0.001;1.70 ± 0.52 pg/ng vs.0.67 ± 0.26 pg/ng, p<0.001). There was no significant difference in α-synTotal、α-synPS129、 α-synPS129/α-synTotal ratio between PD and HCs (P = 0.723, 0.634, 0.734, respectively). α-synOlig 2.05 pg/ng distinguished PD from HCs with sensitivity 92% and specificity 86%; α-synOlig /α-synTotal 0.18 pg/ng differentiated PD from HCs with sensitivity 81% and specificity 71%. No significant correlation between salivary EVs α-synOlig, α-synOlig/α-synTotal and disease severity was found. CONCLUSIONS Exosomes are present in PD saliva. The α-synOlig and α-synOlig/α-synTotal ratio in salivary EVs may serve as potential diagnostic biomarkers for PD.
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Affiliation(s)
- Zhentang Cao
- Center for Neurodegenerative Disease, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yufeng Wu
- Clinical Laboratory, Peking University Third Hospital, Peking University, Beijing, China; Department of Pathology, Peking University School of Basic Medical Sciences, Peking University, Beijing, China; Beijing Key Laboratory of Research and Transformation on Neurodegenerative Diseases Biomarkers, Beijing, China
| | - Genliang Liu
- Center for Neurodegenerative Disease, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Ying Jiang
- Center for Neurodegenerative Disease, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xuemei Wang
- Center for Neurodegenerative Disease, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Zhan Wang
- Center for Neurodegenerative Disease, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Tao Feng
- Center for Neurodegenerative Disease, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Parkinson's Disease Center, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China.
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Palma JA, Norcliffe-Kaufmann L, Kaufmann H. Diagnosis of multiple system atrophy. Auton Neurosci 2018; 211:15-25. [PMID: 29111419 PMCID: PMC5869112 DOI: 10.1016/j.autneu.2017.10.007] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/19/2017] [Accepted: 10/20/2017] [Indexed: 02/08/2023]
Abstract
Multiple system atrophy (MSA) may be difficult to distinguish clinically from other disorders, particularly in the early stages of the disease. An autonomic-only presentation can be indistinguishable from pure autonomic failure. Patients presenting with parkinsonism may be misdiagnosed as having Parkinson disease. Patients presenting with the cerebellar phenotype of MSA can mimic other adult-onset ataxias due to alcohol, chemotherapeutic agents, lead, lithium, and toluene, or vitamin E deficiency, as well as paraneoplastic, autoimmune, or genetic ataxias. A careful medical history and meticulous neurological examination remain the cornerstone for the accurate diagnosis of MSA. Ancillary investigations are helpful to support the diagnosis, rule out potential mimics, and define therapeutic strategies. This review summarizes diagnostic investigations useful in the differential diagnosis of patients with suspected MSA. Currently used techniques include structural and functional brain imaging, cardiac sympathetic imaging, cardiovascular autonomic testing, olfactory testing, sleep study, urological evaluation, and dysphagia and cognitive assessments. Despite advances in the diagnostic tools for MSA in recent years and the availability of consensus criteria for clinical diagnosis, the diagnostic accuracy of MSA remains sub-optimal. As other diagnostic tools emerge, including skin biopsy, retinal biomarkers, blood and cerebrospinal fluid biomarkers, and advanced genetic testing, a more accurate and earlier recognition of MSA should be possible, even in the prodromal stages. This has important implications as misdiagnosis can result in inappropriate treatment, patient and family distress, and erroneous eligibility for clinical trials of disease-modifying drugs.
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Affiliation(s)
- Jose-Alberto Palma
- Department of Neurology, Dysautonomia Center, New York University School of Medicine, NY, USA
| | - Lucy Norcliffe-Kaufmann
- Department of Neurology, Dysautonomia Center, New York University School of Medicine, NY, USA
| | - Horacio Kaufmann
- Department of Neurology, Dysautonomia Center, New York University School of Medicine, NY, USA.
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Zhou X, Wang C, Ding D, Chen Z, Peng Y, Peng H, Hou X, Wang P, Hou X, Ye W, Li T, Yang H, Qiu R, Xia K, Sequeiros J, Tang B, Jiang H. Analysis of (CAG) n expansion in ATXN1, ATXN2 and ATXN3 in Chinese patients with multiple system atrophy. Sci Rep 2018; 8:3889. [PMID: 29497168 PMCID: PMC5832826 DOI: 10.1038/s41598-018-22290-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 02/20/2018] [Indexed: 01/09/2023] Open
Abstract
Multiple system atrophy (MSA) is a complex and multifactorial neurodegenerative disease, and its pathogenesis remains uncertain. Patients with MSA or spinocerebellar ataxia (SCA) show overlapping clinical phenotypes. Previous studies have reported that intermediate or long CAG expansions in SCA genes have been associated with other neurodegenerative disease. In this study, we screened for the number of CAG repeats in ATXN1, 2 and 3 in 200 patients with MSA and 314 healthy controls to evaluate possible associations between (CAG)n in these three polyQ-related genes and MSA. Our findings indicated that longer repeat lengths in ATXN2 were associated with increased risk for MSA in Chinese individuals. No relationship was observed between CAG repeat length in the three examined genes and age at onset (AO) of MSA.
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Affiliation(s)
- X Zhou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, P. R. China
| | - C Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, P. R. China
| | - D Ding
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, P. R. China
| | - Z Chen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, P. R. China
| | - Y Peng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, P. R. China
| | - H Peng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, P. R. China
| | - X Hou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, P. R. China
| | - P Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, P. R. China
| | - X Hou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, P. R. China
| | - W Ye
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, P. R. China
| | - T Li
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, P. R. China
| | - H Yang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, P. R. China
| | - R Qiu
- School of Information Science and Engineering, Central South University, Changsha, Hunan, 410083, P. R. China
| | - K Xia
- Laboratory of Medical Genetics, Central South University, Changsha, Hunan, 410078, P. R. China
| | - J Sequeiros
- IBMC - Institute for Molecular and Cell Biology, i3S - Instituto de Investigação e Inovação na Saúde; and ICBAS; Univ. Porto, Porto, Portugal
| | - B Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, P. R. China.,Laboratory of Medical Genetics, Central South University, Changsha, Hunan, 410078, P. R. China.,Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, Hunan, 410008, P. R. China.,National Clinical Research Center for Geriatric Disorders, Changsha, Hunan, 410078, China
| | - H Jiang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, P. R. China. .,Laboratory of Medical Genetics, Central South University, Changsha, Hunan, 410078, P. R. China. .,Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, Hunan, 410008, P. R. China.
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12
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Yang F, Li WJ, Huang XS. Alpha-synuclein levels in patients with multiple system atrophy: a meta-analysis. Int J Neurosci 2018; 128:477-486. [PMID: 29053035 DOI: 10.1080/00207454.2017.1394851] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE This study evaluates the relationship between multiple system atrophy and α-synuclein levels in the cerebrospinal fluid, plasma and neural tissue. METHOD Literature search for relevant research articles was undertaken in electronic databases and study selection was based on a priori eligibility criteria. Random-effects meta-analyses of standardized mean differences in α-synuclein levels between multiple system atrophy patients and normal controls were conducted to obtain the overall and subgroup effect sizes. Meta-regression analyses were performed to evaluate the effect of age, gender and disease severity on standardized mean differences. RESULTS Data were obtained from 11 studies involving 378 multiple system atrophy patients and 637 healthy controls (age: multiple system atrophy patients 64.14 [95% confidence interval 62.05, 66.23] years; controls 64.16 [60.06, 68.25] years; disease duration: 44.41 [26.44, 62.38] months). Cerebrospinal fluid α-synuclein levels were significantly lower in multiple system atrophy patients than in controls but in plasma and neural tissue, α-synuclein levels were significantly higher in multiple system atrophy patients (standardized mean difference: -0.99 [-1.65, -0.32]; p = 0.001). Percentage of male multiple system atrophy patients was significantly positively associated with the standardized mean differences of cerebrospinal fluid α-synuclein levels (p = 0.029) whereas the percentage of healthy males was not associated with the standardized mean differences of cerebrospinal fluid α-synuclein levels (p = 0.920). CONCLUSION In multiple system atrophy patients, α-synuclein levels were significantly lower in the cerebrospinal fluid and were positively associated with the male gender.
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Affiliation(s)
- Fei Yang
- a Department of Neurology , Chinese PLA General Hospital , Beijing , China
| | - Wan-Jun Li
- a Department of Neurology , Chinese PLA General Hospital , Beijing , China
| | - Xu-Sheng Huang
- a Department of Neurology , Chinese PLA General Hospital , Beijing , China
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13
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Jellinger KA. Potential clinical utility of multiple system atrophy biomarkers. Expert Rev Neurother 2017; 17:1189-1208. [DOI: 10.1080/14737175.2017.1392239] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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14
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Prediction of orthostatic hypotension in multiple system atrophy and Parkinson disease. Sci Rep 2016; 6:21649. [PMID: 26867507 PMCID: PMC4751507 DOI: 10.1038/srep21649] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 01/25/2016] [Indexed: 11/22/2022] Open
Abstract
Orthostatic hypotension (OH) is common in multiple system atrophy (MSA) and Parkinson disease (PD), generally assessed through a lying-to-standing orthostatic test. However, standing blood pressure may not be available due to orthostatic intolerance or immobilization for such patients. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were successively measured in supine, sitting, and standing positions in patients with MSA and PD. Receiver operating characteristic analysis was used to evaluate diagnostic performance of the drops of sitting SBP or DBP. OH and severe OH were respectively regarded as “gold standard”. The drops of SBP in standing position were associated with increased disease severity for MSA and correlated with age for PD. In MSA group, drops in sitting SBP ≥ 14 mmHg or DBP ≥ 6 mmHg had highest validity for prediction of OH, and drops in sitting SBP ≥ 18 mmHg or DBP ≥ 8 mmHg for severe OH. In PD group, drops in sitting SBP ≥ 10 mmHg or DBP ≥ 6 mmHg had highest validity for prediction of OH. The lying-to-sitting orthostatic test is an alternative method for detection of OH in MSA and PD, especially when standing BP could not be validly measured due to various reasons.
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Laurens B, Constantinescu R, Freeman R, Gerhard A, Jellinger K, Jeromin A, Krismer F, Mollenhauer B, Schlossmacher MG, Shaw LM, Verbeek MM, Wenning GK, Winge K, Zhang J, Meissner WG. Fluid biomarkers in multiple system atrophy: A review of the MSA Biomarker Initiative. Neurobiol Dis 2015; 80:29-41. [PMID: 25982836 DOI: 10.1016/j.nbd.2015.05.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 04/29/2015] [Accepted: 05/08/2015] [Indexed: 01/10/2023] Open
Abstract
Despite growing research efforts, no reliable biomarker currently exists for the diagnosis and prognosis of multiple system atrophy (MSA). Such biomarkers are urgently needed to improve diagnostic accuracy, prognostic guidance and also to serve as efficacy measures or surrogates of target engagement for future clinical trials. We here review candidate fluid biomarkers for MSA and provide considerations for further developments and harmonization of standard operating procedures. A PubMed search was performed until April 24, 2015 to review the literature with regard to candidate blood and cerebrospinal fluid (CSF) biomarkers for MSA. Abstracts of 1760 studies were retrieved and screened for eligibility. The final list included 60 studies assessing fluid biomarkers in patients with MSA. Most studies have focused on alpha-synuclein, markers of axonal degeneration or catecholamines. Their results suggest that combining several CSF fluid biomarkers may be more successful than using single markers, at least for the diagnosis. Currently, the clinically most useful markers may comprise a combination of the light chain of neurofilament (which is consistently elevated in MSA compared to controls and Parkinson's disease), metabolites of the catecholamine pathway and proteins such as α-synuclein, DJ-1 and total-tau. Beyond future efforts in biomarker discovery, the harmonization of standard operating procedures will be crucial for future success.
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Affiliation(s)
- Brice Laurens
- Service de Neurologie, CHU de Bordeaux, F-33076 Bordeaux, France
| | - Radu Constantinescu
- Department of Neurology, Sahlgrenska University Hospital, 413 45 Göteborg, Sweden
| | - Roy Freeman
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston
| | - Alexander Gerhard
- Institute of Brain Behaviour and Mental Heath, University of Manchester, UK
| | - Kurt Jellinger
- Institute of Clinical Neurobiology, Kenyongasse 18, A-1070 Vienna, Austria
| | | | - Florian Krismer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Brit Mollenhauer
- Paracelsus-Elena-Klinik, Kassel, Germany and Department of Neuropathology, University Medical Center Goettingen, Germany
| | - Michael G Schlossmacher
- Program in Neuroscience, The Ottawa Hospital, University of Ottawa Brain and Mind Research Institute, Ottawa, Ontario, Canada
| | - Leslie M Shaw
- Perelman School of Medicine, University of Pennsylvania
| | - Marcel M Verbeek
- Department of Neurology, Parkinson Center, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Laboratory Medicine, Parkinson Center, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Gregor K Wenning
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Kristian Winge
- Department of Neurology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Jing Zhang
- Department of Pathology, University of WA, Seattle, USA
| | - Wassilios G Meissner
- Service de Neurologie, CHU de Bordeaux, F-33076 Bordeaux, France; Centre de référence atrophie multisystématisée, CHU de Bordeaux, F-33076 Bordeaux, France; Univ. de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, F-33076 Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293, F-33076 Bordeaux, France.
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16
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Koehler NKU, Stransky E, Meyer M, Gaertner S, Shing M, Schnaidt M, Celej MS, Jovin TM, Leyhe T, Laske C, Batra A, Buchkremer G, Fallgatter AJ, Wernet D, Richartz-Salzburger E. Alpha-synuclein levels in blood plasma decline with healthy aging. PLoS One 2015; 10:e0123444. [PMID: 25844871 PMCID: PMC4386828 DOI: 10.1371/journal.pone.0123444] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 03/03/2015] [Indexed: 11/18/2022] Open
Abstract
There is unequivocal evidence that alpha-synuclein plays a pivotal pathophysiological role in neurodegenerative diseases, and in particular in synucleinopathies. These disorders present with a variable extent of cognitive impairment and alpha-synuclein is being explored as a biomarker in CSF, blood serum and plasma. Considering key events of aging that include proteostasis, alpha-synuclein may not only be useful as a marker for differential diagnosis but also for aging per se. To explore this hypothesis, we developed a highly specific ELISA to measure alpha-synuclein. In healthy males plasma alpha-synuclein levels correlated strongly with age, revealing much lower concentrations in older (avg. 58.1 years) compared to younger (avg. 27.6 years) individuals. This difference between the age groups was enhanced after acidification of the plasmas (p<0.0001), possibly reflecting a decrease of alpha-synuclein-antibody complexes or chaperone activity in older individuals. Our results support the concept that alpha-synuclein homeostasis may be impaired early on, possibly due to disturbance of the proteostasis network, a key component of healthy aging. Thus, alpha-synuclein may be a novel biomarker of aging, a factor that should be considered when analyzing its presence in biological specimens.
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Affiliation(s)
- Niklas K U Koehler
- Department of Psychiatry and Psychotherapy, Eberhard-Karls-University Tübingen, Calwerstr. 14, 72076 Tübingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Otfried-Müller-Strasse 27, 72076 Tübingen, Germany
| | - Elke Stransky
- Department of Psychiatry and Psychotherapy, Eberhard-Karls-University Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - Mirjam Meyer
- Department of Psychiatry and Psychotherapy, Eberhard-Karls-University Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - Susanne Gaertner
- Department of Psychiatry and Psychotherapy, Eberhard-Karls-University Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - Mona Shing
- Department of Psychiatry and Psychotherapy, Eberhard-Karls-University Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - Martina Schnaidt
- Zentrum für Klinische Transfusionsmedizin, Otfried-Müller-Strasse 4, 72076 Tübingen, Germany
| | - Maria S Celej
- Laboratory for Cellular Dynamics, Max-Planck-Institute for Biophysical Chemistry, Am Faßberg 11, 37077 Göttingen, Germany; Department of Biological Chemistry (CIQUIBIC, CONICET), School of Chemical Sciences, National University of Córdoba, Haya de la Torrey Medina Allende, Ciudad Universitaria, X5000HUA Córdoba, Argentina
| | - Thomas M Jovin
- Laboratory for Cellular Dynamics, Max-Planck-Institute for Biophysical Chemistry, Am Faßberg 11, 37077 Göttingen, Germany
| | - Thomas Leyhe
- Department of Psychiatry and Psychotherapy, Eberhard-Karls-University Tübingen, Calwerstr. 14, 72076 Tübingen, Germany; Center of Old Age Psychiatry, Psychiatric University Hospital, Wilhelm Klein-Strasse 27, CH-4012 Basel, Switzerland
| | - Christoph Laske
- Department of Psychiatry and Psychotherapy, Eberhard-Karls-University Tübingen, Calwerstr. 14, 72076 Tübingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Otfried-Müller-Strasse 27, 72076 Tübingen, Germany
| | - Anil Batra
- Department of Psychiatry and Psychotherapy, Eberhard-Karls-University Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - Gerhard Buchkremer
- Department of Psychiatry and Psychotherapy, Eberhard-Karls-University Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, Eberhard-Karls-University Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - Dorothee Wernet
- Zentrum für Klinische Transfusionsmedizin, Otfried-Müller-Strasse 4, 72076 Tübingen, Germany
| | - Elke Richartz-Salzburger
- Department of Psychiatry and Psychotherapy, Eberhard-Karls-University Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
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Watanabe H, Yoshida M, Sobue G. [Clinical picture and diagnostic criteria of multiple system atrophy]. Rinsho Shinkeigaku 2015; 54:963-5. [PMID: 25672682 DOI: 10.5692/clinicalneurol.54.963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In 2013, European MSA Study Group demonstrated the prospective natural history of MSA. This study was greatly useful for better patients' management and future development of disease-modifying therapy. Although the diagnosis of early symptomatic stage is also an important factor for successful outcome of disease-modifying therapy, current diagnostic criteria for MSA, which has focused on the combination of motor and autonomic manifestations cannot diagnose MSA patients showing isolated autonomic failure in the early course of illness. We presented four premotor MSA patients who had sudden death prior to fulfilling the diagnostic criteria. 4 cases had very mild OPC and SN pathology, but significant autonomic system involvement including the intermediolateral nucleus, Onuf's nucleus, and medullary autonomic nucleus. Contrary, Petrovic et al reported four pathologically proven MSA patients with disease duration of 15 years or more. All patients presented isolated parkinsonism for a long time and mean duration from onset to dysautonomia was 9 years. Novel diagnostic biomarkers, which have a potential for evaluation of the component of glial cytoplasmic inclusion such as alpha-synuclein radiotracer and serum and CSF alpha-synuclein levels may be a key way to support the diagnosis of patients at the stage of "mono system atrophy".
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18
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Sun Z, Xiang X, Tang B, Chen Z, Peng H, Xia K, Jiang H. SNP rs11931074 of the SNCA gene may not be associated with multiple system atrophy in Chinese population. Int J Neurosci 2015; 125:612-5. [PMID: 25427997 DOI: 10.3109/00207454.2014.990013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Multiple system atrophy (MSA) is a progressive neurodegenerative disorder characterized by poorly levodopa-responsive parkinsonism, cerebellar ataxia, and autonomic dysfunction. Pathogenic mechanisms remain obscure, but the neuropathological hallmark is the presence of α-synuclein-positive glial cytoplasmic inclusions. Previous studies suggested that a single nucleotide polymorphism (SNP), rs11931074, in the α-synuclein gene, SNCA, had highly significant association with an increased risk of the development of MSA in the Caucasian subjects. In contrast, a Korean study failed to identify an association with disease risk. METHODS To study the effect of rs11931074 on MSA risk in a Chinese population, we conducted a case-control study and genotyped SNP rs11931074 by Sanger sequencing in 96 Chinese patients with MSA and 120 healthy controls. Moreover, we performed a meta-analysis on the topic. RESULTS There was no statistical difference in genotypes or allele frequencies of SNP rs11931074 between MSA and control groups in our cohort. The results of meta-analysis showed that the risk allele T of rs11931074 was associated with MSA (pooled odds ratio = 1.26, 95% confidence interval = 1.07-1.49, P = 0.006). CONCLUSIONS Despite a positive result of the meta-analysis, the significant difference in frequency of allele T of rs11931074 between Asian and Caucasian subjects indicates that population heterogeneity at rs11931074 may exist.
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Affiliation(s)
- ZhanFang Sun
- 1Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, P. R. China
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