1
|
Gérard T, Colmant L, Malotaux V, Salman Y, Huyghe L, Quenon L, Dricot L, Ivanoiu A, Lhommel R, Hanseeuw B. The spatial extent of tauopathy on [ 18F]MK-6240 tau PET shows stronger association with cognitive performances than the standard uptake value ratio in Alzheimer's disease. Eur J Nucl Med Mol Imaging 2024; 51:1662-1674. [PMID: 38228971 PMCID: PMC11043108 DOI: 10.1007/s00259-024-06603-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/04/2024] [Indexed: 01/18/2024]
Abstract
PURPOSE [18F]MK-6240, a second-generation tau PET tracer, is increasingly used for the detection and the quantification of in vivo cerebral tauopathy in Alzheimer's disease (AD). Given that neurological symptoms are better explained by the topography rather than by the nature of brain lesions, our study aimed to evaluate whether cognitive impairment would be more closely associated with the spatial extent than with the intensity of tau-PET signal, as measured by the standard uptake value ratio (SUVr). METHODS [18F]MK6240 tau-PET data from 82 participants in the AD spectrum were quantified in three different brain regions (Braak ≤ 2, Braak ≤ 4, and Braak ≤ 6) using SUVr and the extent of tauopathy (EOT, percentage of voxels with SUVr ≥ 1.3). PET data were first compared between diagnostic categories, and ROC curves were computed to evaluate sensitivity and specificity. PET data were then correlated to cognitive performances and cerebrospinal fluid (CSF) tau values. RESULTS The EOT in the Braak ≤ 2 region provided the highest diagnostic accuracies, distinguishing between amyloid-negative and positive clinically unimpaired individuals (threshold = 9%, sensitivity = 79%, specificity = 82%) as well as between prodromal AD and preclinical AD (threshold = 38%, sensitivity = 81%, specificity = 93%). The EOT better correlated with cognition than SUVr (∆R2 + 0.08-0.09) with the best correlation observed for EOT in the Braak ≤ 4 region (R2 = 0.64). Cognitive performances were more closely associated with PET metrics than with CSF values. CONCLUSIONS Quantifying [18F]MK-6240 tau PET in terms of EOT rather than SUVr significantly increases the correlation with cognitive performances. Quantification in the mesiotemporal lobe is the most useful to diagnose preclinical AD or prodromal AD.
Collapse
Affiliation(s)
- Thomas Gérard
- Nuclear Medicine Department, Cliniques Universitaires Saint Luc, Brussels, Belgium.
- Institute of Neurosciences, Université Catholique de Louvain, Brussels, Belgium.
| | - Lise Colmant
- Institute of Neurosciences, Université Catholique de Louvain, Brussels, Belgium
- Neurology Department, Cliniques Universitaires Saint Luc, Brussels, Belgium
| | - Vincent Malotaux
- Institute of Neurosciences, Université Catholique de Louvain, Brussels, Belgium
| | - Yasmine Salman
- Institute of Neurosciences, Université Catholique de Louvain, Brussels, Belgium
| | - Lara Huyghe
- Institute of Neurosciences, Université Catholique de Louvain, Brussels, Belgium
| | - Lisa Quenon
- Institute of Neurosciences, Université Catholique de Louvain, Brussels, Belgium
- Neurology Department, Cliniques Universitaires Saint Luc, Brussels, Belgium
| | - Laurence Dricot
- Institute of Neurosciences, Université Catholique de Louvain, Brussels, Belgium
| | - Adrian Ivanoiu
- Institute of Neurosciences, Université Catholique de Louvain, Brussels, Belgium
- Neurology Department, Cliniques Universitaires Saint Luc, Brussels, Belgium
| | - Renaud Lhommel
- Nuclear Medicine Department, Cliniques Universitaires Saint Luc, Brussels, Belgium
- Institute of Neurosciences, Université Catholique de Louvain, Brussels, Belgium
| | - Bernard Hanseeuw
- Institute of Neurosciences, Université Catholique de Louvain, Brussels, Belgium
- Neurology Department, Cliniques Universitaires Saint Luc, Brussels, Belgium
- WELBIO Department, WEL Research Institute, Avenue Pasteur, 6, 1300, Wavre, Belgium
- Department of Radiology, Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
2
|
Hernández‐Lorenzo L, Gil‐Moreno MJ, Ortega‐Madueño I, Cárdenas MC, Diez‐Cirarda M, Delgado‐Álvarez A, Palacios‐Sarmiento M, Matias‐Guiu J, Corrochano S, Ayala JL, Matias‐Guiu JA. A data-driven approach to complement the A/T/(N) classification system using CSF biomarkers. CNS Neurosci Ther 2024; 30:e14382. [PMID: 37501389 PMCID: PMC10848077 DOI: 10.1111/cns.14382] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/13/2023] [Accepted: 07/15/2023] [Indexed: 07/29/2023] Open
Abstract
AIMS The AT(N) classification system not only improved the biological characterization of Alzheimer's disease (AD) but also raised challenges for its clinical application. Unbiased, data-driven techniques such as clustering may help optimize it, rendering informative categories on biomarkers' values. METHODS We compared the diagnostic and prognostic abilities of CSF biomarkers clustering results against their AT(N) classification. We studied clinical (patients from our center) and research (Alzheimer's Disease Neuroimaging Initiative) cohorts. The studied CSF biomarkers included Aβ(1-42), Aβ(1-42)/Aβ(1-40) ratio, tTau, and pTau. RESULTS The optimal solution yielded three clusters in both cohorts, significantly different in diagnosis, AT(N) classification, values distribution, and survival. We defined these three CSF groups as (i) non-defined or unrelated to AD, (ii) early stages and/or more delayed risk of conversion to dementia, and (iii) more severe cognitive impairment subjects with faster progression to dementia. CONCLUSION We propose this data-driven three-group classification as a meaningful and straightforward approach to evaluating the risk of conversion to dementia, complementary to the AT(N) system classification.
Collapse
Affiliation(s)
- Laura Hernández‐Lorenzo
- Department of NeurologySan Carlos Research Institute (IdSSC), Hospital Clínico San CarlosMadridSpain
- Department of Computer Architecture and Automation, Computer Science FacultyComplutense University of MadridMadridSpain
| | - Maria José Gil‐Moreno
- Department of NeurologySan Carlos Research Institute (IdSSC), Hospital Clínico San CarlosMadridSpain
| | - Isabel Ortega‐Madueño
- Department of Clinical Analysis, Institute of Laboratory MedicineIdSSC, Hospital Clínico San CarlosMadridSpain
| | - Maria Cruz Cárdenas
- Department of Clinical Analysis, Institute of Laboratory MedicineIdSSC, Hospital Clínico San CarlosMadridSpain
| | - Maria Diez‐Cirarda
- Department of NeurologySan Carlos Research Institute (IdSSC), Hospital Clínico San CarlosMadridSpain
| | - Alfonso Delgado‐Álvarez
- Department of NeurologySan Carlos Research Institute (IdSSC), Hospital Clínico San CarlosMadridSpain
| | - Marta Palacios‐Sarmiento
- Department of NeurologySan Carlos Research Institute (IdSSC), Hospital Clínico San CarlosMadridSpain
| | - Jorge Matias‐Guiu
- Department of NeurologySan Carlos Research Institute (IdSSC), Hospital Clínico San CarlosMadridSpain
| | - Silvia Corrochano
- Department of NeurologySan Carlos Research Institute (IdSSC), Hospital Clínico San CarlosMadridSpain
| | - José L. Ayala
- Department of Computer Architecture and Automation, Computer Science FacultyComplutense University of MadridMadridSpain
| | - Jordi A. Matias‐Guiu
- Department of NeurologySan Carlos Research Institute (IdSSC), Hospital Clínico San CarlosMadridSpain
| | | |
Collapse
|
3
|
Martínez-Dubarbie F, Guerra-Ruiz A, López-García S, Irure-Ventura J, Lage C, Fernández-Matarrubia M, Pozueta-Cantudo A, García-Martínez M, Corrales-Pardo A, Bravo M, Martín-Arroyo J, Infante J, López-Hoyos M, García-Unzueta MT, Sánchez-Juan P, Rodríguez-Rodríguez E. Influence of Physiological Variables and Comorbidities on Plasma Aβ40, Aβ42, and p-tau181 Levels in Cognitively Unimpaired Individuals. Int J Mol Sci 2024; 25:1481. [PMID: 38338759 PMCID: PMC10855058 DOI: 10.3390/ijms25031481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 01/20/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
Plasma biomarkers for Alzheimer's disease (AD) are a promising tool that may help in early diagnosis. However, their levels may be influenced by physiological parameters and comorbidities that should be considered before they can be used at the population level. For this purpose, we assessed the influences of different comorbidities on AD plasma markers in 208 cognitively unimpaired subjects. We analyzed both plasma and cerebrospinal fluid levels of Aβ40, Aβ42, and p-tau181 using the fully automated Lumipulse platform. The relationships between the different plasma markers and physiological variables were studied using linear regression models. The mean differences in plasma markers according to comorbidity groups were also studied. The glomerular filtration rate showed an influence on plasma Aβ40 and Aβ42 levels but not on the Aβ42/Aβ40 ratio. The amyloid ratio was significantly lower in diabetic and hypertensive subjects, and the mean p-tau181 levels were higher in hypertensive subjects. The glomerular filtration rate may have an inverse relationship on plasma Aβ40 and Aβ42 levels but not on the amyloid ratio, suggesting that the latter is a more stable marker to use in the general population. Cardiovascular risk factors might have a long-term effect on the amyloid ratio and plasma levels of p-tau181.
Collapse
Affiliation(s)
- Francisco Martínez-Dubarbie
- Neurology Service, Marqués de Valdecilla University Hospital, 39008 Santander, Spain (C.L.); (M.G.-M.); (J.M.-A.)
- Institute for Research Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
| | - Armando Guerra-Ruiz
- Biochemistry and Clinical Analysis Department, Marqués de Valdecilla University Hospital, 39008 Santander, Spain
| | - Sara López-García
- Neurology Service, Marqués de Valdecilla University Hospital, 39008 Santander, Spain (C.L.); (M.G.-M.); (J.M.-A.)
- Institute for Research Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
| | - Juan Irure-Ventura
- Institute for Research Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
- Immunology Department, Marqués de Valdecilla University Hospital, 39008 Santander, Spain
| | - Carmen Lage
- Neurology Service, Marqués de Valdecilla University Hospital, 39008 Santander, Spain (C.L.); (M.G.-M.); (J.M.-A.)
- Institute for Research Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
- Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, University of California, San Francisco, CA 94143, USA
| | - Marta Fernández-Matarrubia
- Neurology Service, Marqués de Valdecilla University Hospital, 39008 Santander, Spain (C.L.); (M.G.-M.); (J.M.-A.)
- Institute for Research Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
| | - Ana Pozueta-Cantudo
- Neurology Service, Marqués de Valdecilla University Hospital, 39008 Santander, Spain (C.L.); (M.G.-M.); (J.M.-A.)
- Institute for Research Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
| | - María García-Martínez
- Neurology Service, Marqués de Valdecilla University Hospital, 39008 Santander, Spain (C.L.); (M.G.-M.); (J.M.-A.)
- Institute for Research Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
| | - Andrea Corrales-Pardo
- Neurology Service, Marqués de Valdecilla University Hospital, 39008 Santander, Spain (C.L.); (M.G.-M.); (J.M.-A.)
- Institute for Research Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
- Health Sciences Department, Universidad Europea del Atlántico, 39011 Santander, Spain
| | - María Bravo
- Neurology Service, Marqués de Valdecilla University Hospital, 39008 Santander, Spain (C.L.); (M.G.-M.); (J.M.-A.)
- Institute for Research Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
| | - Juan Martín-Arroyo
- Neurology Service, Marqués de Valdecilla University Hospital, 39008 Santander, Spain (C.L.); (M.G.-M.); (J.M.-A.)
| | - Jon Infante
- Neurology Service, Marqués de Valdecilla University Hospital, 39008 Santander, Spain (C.L.); (M.G.-M.); (J.M.-A.)
- Institute for Research Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), 28220 Madrid, Spain
- Medicine and Psychiatry Department, University of Cantabria, 39011 Santander, Spain
| | - Marcos López-Hoyos
- Institute for Research Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
- Immunology Department, Marqués de Valdecilla University Hospital, 39008 Santander, Spain
- Molecular Biology Department, University of Cantabria, 39011 Santander, Spain
| | - María Teresa García-Unzueta
- Institute for Research Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
- Biochemistry and Clinical Analysis Department, Marqués de Valdecilla University Hospital, 39008 Santander, Spain
| | - Pascual Sánchez-Juan
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), 28220 Madrid, Spain
- CIEN Foundation, Queen Sofia Foundation Alzheimer Center, 28220 Madrid, Spain
| | - Eloy Rodríguez-Rodríguez
- Neurology Service, Marqués de Valdecilla University Hospital, 39008 Santander, Spain (C.L.); (M.G.-M.); (J.M.-A.)
- Institute for Research Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), 28220 Madrid, Spain
- Medicine and Psychiatry Department, University of Cantabria, 39011 Santander, Spain
| |
Collapse
|
4
|
Colmant L, Boyer E, Gerard T, Sleegers K, Lhommel R, Ivanoiu A, Lefèvre P, Kienlen-Campard P, Hanseeuw B. Definition of a Threshold for the Plasma Aβ42/Aβ40 Ratio Measured by Single-Molecule Array to Predict the Amyloid Status of Individuals without Dementia. Int J Mol Sci 2024; 25:1173. [PMID: 38256246 PMCID: PMC10816992 DOI: 10.3390/ijms25021173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
Alzheimer's disease (AD) is characterized by amyloid beta (Aβ) plaques and hyperphosphorylated tau in the brain. Aβ plaques precede cognitive impairments and can be detected through amyloid-positron emission tomography (PET) or in cerebrospinal fluid (CSF). Assessing the plasma Aβ42/Aβ40 ratio seems promising for non-invasive and cost-effective detection of brain Aβ accumulation. This approach involves some challenges, including the accuracy of blood-based biomarker measurements and the establishment of clear, standardized thresholds to categorize the risk of developing brain amyloid pathology. Plasma Aβ42/Aβ40 ratio was measured in 277 volunteers without dementia, 70 AD patients and 18 non-AD patients using single-molecule array. Patients (n = 88) and some volunteers (n = 66) were subject to evaluation of amyloid status by CSF Aβ quantification or PET analysis. Thresholds of plasma Aβ42/Aβ40 ratio were determined based on a Gaussian mixture model, a decision tree, and the Youden's index. The 0.0472 threshold, the one with the highest sensitivity, was retained for general population without dementia screening, and the 0.0450 threshold was retained for research and clinical trials recruitment, aiming to minimize the need for CSF or PET analyses to identify amyloid-positive individuals. These findings offer a promising step towards a cost-effective method for identifying individuals at risk of developing AD.
Collapse
Affiliation(s)
- Lise Colmant
- Institute of Neuroscience, UCLouvain, 1200 Brussels, Belgium; (L.C.); (E.B.); (T.G.); (P.L.); (P.K.-C.)
- Neurology Department, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium;
- Institute of Information and Communication Technologies, Electronics and Applied Mathematics, UCLouvain, 1348 Louvain-la-Neuve, Belgium
| | - Emilien Boyer
- Institute of Neuroscience, UCLouvain, 1200 Brussels, Belgium; (L.C.); (E.B.); (T.G.); (P.L.); (P.K.-C.)
- Neurology Department, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium;
| | - Thomas Gerard
- Institute of Neuroscience, UCLouvain, 1200 Brussels, Belgium; (L.C.); (E.B.); (T.G.); (P.L.); (P.K.-C.)
- Neurology Department, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium;
| | - Kristel Sleegers
- Complex Genetics of Alzheimer’s Disease Group, VIB-UAntwerp Center for Molecular Neurology, University of Antwerp, 2000 Antwerpen, Belgium;
| | - Renaud Lhommel
- Neurology Department, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium;
| | - Adrian Ivanoiu
- Institute of Neuroscience, UCLouvain, 1200 Brussels, Belgium; (L.C.); (E.B.); (T.G.); (P.L.); (P.K.-C.)
- Neurology Department, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium;
| | - Philippe Lefèvre
- Institute of Neuroscience, UCLouvain, 1200 Brussels, Belgium; (L.C.); (E.B.); (T.G.); (P.L.); (P.K.-C.)
- Institute of Information and Communication Technologies, Electronics and Applied Mathematics, UCLouvain, 1348 Louvain-la-Neuve, Belgium
| | - Pascal Kienlen-Campard
- Institute of Neuroscience, UCLouvain, 1200 Brussels, Belgium; (L.C.); (E.B.); (T.G.); (P.L.); (P.K.-C.)
| | - Bernard Hanseeuw
- Institute of Neuroscience, UCLouvain, 1200 Brussels, Belgium; (L.C.); (E.B.); (T.G.); (P.L.); (P.K.-C.)
- Neurology Department, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium;
- WELBIO Department, WEL Research Institute, Avenue Pasteur, 6, 1300 Wavre, Belgium
| |
Collapse
|
5
|
Shen Y, Ali M, Timsina J, Wang C, Do A, Western D, Liu M, Gorijala P, Budde J, Liu H, Gordon B, McDade E, Morris JC, Llibre-Guerra JJ, Bateman RJ, Joseph-Mathurin N, Perrin RJ, Maschi D, Wyss-Coray T, Pastor P, Goate A, Renton AE, Surace EI, Johnson ECB, Levey AI, Alvarez I, Levin J, Ringman JM, Allegri RF, Seyfried N, Day GS, Wu Q, Fernández MV, Ibanez L, Sung YJ, Cruchaga C. Systematic proteomics in Autosomal dominant Alzheimer's disease reveals decades-early changes of CSF proteins in neuronal death, and immune pathways. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.12.24301242. [PMID: 38260583 PMCID: PMC10802763 DOI: 10.1101/2024.01.12.24301242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Background To date, there is no high throughput proteomic study in the context of Autosomal Dominant Alzheimer's disease (ADAD). Here, we aimed to characterize early CSF proteome changes in ADAD and leverage them as potential biomarkers for disease monitoring and therapeutic strategies. Methods We utilized Somascan® 7K assay to quantify protein levels in the CSF from 291 mutation carriers (MCs) and 185 non-carriers (NCs). We employed a multi-layer regression model to identify proteins with different pseudo-trajectories between MCs and NCs. We replicated the results using publicly available ADAD datasets as well as proteomic data from sporadic Alzheimer's disease (sAD). To biologically contextualize the results, we performed network and pathway enrichment analyses. Machine learning was applied to create and validate predictive models. Findings We identified 125 proteins with significantly different pseudo-trajectories between MCs and NCs. Twelve proteins showed changes even before the traditional AD biomarkers (Aβ42, tau, ptau). These 125 proteins belong to three different modules that are associated with age at onset: 1) early stage module associated with stress response, glutamate metabolism, and mitochondria damage; 2) the middle stage module, enriched in neuronal death and apoptosis; and 3) the presymptomatic stage module was characterized by changes in microglia, and cell-to-cell communication processes, indicating an attempt of rebuilding and establishing new connections to maintain functionality. Machine learning identified a subset of nine proteins that can differentiate MCs from NCs better than traditional AD biomarkers (AUC>0.89). Interpretation Our findings comprehensively described early proteomic changes associated with ADAD and captured specific biological processes that happen in the early phases of the disease, fifteen to five years before clinical onset. We identified a small subset of proteins with the potentials to become therapy-monitoring biomarkers of ADAD MCs. Funding Proteomic data generation was supported by NIH: RF1AG044546.
Collapse
|
6
|
Sánchez-Soblechero A, López-García S, Lage C, Fernández-Matarrubia M, Irure J, López-Hoyos M, Jiménez-Bonilla J, Quirce R, de Arcocha-Torres M, Cuenca-Vera O, Martín-Arroyo J, Martínez-Dubarbie F, Pozueta A, García-Martínez M, Infante J, Sánchez-Juan P, Rodríguez-Rodríguez E. Where Should I Draw the Line: PET-Driven, Data-Driven, or Manufacturer Cut-Off? J Alzheimers Dis 2024; 98:957-967. [PMID: 38489172 DOI: 10.3233/jad-230678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
Background The optimal cut-off for Alzheimer's disease (AD) CSF biomarkers remains controversial. Objective To analyze the performance of cut-off points standardized by three methods: one that optimized the agreement between 11C-Pittsburgh compound B PET (a-PET) and CSF biomarkers (Aβ1-42, pTau, tTau, and Aβ1-42/Aβ1-40 ratio) in our population, called PET-driven; an unbiased cut-off using data from a healthy research cohort, called data-driven, and that provided by the manufacturer. We also compare changes in ATN classification. Methods CSF biomarkers measured by the LUMIPULSE G600II platform and qualitative visualization of amyloid positron emission tomography (a-PET) were performed in all the patients. We established a cut-off for each single biomarker and Aβ1-42/Aβ1-40 ratio that optimized their agreement with a-PET using ROC curves. Sensitivity, Specificity, and Overall Percent of Agreement are assessed using a-PET or clinical diagnosis as gold standard for every cut-off. Also, we established a data-driven cut-off from our cognitively unimpaired cohort. We then analyzed changes in ATN classification. Results One hundred and ten patients were recruited. Sixty-six (60%) were a-PET positive. PET-driven cut-offs were: pTau > 57, tTau > 362.62, Aβ1-42/Aβ1-40 < 0.069. For a single biomarker, pTau showed the highest accuracy (AUC 0.926). New PET-driven cut-offs classified patients similarly to manufacturer cut-offs (only two patients changed). However, 20 patients (18%) changed when data-driven cut-offs were used. Conclusions We established our sample's best CSF biomarkers cut-offs using a-PET as the gold standard. These cut-offs categorize better symptomatic subjects than data-driven in ATN classification, but they are very similar to the manufacturer's.
Collapse
Affiliation(s)
| | - Sara López-García
- Neurology Department, Cognitive Impairment Unit, 'Marqués de Valdecilla' University Hospital, Santander, Spain
- Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Carmen Lage
- Neurology Department, Cognitive Impairment Unit, 'Marqués de Valdecilla' University Hospital, Santander, Spain
- Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Marta Fernández-Matarrubia
- Neurology Department, Cognitive Impairment Unit, 'Marqués de Valdecilla' University Hospital, Santander, Spain
- Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Juan Irure
- Immunology Department, 'Marqués de Valdecilla' University Hospital, Santander, Spain
- Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
- Department of Medicine and Psychiatry, University of Cantabria, Santander, Spain
| | - Marcos López-Hoyos
- Immunology Department, 'Marqués de Valdecilla' University Hospital, Santander, Spain
- Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
- Department of Medicine and Psychiatry, University of Cantabria, Santander, Spain
| | - Julio Jiménez-Bonilla
- Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
- Nuclear Medicine Department, 'Marqués de Valdecilla' University Hospital, Santander, Spain
| | - Remedios Quirce
- Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
- Nuclear Medicine Department, 'Marqués de Valdecilla' University Hospital, Santander, Spain
| | - María de Arcocha-Torres
- Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
- Nuclear Medicine Department, 'Marqués de Valdecilla' University Hospital, Santander, Spain
| | - Oriana Cuenca-Vera
- Nuclear Medicine Department, 'Marqués de Valdecilla' University Hospital, Santander, Spain
| | - Juan Martín-Arroyo
- Neurology Department, Cognitive Impairment Unit, 'Marqués de Valdecilla' University Hospital, Santander, Spain
| | - Francisco Martínez-Dubarbie
- Neurology Department, Cognitive Impairment Unit, 'Marqués de Valdecilla' University Hospital, Santander, Spain
- Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Ana Pozueta
- Neurology Department, Cognitive Impairment Unit, 'Marqués de Valdecilla' University Hospital, Santander, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - María García-Martínez
- Neurology Department, Cognitive Impairment Unit, 'Marqués de Valdecilla' University Hospital, Santander, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Jon Infante
- Neurology Department, Cognitive Impairment Unit, 'Marqués de Valdecilla' University Hospital, Santander, Spain
- Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
- Department of Medicine and Psychiatry, University of Cantabria, Santander, Spain
| | - Pascual Sánchez-Juan
- Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
- Alzheimer's Centre Reina Sofia-CIEN Foundation-ISCIII, Madrid, Spain
| | - Eloy Rodríguez-Rodríguez
- Neurology Department, Cognitive Impairment Unit, 'Marqués de Valdecilla' University Hospital, Santander, Spain
- Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
- Department of Medicine and Psychiatry, University of Cantabria, Santander, Spain
| |
Collapse
|
7
|
Kurihara M, Kondo S, Ohse K, Nojima H, Kikkawa-Saito E, Iwata A. Relationship Between Cerebrospinal Fluid Alzheimer's Disease Biomarker Values Measured via Lumipulse Assays and Conventional ELISA: Single-Center Experience and Systematic Review. J Alzheimers Dis 2024; 99:1077-1092. [PMID: 38759016 PMCID: PMC11191528 DOI: 10.3233/jad-240185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2024] [Indexed: 05/19/2024]
Abstract
Background Although Lumipulse assays and conventional ELISA are strongly correlated, the precise relationship between their measured values remains undetermined. Objective To determine the relationship between Lumipulse and ELISA measurement values. Methods Patients who underwent cerebrospinal fluid (CSF) Alzheimer's disease (AD) biomarker measurements and consented to biobanking between December 2021 and June 2023 were included. The relationship between values measured via Lumipulse assays and conventional ELISA were evaluated by Passing-Bablok analyses for amyloid-β 1-42 (Aβ42), total tau (t-tau), and phospho-tau 181 (p-tau 181). Studies using both assays were systematically searched for in PubMed and summarized after quality assessment. Results Regression line slopes and intercepts were 1.41 (1.23 to 1.60) and -77.8 (-198.4 to 44.5) for Aβ42, 0.94 (0.88 to 1.01) and 98.2 (76.9 to 114.4) for t-tau, and 1.60 (1.43 to 1.75) and -21.1 (-26.9 to -15.6) for p-tau181. Spearman's correlation coefficients were 0.90, 0.95, and 0.95 for Aβ42, t-tau, and p-tau181, respectively. We identified 13 other studies that included 2,117 patients in total. Aβ42 slope varied among studies, suggesting inter-lab difference of ELISA. The slope and intercept of t-tau were approximately 1 and 0, respectively, suggesting small proportional and systematic differences. Conversely, the p-tau181 slope was significantly higher than 1, distributed between 1.5-2 in most studies, with intercepts significantly lower than 0, suggesting proportional and systematic differences. Conclusions We characterized different relationship between measurement values for each biomarker, which may be useful for understanding the differences in CSF biomarker measurement values on different platforms and for future global harmonization.
Collapse
Affiliation(s)
- Masanori Kurihara
- Department of Neurology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Soichiro Kondo
- Department of Neurology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kensuke Ohse
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | | | | | - Atsushi Iwata
- Department of Neurology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| |
Collapse
|
8
|
Malotaux V, Colmant L, Quenon L, Huyghe L, Gérard T, Dricot L, Ivanoiu A, Lhommel R, Hanseeuw B. Suspecting Non-Alzheimer's Pathologies and Mixed Pathologies: A Comparative Study Between Brain Metabolism and Tau Images. J Alzheimers Dis 2024; 97:421-433. [PMID: 38108350 PMCID: PMC10789317 DOI: 10.3233/jad-230696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) pathology can be disclosed in vivo using amyloid and tau imaging, unlike non-AD neuropathologies for which no specific markers exist. OBJECTIVE We aimed to compare brain hypometabolism and tauopathy to unveil non-AD pathologies. METHODS Sixty-one patients presenting cognitive complaints (age 48-90), including 32 with positive AD biomarkers (52%), performed [18F]-Fluorodeoxyglucose (FDG)-PET (brain metabolism) and [18F]-MK-6240-PET (tau). We normalized these images using data from clinically normal individuals (n = 30), resulting in comparable FDG and tau z-scores. We computed between-patients correlations to evaluate regional associations. For each patient, a predominant biomarker (i.e., Hypometabolism > Tauopathy or Hypometabolism≤Tauopathy) was determined in the temporal and frontoparietal lobes. We computed within-patient correlations between tau and metabolism and investigated their associations with demographics, cognition, cardiovascular risk factors (CVRF), CSF biomarkers, and white matter hypointensities (WMH). RESULTS We observed negative associations between tau and FDG in 37 of the 68 cortical regions-of-interest (average Pearson's r = -0.25), mainly in the temporal lobe. Thirteen patients (21%) had Hypometabolism > Tauopathy whereas twenty-five patients (41%) had Hypometabolism≤Tauopathy. Tau-predominant patients were more frequently females and had greater amyloid burden. Twenty-three patients (38%) had Hypometabolism≤Tauopathy in the temporal lobe, but Hypometabolism > Tauopathy in the frontoparietal lobe. This group was older and had higher CVRF than Tau-predominant patients. Patients with more negative associations between tau and metabolism were younger, had worse cognition, and greater amyloid and WMH burdens. CONCLUSIONS Tau-FDG comparison can help suspect non-AD pathologies in patients presenting cognitive complaints. Stronger Tau-FDG correlations are associated with younger age, worse cognition, and greater amyloid and WMH burdens.
Collapse
Affiliation(s)
- Vincent Malotaux
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Lise Colmant
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
- Department of Neurology, Saint-Luc University Hospital, Brussels, Belgium
| | - Lisa Quenon
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
- Department of Neurology, Saint-Luc University Hospital, Brussels, Belgium
| | - Lara Huyghe
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Thomas Gérard
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
- Department of Nuclear Medicine, Saint-Luc University Hospital, Brussels, Belgium
| | - Laurence Dricot
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Adrian Ivanoiu
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
- Department of Neurology, Saint-Luc University Hospital, Brussels, Belgium
| | - Renaud Lhommel
- Department of Nuclear Medicine, Saint-Luc University Hospital, Brussels, Belgium
| | - Bernard Hanseeuw
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
- Department of Neurology, Saint-Luc University Hospital, Brussels, Belgium
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- WEL Research Institute, Welbio department, Wavre, Belgium
| |
Collapse
|
9
|
Guillén N, Contador J, Buongiorno M, Álvarez I, Culell N, Alcolea D, Lleó A, Fortea J, Piñol-Ripoll G, Carnes-Vendrell A, Lourdes Ispierto M, Vilas D, Puig-Pijoan A, Fernández-Lebrero A, Balasa M, Sánchez-Valle R, Lladó A. Agreement of cerebrospinal fluid biomarkers and amyloid-PET in a multicenter study. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01701-y. [PMID: 37898567 DOI: 10.1007/s00406-023-01701-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 10/02/2023] [Indexed: 10/30/2023]
Abstract
Core Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers have shown incomplete agreement with amyloid-positron emission tomography (PET). Our goal was to analyze the agreement between AD CSF biomarkers and amyloid-PET in a multicenter study. Retrospective multicenter study (5 centers). Participants who underwent both CSF biomarkers and amyloid-PET scan within 18 months were included. Clinical diagnoses were made according to latest diagnostic criteria by the attending clinicians. CSF Amyloid Beta1-42 (Aβ1-42, A), phosphorliated tau 181 (pTau181, T) and total tau (tTau, N) biomarkers were considered normal (-) or abnormal ( +) according to cutoffs of each center. Amyloid-PET was visually classified as positive/negative. Agreement between CSF biomarkers and amyloid-PET was analyzed by overall percent agreement (OPA). 236 participants were included (mean age 67.9 years (SD 9.1), MMSE score 24.5 (SD 4.1)). Diagnoses were mild cognitive impairment or dementia due to AD (49%), Lewy body dementia (22%), frontotemporal dementia (10%) and others (19%). Mean time between tests was 5.1 months (SD 4.1). OPA between single CSF biomarkers and amyloid-PET was 74% for Aβ1-42, 75% for pTau181, 73% for tTau. The use of biomarker ratios improved OPA: 87% for Aβ1-42/Aβ1-40 (n = 155), 88% for pTau181/Aβ1-42 (n = 94) and 82% for tTau/Aβ1-42 (n = 160). A + T + N + cases showed the highest agreement between CSF biomarkers and amyloid-PET (96%), followed by A-T-N- cases (89%). Aβ1-42/Aβ1-40 was a better marker of cerebral amyloid deposition, as identified by amyloid tracers, than Aβ1-42 alone. Combined biomarkers in CSF predicted amyloid-PET result better than single biomarkers.
Collapse
Affiliation(s)
- Núria Guillén
- Alzheimer's Disease and Other Cognitive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Carrer Villarroel, 170, 08036, Barcelona, Spain
| | - José Contador
- Alzheimer's Disease and Other Cognitive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Carrer Villarroel, 170, 08036, Barcelona, Spain
| | - Mariateresa Buongiorno
- Memory Disorders Unit, Department of Neurology, Hospital Universitari Mutua de Terrassa, Terrassa, Spain
- Fundació Docència i Recerca Mútua Terrassa, Terrassa, Spain
| | - Ignacio Álvarez
- Memory Disorders Unit, Department of Neurology, Hospital Universitari Mutua de Terrassa, Terrassa, Spain
- Fundació Docència i Recerca Mútua Terrassa, Terrassa, Spain
| | - Natalia Culell
- Memory Disorders Unit, Department of Neurology, Hospital Universitari Mutua de Terrassa, Terrassa, Spain
- Fundació Docència i Recerca Mútua Terrassa, Terrassa, Spain
| | - Daniel Alcolea
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau-Biomedical Research Institute Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas. CIBERNED, Madrid, Spain
| | - Alberto Lleó
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau-Biomedical Research Institute Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas. CIBERNED, Madrid, Spain
| | - Juan Fortea
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau-Biomedical Research Institute Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas. CIBERNED, Madrid, Spain
| | - Gerard Piñol-Ripoll
- Clinical Neuroscience Research, Unitat Trastorns Cognitius, IRBLleida, Santa Maria University Hospital, Lleida, Spain
| | - Anna Carnes-Vendrell
- Clinical Neuroscience Research, Unitat Trastorns Cognitius, IRBLleida, Santa Maria University Hospital, Lleida, Spain
| | - María Lourdes Ispierto
- Neurodegenerative Diseases Unit, Neurology Service and Neurosciences Department, University Hospital Germans Trias i Pujol (HUGTP), Badalona, Spain
| | - Dolores Vilas
- Neurodegenerative Diseases Unit, Neurology Service and Neurosciences Department, University Hospital Germans Trias i Pujol (HUGTP), Badalona, Spain
| | - Albert Puig-Pijoan
- Cognitive Decline and Movement Disorders Unit, Neurology Department, Hospital del Mar, Barcelona, Spain
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Aida Fernández-Lebrero
- Cognitive Decline and Movement Disorders Unit, Neurology Department, Hospital del Mar, Barcelona, Spain
| | - Mircea Balasa
- Alzheimer's Disease and Other Cognitive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Carrer Villarroel, 170, 08036, Barcelona, Spain
| | - Raquel Sánchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Carrer Villarroel, 170, 08036, Barcelona, Spain
- Institute of Neurosciences, Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Albert Lladó
- Alzheimer's Disease and Other Cognitive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Carrer Villarroel, 170, 08036, Barcelona, Spain.
- Institute of Neurosciences, Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
| |
Collapse
|
10
|
Kyalu Ngoie Zola N, Balty C, Pyr Dit Ruys S, Vanparys AAT, Huyghe NDG, Herinckx G, Johanns M, Boyer E, Kienlen-Campard P, Rider MH, Vertommen D, Hanseeuw BJ. Specific post-translational modifications of soluble tau protein distinguishes Alzheimer's disease and primary tauopathies. Nat Commun 2023; 14:3706. [PMID: 37349319 PMCID: PMC10287718 DOI: 10.1038/s41467-023-39328-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 06/07/2023] [Indexed: 06/24/2023] Open
Abstract
Tau protein aggregates in several neurodegenerative disorders, referred to as tauopathies. The tau isoforms observed in post mortem human brain aggregates is used to classify tauopathies. However, distinguishing tauopathies ante mortem remains challenging, potentially due to differences between insoluble tau in aggregates and soluble tau in body fluids. Here, we demonstrated that tau isoforms differ between tauopathies in insoluble aggregates, but not in soluble brain extracts. We therefore characterized post-translational modifications of both the aggregated and the soluble tau protein obtained from post mortem human brain tissue of patients with Alzheimer's disease, cortico-basal degeneration, Pick's disease, and frontotemporal lobe degeneration. We found specific soluble signatures for each tauopathy and its specific aggregated tau isoforms: including ubiquitination on Lysine 369 for cortico-basal degeneration and acetylation on Lysine 311 for Pick's disease. These findings provide potential targets for future development of fluid-based biomarker assays able to distinguish tauopathies in vivo.
Collapse
Affiliation(s)
- Nathalie Kyalu Ngoie Zola
- Universite catholique de Louvain (UCLouvain) and Institute of Neuroscience (IONS), 1200, Brussels, Belgium
- Universite catholique de Louvain (UCLouvain) and de Duve Institute (DDUV), Protein Phosphorylation (PHOS), 1200, Brussels, Belgium
| | - Clémence Balty
- Universite catholique de Louvain (UCLouvain) and de Duve Institute (DDUV), Protein Phosphorylation (PHOS), 1200, Brussels, Belgium
| | - Sébastien Pyr Dit Ruys
- Universite catholique de Louvain (UClouvain) and Louvain Drug Research Institute (LDRI), Integrated Pharmacometrics, Pharmacogenomics and Pharmacokinetics Group (PMGK), 1200, Brussels, Belgium
| | - Axelle A T Vanparys
- Universite catholique de Louvain (UCLouvain) and Institute of Neuroscience (IONS), 1200, Brussels, Belgium
| | - Nicolas D G Huyghe
- Université catholique de Louvain (UCLouvain) and Institut de Recherche Expérimentale et Clinique (IREC), 1200, Brussels, Belgium
| | - Gaëtan Herinckx
- Universite catholique de Louvain (UCLouvain), de Duve Institute (DDUV), and MASSPROT Platform, 1200, Brussels, Belgium
| | - Manuel Johanns
- Universite catholique de Louvain (UCLouvain) and de Duve Institute (DDUV), Protein Phosphorylation (PHOS), 1200, Brussels, Belgium
| | - Emilien Boyer
- Universite catholique de Louvain (UCLouvain) and Institute of Neuroscience (IONS), 1200, Brussels, Belgium
- Cliniques universitaires Saint-Luc, Neurology Department, 1200, Brussels, Belgium
| | - Pascal Kienlen-Campard
- Universite catholique de Louvain (UCLouvain) and Institute of Neuroscience (IONS), 1200, Brussels, Belgium
| | - Mark H Rider
- Universite catholique de Louvain (UCLouvain) and de Duve Institute (DDUV), Protein Phosphorylation (PHOS), 1200, Brussels, Belgium
| | - Didier Vertommen
- Universite catholique de Louvain (UCLouvain), de Duve Institute (DDUV), and MASSPROT Platform, 1200, Brussels, Belgium
| | - Bernard J Hanseeuw
- Universite catholique de Louvain (UCLouvain) and Institute of Neuroscience (IONS), 1200, Brussels, Belgium.
- Cliniques universitaires Saint-Luc, Neurology Department, 1200, Brussels, Belgium.
- Universite catholique de Louvain (UCLouvain), WELBIO department, WEL Research Institute, avenue Pasteur, 6, 1300, Wavre, Belgium.
- Harvard Medical School, Massachusetts General Hospital, Department of Radiology, Gordon Center for Medical Imaging, Boston, MA, USA.
| |
Collapse
|
11
|
Xu Y, Jiang H, Zhu B, Cao M, Feng T, Sun Z, Du G, Zhao Z. Advances and applications of fluids biomarkers in diagnosis and therapeutic targets of Alzheimer's disease. CNS Neurosci Ther 2023. [PMID: 37144603 DOI: 10.1111/cns.14238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 01/25/2023] [Accepted: 04/12/2023] [Indexed: 05/06/2023] Open
Abstract
AIMS Alzheimer's disease (AD) is a neurodegenerative disease with challenging early diagnosis and effective treatments due to its complex pathogenesis. AD patients are often diagnosed after the appearance of the typical symptoms, thereby delaying the best opportunity for effective measures. Biomarkers could be the key to resolving the challenge. This review aims to provide an overview of application and potential value of AD biomarkers in fluids, including cerebrospinal fluid, blood, and saliva, in diagnosis and treatment. METHODS A comprehensive search of the relevant literature was conducted to summarize potential biomarkers for AD in fluids. The paper further explored the biomarkers' utility in disease diagnosis and drug target development. RESULTS Research on biomarkers mainly focused on amyloid-β (Aβ) plaques, Tau protein abnormal phosphorylation, axon damage, synaptic dysfunction, inflammation, and related hypotheses associated with AD mechanisms. Aβ42 , total Tau (t-Tau), and phosphorylated Tau (p-Tau), have been endorsed for their diagnostic and predictive capability. However, other biomarkers remain controversial. Drugs targeting Aβ have shown some efficacy and those that target BACE1 and Tau are still undergoing development. CONCLUSION Fluid biomarkers hold considerable potential in the diagnosis and drug development of AD. However, improvements in sensitivity and specificity, and approaches for managing sample impurities, need to be addressed for better diagnosis.
Collapse
Affiliation(s)
- Yanan Xu
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- School of Pharmacy, Capital Medical University, Beijing, China
| | - Hailun Jiang
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Bin Zhu
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Mingnan Cao
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tao Feng
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhongshi Sun
- Department of Pharmacy, The Sixth Medical Center of PLA General Hospital, Beijing, China
| | - Guanhua Du
- The State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Beijing, China
- Key Laboratory of Drug Target Research and Drug Screen, Institute of Materia Medica, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Zhigang Zhao
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- School of Pharmacy, Capital Medical University, Beijing, China
| |
Collapse
|
12
|
Zou Y, Yu S, Ma X, Ma C, Mao C, Mu D, Li L, Gao J, Qiu L. How far is the goal of applying β-amyloid in cerebrospinal fluid for clinical diagnosis of Alzheimer's disease with standardization of measurements? Clin Biochem 2023; 112:33-42. [PMID: 36473516 DOI: 10.1016/j.clinbiochem.2022.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 11/02/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
Cerebrospinal fluid (CSF) β-amyloid (Aβ) is important for early diagnosis of Alzheimer's disease (AD). However, the cohort distributions and cut-off values have large variation across different analytical assays, kits, and laboratories. In this review, we summarize the cut-off values and diagnostic performance for CSF Aβ1-42 and Aβ1-42/Aβ1-40, and explore the important effect factors. Based on the Alzheimer's Association external quality control program (AAQC program), the peer group coefficient of variation of manual ELISA assays for CSF Aβ1-42 was unsatisfied (>20%). Fully automated platforms with better performance have recently been developed, but still not widely applied. In 2020, the certified reference material (CRM) for CSF Aβ1-42 was launched; however, the AAQC 2021-round results did not show effective improvements. Thus, further development and popularization of CRM for CSF Aβ1-42 and Aβ1-40 are urgently required. Standardizing the diagnostic procedures of AD and related status and the pre-analytical protocols of CSF samples, improving detection performance of analytical assays, and popularizing the application of fully automated platforms are also important for the establishment of uniform cut-off values. Moreover, each laboratory should verify the applicability of uniform cut-off values, and evaluate whether it is necessary to establish its own population- and assay-specific cut-off values.
Collapse
Affiliation(s)
- Yutong Zou
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China
| | - Songlin Yu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China
| | - Xiaoli Ma
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China; Medical Science Research Center, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China
| | - Chaochao Ma
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China
| | - Chenhui Mao
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Danni Mu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China
| | - Lei Li
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China
| | - Jing Gao
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China.
| | - Ling Qiu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China.
| |
Collapse
|
13
|
Puig-Pijoan A, García-Escobar G, Fernández-Lebrero A, Manero Borràs R, Sánchez-Benavides G, Navalpotro-Gómez I, Cascales Lahoz D, Suárez-Calvet M, Grau-Rivera O, Boltes Alandí A, Pont-Sunyer M, Ortiz-Gil J, Carrillo-Molina S, López-Villegas D, Abellán-Vidal M, Martínez-Casamitjana M, Hernández-Sánchez J, Peña-Casanova J, Roquer J, Padrós Fluvià A, Puente-Périz V. Estudio CORCOBIA: determinación de puntos de corte de biomarcadores de enfermedad de Alzheimer en LCR en una cohorte clínica. Neurologia 2022. [DOI: 10.1016/j.nrl.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
|
14
|
Puig-Pijoan A, García-Escobar G, Fernández-Lebrero A, Manero-Borràs RM, Sánchez-Benavides G, Navalpotro-Gómez I, Cascales Lahoz D, Suárez-Calvet M, Grau-Rivera O, Boltes Alandí A, Pont-Sunyer MC, Ortiz-Gil J, Carrillo-Molina S, López-Villegas D, Abellán-Vidal MT, Martínez-Casamitjana MI, Hernández-Sánchez JJ, Peña-Casanova J, Roquer J, Padrós Fluvià A, Puente-Périz V. The CORCOBIA study: Cut-off points of Alzheimer's disease CSF biomarkers in a clinical cohort. Neurologia 2022:S2173-5808(22)00084-0. [PMID: 35961506 DOI: 10.1016/j.nrleng.2022.05.002] [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: 02/24/2022] [Accepted: 05/24/2022] [Indexed: 10/15/2022] Open
Abstract
INTRODUCTION The analysis of the core biomarkers of Alzheimer's Disease (AD) in the cerebrospinal fluid (CSF) is recommended in the clinical units where it is available. Because of the absence of universal validated values, the determination of specific cut-off points for each center and its population is recommended. The main objective of the CORCOBIA study was to determine the cut-off points of core AD CSF biomarkers for several centers (Parc de Salut Mar, Barcelona and Hospital General de Granollers), which work with the same reference laboratory (Laboratori de Referència de Catalunya). METHODS Prospective study including cognitively unimpaired individuals (CU, n = 42), subjects with amnestic mild cognitive impairment (aMCI, n = 35) and patients with dementia due to Alzheimer's Disease (AD, n = 48), in whom clinical and neuropsychological assessment, neuroimaging, APOE genotyping and lumbar puncture to analyse amyloid beta peptides (Aβ42, Aβ40), total tau (tTau) and phosphorylated Tau (pTau181) using the Lumipulse G600II (Fujirebio) was performed. The values of sensitivity (SE), specificity (SP), predictive values and area under the curve (AUC) were calculated, determining the cut-off point according to the Youden index by comparing the CU and AD groups. RESULTS The resulting cut-offs and their AUC were the following: Aβ42 750 pg/mL (AUC 0.809); Aβ42/Aβ40 0.062 (AUC 0.78); pTau181 69.85 pg/mL (AUC 0.81); tTau 522.0 pg/mL (AUC 0.79); Aβ42/tTau 1.76 (AUC 0.86); Aβ42/pTau181 10.25 (AUC 0.86). CONCLUSIONS The determination of cut-off points of core AD CSF biomarkers for the participating centers allows a better diagnostic accuracy. The ratio CSF Aβ42/pTau181 shows the highest AUC and better balance between sensitivity and specificity.
Collapse
Affiliation(s)
- A Puig-Pijoan
- Unitat de Deteriorament Cognitiu i Transtorns del Moviment, Servei de Neurologia, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain; Farmacologia Integrada i Neurociència de Sistemes, Programa de Neurociències, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
| | - G García-Escobar
- Farmacologia Integrada i Neurociència de Sistemes, Programa de Neurociències, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | - A Fernández-Lebrero
- Unitat de Deteriorament Cognitiu i Transtorns del Moviment, Servei de Neurologia, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain; Farmacologia Integrada i Neurociència de Sistemes, Programa de Neurociències, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; Barcelonaβeta Brain Research Center (BBRC), Fundació Pasqual Maragall, Barcelona, Spain
| | - R M Manero-Borràs
- Unitat de Deteriorament Cognitiu i Transtorns del Moviment, Servei de Neurologia, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain; Farmacologia Integrada i Neurociència de Sistemes, Programa de Neurociències, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | - G Sánchez-Benavides
- Barcelonaβeta Brain Research Center (BBRC), Fundació Pasqual Maragall, Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Hospital del Mar, Barcelona, Spain
| | - I Navalpotro-Gómez
- Unitat de Deteriorament Cognitiu i Transtorns del Moviment, Servei de Neurologia, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain; Farmacologia Integrada i Neurociència de Sistemes, Programa de Neurociències, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; Barcelonaβeta Brain Research Center (BBRC), Fundació Pasqual Maragall, Barcelona, Spain
| | - D Cascales Lahoz
- Unitat de Deteriorament Cognitiu i Transtorns del Moviment, Servei de Neurologia, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - M Suárez-Calvet
- Unitat de Deteriorament Cognitiu i Transtorns del Moviment, Servei de Neurologia, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain; Barcelonaβeta Brain Research Center (BBRC), Fundació Pasqual Maragall, Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Hospital del Mar, Barcelona, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - O Grau-Rivera
- Unitat de Deteriorament Cognitiu i Transtorns del Moviment, Servei de Neurologia, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain; Barcelonaβeta Brain Research Center (BBRC), Fundació Pasqual Maragall, Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Hospital del Mar, Barcelona, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - A Boltes Alandí
- Servei de Neurologia, Hospital General de Granollers, Granollers, Barcelona, Spain
| | - M C Pont-Sunyer
- Servei de Neurologia, Hospital General de Granollers, Granollers, Barcelona, Spain
| | - J Ortiz-Gil
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain; Unitat de Psicologia, Hospital General de Granollers, Granollers, Barcelona, Spain; Fundación para la Investigación y Docencia Maria Angustias Gimenez (FIDMAG), Sant Boi de Llobregat, Barcelona, Spain
| | - S Carrillo-Molina
- Servei de Neurologia, Hospital General de Granollers, Granollers, Barcelona, Spain; Unitat de Psicologia, Hospital General de Granollers, Granollers, Barcelona, Spain
| | - D López-Villegas
- Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Hospital del Mar, Barcelona, Spain; Centre Emili Mira, Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Santa Coloma de Gramenet, Barcelona, Spain
| | - M T Abellán-Vidal
- Centre Emili Mira, Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Santa Coloma de Gramenet, Barcelona, Spain
| | - M I Martínez-Casamitjana
- Centre Emili Mira, Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Santa Coloma de Gramenet, Barcelona, Spain
| | | | - J Peña-Casanova
- Farmacologia Integrada i Neurociència de Sistemes, Programa de Neurociències, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | - J Roquer
- Unitat de Deteriorament Cognitiu i Transtorns del Moviment, Servei de Neurologia, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Hospital del Mar, Barcelona, Spain
| | - A Padrós Fluvià
- Laboratori de Referència de Catalunya, Sant Boi de Llobregat, Barcelona, Spain
| | - V Puente-Périz
- Unitat de Deteriorament Cognitiu i Transtorns del Moviment, Servei de Neurologia, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain; Farmacologia Integrada i Neurociència de Sistemes, Programa de Neurociències, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
| |
Collapse
|
15
|
Zeng C, Xing H, Chen M, Chen L, Li P, Wu X, Li L. Circ_0049472 regulates the damage of Aβ-induced SK-N-SH and CHP-212 cells by mediating the miR-107/KIF1B axis. Exp Brain Res 2022; 240:2299-2309. [PMID: 35881155 DOI: 10.1007/s00221-022-06401-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/14/2022] [Indexed: 11/04/2022]
Abstract
Alzheimer's disease (AD) is a neurodegenerative disease that seriously affects the life and health of the elderly. Studies have found that circular RNAs (circRNAs) are associated with human diseases, including AD. Hsa_circ_0049472 has been uncovered to be overexpressed in AD, but the role of circ_0049472 remains unclear. AD patients were recruited to collect cerebrospinal fluid (CSF) and serum samples. Amyloid beta (Aβ)-induced SK-N-SH and CHP-212 cells were used as the AD cell models in vitro. Quantitative real-time PCR (qRT-PCR) was used to assess the expression of circ_0049472, microRNA-107 (miR-107) and kinesin family member 1B (KIF1B). Cell counting kit-8 assay tested the cell viability, and flow cytometry measured cell apoptosis. The levels of proliferating cell nuclear antigen (PCNA), BCL2 Associated X (Bax) and kinesin family member 1B (KIF1B) protein were examined by western blot. In addition, the relative inflammatory cytokines (TNF-α, IL-6 and IL-1β) were detected by enzyme-linked immunosorbent assay (ELISA). The malondialdehyde (MDA) level and superoxide dismutase (SOD) activity were measured by relative kits. Dual-luciferase reporter assays and RNA pull-down assay verified the relationship between miR-107 and circ_0049472 or KIF1B. Circ_0049472 and KIF1B were overexpressed in AD patient-derived cerebrospinal fluid (CSF) and serum samples, as well as Aβ-induced SK-N-SH and CHP-212 cells. Silencing circ_0049472 promoted cell proliferation, and inhibited cell apoptosis in Aβ-induced SK-N-SH and CHP-212 cells. MiR-107 was a target of circ_0049472. MiR-107 silencing abolished the cell viability and apoptosis affected by down-regulation of circ_0049472 in Aβ-induced SK-N-SH and CHP-212 cells. Besides, miR-107 targeted KIF1B, and overexpressed KIF1B reverted miR-107 elevation-mediated effects on cell apoptosis, inflammation, and oxidative stress of Aβ-induced SK-N-SH and CHP-212 cells. Circ_0049472 modulated KIF1B by serving as a miR-107 decoy, thereby mediating Aβ-induced neurotoxicity, suggesting that circ_0049472 may be involved in AD pathogenesis.
Collapse
Affiliation(s)
- Chaosheng Zeng
- Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, No. 48, Baishuitang Road, Longhua District, Haikou City, 570311, Hainan Province, China
| | - Huaijie Xing
- Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, No. 48, Baishuitang Road, Longhua District, Haikou City, 570311, Hainan Province, China
| | - Min Chen
- Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, No. 48, Baishuitang Road, Longhua District, Haikou City, 570311, Hainan Province, China
| | - Lin Chen
- Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, No. 48, Baishuitang Road, Longhua District, Haikou City, 570311, Hainan Province, China
| | - Pengxiang Li
- Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, No. 48, Baishuitang Road, Longhua District, Haikou City, 570311, Hainan Province, China
| | - Xiaowen Wu
- Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, No. 48, Baishuitang Road, Longhua District, Haikou City, 570311, Hainan Province, China
| | - Li Li
- Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, No. 48, Baishuitang Road, Longhua District, Haikou City, 570311, Hainan Province, China.
| |
Collapse
|
16
|
Orellana A, García-González P, Valero S, Montrreal L, de Rojas I, Hernández I, Rosende-Roca M, Vargas L, Tartari JP, Esteban-De Antonio E, Bojaryn U, Narvaiza L, Alarcón-Martín E, Alegret M, Alcolea D, Lleó A, Tárraga L, Pytel V, Cano A, Marquié M, Boada M, Ruiz A. Establishing In-House Cutoffs of CSF Alzheimer’s Disease Biomarkers for the AT(N) Stratification of the Alzheimer Center Barcelona Cohort. Int J Mol Sci 2022; 23:ijms23136891. [PMID: 35805894 PMCID: PMC9266894 DOI: 10.3390/ijms23136891] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Clinical diagnosis of Alzheimer’s disease (AD) increasingly incorporates CSF biomarkers. However, due to the intrinsic variability of the immunodetection techniques used to measure these biomarkers, establishing in-house cutoffs defining the positivity/negativity of CSF biomarkers is recommended. However, the cutoffs currently published are usually reported by using cross-sectional datasets, not providing evidence about its intrinsic prognostic value when applied to real-world memory clinic cases. Methods: We quantified CSF Aβ1-42, Aβ1-40, t-Tau, and p181Tau with standard INNOTEST® ELISA and Lumipulse G® chemiluminescence enzyme immunoassay (CLEIA) performed on the automated Lumipulse G600II. Determination of cutoffs included patients clinically diagnosed with probable Alzheimer’s disease (AD, n = 37) and subjective cognitive decline subjects (SCD, n = 45), cognitively stable for 3 years and with no evidence of brain amyloidosis in 18F-Florbetaben-labeled positron emission tomography (FBB-PET). To compare both methods, a subset of samples for Aβ1-42 (n = 519), t-Tau (n = 399), p181Tau (n = 77), and Aβ1-40 (n = 44) was analyzed. Kappa agreement of single biomarkers and Aβ1-42/Aβ1-40 was evaluated in an independent group of mild cognitive impairment (MCI) and dementia patients (n = 68). Next, established cutoffs were applied to a large real-world cohort of MCI subjects with follow-up data available (n = 647). Results: Cutoff values of Aβ1-42 and t-Tau were higher for CLEIA than for ELISA and similar for p181Tau. Spearman coefficients ranged between 0.81 for Aβ1-40 and 0.96 for p181TAU. Passing–Bablok analysis showed a systematic and proportional difference for all biomarkers but only systematic for Aβ1-40. Bland–Altman analysis showed an average difference between methods in favor of CLEIA. Kappa agreement for single biomarkers was good but lower for the Aβ1-42/Aβ1-40 ratio. Using the calculated cutoffs, we were able to stratify MCI subjects into four AT(N) categories. Kaplan–Meier analyses of AT(N) categories demonstrated gradual and differential dementia conversion rates (p = 9.815−27). Multivariate Cox proportional hazard models corroborated these findings, demonstrating that the proposed AT(N) classifier has prognostic value. AT(N) categories are only modestly influenced by other known factors associated with disease progression. Conclusions: We established CLEIA and ELISA internal cutoffs to discriminate AD patients from amyloid-negative SCD individuals. The results obtained by both methods are not interchangeable but show good agreement. CLEIA is a good and faster alternative to manual ELISA for providing AT(N) classification of our patients. AT(N) categories have an impact on disease progression. AT(N) classifiers increase the certainty of the MCI prognosis, which can be instrumental in managing real-world MCI subjects.
Collapse
Affiliation(s)
- Adelina Orellana
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08029 Barcelona, Spain; (A.O.); (P.G.-G.); (S.V.); (L.M.); (I.d.R.); (I.H.); (M.R.-R.); (L.V.); (J.P.T.); (E.E.-D.A.); (U.B.); (L.N.); (E.A.-M.); (M.A.); (L.T.); (V.P.); (A.C.); (M.M.); (M.B.)
| | - Pablo García-González
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08029 Barcelona, Spain; (A.O.); (P.G.-G.); (S.V.); (L.M.); (I.d.R.); (I.H.); (M.R.-R.); (L.V.); (J.P.T.); (E.E.-D.A.); (U.B.); (L.N.); (E.A.-M.); (M.A.); (L.T.); (V.P.); (A.C.); (M.M.); (M.B.)
| | - Sergi Valero
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08029 Barcelona, Spain; (A.O.); (P.G.-G.); (S.V.); (L.M.); (I.d.R.); (I.H.); (M.R.-R.); (L.V.); (J.P.T.); (E.E.-D.A.); (U.B.); (L.N.); (E.A.-M.); (M.A.); (L.T.); (V.P.); (A.C.); (M.M.); (M.B.)
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), 28031 Madrid, Spain; (D.A.); (A.L.)
| | - Laura Montrreal
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08029 Barcelona, Spain; (A.O.); (P.G.-G.); (S.V.); (L.M.); (I.d.R.); (I.H.); (M.R.-R.); (L.V.); (J.P.T.); (E.E.-D.A.); (U.B.); (L.N.); (E.A.-M.); (M.A.); (L.T.); (V.P.); (A.C.); (M.M.); (M.B.)
| | - Itziar de Rojas
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08029 Barcelona, Spain; (A.O.); (P.G.-G.); (S.V.); (L.M.); (I.d.R.); (I.H.); (M.R.-R.); (L.V.); (J.P.T.); (E.E.-D.A.); (U.B.); (L.N.); (E.A.-M.); (M.A.); (L.T.); (V.P.); (A.C.); (M.M.); (M.B.)
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), 28031 Madrid, Spain; (D.A.); (A.L.)
| | - Isabel Hernández
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08029 Barcelona, Spain; (A.O.); (P.G.-G.); (S.V.); (L.M.); (I.d.R.); (I.H.); (M.R.-R.); (L.V.); (J.P.T.); (E.E.-D.A.); (U.B.); (L.N.); (E.A.-M.); (M.A.); (L.T.); (V.P.); (A.C.); (M.M.); (M.B.)
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), 28031 Madrid, Spain; (D.A.); (A.L.)
| | - Maitee Rosende-Roca
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08029 Barcelona, Spain; (A.O.); (P.G.-G.); (S.V.); (L.M.); (I.d.R.); (I.H.); (M.R.-R.); (L.V.); (J.P.T.); (E.E.-D.A.); (U.B.); (L.N.); (E.A.-M.); (M.A.); (L.T.); (V.P.); (A.C.); (M.M.); (M.B.)
| | - Liliana Vargas
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08029 Barcelona, Spain; (A.O.); (P.G.-G.); (S.V.); (L.M.); (I.d.R.); (I.H.); (M.R.-R.); (L.V.); (J.P.T.); (E.E.-D.A.); (U.B.); (L.N.); (E.A.-M.); (M.A.); (L.T.); (V.P.); (A.C.); (M.M.); (M.B.)
| | - Juan Pablo Tartari
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08029 Barcelona, Spain; (A.O.); (P.G.-G.); (S.V.); (L.M.); (I.d.R.); (I.H.); (M.R.-R.); (L.V.); (J.P.T.); (E.E.-D.A.); (U.B.); (L.N.); (E.A.-M.); (M.A.); (L.T.); (V.P.); (A.C.); (M.M.); (M.B.)
| | - Ester Esteban-De Antonio
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08029 Barcelona, Spain; (A.O.); (P.G.-G.); (S.V.); (L.M.); (I.d.R.); (I.H.); (M.R.-R.); (L.V.); (J.P.T.); (E.E.-D.A.); (U.B.); (L.N.); (E.A.-M.); (M.A.); (L.T.); (V.P.); (A.C.); (M.M.); (M.B.)
| | - Urszula Bojaryn
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08029 Barcelona, Spain; (A.O.); (P.G.-G.); (S.V.); (L.M.); (I.d.R.); (I.H.); (M.R.-R.); (L.V.); (J.P.T.); (E.E.-D.A.); (U.B.); (L.N.); (E.A.-M.); (M.A.); (L.T.); (V.P.); (A.C.); (M.M.); (M.B.)
| | - Leire Narvaiza
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08029 Barcelona, Spain; (A.O.); (P.G.-G.); (S.V.); (L.M.); (I.d.R.); (I.H.); (M.R.-R.); (L.V.); (J.P.T.); (E.E.-D.A.); (U.B.); (L.N.); (E.A.-M.); (M.A.); (L.T.); (V.P.); (A.C.); (M.M.); (M.B.)
| | - Emilio Alarcón-Martín
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08029 Barcelona, Spain; (A.O.); (P.G.-G.); (S.V.); (L.M.); (I.d.R.); (I.H.); (M.R.-R.); (L.V.); (J.P.T.); (E.E.-D.A.); (U.B.); (L.N.); (E.A.-M.); (M.A.); (L.T.); (V.P.); (A.C.); (M.M.); (M.B.)
| | - Montserrat Alegret
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08029 Barcelona, Spain; (A.O.); (P.G.-G.); (S.V.); (L.M.); (I.d.R.); (I.H.); (M.R.-R.); (L.V.); (J.P.T.); (E.E.-D.A.); (U.B.); (L.N.); (E.A.-M.); (M.A.); (L.T.); (V.P.); (A.C.); (M.M.); (M.B.)
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), 28031 Madrid, Spain; (D.A.); (A.L.)
| | - Daniel Alcolea
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), 28031 Madrid, Spain; (D.A.); (A.L.)
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, 08029 Barcelona, Spain
| | - Alberto Lleó
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), 28031 Madrid, Spain; (D.A.); (A.L.)
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, 08029 Barcelona, Spain
| | - Lluís Tárraga
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08029 Barcelona, Spain; (A.O.); (P.G.-G.); (S.V.); (L.M.); (I.d.R.); (I.H.); (M.R.-R.); (L.V.); (J.P.T.); (E.E.-D.A.); (U.B.); (L.N.); (E.A.-M.); (M.A.); (L.T.); (V.P.); (A.C.); (M.M.); (M.B.)
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), 28031 Madrid, Spain; (D.A.); (A.L.)
| | - Vanesa Pytel
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08029 Barcelona, Spain; (A.O.); (P.G.-G.); (S.V.); (L.M.); (I.d.R.); (I.H.); (M.R.-R.); (L.V.); (J.P.T.); (E.E.-D.A.); (U.B.); (L.N.); (E.A.-M.); (M.A.); (L.T.); (V.P.); (A.C.); (M.M.); (M.B.)
| | - Amanda Cano
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08029 Barcelona, Spain; (A.O.); (P.G.-G.); (S.V.); (L.M.); (I.d.R.); (I.H.); (M.R.-R.); (L.V.); (J.P.T.); (E.E.-D.A.); (U.B.); (L.N.); (E.A.-M.); (M.A.); (L.T.); (V.P.); (A.C.); (M.M.); (M.B.)
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), 28031 Madrid, Spain; (D.A.); (A.L.)
| | - Marta Marquié
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08029 Barcelona, Spain; (A.O.); (P.G.-G.); (S.V.); (L.M.); (I.d.R.); (I.H.); (M.R.-R.); (L.V.); (J.P.T.); (E.E.-D.A.); (U.B.); (L.N.); (E.A.-M.); (M.A.); (L.T.); (V.P.); (A.C.); (M.M.); (M.B.)
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), 28031 Madrid, Spain; (D.A.); (A.L.)
| | - Mercè Boada
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08029 Barcelona, Spain; (A.O.); (P.G.-G.); (S.V.); (L.M.); (I.d.R.); (I.H.); (M.R.-R.); (L.V.); (J.P.T.); (E.E.-D.A.); (U.B.); (L.N.); (E.A.-M.); (M.A.); (L.T.); (V.P.); (A.C.); (M.M.); (M.B.)
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), 28031 Madrid, Spain; (D.A.); (A.L.)
| | - Agustín Ruiz
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08029 Barcelona, Spain; (A.O.); (P.G.-G.); (S.V.); (L.M.); (I.d.R.); (I.H.); (M.R.-R.); (L.V.); (J.P.T.); (E.E.-D.A.); (U.B.); (L.N.); (E.A.-M.); (M.A.); (L.T.); (V.P.); (A.C.); (M.M.); (M.B.)
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), 28031 Madrid, Spain; (D.A.); (A.L.)
- Correspondence:
| |
Collapse
|
17
|
Clinical usefulness of the CSF β-amyloid Aβ1-42/Aβ1-40 ratio for Alzheimer's disease diagnosis: a retrospective study in a Belgian academic hospital. Acta Neurol Belg 2022; 122:245-247. [PMID: 35037226 DOI: 10.1007/s13760-021-01846-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/06/2021] [Indexed: 11/01/2022]
|
18
|
Feng L, Li J, Zhang R. Current research status of blood biomarkers in Alzheimer's disease: Diagnosis and prognosis. Ageing Res Rev 2021; 72:101492. [PMID: 34673262 DOI: 10.1016/j.arr.2021.101492] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 08/04/2021] [Accepted: 10/15/2021] [Indexed: 01/10/2023]
Abstract
Alzheimer's disease (AD), which mainly occurs in the elderly, is a neurodegenerative disease with a hidden onset, which leads to progressive cognitive and behavioral changes. The annually increasing prevalence rate and number of patients with AD exert great pressure on the society. No effective disease-modifying drug treatments are available; thus, there is no cure yet. The disease progression can only be delayed through early detection and drug assistance. Therefore, the importance of exploring associated biomarkers for the early diagnosis and prediction of the disease progress is highlighted. The National Institute on Aging- Alzheimer's Association (NIA-AA) proposed A/T/N diagnostic criteria in 2018, including Aβ42, p-tau, t-tau in cerebrospinal fluid (CSF), and positron emission tomography (PET). However, the invasiveness of lumbar puncture for CSF assessment and non-popularity of PET have prompted researchers to look for minimally invasive, easy to collect, and cost-effective biomarkers. Therefore, studies have largely focused on some novel molecules in the peripheral blood. This is an emerging research field, facing many obstacles and challenges while achieving some promising results.
Collapse
|
19
|
Gobom J, Parnetti L, Rosa-Neto P, Vyhnalek M, Gauthier S, Cataldi S, Lerch O, Laczo J, Cechova K, Clarin M, Benet AI, Pascoal TA, Rahmouni N, Vandijck M, Huyck E, Le Bastard N, Stevenson J, Chamoun M, Alcolea D, Lleó A, Andreasson U, Verbeek MM, Bellomo G, Rinaldi R, Ashton N, Zetterberg H, Sheardova K, Hort J, Blennow K. Validation of the LUMIPULSE automated immunoassay for the measurement of core AD biomarkers in cerebrospinal fluid. Clin Chem Lab Med 2021; 60:207-219. [PMID: 34773730 DOI: 10.1515/cclm-2021-0651] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 11/02/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The core cerebrospinal fluid (CSF) biomarkers; total tau (tTau), phospho-tau (pTau), amyloid β 1-42 (Aβ 1-42), and the Aβ 1-42/Aβ 1-40 ratio have transformed Alzheimer's disease (AD) research and are today increasingly used in clinical routine laboratories as diagnostic tools. Fully automated immunoassay instruments with ready-to-use assay kits and calibrators has simplified their analysis and improved reproducibility of measurements. We evaluated the analytical performance of the fully automated immunoassay instrument LUMIPULSE G (Fujirebio) for measurement of the four core AD CSF biomarkers and determined cutpoints for AD diagnosis. METHODS Comparison of the LUMIPULSE G assays was performed with the established INNOTEST ELISAs (Fujirebio) for hTau Ag, pTau 181, β-amyloid 1-42, and with V-PLEX Plus Aβ Peptide Panel 1 (6E10) (Meso Scale Discovery) for Aβ 1-42/Aβ 1-40, as well as with a LC-MS reference method for Aβ 1-42. Intra- and inter-laboratory reproducibility was evaluated for all assays. Clinical cutpoints for Aβ 1-42, tTau, and pTau was determined by analysis of three cohorts of clinically diagnosed patients, comprising 651 CSF samples. For the Aβ 1-42/Aβ 1-40 ratio, the cutpoint was determined by mixture model analysis of 2,782 CSF samples. RESULTS The LUMIPULSE G assays showed strong correlation to all other immunoassays (r>0.93 for all assays). The repeatability (intra-laboratory) CVs ranged between 2.0 and 5.6%, with the highest variation observed for β-amyloid 1-40. The reproducibility (inter-laboratory) CVs ranged between 2.1 and 6.5%, with the highest variation observed for β-amyloid 1-42. The clinical cutpoints for AD were determined to be 409 ng/L for total tau, 50.2 ng/L for pTau 181, 526 ng/L for β-amyloid 1-42, and 0.072 for the Aβ 1-42/Aβ 1-40 ratio. CONCLUSIONS Our results suggest that the LUMIPULSE G assays for the CSF AD biomarkers are fit for purpose in clinical laboratory practice. Further, they corroborate earlier presented reference limits for the biomarkers.
Collapse
Affiliation(s)
- Johan Gobom
- 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
| | - Lucilla Parnetti
- Laboratory of Clinical Neurochemistry, Section of Neurology, University of Perugia, Perugia, Italy
| | - Pedro Rosa-Neto
- Department of Neurology and Neurosurgery, McGill University Research Centre for Studies in Aging, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, QC, Canada.,Montreal Neurological Institute, Montreal, QC, Canada
| | - Martin Vyhnalek
- Department of Neurology, Second Medical Faculty, Charles University, Prague, Czech Republic.,Motol University Hospital, Prague, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic
| | - Serge Gauthier
- Department of Neurology and Neurosurgery, McGill University Research Centre for Studies in Aging, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, QC, Canada.,Montreal Neurological Institute, Montreal, QC, Canada
| | - Samuela Cataldi
- Laboratory of Clinical Neurochemistry, Section of Neurology, University of Perugia, Perugia, Italy
| | - Ondrej Lerch
- Department of Neurology, Second Medical Faculty, Charles University, Prague, Czech Republic.,Motol University Hospital, Prague, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic
| | - Jan Laczo
- Department of Neurology, Second Medical Faculty, Charles University, Prague, Czech Republic.,Motol University Hospital, Prague, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic
| | - Katerina Cechova
- Department of Neurology, Second Medical Faculty, Charles University, Prague, Czech Republic.,Motol University Hospital, Prague, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic
| | - Marcus Clarin
- 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
| | - Andrea I Benet
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, McGill University, Montreal, QC, Canada
| | - Tharick A Pascoal
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, McGill University, Montreal, QC, Canada
| | - Neserine Rahmouni
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, McGill University, Montreal, QC, Canada
| | | | | | | | - Jenna Stevenson
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, McGill University, Montreal, QC, Canada
| | - Mira Chamoun
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, McGill University, Montreal, QC, Canada
| | - Daniel Alcolea
- Department of Neurology, Memory Unit, Hospital de la Santa Creu i Sant Pau- Biomedical Research Institute Sant Pau-Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Alberto Lleó
- Department of Neurology, Memory Unit, Hospital de la Santa Creu i Sant Pau- Biomedical Research Institute Sant Pau-Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Ulf Andreasson
- 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
| | - Marcel M Verbeek
- Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Neurology, Radboud Alzheimer Centre, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Giovanni Bellomo
- Laboratory of Clinical Neurochemistry, Section of Neurology, University of Perugia, Perugia, Italy
| | - Roberta Rinaldi
- Laboratory of Clinical Neurochemistry, Section of Neurology, University of Perugia, Perugia, Italy
| | - Nicholas 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
| | - 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
| | - Katerina Sheardova
- Department of Neurology, Second Medical Faculty, Charles University, Prague, Czech Republic.,First Department of Neurology, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czech Republic
| | - Jakub Hort
- Department of Neurology, Second Medical Faculty, Charles University, Prague, Czech Republic.,Motol University Hospital, Prague, Czech Republic.,First Department of Neurology, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czech Republic
| | - 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
| |
Collapse
|
20
|
Lombardi G, Pupi A, Bessi V, Polito C, Padiglioni S, Ferrari C, Lucidi G, Berti V, De Cristofaro MT, Piaceri I, Bagnoli S, Nacmias B, Sorbi S. Challenges in Alzheimer's Disease Diagnostic Work-Up: Amyloid Biomarker Incongruences. J Alzheimers Dis 2021; 77:203-217. [PMID: 32716357 DOI: 10.3233/jad-200119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Discordance among amyloid biomarkers is a challenge to overcome in order to increase diagnostic accuracy in dementia. OBJECTIVES 1) To verify that cerebrospinal fluid (CSF) Aβ42/Aβ40 ratio (AβR) better agrees with Amyloid PET (Amy-PET) results compared to CSF Aβ42; 2) to detect differences among concordant positive, concordant negative, and discordant cases, basing the concordance definition on the agreement between CSF AβR and Amy-PET results; 3) to define the suspected underlying pathology of discordant cases using in vivo biomarkers. METHOD We retrospectively enrolled 39 cognitively impaired participants in which neuropsychological tests, apolipoprotein E genotype determination, TC/MRI, FDG-PET, Amy-PET, and CSF analysis had been performed. In all cases, CSF analysis was repeated using the automated Lumipulse method. In discordant cases, FDG-PET scans were evaluated visually and using automated classifiers. RESULTS CSF AβR better agreed with Amy-PET compared to CSF Aβ42 (Cohen's K 0.431 versus 0.05). Comparisons among groups did not show any difference in clinical characteristics except for age at symptoms onset that was higher in the 6 discordant cases with abnormal CSF AβR values and negative Amy-PET (CSF AβR+/AmyPET-). FDG-PET and all CSF markers (Aβ42, AβR, p-Tau, t-Tau) were suggestive of Alzheimer's disease (AD) in 5 of these 6 cases. CONCLUSION 1) CSF AβR is the CSF amyloid marker that shows the better level of agreement with Amy-PET results; 2) The use of FDG-PET and CSF-Tau markers in CSFAβR+/Amy-PET-discordant cases can support AD diagnosis; 3) Disagreement between positive CSF AβR and negative Amy-PET in symptomatic aged AD patients could be due to the variability in plaques conformation and a negative Amy-PET scan cannot be always sufficient to rule out AD.
Collapse
Affiliation(s)
- Gemma Lombardi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy.,Fondazione Filippo Turati, Pistoia, Italy
| | | | | | - Cristina Polito
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", Nuclear Medicine Unit, University of Florence, Florence, Italy
| | - Sonia Padiglioni
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Camilla Ferrari
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | | | - Valentina Berti
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", Nuclear Medicine Unit, University of Florence, Florence, Italy
| | | | - Irene Piaceri
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Silvia Bagnoli
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy.,Fondazione IRCCS Don Carlo Gnocchi, Florence, Italy
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy.,Fondazione IRCCS Don Carlo Gnocchi, Florence, Italy
| |
Collapse
|
21
|
Arnold SE. "Senior Moments" or More? Diagnostic Evaluation of Cognitive Complaints in Older Adults and the Role of Cerebrospinal Fluid Biomarkers. J Appl Lab Med 2021; 5:219-224. [PMID: 31811078 DOI: 10.1373/jalm.2019.029546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 10/21/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Steven E Arnold
- Massachusetts Alzheimer's Disease Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA
| |
Collapse
|
22
|
Agnello L, Colletti T, Lo Sasso B, Vidali M, Spataro R, Gambino CM, Giglio RV, Piccoli T, Bivona G, La Bella V, Ciaccio M. Tau protein as a diagnostic and prognostic biomarker in amyotrophic lateral sclerosis. Eur J Neurol 2021; 28:1868-1875. [PMID: 33638255 DOI: 10.1111/ene.14789] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/11/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND PURPOSE To test the hypothesis that total tau (tTau), tau phosphorylated at threonine 181 (pTau) and pTau/tTau ratio in the cerebrospinal fluid (CSF) are diagnostic and prognostic biomarkers of amyotrophic lateral sclerosis (ALS), we performed a retrospective observational study in a large cohort of ALS patients and controls. METHODS We enrolled 196 ALS patients and 91 controls, who included patients with ALS-mimicking diseases and those with non-neurodegenerative diseases. All patients underwent lumbar puncture for CSF analysis at the time of the diagnostic evaluation or to first referral. We measured tTau and pTau levels in the CSF by chemiluminescence enzyme immunoassay. RESULTS Patients with ALS showed significantly higher levels of CSF tTau and a lower pTau/tTau ratio than controls (tTau: 245 vs. 146 pg/ml; p < 0.001; pTau/tTau ratio: 0.12 vs. 0.18; p < 0.001, respectively). No differences in pTau levels were detected. Receiver-operating characteristic curve analysis showed a good diagnostic accuracy of tTau and pTau/tTau ratio (tTau: area under the curve [AUC] 0.685, 95% confidence interval [CI] 0.616-0.754, p = 0.039; pTau/tTau ratio: AUC 0.777, 95% CI 0.707-0.848, p < 0.001). Among ALS patients, increased tTau levels were associated with advanced age of onset, increased revised amyotrophic lateral sclerosis functional rating scale (ALSFRS-R) score (ΔFS) rate of progression, and spinal onset. Multivariate analysis showed that in ALS patients, this biomarker was an independent negative predictor of overall survival. CONCLUSIONS Our findings suggest that tTau and pTau/tTau ratio can be diagnostic biomarkers of ALS. In addition, CSF tTau level at diagnosis might play a relevant prognostic role in the disease.
Collapse
Affiliation(s)
- Luisa Agnello
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, University of Palermo, Palermo, Italy
| | - Tiziana Colletti
- ALS Clinical Research Center and Laboratory of Neurochemistry, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Bruna Lo Sasso
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, University of Palermo, Palermo, Italy.,Department of Laboratory Medicine, University Hospital "P. Giaccone", Palermo, Italy
| | - Matteo Vidali
- Unit of Clinical Chemistry, Maggiore della Carità Hospital, Novara, Italy
| | | | - Caterina Maria Gambino
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, University of Palermo, Palermo, Italy
| | - Rosaria Vincenza Giglio
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, University of Palermo, Palermo, Italy
| | - Tommaso Piccoli
- Unit of Neurology, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Giulia Bivona
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, University of Palermo, Palermo, Italy
| | - Vincenzo La Bella
- ALS Clinical Research Center and Laboratory of Neurochemistry, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Marcello Ciaccio
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, University of Palermo, Palermo, Italy.,Department of Laboratory Medicine, University Hospital "P. Giaccone", Palermo, Italy
| |
Collapse
|
23
|
2020 update on the clinical validity of cerebrospinal fluid amyloid, tau, and phospho-tau as biomarkers for Alzheimer's disease in the context of a structured 5-phase development framework. Eur J Nucl Med Mol Imaging 2021; 48:2121-2139. [PMID: 33674895 PMCID: PMC8175301 DOI: 10.1007/s00259-021-05258-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/11/2021] [Indexed: 12/15/2022]
Abstract
Purpose In the last decade, the research community has focused on defining reliable biomarkers for the early detection of Alzheimer’s disease (AD) pathology. In 2017, the Geneva AD Biomarker Roadmap Initiative adapted a framework for the systematic validation of oncological biomarkers to cerebrospinal fluid (CSF) AD biomarkers—encompassing the 42 amino-acid isoform of amyloid-β (Aβ42), phosphorylated-tau (P-tau), and Total-tau (T-tau)—with the aim to accelerate their development and clinical implementation. The aim of this work is to update the current validation status of CSF AD biomarkers based on the Biomarker Roadmap methodology. Methods A panel of experts in AD biomarkers convened in November 2019 at a 2-day workshop in Geneva. The level of maturity (fully achieved, partly achieved, preliminary evidence, not achieved, unsuccessful) of CSF AD biomarkers was assessed based on the Biomarker Roadmap methodology before the meeting and presented and discussed during the workshop. Results By comparison to the previous 2017 Geneva Roadmap meeting, the primary advances in CSF AD biomarkers have been in the area of a unified protocol for CSF sampling, handling and storage, the introduction of certified reference methods and materials for Aβ42, and the introduction of fully automated assays. Additional advances have occurred in the form of defining thresholds for biomarker positivity and assessing the impact of covariates on their discriminatory ability. Conclusions Though much has been achieved for phases one through three, much work remains in phases four (real world performance) and five (assessment of impact/cost). To a large degree, this will depend on the availability of disease-modifying treatments for AD, given these will make accurate and generally available diagnostic tools key to initiate therapy. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-021-05258-7.
Collapse
|
24
|
Dakterzada F, López-Ortega R, Arias A, Riba-Llena I, Ruiz-Julián M, Huerto R, Tahan N, Piñol-Ripoll G. Assessment of the Concordance and Diagnostic Accuracy Between Elecsys and Lumipulse Fully Automated Platforms and Innotest. Front Aging Neurosci 2021; 13:604119. [PMID: 33746733 PMCID: PMC7970049 DOI: 10.3389/fnagi.2021.604119] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 02/10/2021] [Indexed: 11/13/2022] Open
Abstract
Manual ELISA assays are the most commonly used methods for quantification of biomarkers; however, they often show inter- and intra-laboratory variability that limits their wide use. Here, we compared the Innotest ELISA method with two fully automated platforms (Lumipulse and Elecsys) to determine whether these new methods can provide effective substitutes for ELISA assays. We included 149 patients with AD (n = 34), MCI (n = 94) and non-AD dementias (n = 21). Aβ42, T-tau, and P-tau were quantified using the ELISA method (Innotest, Fujirebio Europe), CLEIA method on a Lumipulse G600II (Fujirebio Diagnostics), and ECLIA method on a Cobas e 601 (Roche Diagnostics) instrument. We found a high correlation between the three methods, although there were systematic differences between biomarker values measured by each method. Both Lumipulse and Elecsys methods were highly concordant with clinical diagnoses, and the combination of Lumipulse Aβ42 and P-tau had the highest discriminating power (AUC 0.915, 95% CI 0.822–1.000). We also assessed the agreement of AT(N) classification for each method with AD diagnosis. Although differences were not significant, the use of Aβ42/Aβ40 ratio instead of Aβ42 alone in AT(N) classification enhanced the diagnostic accuracy (AUC 0.798, 95% CI 0.649–0.947 vs. AUC 0.778, 95% CI 0.617–0.939). We determined the cut-offs for the Lumipulse and Elecsys assays based on the Aβ42/Aβ40 ratio ± status as a marker of amyloid pathology, and these cut-offs were consistent with those recommended by manufacturers, which had been determined based on visual amyloid PET imaging or diagnostic accuracy. Finally, the biomarker ratios (P-tau/Aβ42 and T-tau/Aβ42) were more consistent with the Aβ42/Aβ40 ratio for both Lumipulse and Elecsys methods, and Elecsys P-tau/Aβ42 had the highest consistency with amyloid pathology (AUC 0.994, 95% CI 0.986–1.000 and OPA 96.4%) at the ≥0.024 cut-off. The Lumipulse and Elecsys cerebrospinal fluid (CSF) AD assays showed high analytical and clinical performances. As both automated platforms were standardized for reference samples, their use is recommended for the measurement of CSF AD biomarkers compared with unstandardized manual methods, such as Innotest ELISA, that have demonstrated a high inter and intra-laboratory variability.
Collapse
Affiliation(s)
- Farida Dakterzada
- Cognitive Disorders Unit, Clinical Neuroscience Research Group, Santa Maria University Hospital, IRBLleida, Lleida, Spain
| | - Ricard López-Ortega
- Cognitive Disorders Unit, Clinical Neuroscience Research Group, Santa Maria University Hospital, IRBLleida, Lleida, Spain
| | - Alfonso Arias
- Cognitive Disorders Unit, Clinical Neuroscience Research Group, Santa Maria University Hospital, IRBLleida, Lleida, Spain
| | - Iolanda Riba-Llena
- Cognitive Disorders Unit, Clinical Neuroscience Research Group, Santa Maria University Hospital, IRBLleida, Lleida, Spain
| | - Maria Ruiz-Julián
- Cognitive Disorders Unit, Clinical Neuroscience Research Group, Santa Maria University Hospital, IRBLleida, Lleida, Spain
| | - Raquel Huerto
- Cognitive Disorders Unit, Clinical Neuroscience Research Group, Santa Maria University Hospital, IRBLleida, Lleida, Spain
| | - Nuria Tahan
- Cognitive Disorders Unit, Clinical Neuroscience Research Group, Santa Maria University Hospital, IRBLleida, Lleida, Spain
| | - Gerard Piñol-Ripoll
- Cognitive Disorders Unit, Clinical Neuroscience Research Group, Santa Maria University Hospital, IRBLleida, Lleida, Spain
| |
Collapse
|
25
|
Keshavan A, Wellington H, Chen Z, Khatun A, Chapman M, Hart M, Cash DM, Coath W, Parker TD, Buchanan SM, Keuss SE, Harris MJ, Murray‐Smith H, Heslegrave A, Fox NC, Zetterberg H, Schott JM. Concordance of CSF measures of Alzheimer's pathology with amyloid PET status in a preclinical cohort: A comparison of Lumipulse and established immunoassays. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12131. [PMID: 33598527 PMCID: PMC7867115 DOI: 10.1002/dad2.12131] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 01/19/2023]
Abstract
INTRODUCTION We assessed the concordance of cerebrospinal fluid (CSF) amyloid beta (Aβ) and tau measured on the fully automated Lumipulse platform with pre-symptomatic Alzheimer's disease (AD) pathology on amyloid positron emission tomography (PET). METHODS In 72 individuals from the Insight 46 study, CSF Aβ40, Aβ42, total tau (t-tau), and phosphorylated tau at site 181 (p-tau181) were measured using Lumipulse, INNOTEST, and Meso Scale Discovery (MSD) assays and inter-platform Pearson correlations derived. Lumipulse Aβ42 measures were adjusted to incorporate standardization to certified reference materials. Logistic regressions and receiver operating characteristics analysis generated CSF cut-points optimizing concordance with 18F-florbetapir amyloid PET status (n = 63). RESULTS Measurements of CSF Aβ, p-tau181, and their ratios correlated well across platforms (r 0.84 to 0.94, P < .0001); those of t-tau and t-tau/Aβ42 correlated moderately (r 0.57 to 0.79, P < .0001). The best concordance with amyloid PET (100% sensitivity and 94% specificity) was afforded by cut-points of 0.075 for Lumipulse Aβ42/Aβ40, 0.087 for MSD Aβ42/Aβ40 and 17.3 for Lumipulse Aβ42/p-tau181. DISCUSSION The Lumipulse platform provides comparable sensitivity and specificity to established CSF immunoassays in identifying pre-symptomatic AD pathology.
Collapse
Affiliation(s)
- Ashvini Keshavan
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - Henrietta Wellington
- UK Dementia Research Institute Fluid Biomarkers LaboratoryUK DRI at University College LondonLondonUK
| | - Zhongbo Chen
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - Ayesha Khatun
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - Miles Chapman
- Neuroimmunology and CSF LaboratoryNational Hospital for Neurology and NeurosurgeryLondonUK
| | - Melanie Hart
- Neuroimmunology and CSF LaboratoryNational Hospital for Neurology and NeurosurgeryLondonUK
- Department of NeuroinflammationUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - David M. Cash
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - William Coath
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - Thomas D. Parker
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - Sarah M. Buchanan
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - Sarah E. Keuss
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - Matthew J. Harris
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - Heidi Murray‐Smith
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - Amanda Heslegrave
- UK Dementia Research Institute Fluid Biomarkers LaboratoryUK DRI at University College LondonLondonUK
| | - Nick C. Fox
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - Henrik Zetterberg
- UK Dementia Research Institute Fluid Biomarkers LaboratoryUK DRI at University College LondonLondonUK
- Clinical Neurochemistry Laboratory, Department of Psychiatry and NeurochemistryInstitute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University HospitalMölndalSweden
| | - Jonathan M Schott
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| |
Collapse
|
26
|
Moon S, Kim S, Mankhong S, Choi SH, Vandijck M, Kostanjevecki V, Jeong JH, Yoon SJ, Park KW, Kim EJ, Yoon B, Kim HJ, Jang JW, Hong JY, Park DH, Shaw LM, Kang JH. Alzheimer's cerebrospinal biomarkers from Lumipulse fully automated immunoassay: concordance with amyloid-beta PET and manual immunoassay in Koreans : CSF AD biomarkers measured by Lumipulse in Koreans. ALZHEIMERS RESEARCH & THERAPY 2021; 13:22. [PMID: 33436035 PMCID: PMC7802266 DOI: 10.1186/s13195-020-00767-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 12/29/2020] [Indexed: 12/14/2022]
Abstract
Background Alzheimer’s disease (AD) cerebrospinal fluid (CSF) biomarker cutoffs from immunoassays with low interlaboratory variability in diverse ethnic groups are necessary for their use in clinics and clinical trials. With lack of cutoffs from fully automated immunoassay platforms in diverse races, the aim of this study is to evaluate the clinical utility of CSF AD biomarkers from the Lumipulse fully automated immunoassay based on β-amyloid (Aβ) positron emission tomography (PET) status comparing with these from two manual immunoassays, in Koreans. Methods Among 331 Korean participants enrolled from a prospective, 3-year longitudinal observational study of the validation cohort of Korean Brain Aging Study for the Early Diagnosis and Prediction of AD, 139 (29 CN, 58 SCD, 29 MCI, and 23 AD) provided CSF and 271 underwent baseline amyloid PET (n = 128 with overlapping CSF and Aβ-PET, and 143 without CSFs). Three annual cognitive and neuropsychiatric function tests were conducted. Aβ42, Aβ40, total-tau, and phosphorylated-tau181 were measured by Lumipulse fully automated immunoassay and two manual immunoassays (INNO-BIA AlzBio3, INNOTEST). Clinical utility of CSF biomarker cutoffs, based on 128 participants with Aβ-PET, was evaluated. Results Cognitive and neuropsychological scores differed significantly among the groups, with descending performance among CN>SCD>MCI>AD. Biomarker levels among immunoassays were strongly intercorrelated. We determined the Aβ-PET status in a subgroup without CSF (n = 143), and then when we applied CSF biomarker cutoffs determined based on the Aβ-PET status, the CSF biomarkers (cutoffs of 642.1 pg/mL for Aβ42, 0.060 for Aβ42/Aβ40, 0.315 for t-tau/Aβ42, and 0.051 for p-tau/Aβ42, respectively) showed good agreement with Aβ-PET (overall AUC ranges of 0.840–0.898). Use of the Aβ-PET-based CSF cutoffs showed excellent diagnostic discrimination between AD and CN (Aβ42, Aβ42/Aβ40, t-tau/Aβ42, and p-tau/Aβ42) with overall AUC ranges of 0.876–0.952. During follow-up, participants with AD-like CSF signature determined by Aβ-PET-based cutoffs from Lumipulse showed rapid progression of cognitive decline in 139 subjects, after adjustment for potential confounders, compared with those with a normal CSF signature. Conclusion CSF AD biomarkers measured by different immunoassay platforms show strong intercorrelated agreement with Aβ-PET in Koreans. The Korean-specific Aβ-PET-based CSF biomarker cutoffs measured by the Lumipulse assay strongly predicts progression of cognitive decline. The clinical utility of CSF biomarkers from fully-automated immunoassay platforms should be evaluated in larger, more diverse cohorts.
Collapse
Affiliation(s)
- Sohee Moon
- Department of Pharmacology and Hypoxia-related Disease Research Center, College of Medicine, Inha University, Room 1015, 60th Anniversary Hall, 100, Inha-ro, Nam-gu, Incheon, 22212, South Korea
| | - Sujin Kim
- Department of Pharmacology and Hypoxia-related Disease Research Center, College of Medicine, Inha University, Room 1015, 60th Anniversary Hall, 100, Inha-ro, Nam-gu, Incheon, 22212, South Korea.,Department of Kinesiology, Inha University, Incheon, 22212, South Korea
| | - Sakulrat Mankhong
- Department of Pharmacology and Hypoxia-related Disease Research Center, College of Medicine, Inha University, Room 1015, 60th Anniversary Hall, 100, Inha-ro, Nam-gu, Incheon, 22212, South Korea.,Program in Biomedical Science and Engineering, Inha University, Incheon, 22212, South Korea
| | - Seong Hye Choi
- Department of Neurology, College of Medicine, Inha University, Incheon, 22332, South Korea
| | - Manu Vandijck
- Fujirebio-Europe N.V., Technologiepark 6, 9052, Ghent, Belgium
| | | | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, 07985, South Korea
| | - Soo Jin Yoon
- Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, 35233, South Korea
| | - Kyung Won Park
- Department of Neurology, Dong-A Medical Center, Dong-A University College of Medicine, Busan, 49201, South Korea
| | - Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, 49241, South Korea
| | - Bora Yoon
- Department of Neurology, Konyang University College of Medicine, Daejeon, 35365, South Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, South Korea
| | - Jae-Won Jang
- Department of Neurology, Kangwon National University Hospital, Chuncheon, 24289, South Korea
| | - Jin Yong Hong
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, 26426, South Korea
| | - Dong-Ho Park
- Department of Kinesiology, Inha University, Incheon, 22212, South Korea
| | - Leslie M Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, 19104, PA, USA
| | - Ju-Hee Kang
- Department of Pharmacology and Hypoxia-related Disease Research Center, College of Medicine, Inha University, Room 1015, 60th Anniversary Hall, 100, Inha-ro, Nam-gu, Incheon, 22212, South Korea. .,Program in Biomedical Science and Engineering, Inha University, Incheon, 22212, South Korea.
| |
Collapse
|
27
|
Rossini PM, Cappa SF, Lattanzio F, Perani D, Spadin P, Tagliavini F, Vanacore N. The Italian INTERCEPTOR Project: From the Early Identification of Patients Eligible for Prescription of Antidementia Drugs to a Nationwide Organizational Model for Early Alzheimer's Disease Diagnosis. J Alzheimers Dis 2020; 72:373-388. [PMID: 31594234 DOI: 10.3233/jad-190670] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Alzheimer's disease is the most common age-related neurodegenerative disorder and its burden on patients, families, and society grows significantly with lifespan. Early modifications of risk-enhancing lifestyles and treatment initiation expand personal autonomy and reduce management costs. Many clinical trials with potentially disease-modifying drugs are devoted to mild cognitive impairment (MCI) prodromal-to-Alzheimer's disease. The identification of biomarkers for early diagnosis may thus be crucial for early intervention and identification of high-risk subjects, the most appropriate target of new drugs as soon as they will be discovered. INTERCEPTOR is a strategic project by the Italian Ministry of Health and the Italian Medicines Agency (AIFA), aiming to validate the best combination (highly accurate, non-invasive, available on the whole national territory and financially sustainable) of biomarkers and organizational model for early diagnosis. 500 MCI subjects will be enrolled at baseline and followed-up for 3 years for at least 400 of them in order to define a "hub & spoke" nationwide model with recruiting (spokes) centers for MCI identification and expert (hubs) centers for risk diagnosis.
Collapse
Affiliation(s)
- Paolo Maria Rossini
- Area of Neuroscience, University Policlinic A. Gemelli Foundation-IRCCS, Rome, Italy.,Institute of Neurology, Catholic University, Rome, Italy
| | - Stefano F Cappa
- University School for Advanced Studies IUSS Pavia, Pavia, Italy.,IRCCS St. John of God, Brescia, Italy
| | | | - Daniela Perani
- Nuclear Medicine Unit and Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Patrizia Spadin
- President "Associazione Italiana Malattia di Alzheimer" - AIMA, Italy
| | | | - Nicola Vanacore
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| |
Collapse
|
28
|
Keshavan A, Wellington H, Chen Z, Khatun A, Chapman M, Hart M, Cash DM, Coath W, Parker TD, Buchanan SM, Keuss SE, Harris MJ, Murray‐Smith H, Heslegrave A, Fox NC, Zetterberg H, Schott JM. Concordance of CSF measures of Alzheimer's pathology with amyloid PET status in a preclinical cohort: A comparison of Lumipulse and established immunoassays. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12097. [PMID: 32999915 PMCID: PMC7503103 DOI: 10.1002/dad2.12097] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/27/2020] [Accepted: 07/30/2020] [Indexed: 12/23/2022]
Abstract
INTRODUCTION We assessed the concordance of cerebrospinal fluid (CSF) amyloid beta (Aβ) and tau measured on the fully automated Lumipulse platform with pre-symptomatic Alzheimer's disease (AD) pathology on amyloid positron emission tomography (PET). METHODS In 72 individuals from the Insight 46 study, CSF Aβ40, Aβ42, total tau (t-tau), and phosphorylated tau at site 181 (p-tau181) were measured using Lumipulse, INNOTEST, and Meso Scale Discovery (MSD) assays, and inter-platform Pearson correlations were derived. Logistic regressions and receiver-operating characteristic analysis generated CSF cut-points optimizing concordance with 18F-florbetapir amyloid PET status (n = 63). RESULTS Measurements of CSF Aβ, p-tau181, and their ratios correlated well across platforms (r 0.84-.94, P < .0001); those of t-tau and t-tau/Aβ42 correlated moderately (r 0.57-0.79, P < .0001). The best concordance with amyloid PET (100% sensitivity and 94% specificity) was afforded by cut-points of 0.110 for Lumipulse Aβ42/Aβ40, 0.087 for MSD Aβ42/Aβ40, and 25.3 for Lumipulse Aβ42/p-tau181. DISCUSSION The Lumipulse platform provides comparable sensitivity and specificity to established CSF immunoassays in identifying pre-symptomatic AD pathology.
Collapse
Affiliation(s)
- Ashvini Keshavan
- Dementia Research CentreUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Henrietta Wellington
- UK Dementia Research Institute Fluid Biomarkers LaboratoryUK DRI at University College LondonLondonUK
| | - Zhongbo Chen
- Dementia Research CentreUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Ayesha Khatun
- Dementia Research CentreUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Miles Chapman
- Neuroimmunology and CSF LaboratoryNational Hospital for Neurology and NeurosurgeryLondonUK
| | - Melanie Hart
- Neuroimmunology and CSF LaboratoryNational Hospital for Neurology and NeurosurgeryLondonUK
- Department of NeuroinflammationUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - David M. Cash
- Dementia Research CentreUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - William Coath
- Dementia Research CentreUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Thomas D. Parker
- Dementia Research CentreUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Sarah M. Buchanan
- Dementia Research CentreUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Sarah E. Keuss
- Dementia Research CentreUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Matthew J. Harris
- Dementia Research CentreUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Heidi Murray‐Smith
- Dementia Research CentreUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Amanda Heslegrave
- UK Dementia Research Institute Fluid Biomarkers LaboratoryUK DRI at University College LondonLondonUK
| | - Nick C. Fox
- Dementia Research CentreUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Henrik Zetterberg
- UK Dementia Research Institute Fluid Biomarkers LaboratoryUK DRI at University College LondonLondonUK
- Clinical Neurochemistry LaboratoryDepartment of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologyThe Sahlgrenska Academy at University of GothenburgSahlgrenska University HospitalMölndalSweden
| | - Jonathan M. Schott
- Dementia Research CentreUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| |
Collapse
|
29
|
Agnello L, Piccoli T, Vidali M, Cuffaro L, Lo Sasso B, Iacolino G, Giglio VR, Lupo F, Alongi P, Bivona G, Ciaccio M. Diagnostic accuracy of cerebrospinal fluid biomarkers measured by chemiluminescent enzyme immunoassay for Alzheimer disease diagnosis. Scandinavian Journal of Clinical and Laboratory Investigation 2020; 80:313-317. [PMID: 32255379 DOI: 10.1080/00365513.2020.1740939] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
In the last decades, an important role of cerebrospinal fluid (CSF) biomarkers for Alzheimer disease (AD) diagnosis has emerged. The evaluation of the triad consisting of 42 aminoacid-long amyloid-beta peptide (Aβ42), total Tau (tTau) and Tau phosphorylated at threonine 181 (pTau) have been recently integrated into the research diagnostic criteria of AD. For a long time, the enzyme-linked immunosorbent assay (ELISA) has represented the most commonly used method for the measurement of CSF biomarkers levels. This study aimed to assess the diagnostic accuracy of CSF biomarkers, namely Aβ42, tTau and pTau and their ratio, measured by fully automated CLEIA assay (Lumipulse). We included 96 patients clinically diagnosed as AD (48) and non-AD (48). All CSF biomarkers levels were measured on Lumipulse G1200 fully automated platform (Fujirebio Inc. Europe, Gent, Belgium). Aβ42 levels, 42/40 ratio, 42/tTau ratio, 42/PTau ratio were significantly reduced, and tTau and PTau levels were significantly increased in AD patients in comparison with non-AD patients. The receiving operator curve (ROC) analysis showed good diagnostic accuracy of all CSF biomarkers and their ratios for discriminating AD patients from non-AD patients, with 42/40 ratio having the best AUC (0.724, 95%CI 0.619-0.828; p < 0.001). Our findings support the use of CSF biomarkers measured by CLEIA method on a fully automated platform for AD diagnosis.
Collapse
Affiliation(s)
- Luisa Agnello
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, University of Palermo, Palermo, Italy
| | - Tommaso Piccoli
- Unit of Neurology, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Matteo Vidali
- Unit of Clinical Chemistry, Maggiore della Carità Hospital, Novara, Italy
| | - Luca Cuffaro
- Unit of Neurology, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Bruna Lo Sasso
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, University of Palermo, Palermo, Italy
| | - Giorgia Iacolino
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, University of Palermo, Palermo, Italy
| | - Vincenza Rosaria Giglio
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, University of Palermo, Palermo, Italy
| | - Federica Lupo
- Unit of Neurology, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Pierpaolo Alongi
- Unit of Neurology, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Giulia Bivona
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, University of Palermo, Palermo, Italy
| | - Marcello Ciaccio
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, University of Palermo, Palermo, Italy.,Department of Laboratory Medicine, AOUP "P. Giaccone", Palermo, Italy
| |
Collapse
|
30
|
Wilson EN, Swarovski MS, Linortner P, Shahid M, Zuckerman AJ, Wang Q, Channappa D, Minhas PS, Mhatre SD, Plowey ED, Quinn JF, Zabetian CP, Tian L, Longo FM, Cholerton B, Montine TJ, Poston KL, Andreasson KI. Soluble TREM2 is elevated in Parkinson's disease subgroups with increased CSF tau. Brain 2020; 143:932-943. [PMID: 32065223 PMCID: PMC7089668 DOI: 10.1093/brain/awaa021] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/26/2019] [Accepted: 12/11/2019] [Indexed: 12/16/2022] Open
Abstract
Parkinson's disease is the second most common neurodegenerative disease after Alzheimer's disease and affects 1% of the population above 60 years old. Although Parkinson's disease commonly manifests with motor symptoms, a majority of patients with Parkinson's disease subsequently develop cognitive impairment, which often progresses to dementia, a major cause of morbidity and disability. Parkinson's disease is characterized by α-synuclein accumulation that frequently associates with amyloid-β and tau fibrils, the hallmarks of Alzheimer's disease neuropathological changes; this co-occurrence suggests that onset of cognitive decline in Parkinson's disease may be associated with appearance of pathological amyloid-β and/or tau. Recent studies have highlighted the appearance of the soluble form of the triggering receptor expressed on myeloid cells 2 (sTREM2) receptor in CSF during development of Alzheimer's disease. Given the known association of microglial activation with advancing Parkinson's disease, we investigated whether CSF and/or plasma sTREM2 differed between CSF biomarker-defined Parkinson's disease participant subgroups. In this cross-sectional study, we examined 165 participants consisting of 17 cognitively normal elderly subjects, 45 patients with Parkinson's disease with no cognitive impairment, 86 with mild cognitive impairment, and 17 with dementia. Stratification of subjects by CSF amyloid-β and tau levels revealed that CSF sTREM2 concentrations were elevated in Parkinson's disease subgroups with a positive tau CSF biomarker signature, but not in Parkinson's disease subgroups with a positive CSF amyloid-β biomarker signature. These findings indicate that CSF sTREM2 could serve as a surrogate immune biomarker of neuronal injury in Parkinson's disease.
Collapse
Affiliation(s)
- Edward N Wilson
- Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | - Michelle S Swarovski
- Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | - Patricia Linortner
- Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | - Marian Shahid
- Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | - Abigail J Zuckerman
- Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | - Qian Wang
- Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | - Divya Channappa
- Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
- Pathology, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | - Paras S Minhas
- Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | - Siddhita D Mhatre
- Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | - Edward D Plowey
- Pathology, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | - Joseph F Quinn
- Neurology, Oregon Health and Sciences University, Portland, OR, USA
- Neurology, Portland VA Medical Center, Portland, OR, USA
| | - Cyrus P Zabetian
- VA Puget Sound Health Care System, Seattle, WA, USA
- Neurology, University of Washington, Seattle, WA, USA
| | - Lu Tian
- Biomedical Data Science and Statistics, Stanford University, Stanford, CA, USA
| | - Frank M Longo
- Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | - Brenna Cholerton
- Pathology, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | - Thomas J Montine
- Pathology, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | - Kathleen L Poston
- Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
- Neurosurgery, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | - Katrin I Andreasson
- Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| |
Collapse
|
31
|
Leitão MJ, Silva-Spínola A, Santana I, Olmedo V, Nadal A, Le Bastard N, Baldeiras I. Clinical validation of the Lumipulse G cerebrospinal fluid assays for routine diagnosis of Alzheimer's disease. Alzheimers Res Ther 2019; 11:91. [PMID: 31759396 PMCID: PMC6875031 DOI: 10.1186/s13195-019-0550-8] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 10/28/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Ongoing efforts within the Alzheimer's disease (AD) field have focused on improving the intra- and inter-laboratory variability for cerebrospinal fluid (CSF) biomarkers. Fully automated assays offer the possibility to eliminate sample manipulation steps and are expected to contribute to this improvement. Recently, fully automated chemiluminescence enzyme immunoassays for the quantification of all four AD biomarkers in CSF became available. The aims of this study were to (i) evaluate the analytical performance of the Lumipulse G β-Amyloid 1-42 (restandardized to Certified Reference Materials), β-Amyloid 1-40, total Tau, and pTau 181 assays on the fully automated LUMIPULSE G600II; (ii) compare CSF biomarker results of the Lumipulse G assays with the established manual ELISA assays (INNOTEST®) from the same company (Fujirebio); and (iii) establish cut-off values and the clinical performance of the Lumipulse G assays for AD diagnosis. METHODS Intra- and inter-assay variation was assessed in CSF samples with low, medium, and high concentrations of each parameter. Method comparison and clinical evaluation were performed on 40 neurological controls (NC) and 80 patients with a diagnosis of probable AD supported by a follow-up ≥ 3 years and/or positive amyloid PET imaging. A small validation cohort of 10 NC and 20 AD patients was also included to validate the cut-off values obtained on the training cohort. RESULTS The maximal observed intra-assay and inter-assay coefficients of variation (CVs) were 3.25% and 5.50%, respectively. Method comparisons revealed correlation coefficients ranging from 0.89 (for Aβ40) to 0.98 (for t-Tau), with those for Aβ42 (0.93) and p-Tau (0.94) in-between. ROC curve analysis showed area under the curve values consistently above 0.85 for individual biomarkers other than Aβ40, and with the Aβ42/40, Aβ42/t-Tau, and Aβ42/p-Tau ratios outperforming Aβ42. Validation of the cut-off values in the independent cohort showed a sensitivity ranging from 75 to 95% and a specificity of 100%. The overall percentage of agreement between Lumipulse and INNOTEST was very high (> 87.5%). CONCLUSIONS The Lumipulse G assays show a very good analytical performance that makes them well-suited for CSF clinical routine measurements. The good clinical concordance between the Lumipulse G and INNOTEST assays facilitates the implementation of the new method in routine practice.
Collapse
Affiliation(s)
- Maria João Leitão
- Laboratory of Neurochemistry, Neurology Department, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal
- Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
| | - Anuschka Silva-Spínola
- Laboratory of Neurochemistry, Neurology Department, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal
- Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
| | - Isabel Santana
- Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- Dementia Clinic, Neurology Department, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | | | | | | | - Inês Baldeiras
- Laboratory of Neurochemistry, Neurology Department, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal
- Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| |
Collapse
|
32
|
Pan H, Qiu H, Zhang K, Zhang P, Liang W, Yang M, Mou C, Lin M, He M, Xiao X, Zhang D, Wang H, Liu F, Li Y, Jin H, Yan X, Liang H, Cui W. Fascaplysin Derivatives Are Potent Multitarget Agents against Alzheimer's Disease: in Vitro and in Vivo Evidence. ACS Chem Neurosci 2019; 10:4741-4756. [PMID: 31639294 DOI: 10.1021/acschemneuro.9b00503] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Alzheimer's disease (AD) is characterized by progressive neurodegeneration and impaired cognitive functions. Fascaplysin is a β-carboline alkaloid isolated from marine sponge Fascaplysinopsis bergquist in 1988. Previous studies have shown that fascaplysin might act on acetylcholinesterase and β-amyloid (Aβ) to produce anti-AD properties. In this study, a series of fascaplysin derivatives were synthesized. The cholinesterase inhibition activities, the neuronal protective effects, and the toxicities of these compounds were evaluated in vitro. Compounds 2a and 2b, the two most powerful compounds in vitro, were further selected to evaluate their cognitive-enhancing effects in animals. Both 2a and 2b could ameliorate cognitive dysfunction induced by scopolamine or Aβ oligomers without affecting locomotor functions in mice. We also found that 2a and 2b could prevent cholinergic dysfunctions, decrease pro-inflammatory cytokine expression, and inhibit Aβ-induced tau hyperphosphorylation in vivo. Most importantly, pharmacodynamics studies suggested that 2b could penetrate the blood-brain barrier and be retained in the central nervous system. All these results suggested that fascaplysin derivatives are potent multitarget agents against AD and might be clinical useful for AD treatment.
Collapse
Affiliation(s)
- Hanbo Pan
- Ningbo Key Laboratory of Behavior Neuroscience, Zhejiang Province Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo 315211, China
| | - Hongda Qiu
- School of Materials Science and Chemical Engineering, Ningbo University, Ningbo 315211, China
| | - Ke Zhang
- Ningbo Key Laboratory of Behavior Neuroscience, Zhejiang Province Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo 315211, China
| | - Panpan Zhang
- Ningbo Key Laboratory of Behavior Neuroscience, Zhejiang Province Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo 315211, China
| | - Weida Liang
- Ningbo Key Laboratory of Behavior Neuroscience, Zhejiang Province Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo 315211, China
| | - Mengxiang Yang
- Ningbo Key Laboratory of Behavior Neuroscience, Zhejiang Province Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo 315211, China
| | - Chenye Mou
- Ningbo Key Laboratory of Behavior Neuroscience, Zhejiang Province Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo 315211, China
| | - Miaoman Lin
- School of Materials Science and Chemical Engineering, Ningbo University, Ningbo 315211, China
| | - Ming He
- School of Materials Science and Chemical Engineering, Ningbo University, Ningbo 315211, China
| | - Xiao Xiao
- Ningbo Key Laboratory of Behavior Neuroscience, Zhejiang Province Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo 315211, China
| | - Difan Zhang
- Ningbo Key Laboratory of Behavior Neuroscience, Zhejiang Province Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo 315211, China
| | - Haixing Wang
- Zhejiang Province Key Laboratory of Anesthesiology, Department of Anesthesiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Fufeng Liu
- State Key Laboratory of Food Nutrition and Safety, College of Biotechnology, Tianjin University of Science & Technology, Tianjin 300457, China
| | - Yongmei Li
- School of Materials Science and Chemical Engineering, Ningbo University, Ningbo 315211, China
| | - Haixiao Jin
- Li Dak Sum Yip Yio Chin Kenneth Li Marine Biopharmaceutical Research Center, College of Food and Pharmaceutical Sciences, Ningbo University, Ningbo 315800, China
| | - Xiaojun Yan
- Li Dak Sum Yip Yio Chin Kenneth Li Marine Biopharmaceutical Research Center, College of Food and Pharmaceutical Sciences, Ningbo University, Ningbo 315800, China
| | - Hongze Liang
- School of Materials Science and Chemical Engineering, Ningbo University, Ningbo 315211, China
| | - Wei Cui
- Ningbo Key Laboratory of Behavior Neuroscience, Zhejiang Province Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo 315211, China
- State Key Laboratory of Food Nutrition and Safety, College of Biotechnology, Tianjin University of Science & Technology, Tianjin 300457, China
| |
Collapse
|