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Sheikh A, Mughal S, Owais R, Siddiqui MS. SOBA (soluble oligomer binding assay): A breakthrough or the early diagnosis of Alzheimer's disease. Health Sci Rep 2023; 6:e1492. [PMID: 37599661 PMCID: PMC10435830 DOI: 10.1002/hsr2.1492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 07/05/2023] [Accepted: 08/01/2023] [Indexed: 08/22/2023] Open
Affiliation(s)
- Ayesha Sheikh
- Department of MedicineDow University of Health SciencesKarachiPakistan
| | - Sanila Mughal
- Department of MedicineDow University of Health SciencesKarachiPakistan
| | - Rabia Owais
- Department of MedicineDow University of Health SciencesKarachiPakistan
| | - Mishal Shan Siddiqui
- Department of Surgery. Dr. Ruth K. M. Pfau, Civil Hospital KarachiDow University of Health SciencesKarachiPakistan
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Turner RS, Stubbs T, Davies DA, Albensi BC. Potential New Approaches for Diagnosis of Alzheimer's Disease and Related Dementias. Front Neurol 2020; 11:496. [PMID: 32582013 PMCID: PMC7290039 DOI: 10.3389/fneur.2020.00496] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 05/06/2020] [Indexed: 12/21/2022] Open
Abstract
Dementia is an umbrella term-caused by a large number of specific diagnoses, including several neurodegenerative disorders. Alzheimer's disease (AD) is now the most common cause of dementia in advanced countries, while dementia due to neurosyphilis was the leading cause a century ago. Many challenges remain for diagnosing dementia definitively. Some of these include variability of early symptoms and overlap with similar disorders, as well as the possibility of combined, or mixed, etiologies in some cases. Newer technologies, including the incorporation of PET neuroimaging and other biomarkers (genomics and proteomics), are being incorporated into revised diagnostic criteria. However, the application of novel diagnostic methods at clinical sites is plagued by many caveats including availability and access. This review surveys new diagnostic methods as well as remaining challenges-for clinical care and clinical research.
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Affiliation(s)
- R Scott Turner
- Department of Neurology, Georgetown University, Washington, DC, United States
| | - Terry Stubbs
- ActivMed, Practices & Research, Methuen, MA, United States
| | - Don A Davies
- Division of Neurodegenerative Disorders, St Boniface Hospital Research, University of Manitoba, Winnipeg, MB, Canada
| | - Benedict C Albensi
- Division of Neurodegenerative Disorders, St Boniface Hospital Research, University of Manitoba, Winnipeg, MB, Canada.,Department of Pharmacology & Therapeutics, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
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Kim D, Kim YS, Shin DW, Park CS, Kang JH. Harnessing Cerebrospinal Fluid Biomarkers in Clinical Trials for Treating Alzheimer's and Parkinson's Diseases: Potential and Challenges. J Clin Neurol 2016; 12:381-392. [PMID: 27819412 PMCID: PMC5063862 DOI: 10.3988/jcn.2016.12.4.381] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Revised: 03/28/2016] [Accepted: 03/29/2016] [Indexed: 01/04/2023] Open
Abstract
No disease-modifying therapies (DMT) for neurodegenerative diseases (NDs) have been established, particularly for Alzheimer's disease (AD) and Parkinson's disease (PD). It is unclear why candidate drugs that successfully demonstrate therapeutic effects in animal models fail to show disease-modifying effects in clinical trials. To overcome this hurdle, patients with homogeneous pathologies should be detected as early as possible. The early detection of AD patients using sufficiently tested biomarkers could demonstrate the potential usefulness of combining biomarkers with clinical measures as a diagnostic tool. Cerebrospinal fluid (CSF) biomarkers for NDs are being incorporated in clinical trials designed with the aim of detecting patients earlier, evaluating target engagement, collecting homogeneous patients, facilitating prevention trials, and testing the potential of surrogate markers relative to clinical measures. In this review we summarize the latest information on CSF biomarkers in NDs, particularly AD and PD, and their use in clinical trials. The large number of issues related to CSF biomarker measurements and applications has resulted in relatively few clinical trials on CSF biomarkers being conducted. However, the available CSF biomarker data obtained in clinical trials support the advantages of incorporating CSF biomarkers in clinical trials, even though the data have mostly been obtained in AD trials. We describe the current issues with and ongoing efforts for the use of CSF biomarkers in clinical trials and the plans to harness CSF biomarkers for the development of DMT and clinical routines. This effort requires nationwide, global, and multidisciplinary efforts in academia, industry, and regulatory agencies to facilitate a new era.
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Affiliation(s)
- Dana Kim
- Department of Pharmacology and Medicinal Toxicology Research Center, Incheon, Korea.,Hypoxia-Related Diseases Research Center, Inha University School of Medicine, Incheon, Korea
| | - Young Sam Kim
- Department of Thoracic Surgery, Inha University Hospital, Inha University, Incheon, Korea
| | - Dong Wun Shin
- Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Chang Shin Park
- Department of Pharmacology and Medicinal Toxicology Research Center, Incheon, Korea.,Hypoxia-Related Diseases Research Center, Inha University School of Medicine, Incheon, Korea
| | - Ju Hee Kang
- Department of Pharmacology and Medicinal Toxicology Research Center, Incheon, Korea.,Hypoxia-Related Diseases Research Center, Inha University School of Medicine, Incheon, Korea.
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Campbell NL, Unverzagt F, LaMantia MA, Khan BA, Boustani MA. Risk factors for the progression of mild cognitive impairment to dementia. Clin Geriatr Med 2013; 29:873-93. [PMID: 24094301 PMCID: PMC5915285 DOI: 10.1016/j.cger.2013.07.009] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The increasing prevalence of cognitive impairment among the older adult population warrants attention to the identification of practices that may minimize the progression of early forms of cognitive impairment, including the transitional stage of mild cognitive impairment (MCI), to permanent stages of dementia. This article identifies both markers of disease progress and risk factors linked to the progression of MCI to dementia. Potentially modifiable risk factors may offer researchers a point of intervention to modify the effect of the risk factor and to minimize the future burden of dementia.
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Affiliation(s)
- Noll L Campbell
- College of Pharmacy, Purdue University, 575 Stadium Mall Drive, West Lafayette, IN 47907, USA; Indiana University Center for Aging Research, 410 West 10th Street, Indianapolis, IN 46202, USA; Regenstrief Institute, Inc, 410 West 10th Street, Indianapolis, IN 46202, USA; Department of Pharmacy, Wishard/Eskenazi Health Services, 1001 West 10th Street, Indianapolis, IN 46202, USA.
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A quantum dot probe conjugated with aβ antibody for molecular imaging of Alzheimer's disease in a mouse model. Cell Mol Neurobiol 2013; 33:759-65. [PMID: 23695800 DOI: 10.1007/s10571-013-9943-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 04/27/2013] [Indexed: 10/26/2022]
Abstract
The treatment of Alzheimer's disease (AD) has been hampered by a lack of sensitive and specific non-invasive diagnostic methods. Quantum dots (QD) are nano-crystals with unique photo-physical properties that bypass some of the limitations of conventional dyes and imaging tools. This study is aimed to evaluate the fluorescence properties of a QD probe conjugated with an anti-Aβ antibody (QD-Aβ-Ab). Healthy mice and mice bearing mutated human APP695swe and APP717 V-F transgenes received intracerebroventricular injection of the probe for subsequent imaging. Immunohistochemistry revealed that Aβ1-42 was distributed in the hippocampus CA1 area in the APP transgenic mice. Fluorescence microscopy demonstrated that fluorescence was mainly observed in the hippocampus area, the cerebral cortex, sagittal septum and striatum of APP transgenic mice. In vivo imaging of mice receiving the QD-Aβ-Ab probe showed that healthy mice exhibited a narrow range of fluorescence and lower fluorescence intensity compared with APP transgenic mice. The mean fluorescence intensity of brain tissues of healthy C57BL mice was 12.3784 ± 3.9826, which was significantly lower than that of 10- and 16-month-old APP transgenic mice (45.03 ± 2.66 and 46.69 ± 3.22, respectively; P < 0.05). In this study we present the first direct evidence that QD-Aβ-Ab conjugate probes can track in vivo state of Aβ accumulation in mice and the findings suggest that such probes may be of potential use for early molecular diagnostic imaging of AD.
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Wan HI, Soares H, Waring JF. Use of cerebrospinal fluid biomarkers in clinical trials for schizophrenia and depression. Biomark Med 2012; 6:119-29. [DOI: 10.2217/bmm.11.98] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The pharmaceutical industry is increasingly using biomarkers in clinical trials in order to determine if new drug candidates are displaying the expected pharmacological properties and to give early indications if they are showing efficacy or unexpected toxicity. This is especially true for the development of new drug candidates for psychiatric disorders such as schizophrenia and depression, where it is imperative to understand whether the drug is reaching the brain and acting on the target. A particular challenge for biochemical biomarkers used to determine centrally mediated activity is the relative inaccessibility of the brain to direct sampling of cells or tissues. As a result, the use of biomarkers located in the cerebrospinal fluid and in close contact with the interstitial fluid of the brain has risen in prominence. Cerebrospinal fluid biomarkers allow for the analysis of biochemical changes that reflect pharmacological activity or that may be related to the disease. In the area of psychiatric disorders, many studies have utilized biochemical biomarkers in the cerebrospinal fluid for gaining pharmacodynamic or disease modification information. This review summarizes many of these efforts, and identifies challenges and opportunities for utilizing biomarkers for new drug candidates targeting psychiatric disorders.
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Affiliation(s)
- Hong I Wan
- Translational Medicine, BioTherapeutics, Pfizer Inc., South San Francisco, CA 94080, USA
| | - Holly Soares
- Clinical Biomarkers, Bristol-Meyers Squibb, Wallingford, CT 06492, USA
| | - Jeffrey F Waring
- Translational Sciences, Abbott Laboratories, R4DA, 100 Abbott Park Road, Abbott Park, IL, 60064-6123, USA
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Hampel H, Wilcock G, Andrieu S, Aisen P, Blennow K, Broich K, Carrillo M, Fox NC, Frisoni GB, Isaac M, Lovestone S, Nordberg A, Prvulovic D, Sampaio C, Scheltens P, Weiner M, Winblad B, Coley N, Vellas B. Biomarkers for Alzheimer's disease therapeutic trials. Prog Neurobiol 2011; 95:579-93. [PMID: 21130138 DOI: 10.1016/j.pneurobio.2010.11.005] [Citation(s) in RCA: 96] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 11/10/2010] [Accepted: 11/22/2010] [Indexed: 11/26/2022]
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Abstract
Co-developing a drug with a diagnostic to create a stratified medicine - a therapy that is targeted to a specific patient population on the basis of a clinical characteristic such as a biomarker that predicts treatment response - presents challenges for product developers, regulators, payers and physicians. With the aim of developing a shared framework and tools for addressing these challenges, here we present an analysis using data from case studies in oncology and Alzheimer's disease, coupled with integrated computational modelling of clinical outcomes and developer economic value, to quantify the effects of decisions related to key issues such as the design of clinical trials. This illustrates how such analyses can aid the coordination of diagnostic and drug development, and the selection of optimal development and commercialization strategies. It also illustrates the impact of the interplay of these factors on the economic feasibility of stratified medicine, which has important implications for public policy makers.
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Okonkwo OC, Mielke MM, Griffith HR, Moghekar AR, O'Brien RJ, Shaw LM, Trojanowski JQ, Albert MS. Cerebrospinal fluid profiles and prospective course and outcome in patients with amnestic mild cognitive impairment. ACTA ACUST UNITED AC 2011; 68:113-9. [PMID: 21220682 DOI: 10.1001/archneurol.2010.334] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To examine the effect of specific cerebrospinal fluid (CSF) profiles on the rate of cognitive decline, disease progression, and risk of conversion to Alzheimer disease (AD) dementia in patients with amnestic mild cognitive impairment (MCI). DESIGN Total tau (T-tau), tau phosphorylated at threonine 181, and β-amyloid 1-42 peptide (Aβ42) were immunoassayed in CSF samples obtained from patients with MCI enrolled in the Alzheimer's Disease Neuroimaging Initiative. Patients were then stratified by CSF profiles: (1) normal T-tau and normal Aβ42 (ie, normal-T-tauAβ42), (2) normal T-tau but abnormal Aβ42 (ie, abnormal-Aβ42), (3) abnormal T-tau but normal Aβ42 (ie, abnormal-T-tau), and (4) abnormal T-tau and abnormal Aβ42 (ie, abnormal-T-tauAβ42). SETTING Fifty-eight sites in the United States and Canada. PARTICIPANTS One hundred ninety-five patients with MCI. MAIN OUTCOME MEASURES A composite cognitive measure, the Clinical Dementia Rating Scale-sum of boxes subscale, and conversion to AD dementia. RESULTS Patients with MCI with a CSF profile of abnormal-Aβ42 or abnormal-T-tauAβ42 experienced a faster rate of decline on the composite cognitive measure and the Clinical Dementia Rating Scale-sum of boxes subscale compared with those with normal-T-tauAβ42. They also had a greater risk of converting to AD dementia relative to the normal-T-tauAβ42 group. In contrast, those with a CSF profile of abnormal-T-tau did not differ from the normal-T-tauAβ42 group on any outcome. These findings were generally replicated when the sample was reclassified by patterns of tau phosphorylated at threonine 181 and Aβ42 abnormalities. CONCLUSIONS β-Amyloid abnormalities but not tau alterations are associated with cognitive deterioration, disease progression, and increased risk of conversion to AD dementia in patients with MCI. Patients with abnormal Aβ42 may be prime candidates for drug treatment and clinical trials in MCI.
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Affiliation(s)
- Ozioma C Okonkwo
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
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Abstract
Intense research during the last decades has resulted in an unprecedented accumulation of knowledge regarding the pathogenesis of Alzheimer's disease. Primarily, the focus has been directed toward amyloid and tau pathology and their relations to synaptic and neuronal loss. However, as the complexity of the disease becomes increasingly evident, the importance of other factors, such as inflammation, oxidative stress, and mitochondrial dysfunction, grow apparent. Here, we review available CSF biomarkers for these pathological processes. We also consider their usability in clinical practice and in clinical trials.
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Affiliation(s)
- Niklas Mattsson
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at University of Gothenburg, S-431 80 Mölndal, Sweden
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Coley N, Andrieu S, Delrieu J, Voisin T, Vellas B. Biomarkers in Alzheimer's Disease. Ann N Y Acad Sci 2009; 1180:119-24. [DOI: 10.1111/j.1749-6632.2009.04947.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Weiner MW. Imaging and biomarkers will be used for detection and monitoring progression of early Alzheimer's disease. J Nutr Health Aging 2009; 13:332. [PMID: 19300869 DOI: 10.1007/s12603-009-0032-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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