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Burgio MI, Veronese N, Sarà D, Saccaro C, Masnata R, Vassallo G, Catania A, Catanese G, Mueller C, Smith L, Dominguez LJ, Vernuccio L, Barbagallo M. Markers for the detection of Lewy body disease versus Alzheimer's disease in mild cognitive impairment: a systematic review and meta-analysis. Aging Clin Exp Res 2024; 36:60. [PMID: 38451331 PMCID: PMC10920203 DOI: 10.1007/s40520-024-02704-y] [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: 11/29/2023] [Accepted: 01/17/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Mild cognitive impairment (MCI) may evolve into dementia. Early recognition of possible evolution to Alzheimer's disease (AD) and dementia with Lewy Bodies (DLB) is of importance, but actual diagnostic criteria have some limitations. In this systematic review and meta-analysis, we aimed to find the most accurate markers that can discriminate patients with DLB versus AD, in MCI stage. METHODS We searched several databases up to 17 August 2023 including studies comparing markers that may distinguish DLB-MCI from AD-MCI. We reported data regarding sensitivity, specificity, and the area under the curves (AUCs) with their 95% confidence intervals (CIs). RESULTS Among 2219 articles initially screened, eight case-control studies and one cohort study were included for a total of 832 outpatients with MCI. The accuracy of cerebrospinal fluid (CSF) markers was the highest among the markers considered (AUC > 0.90 for the CSF markers), with the AUC of CSF Aβ42/Aβ40 of 0.94. The accuracy for clinical symptom scales was very good (AUC = 0.93), as evaluated in three studies. Although limited to one study, the accuracy of FDG-PET (cingulate island sign ratio) was very good (AUC = 0.95) in discriminating DLB from AD in MCI, while the accuracy of SPECT markers and EEG frequencies was variable. CONCLUSIONS Few studies have assessed the accuracy of biomarkers and clinical tools to distinguish DLB from AD at the MCI stage. While results are promising for CSF markers, FDG-PET and clinical symptoms scales, more studies, particularly with a prospective design, are needed to evaluate their accuracy and clinical usefulness. CLINICAL TRIAL REGISTRATION Prospero (CRD42023422600).
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Affiliation(s)
- Marianna Ilarj Burgio
- Department of Health Promotion, Mother Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127, Palermo, Italy
| | - Nicola Veronese
- Department of Health Promotion, Mother Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127, Palermo, Italy.
| | - Davide Sarà
- Department of Health Promotion, Mother Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127, Palermo, Italy
| | - Carlo Saccaro
- Department of Health Promotion, Mother Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127, Palermo, Italy
| | - Roberta Masnata
- Department of Health Promotion, Mother Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127, Palermo, Italy
| | - Giusy Vassallo
- Department of Health Promotion, Mother Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127, Palermo, Italy
| | - Angela Catania
- International School of Advanced Studies, University of Camerino, Camerino, Italy
| | - Giuseppina Catanese
- Geriatric Unit, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Palermo, Italy
| | - Christoph Mueller
- South London and Maudsley National Health Service Foundation Trust, London, UK
- Institute of Psychiatry Psychology and Neuroscience, Kings College London, London, UK
| | - Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Ligia Juliana Dominguez
- Department of Health Promotion, Mother Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127, Palermo, Italy
| | - Laura Vernuccio
- Geriatric Unit, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Palermo, Italy
| | - Mario Barbagallo
- Department of Health Promotion, Mother Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127, Palermo, Italy
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Abdelmoaty MM, Lu E, Kadry R, Foster EG, Bhattarai S, Mosley RL, Gendelman HE. Clinical biomarkers for Lewy body diseases. Cell Biosci 2023; 13:209. [PMID: 37964309 PMCID: PMC10644566 DOI: 10.1186/s13578-023-01152-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/24/2023] [Indexed: 11/16/2023] Open
Abstract
Synucleinopathies are a group of neurodegenerative disorders characterized by pathologic aggregates of neural and glial α-synuclein (α-syn) in the form of Lewy bodies (LBs), Lewy neurites, and cytoplasmic inclusions in both neurons and glia. Two major classes of synucleinopathies are LB disease and multiple system atrophy. LB diseases include Parkinson's disease (PD), PD with dementia, and dementia with LBs. All are increasing in prevalence. Effective diagnostics, disease-modifying therapies, and therapeutic monitoring are urgently needed. Diagnostics capable of differentiating LB diseases are based on signs and symptoms which might overlap. To date, no specific diagnostic test exists despite disease-specific pathologies. Diagnostics are aided by brain imaging and cerebrospinal fluid evaluations, but more accessible biomarkers remain in need. Mechanisms of α-syn evolution to pathologic oligomers and insoluble fibrils can provide one of a spectrum of biomarkers to link complex neural pathways to effective therapies. With these in mind, we review promising biomarkers linked to effective disease-modifying interventions.
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Affiliation(s)
- Mai M Abdelmoaty
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Eugene Lu
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Rana Kadry
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Emma G Foster
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Shaurav Bhattarai
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - R Lee Mosley
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Howard E Gendelman
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA.
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Buzoianu AD, Sharma A, Muresanu DF, Feng L, Huang H, Chen L, Tian ZR, Nozari A, Lafuente JV, Wiklund L, Sharma HS. Nanodelivery of Histamine H3/H4 Receptor Modulators BF-2649 and Clobenpropit with Antibodies to Amyloid Beta Peptide in Combination with Alpha Synuclein Reduces Brain Pathology in Parkinson's Disease. ADVANCES IN NEUROBIOLOGY 2023; 32:55-96. [PMID: 37480459 DOI: 10.1007/978-3-031-32997-5_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Abstract
Parkinson's disease (PD) in military personnel engaged in combat operations is likely to develop in their later lives. In order to enhance the quality of lives of PD patients, exploration of novel therapy based on new research strategies is highly warranted. The hallmarks of PD include increased alpha synuclein (ASNC) and phosphorylated tau (p-tau) in the cerebrospinal fluid (CSF) leading to brain pathology. In addition, there are evidences showing increased histaminergic nerve fibers in substantia niagra pars compacta (SNpc), striatum (STr), and caudate putamen (CP) associated with upregulation of histamine H3 receptors and downregulation of H4 receptors in human brain. Previous studies from our group showed that modulation of potent histaminergic H3 receptor inverse agonist BF-2549 or clobenpropit (CLBPT) partial histamine H4 agonist with H3 receptor antagonist induces neuroprotection in PD brain pathology. Recent studies show that PD also enhances amyloid beta peptide (AβP) depositions in brain. Keeping these views in consideration in this review, nanowired delivery of monoclonal antibodies to AβP together with ASNC and H3/H4 modulator drugs on PD brain pathology is discussed based on our own observations. Our investigation shows that TiO2 nanowired BF-2649 (1 mg/kg, i.p.) or CLBPT (1 mg/kg, i.p.) once daily for 1 week together with nanowired delivery of monoclonal antibodies (mAb) to AβP and ASNC induced superior neuroprotection in PD-induced brain pathology. These observations are the first to show the modulation of histaminergic receptors together with antibodies to AβP and ASNC induces superior neuroprotection in PD. These observations open new avenues for the development of novel drug therapies for clinical strategies in PD.
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Affiliation(s)
- Anca D Buzoianu
- Department of Clinical Pharmacology and Toxicology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Aruna Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Dafin F Muresanu
- Department of Clinical Neurosciences, University of Medicine & Pharmacy, Cluj-Napoca, Romania
- "RoNeuro" Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Lianyuan Feng
- Department of Neurology, Bethune International Peace Hospital, Zhongshan, Hebei Province, China
| | - Hongyun Huang
- Beijing Hongtianji Neuroscience Academy, Beijing, China
| | - Lin Chen
- Department of Neurosurgery, Dongzhimen Hospital, Beijing University of Traditional Chinese Medicine, Beijing, China
| | - Z Ryan Tian
- Department of Chemistry & Biochemistry, University of Arkansas, Fayetteville, AR, USA
| | - Ala Nozari
- Anesthesiology & Intensive Care, Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, USA
| | - José Vicente Lafuente
- LaNCE, Department of Neuroscience, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
| | - Lars Wiklund
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Hari Shanker Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden.
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Blanc F, Bousiges O. Biomarkers and diagnosis of dementia with Lewy bodies including prodromal: Practical aspects. Rev Neurol (Paris) 2022; 178:472-483. [PMID: 35491246 DOI: 10.1016/j.neurol.2022.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 10/18/2022]
Abstract
Dementia with Lewy Bodies (DLB) is a common form of cognitive neurodegenerative disease. More than half of the patients affected are not or misdiagnosed because of the clinical similarity with Alzheimer's disease (AD), Parkinson's disease but also psychiatric diseases such as depression or psychosis. In this review, we evaluate the interest of different biomarkers in the diagnostic process: cerebrospinal fluid (CSF), brain MRI, FP-CIT SPECT, MIBG SPECT, perfusion SPECT, FDG-PET by focusing more specifically on differential diagnosis between DLB and AD. FP-CIT SPECT is of high interest to discriminate DLB and AD, but not at the prodromal stage. Brain MRI has shown differences in group study with lower grey matter concentration of the Insula in prodromal DLB, but its interest in clinical routine is not demonstrated. Among the AD biomarkers (t-Tau, phospho-Tau181, Aβ42 and Aβ40) used routinely, t-Tau and phospho-Tau181 have shown excellent discrimination whatever the clinical stages severity. CSF Alpha-synuclein assay in the CSF has also an interest in the discrimination between DLB and AD but not in segregation between DLB and healthy elderly subjects. CSF synuclein RT-QuIC seems to be an excellent biomarker but its application in clinical routine remains to be demonstrated, given the non-automation of the process.
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Affiliation(s)
- F Blanc
- Hôpitaux Universitaire de Strasbourg, CM2R (Centre Mémoire de Ressource et de Recherche), Hôpital de jour, pôle de Gériatrie, Strasbourg, France; CNRS, laboratoire ICube UMR 7357 et FMTS (Fédération de Médecine Translationnelle de Strasbourg), équipe IMIS, Strasbourg, France.
| | - O Bousiges
- CNRS, laboratoire ICube UMR 7357 et FMTS (Fédération de Médecine Translationnelle de Strasbourg), équipe IMIS, Strasbourg, France; Hôpitaux Universitaire de Strasbourg, Laboratoire de Biochimie et Biologie Moléculaire, Strasbourg, France
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Kokkinou M, Beishon LC, Smailagic N, Noel-Storr AH, Hyde C, Ukoumunne O, Worrall RE, Hayen A, Desai M, Ashok AH, Paul EJ, Georgopoulou A, Casoli T, Quinn TJ, Ritchie CW. Plasma and cerebrospinal fluid ABeta42 for the differential diagnosis of Alzheimer's disease dementia in participants diagnosed with any dementia subtype in a specialist care setting. Cochrane Database Syst Rev 2021; 2:CD010945. [PMID: 33566374 PMCID: PMC8078224 DOI: 10.1002/14651858.cd010945.pub2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Dementia is a syndrome that comprises many differing pathologies, including Alzheimer's disease dementia (ADD), vascular dementia (VaD) and frontotemporal dementia (FTD). People may benefit from knowing the type of dementia they live with, as this could inform prognosis and may allow for tailored treatment. Beta-amyloid (1-42) (ABeta42) is a protein which decreases in both the plasma and cerebrospinal fluid (CSF) of people living with ADD, when compared to people with no dementia. However, it is not clear if changes in ABeta42 are specific to ADD or if they are also seen in other types of dementia. It is possible that ABeta42 could help differentiate ADD from other dementia subtypes. OBJECTIVES To determine the accuracy of plasma and CSF ABeta42 for distinguishing ADD from other dementia subtypes in people who meet the criteria for a dementia syndrome. SEARCH METHODS We searched MEDLINE, and nine other databases up to 18 February 2020. We checked reference lists of any relevant systematic reviews to identify additional studies. SELECTION CRITERIA We considered cross-sectional studies that differentiated people with ADD from other dementia subtypes. Eligible studies required measurement of participant plasma or CSF ABeta42 levels and clinical assessment for dementia subtype. DATA COLLECTION AND ANALYSIS Seven review authors working independently screened the titles and abstracts generated by the searches. We collected data on study characteristics and test accuracy. We used the second version of the 'Quality Assessment of Diagnostic Accuracy Studies' (QUADAS-2) tool to assess internal and external validity of results. We extracted data into 2 x 2 tables, cross-tabulating index test results (ABeta42) with the reference standard (diagnostic criteria for each dementia subtype). We performed meta-analyses using bivariate, random-effects models. We calculated pooled estimates of sensitivity, specificity, positive predictive values, positive and negative likelihood ratios, and corresponding 95% confidence intervals (CIs). In the primary analysis, we assessed accuracy of plasma or CSF ABeta42 for distinguishing ADD from other mixed dementia types (non-ADD). We then assessed accuracy of ABeta42 for differentiating ADD from specific dementia types: VaD, FTD, dementia with Lewy bodies (DLB), alcohol-related cognitive disorder (ARCD), Creutzfeldt-Jakob disease (CJD) and normal pressure hydrocephalus (NPH). To determine test-positive cases, we used the ABeta42 thresholds employed in the respective primary studies. We then performed sensitivity analyses restricted to those studies that used common thresholds for ABeta42. MAIN RESULTS We identified 39 studies (5000 participants) that used CSF ABeta42 levels to differentiate ADD from other subtypes of dementia. No studies of plasma ABeta42 met the inclusion criteria. No studies were rated as low risk of bias across all QUADAS-2 domains. High risk of bias was found predominantly in the domains of patient selection (28 studies) and index test (25 studies). The pooled estimates for differentiating ADD from other dementia subtypes were as follows: ADD from non-ADD: sensitivity 79% (95% CI 0.73 to 0.85), specificity 60% (95% CI 0.52 to 0.67), 13 studies, 1704 participants, 880 participants with ADD; ADD from VaD: sensitivity 79% (95% CI 0.75 to 0.83), specificity 69% (95% CI 0.55 to 0.81), 11 studies, 1151 participants, 941 participants with ADD; ADD from FTD: sensitivity 85% (95% CI 0.79 to 0.89), specificity 72% (95% CI 0.55 to 0.84), 17 studies, 1948 participants, 1371 participants with ADD; ADD from DLB: sensitivity 76% (95% CI 0.69 to 0.82), specificity 67% (95% CI 0.52 to 0.79), nine studies, 1929 participants, 1521 participants with ADD. Across all dementia subtypes, sensitivity was greater than specificity, and the balance of sensitivity and specificity was dependent on the threshold used to define test positivity. AUTHORS' CONCLUSIONS Our review indicates that measuring ABeta42 levels in CSF may help differentiate ADD from other dementia subtypes, but the test is imperfect and tends to misdiagnose those with non-ADD as having ADD. We would caution against the use of CSF ABeta42 alone for dementia classification. However, ABeta42 may have value as an adjunct to a full clinical assessment, to aid dementia diagnosis.
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Affiliation(s)
- Michelle Kokkinou
- MRC London Institute of Medical Sciences, Imperial College London, London, UK
| | - Lucy C Beishon
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Nadja Smailagic
- Institute of Public Health, University of Cambridge , Cambridge, UK
| | | | - Chris Hyde
- Exeter Test Group, College of Medicine and Health, University of Exeter Medical School, University of Exeter, Exeter , UK
| | - Obioha Ukoumunne
- NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, UK
| | | | - Anja Hayen
- Department of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Meera Desai
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Abhishekh Hulegar Ashok
- MRC London Institute of Medical Sciences, Imperial College London, London, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College , London, UK
| | - Eleanor J Paul
- MRC London Institute of Medical Sciences, Imperial College London, London, UK
- Institute of Clinical Sciences (ICS), Faculty of Medicine, Imperial College London, London, UK
| | | | - Tiziana Casoli
- Center for Neurobiology of Aging, IRCCS INRCA, Ancona, Italy
| | - Terry J Quinn
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Craig W Ritchie
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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Mavroudis I, Petridis F, Kazis D. Cerebrospinal Fluid, Imaging, and Physiological Biomarkers in Dementia With Lewy Bodies. Am J Alzheimers Dis Other Demen 2019; 34:421-432. [PMID: 31422676 PMCID: PMC10653361 DOI: 10.1177/1533317519869700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Dementia with Lewy bodies is a progressive neurodegenerative disorder, clinically characterized by gradual cognitive impairment and fluctuating cognition, behavioral changes and recurrent visual hallucinations, and autonomic function and movement symptoms in the type of parkinsonism. It is the second most common type of dementia in the Western world after Alzheimer disease. Over the last 20 years, many neurophysiological, neuroimaging, and cerebrospinal fluid (CSF) biomarkers have been described toward a better discrimination between dementia with Lewy bodies, Alzheimer disease, and other neurodegenerative conditions.In the present review, we aim to describe the neurophysiological, imaging, and CSF biomarkers in dementia with Lewy bodies and to question whether they could be reliable tools for the clinical practice.
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Affiliation(s)
- Ioannis Mavroudis
- Department of Neurology, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Foivos Petridis
- Third Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Kazis
- Third Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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7
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Parkinson's and Lewy body dementia CSF biomarkers. Clin Chim Acta 2019; 495:318-325. [PMID: 31051162 DOI: 10.1016/j.cca.2019.04.078] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 04/24/2019] [Accepted: 04/24/2019] [Indexed: 11/24/2022]
Abstract
The clinical diagnosis of Parkinson's disease (PD) and Dementia with Lewy bodies (DLB) is challenging due to highly variable clinical presentation and clinical and pathological overlap with other neurodegenerative diseases. Since cerebrospinal fluid (CSF) mirrors the pathological changes taking place in the brain, it represents a promising source of biomarkers. With respect to classical AD biomarkers, low CSF Aβ42 levels have shown a robust prognostic value in terms of development of cognitive impairment in PD and DLB. In the differential diagnosis between AD and DLB, a potential role of t-tau, p-tau and Aβ42/Aβ38 ratio has been demonstrated. Regarding CSF α-synuclein (α-syn) species, lower levels of total α-synuclein (t-α-syn) and higher concentration of oligomeric-α-synuclein (o-α-syn) and phosphorylated α-synuclein (p-α-syn) have been observed in PD. Furthermore, the detection of "pro-aggregating" α-synuclein has enabled the discrimination of patients affected by synucleinopathies with high sensitivity and specificity. New promising biomarkers are emerging: GCase activity (reduced in PD and DLB patients vs. controls), CSF/serum albumin ratio (increased in PD and DLB), fatty-acid-binding protein (increased in AD and DLB vs. PD), visinin-like protein-1 (increased in AD vs. DLB) and monoamines (useful in differential diagnosis among PD and DLB). These encouraging results need to be confirmed by future studies.
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Farotti L, Sepe FN, Toja A, Rinaldi R, Parnetti L. Differential diagnosis between Alzheimer's disease and other dementias: Role of cerebrospinal fluid biomarkers. Clin Biochem 2019; 72:24-29. [PMID: 30998910 DOI: 10.1016/j.clinbiochem.2019.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 04/13/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Lucia Farotti
- Centre for Memory Disturbances, Laboratory of Clinical Neurochemistry, Section of Neurology, Department of Medicine, University of Perugia, Perugia, Italy
| | - Federica Nicoletta Sepe
- Centre for Memory Disturbances, Laboratory of Clinical Neurochemistry, Section of Neurology, Department of Medicine, University of Perugia, Perugia, Italy
| | - Andrea Toja
- Centre for Memory Disturbances, Laboratory of Clinical Neurochemistry, Section of Neurology, Department of Medicine, University of Perugia, Perugia, Italy
| | - Roberta Rinaldi
- Centre for Memory Disturbances, Laboratory of Clinical Neurochemistry, Section of Neurology, Department of Medicine, University of Perugia, Perugia, Italy
| | - Lucilla Parnetti
- Centre for Memory Disturbances, Laboratory of Clinical Neurochemistry, Section of Neurology, Department of Medicine, University of Perugia, Perugia, Italy.
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Bousiges O, Blanc F. Diagnostic value of cerebro-spinal fluid biomarkers in dementia with lewy bodies. Clin Chim Acta 2019; 490:222-228. [DOI: 10.1016/j.cca.2018.11.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 11/20/2018] [Accepted: 11/20/2018] [Indexed: 12/17/2022]
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10
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Bousiges O, Cretin B, Lavaux T, Philippi N, Jung B, Hezard S, Heitz C, Demuynck C, Gabel A, Martin-Hunyadi C, Blanc F. Diagnostic Value of Cerebrospinal Fluid Biomarkers (Phospho-Tau181, total-Tau, Aβ42, and Aβ40) in Prodromal Stage of Alzheimer's Disease and Dementia with Lewy Bodies. J Alzheimers Dis 2016; 51:1069-83. [PMID: 26923009 DOI: 10.3233/jad-150731] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Dementia with Lewy bodies (DLB) symptoms are close to those of Alzheimer's disease (AD), and the differential diagnosis is difficult especially early in the disease. Unfortunately, AD biomarkers in cerebrospinal fluid (CSF), and more particularly Aβ1 - 42, appear to be altered in dementia with Lewy bodies (DLB). However, the level of these biomarkers has never been studied in the prodromal stage of the disease. OBJECTIVE To compare these biomarkers between DLB and AD, with a particular focus on the prodromal stage. METHODS A total of 166 CSF samples were collected at the memory clinic of Strasbourg. They were obtained from prodromal DLB (pro-DLB), DLB dementia, prodromal AD (pro-AD), and AD dementia patients, and elderly controls. Phospho-Tau181, total-Tau, Aβ42, and Aβ40 were measured in the CSF. RESULTS At the prodromal stage, contrary to AD patients, DLB patients' biomarker levels in the CSF were not altered. At the demented stage of DLB, Aβ42 levels were reduced as well as Aβ40 levels. Thus, the Aβ42/Aβ40 ratio remained unchanged between the prodromal and demented stages, contrary to what was observed in AD. Tau and Phospho-Tau181 levels were unaltered in DLB patients. CONCLUSIONS We have shown that at the prodromal stage the DLB patients had no pathological profile. Consequently, CSF AD biomarkers are extremely useful for differentiating AD from DLB patients particularly at this stage when the clinical diagnosis is difficult. Thus, these results open up new perspectives on the interpretation of AD biomarkers in DLB.
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Affiliation(s)
- Olivier Bousiges
- University Hospital of Strasbourg, Laboratory of Biochemistry and Molecular Biology, Strasbourg, France.,University of Strasbourg and CNRS, Laboratoire de Neurosciences Cognitives et Adaptatives (LNCA), UMR7364, Strasbourg, France
| | - Benjamin Cretin
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France.,University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France.,University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
| | - Thomas Lavaux
- University Hospital of Strasbourg, Laboratory of Biochemistry and Molecular Biology, Strasbourg, France
| | - Nathalie Philippi
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France.,University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France.,University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France.,University Hospital of Strasbourg, Geriatrics Day Hospital, Geriatrics Service, Strasbourg, France
| | - Barbara Jung
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France.,University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France.,University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France.,University Hospital of Strasbourg, Geriatrics Day Hospital, Geriatrics Service, Strasbourg, France
| | - Sylvie Hezard
- University Hospital of Strasbourg, Laboratory of Biochemistry and Molecular Biology, Strasbourg, France
| | - Camille Heitz
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France.,University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France.,University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
| | - Catherine Demuynck
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France.,University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France.,University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France.,University Hospital of Strasbourg, Geriatrics Day Hospital, Geriatrics Service, Strasbourg, France
| | - Aurelia Gabel
- University Hospital of Strasbourg, Laboratory of Biochemistry and Molecular Biology, Strasbourg, France
| | - Catherine Martin-Hunyadi
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France.,University Hospital of Strasbourg, Geriatrics Day Hospital, Geriatrics Service, Strasbourg, France
| | - Frédéric Blanc
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France.,University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France.,University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France.,University Hospital of Strasbourg, Geriatrics Day Hospital, Geriatrics Service, Strasbourg, France
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11
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Mishima A, Nihashi T, Ando Y, Kawai H, Kato T, Ito K, Terasawa T. Biomarkers Differentiating Dementia with Lewy Bodies from Other Dementias: A Meta-Analysis. J Alzheimers Dis 2015; 50:161-74. [DOI: 10.3233/jad-150675] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Aki Mishima
- Section of General Internal Medicine, Department of Emergency and General Internal Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Takashi Nihashi
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yoshio Ando
- Department of Radiology, Toyota Memorial Hospital, Toyota, Aichi, Japan
| | - Hisashi Kawai
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Takashi Kato
- Department of Radiology, Clinical and Experimental Neuroimaging, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Kengo Ito
- Department of Radiology, Clinical and Experimental Neuroimaging, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Teruhiko Terasawa
- Section of General Internal Medicine, Department of Emergency and General Internal Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
- Center for Clinical Evidence Synthesis, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
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12
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Botz A, Gasparik V, Devillers E, Hoffmann ARF, Caillon L, Chelain E, Lequin O, Brigaud T, Khemtemourian L. (R)-α-trifluoromethylalanine containing short peptide in the inhibition of amyloid peptide fibrillation. Biopolymers 2015; 104:601-10. [DOI: 10.1002/bip.22670] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 03/16/2015] [Accepted: 05/04/2015] [Indexed: 12/25/2022]
Affiliation(s)
- Alexandra Botz
- Sorbonne Universités, UPMC Univ Paris 06, Laboratoire des Biomolécules; 4 Place Jussieu F-75005 Paris France
- Ecole Normale Supérieure-PSL Research University, Département De Chimie; 24 rue Lhomond F-75005 Paris France
- CNRS, UMR 7203 Laboratoire Des Biomolécules; F-75005 Paris France
| | - Vincent Gasparik
- Laboratoire De Chimie Biologique, Université De Cergy-Pontoise; EA 4505, 5 Mail Gay-Lussac 95000 Cergy-Pontoise France
| | - Emmanuelle Devillers
- Laboratoire De Chimie Biologique, Université De Cergy-Pontoise; EA 4505, 5 Mail Gay-Lussac 95000 Cergy-Pontoise France
| | - Anais R. F. Hoffmann
- Sorbonne Universités, UPMC Univ Paris 06, Laboratoire des Biomolécules; 4 Place Jussieu F-75005 Paris France
- Ecole Normale Supérieure-PSL Research University, Département De Chimie; 24 rue Lhomond F-75005 Paris France
- CNRS, UMR 7203 Laboratoire Des Biomolécules; F-75005 Paris France
| | - Lucie Caillon
- Sorbonne Universités, UPMC Univ Paris 06, Laboratoire des Biomolécules; 4 Place Jussieu F-75005 Paris France
- Ecole Normale Supérieure-PSL Research University, Département De Chimie; 24 rue Lhomond F-75005 Paris France
- CNRS, UMR 7203 Laboratoire Des Biomolécules; F-75005 Paris France
| | - Evelyne Chelain
- Laboratoire De Chimie Biologique, Université De Cergy-Pontoise; EA 4505, 5 Mail Gay-Lussac 95000 Cergy-Pontoise France
| | - Olivier Lequin
- Sorbonne Universités, UPMC Univ Paris 06, Laboratoire des Biomolécules; 4 Place Jussieu F-75005 Paris France
- Ecole Normale Supérieure-PSL Research University, Département De Chimie; 24 rue Lhomond F-75005 Paris France
- CNRS, UMR 7203 Laboratoire Des Biomolécules; F-75005 Paris France
| | - Thierry Brigaud
- Laboratoire De Chimie Biologique, Université De Cergy-Pontoise; EA 4505, 5 Mail Gay-Lussac 95000 Cergy-Pontoise France
| | - Lucie Khemtemourian
- Sorbonne Universités, UPMC Univ Paris 06, Laboratoire des Biomolécules; 4 Place Jussieu F-75005 Paris France
- Ecole Normale Supérieure-PSL Research University, Département De Chimie; 24 rue Lhomond F-75005 Paris France
- CNRS, UMR 7203 Laboratoire Des Biomolécules; F-75005 Paris France
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13
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Dumurgier J, Schraen S, Gabelle A, Vercruysse O, Bombois S, Laplanche JL, Peoc'h K, Sablonnière B, Kastanenka KV, Delaby C, Pasquier F, Touchon J, Hugon J, Paquet C, Lehmann S. Cerebrospinal fluid amyloid-β 42/40 ratio in clinical setting of memory centers: a multicentric study. ALZHEIMERS RESEARCH & THERAPY 2015; 7:30. [PMID: 26034513 PMCID: PMC4450486 DOI: 10.1186/s13195-015-0114-5] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 03/05/2015] [Indexed: 11/13/2022]
Abstract
Introduction The cerebrospinal fluid (CSF) biomarkers amyloid-β (Aβ), tau and phosphorylated tau (p-tau181) are now used for the diagnosis of Alzheimer’s disease (AD). Aβ40 is the most abundant Aβ peptide isoform in the CSF, and the Aβ 42/40 ratio has been proposed to better reflect brain amyloid production. However, its additional value in the clinical setting remains uncertain. Methods A total of 367 subjects with cognitive disorders who underwent a lumbar puncture were prospectively included at three French memory centers (Paris-North, Lille and Montpellier; the PLM Study). The frequency of positive, negative and indeterminate CSF profiles were assessed by various methods, and their adequacies with the diagnosis of clinicians were tested using net reclassification improvement (NRI) analyses. Results On the basis of local optimum cutoffs for Aβ42 and p-tau181, 22% of the explored patients had indeterminate CSF profiles. The systematic use of Aβ 42/40 ratio instead of Aβ42 levels alone decreased the number of indeterminate profiles (17%; P = 0.03), but it failed to improve the classification of subjects (NRI = −2.1%; P = 0.64). In contrast, the use of Aβ 42/40 ratio instead of Aβ42 levels alone in patients with a discrepancy between p-tau181 and Aβ42 led to a reduction by half of the number of indeterminate profiles (10%; P < 0.001) and was further in agreement with clinician diagnosis (NRI = 10.5%; P = 0.003). Conclusions In patients with a discrepancy between CSF p-tau181 and CSF Aβ42, the assessment of Aβ 42/40 ratio led to a reliable biological conclusion in over 50% of cases that agreed with a clinician’s diagnosis. Electronic supplementary material The online version of this article (doi:10.1186/s13195-015-0114-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Julien Dumurgier
- Centre Mémoire Ressources Recherche (CM2R), Paris Nord Ile-de-France, Saint Louis, Lariboisière, Fernand-Widal Hospital, AP-HP, 200 rue du Faubourg Saint-Denis, 75010 Paris, France ; INSERM U942, Biomarkers in CardioNeuroVascular diseases (Bio-CANVAS), University of Paris 7-Denis Diderot, Paris, France
| | - Susanna Schraen
- Inserm, UMR 1172, JPArc, Faculté de Médecine, Université de Lille, 59045 Lille, France ; Centre de Biologie-Pathologie, Centre Hospitalier Régional Universitaire, 59037 Lille, France
| | - Audrey Gabelle
- Centre Mémoire Ressources Recherche de Montpellier, Université de Montpellier, Montpellier, France ; Biochimie-Protéomique Clinique - IRB - CCBHM, INSERM U1040, Université de Montpellier, Montpellier, France
| | - Olivier Vercruysse
- Centre Mémoire Ressources Recherche, EA 1046, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - Stéphanie Bombois
- Centre Mémoire Ressources Recherche, EA 1046, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - Jean-Louis Laplanche
- Service de Biochimie et Biologie Moléculaire, Hôpitaux universitaires Saint-Louis, Lariboisière, Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), PRES Sorbonne Paris Cité, Paris, France
| | - Katell Peoc'h
- Service de Biochimie et Biologie Moléculaire, Hôpitaux universitaires Saint-Louis, Lariboisière, Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), PRES Sorbonne Paris Cité, Paris, France
| | - Bernard Sablonnière
- Inserm, UMR 1172, JPArc, Faculté de Médecine, Université de Lille, 59045 Lille, France ; Centre de Biologie-Pathologie, Centre Hospitalier Régional Universitaire, 59037 Lille, France
| | - Ksenia V Kastanenka
- Department of Neurology, MassGeneral Institute for Neurodegenerative Disease, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129 USA
| | - Constance Delaby
- Biochimie-Protéomique Clinique - IRB - CCBHM, INSERM U1040, Université de Montpellier, Montpellier, France
| | - Florence Pasquier
- Centre Mémoire Ressources Recherche, EA 1046, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - Jacques Touchon
- Centre Mémoire Ressources Recherche de Montpellier, Université de Montpellier, Montpellier, France
| | - Jacques Hugon
- Centre Mémoire Ressources Recherche (CM2R), Paris Nord Ile-de-France, Saint Louis, Lariboisière, Fernand-Widal Hospital, AP-HP, 200 rue du Faubourg Saint-Denis, 75010 Paris, France ; INSERM U942, Biomarkers in CardioNeuroVascular diseases (Bio-CANVAS), University of Paris 7-Denis Diderot, Paris, France
| | - Claire Paquet
- Centre Mémoire Ressources Recherche (CM2R), Paris Nord Ile-de-France, Saint Louis, Lariboisière, Fernand-Widal Hospital, AP-HP, 200 rue du Faubourg Saint-Denis, 75010 Paris, France ; INSERM U942, Biomarkers in CardioNeuroVascular diseases (Bio-CANVAS), University of Paris 7-Denis Diderot, Paris, France
| | - Sylvain Lehmann
- Biochimie-Protéomique Clinique - IRB - CCBHM, INSERM U1040, Université de Montpellier, Montpellier, France
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Fagan AM, Xiong C, Jasielec MS, Bateman RJ, Goate AM, Benzinger TLS, Ghetti B, Martins RN, Masters CL, Mayeux R, Ringman JM, Rossor MN, Salloway S, Schofield PR, Sperling RA, Marcus D, Cairns NJ, Buckles VD, Ladenson JH, Morris JC, Holtzman DM. Longitudinal change in CSF biomarkers in autosomal-dominant Alzheimer's disease. Sci Transl Med 2014; 6:226ra30. [PMID: 24598588 DOI: 10.1126/scitranslmed.3007901] [Citation(s) in RCA: 283] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Clinicopathological evidence suggests that the pathology of Alzheimer's disease (AD) begins many years before the appearance of cognitive symptoms. Biomarkers are required to identify affected individuals during this asymptomatic ("preclinical") stage to permit intervention with potential disease-modifying therapies designed to preserve normal brain function. Studies of families with autosomal-dominant AD (ADAD) mutations provide a unique and powerful means to investigate AD biomarker changes during the asymptomatic period. In this biomarker study, we collected cerebrospinal fluid (CSF), plasma, and in vivo amyloid imaging cross-sectional data at baseline in individuals from ADAD families enrolled in the Dominantly Inherited Alzheimer Network. Our study revealed reduced concentrations of CSF amyloid-β1-42 (Aβ1-42) associated with the presence of Aβ plaques, and elevated concentrations of CSF tau, ptau181 (phosphorylated tau181), and VILIP-1 (visinin-like protein-1), markers of neurofibrillary tangles and neuronal injury/death, in asymptomatic mutation carriers 10 to 20 years before their estimated age at symptom onset (EAO) and before the detection of cognitive deficits. When compared longitudinally, however, the concentrations of CSF biomarkers of neuronal injury/death within individuals decreased after their EAO, suggesting a slowing of acute neurodegenerative processes with symptomatic disease progression. These results emphasize the importance of longitudinal, within-person assessment when modeling biomarker trajectories across the course of the disease. If corroborated, this pattern may influence the definition of a positive neurodegenerative biomarker outcome in clinical trials.
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Affiliation(s)
- Anne M Fagan
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA
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15
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Fu Y, Zhao D, Yang L. Protein-Based Biomarkers in Cerebrospinal Fluid and Blood for Alzheimer’s Disease. J Mol Neurosci 2014; 54:739-47. [DOI: 10.1007/s12031-014-0356-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 06/11/2014] [Indexed: 12/21/2022]
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16
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Translational proteomics in Alzheimer's disease and related disorders. Clin Biochem 2013; 46:480-6. [DOI: 10.1016/j.clinbiochem.2012.10.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Revised: 10/08/2012] [Accepted: 10/11/2012] [Indexed: 12/11/2022]
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17
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N-truncated Aβ peptides in complex fluids unraveled by new specific immunoassays. Neurobiol Aging 2013; 34:523-39. [DOI: 10.1016/j.neurobiolaging.2012.05.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Revised: 05/10/2012] [Accepted: 05/25/2012] [Indexed: 11/18/2022]
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18
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Slats D, Claassen JA, Spies PE, Borm G, Besse KT, van Aalst W, Tseng J, Sjögren MJ, Olde Rikkert MG, Verbeek MM. Hourly variability of cerebrospinal fluid biomarkers in Alzheimer's disease subjects and healthy older volunteers. Neurobiol Aging 2012; 33:831.e1-9. [DOI: 10.1016/j.neurobiolaging.2011.07.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2010] [Revised: 06/17/2011] [Accepted: 07/12/2011] [Indexed: 11/16/2022]
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19
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Cognitive and Behavioral Neurology. Neurology 2012. [DOI: 10.1007/978-0-387-88555-1_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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20
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A window into the heterogeneity of human cerebrospinal fluid Aβ peptides. J Biomed Biotechnol 2011; 2011:697036. [PMID: 21876644 PMCID: PMC3163146 DOI: 10.1155/2011/697036] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 06/27/2011] [Accepted: 06/30/2011] [Indexed: 12/20/2022] Open
Abstract
The initiating event in Alzheimer's disease (AD) is an imbalance in the production and clearance of amyloid beta (Aβ) peptides leading to the formation of neurotoxic brain Aβ assemblies. Cerebrospinal Fluid (CSF), which is a continuum of the brain, is an obvious source of markers reflecting central neuropathologic features of brain diseases. In this review, we provide an overview and update on our current understanding of the pathobiology of human CSF Aβ peptides. Specifically, we focused our attention on the heterogeneity of the CSF Aβ world discussing (1) basic research studies and what has been translated to clinical practice, (2) monomers and other soluble circulating Aβ assemblies, and (3) communication modes for Aβ peptides and their microenvironment targets. Finally, we suggest that Aβ peptides as well as other key signals in the central nervous system (CNS), mainly involved in learning and hence plasticity, may have a double-edged sword action on neuron survival and function.
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21
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Current strategies in the discovery of small-molecule biomarkers for Alzheimer’s disease. Bioanalysis 2011; 3:1121-42. [DOI: 10.4155/bio.11.62] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
With the number of patients suffering from Alzheimer’s disease rapidly increasing, there is a major requirement for an accurate biomarker capable of diagnosing the disease early. Much of the research is focused on protein and genetic approaches; however, small molecules may provide viable marker molecules. Examples that support this approach include known abnormalities in lipid metabolism, glucose utilization and oxidative stress, which have been demonstrated in patients suffering from the disease. Therefore, by-products of this irregular metabolism may provide accurate biomarkers. In this review we present the current approaches previously published in the literature used to investigate potential small-molecule and metabolite markers, and report their findings. A wide range of techniques are discussed, including separation approaches (LC, GC and CE), magnetic resonance technologies (NMR and magnetic resonance spectroscopy), and immunoassays.
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22
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van Harten AC, Kester MI, Visser PJ, Blankenstein MA, Pijnenburg YAL, van der Flier WM, Scheltens P. Tau and p-tau as CSF biomarkers in dementia: a meta-analysis. Clin Chem Lab Med 2011; 49:353-66. [PMID: 21342021 DOI: 10.1515/cclm.2011.086] [Citation(s) in RCA: 96] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND To evaluate the value of total tau (tau) and phosphorylated tau (p-tau) in cerebrospinal fluid (CSF) in the differential diagnosis of dementia, more specifically: dementia with Lewy Bodies (DLB), frontotemporal lobar degeneration (FTLD), vascular dementia (VaD), and Creutzfeldt-Jacob disease (CJD). METHODS A systematic literature search was performed to identify studies on tau and p-tau in DLB, FTLD, VaD and CJD. Tau concentrations were compared to healthy controls and to subjects with Alzheimer's disease (AD) using random effect meta-analysis. Outcome measures were Cohen's delta, sensitivity and specificity. RESULTS Compared to controls, tau concentrations are moderately elevated in DLB, FTLD and VaD, while p-tau concentrations are only slightly elevated in DLB and not elevated in FTLD and VaD. Compared to AD, lower tau concentrations differentiated DLB with a sensitivity of 73% and a specificity of 90%, FTLD with sensitivity and specificity of 74%, and VaD with a sensitivity of 73% and a specificity of 86%. Relative to AD, lower p-tau values differentiated FTLD with a sensitivity of 79% and specificity of 83%, and VaD with a sensitivity of 88% and a specificity of 78%. CJD is characterized by extremely elevated tau concentrations with a sensitivity of 91% and a specificity of 98% vs. AD. CONCLUSIONS CSF tau concentrations in DLB, FTLD and VaD are intermediate between controls and AD patients. Overlap with both controls and AD patients results in insufficient diagnostic accuracy, and the development of more specific biomarkers for these disorders is needed. CJD is characterized by extremely increased tau values, resulting in a sensitivity and specificity that exceeds 90%.
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Skogseth R, Fladby T, Mulugeta E, Aarsland D. Biomarkører i spinalvæske ved demens. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2011; 131:2235-8. [DOI: 10.4045/tidsskr.10.0104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Mukaetova-Ladinska EB, Monteith R, Perry EK. Cerebrospinal fluid biomarkers for dementia with lewy bodies. Int J Alzheimers Dis 2010; 2010:536538. [PMID: 21048932 PMCID: PMC2965495 DOI: 10.4061/2010/536538] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Revised: 07/06/2010] [Accepted: 08/04/2010] [Indexed: 01/05/2023] Open
Abstract
More than 750,000 of the UK population suffer from some form of cognitive
impairment and dementia. Of these, 5–20% will have Dementia with Lewy Bodies
(DLB). Clinico-pathological studies have shown that it is the low frequency of DLB
clinical core features that makes the DLB diagnosis hardly recognisable during life,
and easily misdiagnosed for other forms of dementia. This has an impact on the
treatment and long-term care of the affected subjects. Having a biochemical test,
based on quantification of a specific DLB biomarker within Cerebrospinal Fluid
(CSF) could be an effective diagnostic method to improve the differential diagnosis.
Although some of the investigated DLB CSF biomarkers are well within the
clinical criteria for sensitivity and specificity (>90%), they all seem to be confounded
by the contradictory data for each of the major groups of biomarkers (α-synuclein, tau
and amyloid proteins). However, a combination of CSF measures appear to emerge,
that may well be able to differentiate DLB from other dementias: α-synuclein
reduction in early DLB, a correlation between CSF α-synuclein and Aβ42 measures
(characteristic for DLB only), and t-tau and p-tau181 profile (differentiating AD from
DLB).
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Affiliation(s)
- Elizabeta B Mukaetova-Ladinska
- Institute for Ageing and Health, Campus for Ageing and Vitality, Newcastle University, Westgate Road, Newcastle upon Tyne, Newcastle NE5 5PL, UK
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Bibl M, Esselmann H, Lewczuk P, Trenkwalder C, Otto M, Kornhuber J, Wiltfang J, Mollenhauer B. Combined Analysis of CSF Tau, Aβ42, Aβ1-42% and Aβ1-40% in Alzheimer's Disease, Dementia with Lewy Bodies and Parkinson's Disease Dementia. Int J Alzheimers Dis 2010; 2010:761571. [PMID: 20862375 PMCID: PMC2938459 DOI: 10.4061/2010/761571] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Revised: 07/08/2010] [Accepted: 07/11/2010] [Indexed: 11/20/2022] Open
Abstract
We studied the diagnostic value of CSF Aβ42/tau versus low Aβ1-42% and high Aβ1-40(ox)% levels for differential diagnosis of Alzheimer's disease (AD) and dementia with Lewy bodies (DLB), respectively. CSF of 45 patients with AD, 15 with DLB, 21 with Parkinson's disease dementia (PDD), and 40 nondemented disease controls (NDC) was analyzed by Aβ-SDS-PAGE/immunoblot and ELISAs (Aβ42 and tau). Aβ42/tau lacked specificity in discriminating AD from DLB and PDD. Best discriminating biomarkers were Aβ1-42% and Aβ1-40(ox)% for AD and DLB, respectively. AD and DLB could be differentiated by both Aβ1-42% and Aβ1-40(ox)% with an accuracy of 80% at minimum. Thus, we consider Aβ1-42% and Aβ1-40(ox)% to be useful biomarkers for AD and DLB, respectively. We propose further studies on the integration of Aβ1-42% and Aβ1-40(ox)% into conventional assay formats. Moreover, future studies should investigate the combination of Aβ1-40(ox)% and CSF alpha-synuclein for the diagnosis of DLB.
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Affiliation(s)
- Mirko Bibl
- Department of Psychiatry, Psychotherapy and Addiction Medicine, Kliniken Essen-Mitte, University of Duisburg-Essen, Henricistrasse 92, 45136 Essen, Germany
| | - Hermann Esselmann
- Department of Psychiatry, Psychotherapy, Rheinische Kliniken Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, University of Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany
| | | | - Markus Otto
- Institute for Neurology, University of Ulm, 89075 Ulm, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University of Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany
| | - Jens Wiltfang
- Department of Psychiatry, Psychotherapy, Rheinische Kliniken Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Brit Mollenhauer
- Paracelsus-Elena Klinik, University of Goettingen, 34128 Kassel, Germany
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Galluzzi S, Geroldi C, Ghidoni R, Paghera B, Amicucci G, Bonetti M, Zanetti O, Cotelli M, Gennarelli M, Frisoni GB. The new Alzheimer’s criteria in a naturalistic series of patients with mild cognitive impairment. J Neurol 2010; 257:2004-14. [DOI: 10.1007/s00415-010-5650-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2010] [Revised: 06/27/2010] [Accepted: 06/29/2010] [Indexed: 10/19/2022]
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27
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Schraen-Maschke S, Sergeant N, Dhaenens CM, Bombois S, Deramecourt V, Caillet-Boudin ML, Pasquier F, Maurage CA, Sablonnière B, Vanmechelen E, Buée L. Tau as a biomarker of neurodegenerative diseases. Biomark Med 2010; 2:363-84. [PMID: 20477391 DOI: 10.2217/17520363.2.4.363] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The microtubule-associated protein Tau is mainly expressed in neurons of the CNS and is crucial in axonal maintenance and axonal transport. The rationale for Tau as a biomarker of neurodegenerative diseases is that it is a major component of abnormal intraneuronal aggregates observed in numerous tauopathies, including Alzheimer's disease. The molecular diversity of Tau is very useful when analyzing it in the brain or in the peripheral fluids. Immunohistochemical and biochemical characterization of Tau aggregates in the brain allows the postmortem classification and differential diagnosis of tauopathies. As peripheral biomarkers of Alzheimer's disease in the cerebrospinal fluid, Tau proteins are now validated for diagnosis and predictive purposes. For the future, the detailed characterization of Tau in the brain and in peripheral fluids will lead to novel promising biomarkers for differential diagnosis of dementia and monitoring of therapeutics.
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Abstract
Alzheimer's disease will reach epidemic proportions within the next 20-30 years if left unchecked. Currently, there are no treatments that prevent or slow Alzheimer's disease but many are being developed. Parallel efforts to develop biomarkers to aid in disease diagnosis and prognosis, and assess disease risk are currently underway. Clinicopathological and biomarker studies have demonstrated that Alzheimer's disease pathology can be detected preclinically. Using biomarkers to identify affected individuals prior to the onset of clinical symptoms and associated synaptic/neuronal loss should enable novel clinical trial design and early mechanism-based therapeutic intervention. This article summarizes the most promising cerebrospinal fluid biomarkers, highlights novel applications and current challenges, and provides a prediction on how the field may evolve in 5-10 years.
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Affiliation(s)
- Anne M Fagan
- Department of Neurology, Hope Center for Neuological Disorder, Washington University, School of Medicine, St. Louis, MO 63110, USA.
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Slats D, Spies PE, Sjögren MJC, Verhey FRJ, Verbeek MM, Olde Rikkert MGM. Cerebrospinal Fluid Biomarkers in Diagnosing Alzheimer's Disease in Clinical Practice: An Illustration with 3 Case Reports. Case Rep Neurol 2010; 2:5-11. [PMID: 20689628 PMCID: PMC2914365 DOI: 10.1159/000286280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Analysis of the brain specific biomarkers amyloid β42 (Aβ42) and total tau (t-tau) protein in cerebrospinal fluid (CSF) has a sensitivity and specificity of more than 85% for differentiating Alzheimer's Disease (AD) from non-demented controls. International guidelines are contradictory in their advice on the use of CSF biomarkers in AD diagnostics, resulting in a lack of consistency in clinical practice. We present three case reports that illustrate clinical practice according to the Dutch and European guidelines and portray the value of CSF biomarker analysis as an add-on diagnostic to the standard diagnostic workup for AD.
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Affiliation(s)
- Diane Slats
- Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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Mollenhauer B, Trenkwalder C. Neurochemical biomarkers in the differential diagnosis of movement disorders. Mov Disord 2009; 24:1411-26. [PMID: 19412961 DOI: 10.1002/mds.22510] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
In recent years, the neurochemical analysis of neuronal proteins in cerebrospinal fluid (CSF) has become increasingly accepted for the diagnosis of neurodegenerative dementia diseases such as Alzheimer's disease and Creutzfeldt-Jakob disease. CSF surrounds the central nervous system, and in the composition of CSF proteins one finds brain-specific proteins that are prioritized from blood-derived proteins. Levels of specific CSF proteins could be very promising biomarkers for central nervous system diseases. We need the development of more easily accessible biomarkers, in the blood. In neurodegenerative diseases with and without dementia, studies on CSF and blood proteins have investigated the usefulness of biomarkers in differential diagnosis. The clinical diagnoses of Parkinson's disease, dementia with Lewy bodies, multiple system atrophy, progressive supranuclear palsy, and corticobasal degeneration still rely mainly on clinical symptoms as defined by international classification criteria. In this article, we review CSF biomarkers in these movement disorders and discuss recent published reports on the neurochemical intra vitam diagnosis of neurodegenerative disorders (including recent CSF alpha-synuclein findings).
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Smirnov A, Trupp A, Henkel A, Bloch E, Reulbach U, Lewczuk P, Riggert J, Kornhuber J, Wiltfang J. Differential processing and secretion of Aβ peptides and sAPPα in human platelets is regulated by thrombin and prostaglandine 2. Neurobiol Aging 2009; 30:1552-62. [DOI: 10.1016/j.neurobiolaging.2007.12.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2007] [Revised: 12/06/2007] [Accepted: 12/11/2007] [Indexed: 10/22/2022]
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Kim YH, Marcus K, Grinberg LT, Goehler H, Wiltfang J, Stephan C, Eisenacher M, Hardt T, Martens L, J Dunn M, Park YM, Meyer HE. Toward a Successful Clinical Neuroproteomics The 11th HUPO Brain Proteome Project Workshop 3 March, 2009, Kolymbari, Greece. Proteomics Clin Appl 2009; 3:1012-6. [PMID: 21137003 DOI: 10.1002/prca.200900100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2009] [Accepted: 06/19/2009] [Indexed: 11/07/2022]
Abstract
The HUPO Brain Proteome Project (HUPO BPP) held its 11th workshop in Kolymbari on March 3, 2009. The principal aim of this project is to obtain a better understanding of neurodiseases and ageing, with the ultimate objective of discovering prognostic and diagnostic biomarkers, in addition to the development of novel diagnostic techniques and new medications. The attendees came together to discuss sub-project progress in the clinical neuroproteomics of human or mouse models of Alzheimer's and Parkinson's disease, and to define the needs and guidelines required for more advanced proteomics approaches. With the election of new steering committees, the members of the HUPO BPP elaborated an actual plan promoting activities, outcomes, and future directions of the HUPO BPP to acquire new funding and new participants.
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Affiliation(s)
- Young Hye Kim
- Korea Basic Science Institute, Yusung-gu, Daejeon, Republic of Korea
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Clearance mechanisms of Alzheimer's amyloid-beta peptide: implications for therapeutic design and diagnostic tests. Mol Psychiatry 2009; 14:469-86. [PMID: 18794889 DOI: 10.1038/mp.2008.96] [Citation(s) in RCA: 172] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Currently, the 'amyloid hypothesis' is the most widely accepted explanation for the pathogenesis of Alzheimer's disease (AD). According to this hypothesis, altered metabolism of the amyloid-beta (Abeta) peptide is central to the pathological cascade involved in the pathogenesis of AD. Although Abeta is produced by almost every cell in the body, a physiological function for the peptide has not been determined, and the pathways by which Abeta leads to cognitive dysfunction and cell death are unclear. Numerous therapeutic approaches that target the production, toxicity and removal of Abeta are being developed worldwide. Although therapeutic treatment for AD may be imminent, the value and effectiveness of such treatment are largely dependent on early diagnosis of the disease. This review summarizes current knowledge of Abeta clearance, transport and degradation, and evaluates the use of such information in the development of diagnostic tools. The conflicting results of plasma Abeta ELISAs are discussed, as are the more promising results of Abeta imaging by positron emission tomography. Current knowledge of Abeta-binding proteins and Abeta-degrading enzymes is analysed in the context of a potential therapy for AD. Transport across the blood-brain barrier by the receptor for advanced glycation end products and efflux via the multi-ligand lipoprotein receptor LRP-1 is also reviewed. Enhancing clearance and degradation of Abeta remains an attractive therapeutic strategy, and improved understanding of Abeta clearance may lead to advances in diagnostics and interventions designed to prevent or delay the onset of AD.
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Welge V, Fiege O, Lewczuk P, Mollenhauer B, Esselmann H, Klafki HW, Wolf S, Trenkwalder C, Otto M, Kornhuber J, Wiltfang J, Bibl M. Combined CSF tau, p-tau181 and amyloid-β 38/40/42 for diagnosing Alzheimer’s disease. J Neural Transm (Vienna) 2009; 116:203-12. [DOI: 10.1007/s00702-008-0177-6] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2008] [Accepted: 12/17/2008] [Indexed: 11/28/2022]
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Parnetti L, Tiraboschi P, Lanari A, Peducci M, Padiglioni C, D'Amore C, Pierguidi L, Tambasco N, Rossi A, Calabresi P. Cerebrospinal fluid biomarkers in Parkinson's disease with dementia and dementia with Lewy bodies. Biol Psychiatry 2008; 64:850-5. [PMID: 18395699 DOI: 10.1016/j.biopsych.2008.02.016] [Citation(s) in RCA: 121] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2007] [Revised: 02/25/2008] [Accepted: 02/26/2008] [Indexed: 11/25/2022]
Abstract
BACKGROUND Clinical criteria for differentiating Parkinson's disease (PD) with dementia (PDD) from dementia with Lewy bodies (DLB) are unsatisfactory. Their existence as distinct clinicopathologic entities is still debated, although the burden of Alzheimer's disease (AD) pathology seems higher in DLB. Thus, analysis of cerebrospinal fluid (CSF) biomarkers (beta-amyloid(1-42) [Abeta42], total tau, and hyperphosphorylated tau [p-tau]) in living subjects might provide significant pathophysiological information on these diseases. METHODS Cerebrospinal fluid biomarkers were measured in DLB (n = 19), PDD (n = 18), and AD (n = 23) subjects matched for age, sex, and dementia severity, as well as in PD (n = 20) and normal control subjects (n = 20). RESULTS DLB showed the lowest mean CSF Abeta42 levels, with a negative association to dementia duration (rho = -.42, p = .07). In DLB patients, mean CSF total tau levels were significantly lower than in AD patients (508 +/- 387 vs. 960 +/- 619, respectively) but twofold to threefold higher than in PDD (286 +/- 184), PD (160 +/- 64), or normal control subjects (177 +/- 76), with a positive association to dementia severity (Mini-Mental State Examination: rho = -.54, p = .02; Milan Overall Dementia Assessment: rho = -.66, p = .002). PDD patients had mean CSF Abeta42 and total tau levels similar to those seen in PD patients. Hyperphosphorylated tau was significantly increased in the AD group only. CONCLUSIONS Cerebrospinal fluid Abeta42 and total tau have a different behavior in DLB and PDD, being related to duration and severity of dementia in DLB alone. Hyperphosphorylated tau is not significantly altered in these conditions.
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Affiliation(s)
- Lucilla Parnetti
- Section of Neurology, Department of Medical and Surgical Specialties and Public Health, University of Perugia, Perugia General Hospital, Perugia, Italy.
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Jan A, Gokce O, Luthi-Carter R, Lashuel HA. The ratio of monomeric to aggregated forms of Abeta40 and Abeta42 is an important determinant of amyloid-beta aggregation, fibrillogenesis, and toxicity. J Biol Chem 2008; 283:28176-89. [PMID: 18694930 PMCID: PMC2661389 DOI: 10.1074/jbc.m803159200] [Citation(s) in RCA: 206] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2008] [Revised: 08/06/2008] [Indexed: 11/06/2022] Open
Abstract
Aggregation and fibril formation of amyloid-beta (Abeta) peptides Abeta40 and Abeta42 are central events in the pathogenesis of Alzheimer disease. Previous studies have established the ratio of Abeta40 to Abeta42 as an important factor in determining the fibrillogenesis, toxicity, and pathological distribution of Abeta. To better understand the molecular basis underlying the pathologic consequences associated with alterations in the ratio of Abeta40 to Abeta42, we probed the concentration- and ratio-dependent interactions between well defined states of the two peptides at different stages of aggregation along the amyloid formation pathway. We report that monomeric Abeta40 alters the kinetic stability, solubility, and morphological properties of Abeta42 aggregates and prevents their conversion into mature fibrils. Abeta40, at approximately equimolar ratios (Abeta40/Abeta42 approximately 0.5-1), inhibits (> 50%) fibril formation by monomeric Abeta42, whereas inhibition of protofibrillar Abeta42 fibrillogenesis is achieved at lower, substoichiometric ratios (Abeta40/Abeta42 approximately 0.1). The inhibitory effect of Abeta40 on Abeta42 fibrillogenesis is reversed by the introduction of excess Abeta42 monomer. Additionally, monomeric Abeta42 and Abeta40 are constantly recycled and compete for binding to the ends of protofibrillar and fibrillar Abeta aggregates. Whereas the fibrillogenesis of both monomeric species can be seeded by fibrils composed of either peptide, Abeta42 protofibrils selectively seed the fibrillogenesis of monomeric Abeta42 but not monomeric Abeta40. Finally, we also show that the amyloidogenic propensities of different individual and mixed Abeta species correlates with their relative neuronal toxicities. These findings, which highlight specific points in the amyloid peptide equilibrium that are highly sensitive to the ratio of Abeta40 to Abeta42, carry important implications for the pathogenesis and current therapeutic strategies of Alzheimer disease.
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Affiliation(s)
- Asad Jan
- Laboratory of Molecular Neurobiology and Neuroproteomics, Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne, CH-1015 Lausanne, Switzerland
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Bibl M, Wiltfang J. Diagnostic and prognostic needs in neurodegenerative disorders: focus on proteomics. Expert Rev Proteomics 2008; 5:153-6. [PMID: 18466046 DOI: 10.1586/14789450.5.2.153] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Bibl M, Mollenhauer B, Esselmann H, Schneider M, Lewczuk P, Welge V, Gross M, Falkai P, Kornhuber J, Wiltfang J. Cerebrospinal fluid neurochemical phenotypes in vascular dementias: original data and mini-review. Dement Geriatr Cogn Disord 2008; 25:256-65. [PMID: 18270488 DOI: 10.1159/000115975] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/08/2007] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND/AIMS The study evaluated the patterns of cerebrospinal fluid (CSF), amyloid-beta (Abeta) peptides, total tau and phospho-tau among Alzheimer's disease (AD) and vascular dementias (VAD). METHODS Abeta-SDS-PAGE immunoblot and commercially available ELISAs were applied to the CSF analysis of 52 patients with probable (n = 21) and possible (n = 16) VAD, AD with cerebrovascular disease (n = 15), 30 patients with probable AD and 30 nondemented disease controls. RESULTS AD and AD with cerebrovascular disease displayed a similar neurochemical phenotype in contrast to nondemented disease controls and probable VAD with regard to tau, p-tau, Abeta1-40(ox) and Abeta1-42%. Possible VAD displayed AD-like changes only for Abeta1-40(ox) and Abeta1-42%. CONCLUSION CSF neurochemical phenotypes sufficiently discriminate probable AD and VAD from each other, but their diagnostic value is limited in case of no clear-cut clinical appearance, such as possible VAD. Conversely, CSF Abeta peptides and p-tau levels may help estimate the involvement of AD-like pathophysiological pathways in VAD subgroups.
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Affiliation(s)
- Mirko Bibl
- Klinik fur Psychiatrie und Psychotherapie der Rheinischen Kliniken Essen, Universitat Duisburg-Essen, Essen, Germany.
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Wada-Isoe K, Kitayama M, Nakaso K, Nakashima K. Diagnostic markers for diagnosing dementia with Lewy bodies: CSF and MIBG cardiac scintigraphy study. J Neurol Sci 2007; 260:33-7. [PMID: 17459416 DOI: 10.1016/j.jns.2007.03.016] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2007] [Revised: 03/18/2007] [Accepted: 03/21/2007] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study examined the diagnostic value of cerebrospinal fluid (CSF) markers and iodine-123 metaiodobenzylguanidine ((123)I-MIBG) cardiac scintigraphy in distinguishing dementia with Lewy bodies (DLB) from Alzheimer's disease (AD). METHODS CSF levels of amyloid beta1-42 (Abeta42) and 181-Thr phosphorylated tau (p-tau) were measured using enzyme linked immunosorbent assay (ELISA) kits. (123)I-MIBG cardiac scintigraphy was performed in patients with AD and DLB, and control (CTL) subjects. RESULTS Increased CSF levels of p-tau in AD were found compared to DLB patients and CTL subjects (P<0.01), but there was no significant difference in CSF levels of Abeta42 between AD and DLB patients. The early and delayed heart to mediastinum (H/M) ratios of (123)I-MIBG cardiac scintigraphy were significantly decreased in patients with DLB compared to AD patients and CTL subjects (P<0.01). The receiver operating characteristic (ROC) analysis revealed that the diagnostic value of (123)I-MIBG cardiac scintigraphy was superior to that of CSF markers. CONCLUSIONS (123)I-MIBG cardiac scintigraphy may be useful for discriminating between DLB and AD.
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Affiliation(s)
- Kenji Wada-Isoe
- Department of Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Yonago, Japan.
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Bibl M, Mollenhauer B, Lewczuk P, Esselmann H, Wolf S, Trenkwalder C, Otto M, Stiens G, Rüther E, Kornhuber J, Wiltfang J. Validation of amyloid-beta peptides in CSF diagnosis of neurodegenerative dementias. Mol Psychiatry 2007; 12:671-80. [PMID: 17339876 DOI: 10.1038/sj.mp.4001967] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Biomarkers for differential diagnosis of the three most frequent degenerative forms of dementia, Alzheimer's disease (AD), dementia with Lewy bodies (DLB) and frontotemporal dementias (FTD), are currently under intensive investigation, but disease-specific biomarkers for FTD and DLB are still lacking. We analyzed 303 cerebrospinal fluid (CSF) samples of 71 AD, 32 DLB and 36 FTD patients in comparison to 93 various other dementias (OD), 20 peripheral neurologic disease (PND) controls, 25 neurodegenerative disorders without dementia (ND) and 26 depressive cognitive complainers (DCC) for distinct CSF amyloid-beta (Abeta) peptide patterns, using the quantitative Abeta-SDS-PAGE/immunoblot. Additionally, the novel electrochemiluminescence technique (MSD) was used to validate the measures on Abeta1-38. The main outcome measures were a striking decrease of Abeta1-42 in AD (P=7.4 x 10(-19)), and most interestingly a pronounced decrease of Abeta1-38 in FTD (P=9.6 x 10(-7)). Moreover, a novel peptide that most probably represents an oxidized alpha-helical form of Abeta1-40 (Abeta1-40(ox)) displayed a highly significant increase in DLB (P=3.7 x 10(-3)) as compared to non-demented disease controls. The overall diagnostic accuracy of percentage Abeta peptide abundances (Abeta1-X%) was clearly superior to absolute CSF Abeta levels. Abeta1-42% and Abeta1-38% enabled contrasts of 85% or beyond to distinguish AD and FTD, respectively, from all other investigated subjects. Abeta1-40(ox)% yielded a diagnostic sensitivity and specificity of 88 and 73% for the detection of DLB among all other investigated patients. We found a strong correlation between Abeta1-38 levels as measured by the Abeta-SDS-PAGE/immunoblot and MSD, respectively. CSF Abeta peptides may reflect disease-specific impact of distinct neurodegenerative processes on Abeta peptide metabolism and represent a potential diagnostic biomarker for AD, FTD and DLB.
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Affiliation(s)
- M Bibl
- Department of Psychiatry, University of Goettingen, Goettingen, Germany.
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Bibl M, Mollenhauer B, Wolf S, Esselmann H, Lewczuk P, Kornhuber J, Wiltfang J. Reduced CSF carboxyterminally truncated Abeta peptides in frontotemporal lobe degenerations. J Neural Transm (Vienna) 2007; 114:621-8. [PMID: 17245538 DOI: 10.1007/s00702-006-0618-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2006] [Accepted: 11/28/2006] [Indexed: 11/27/2022]
Abstract
Cerebrospinal fluid (CSF) carboxyterminally truncated amyloid-beta (Abeta) peptides, Abeta1-42 and tau protein were evaluated in 30 patients with frontotemporal lobe degenerations (FTLD), 30 Alzheimer's disease (AD) patients and 30 non-demented disease controls (NDC) by Abeta-SDS-PAGE/immunoblot as well as commercial ELISAs for Abeta1-42 and total tau. FTLD displayed a significant drop of Abeta1-37 (p = 2.7 x 10(-4)), Abeta1-38 (p = 4.2 x 10(-5)) and Abeta1-42 (p = 3.3 x 10(-4)). Abeta1-42 was selectively decreased in AD (p = 8.5 x 10(-10)). Decreased Abeta1-38 enabled contrasts of beyond 85% to distinguish FTLD from AD and NDC patients, alone or in combination. Accordingly, low CSF Abeta1-37 and Abeta1-38 represent a biomarker candidate for FTLD and may reflect disease-specific changes of APP metabolism. Further validation should be carried out on dementias other than AD, diagnostically relevant control groups without dementia and without any evident affection of the central nervous system and subgroups of FTLD. Moreover, independent methods of measurement should be applied to CSF Abeta1-38.
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Affiliation(s)
- M Bibl
- Department of Psychiatry, University of Goettingen, Goettingen, Germany.
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