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Hanon O, Vidal JS, Lehmann S, Bombois S, Allinquant B, Baret-Rose C, Tréluyer JM, Abdoul H, Gelé P, Delmaire C, Blanc F, Mangin JF, Buée L, Touchon J, Hugon J, Vellas B, Galbrun E, Benetos A, Berrut G, Paillaud E, Wallon D, Castelnovo G, Volpe-Gillot L, Paccalin M, Robert P, Godefroy O, Camus V, Belmin J, Vandel P, Novella JL, Duron E, Rigaud AS, Schraen-Maschke S, Gabelle A. Plasma amyloid beta predicts conversion to dementia in subjects with mild cognitive impairment: The BALTAZAR study. Alzheimers Dement 2022; 18:2537-2550. [PMID: 35187794 DOI: 10.1002/alz.12613] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/20/2021] [Accepted: 12/10/2021] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Blood-based biomarkers are the next challenge for Alzheimer's disease (AD) diagnosis and prognosis. METHODS Mild cognitive impairment (MCI) participants (N = 485) of the BALTAZAR study, a large-scale longitudinal multicenter cohort, were followed-up for 3 years. A total of 165 of them converted to dementia (95% AD). Associations of conversion and plasma amyloid beta (Aβ)1-42 , Aβ1-40 , Aβ1-42 /Aβ1-40 ratio were analyzed with logistic and Cox models. RESULTS Converters to dementia had lower level of plasma Aβ1-42 (37.1 pg/mL [12.5] vs. 39.2 [11.1] , P value = .03) and lower Aβ1-42 /Aβ1-40 ratio than non-converters (0.148 [0.125] vs. 0.154 [0.076], P value = .02). MCI participants in the highest quartile of Aβ1-42 /Aβ1-40 ratio (>0.169) had a significant lower risk of conversion (hazard ratio adjusted for age, sex, education, apolipoprotein E ε4, hippocampus atrophy = 0.52 (95% confidence interval [0.31-0.86], P value = .01). DISCUSSION In this large cohort of MCI subjects we identified a threshold for plasma Aβ1-42 /Aβ1-40 ratio that may detect patients with a low risk of conversion to dementia within 3 years.
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Affiliation(s)
- Olivier Hanon
- Memory Resource and Research Centre of de Paris-Broca-Ile de France, Université de Paris, EA 4468, APHP, Hopital Broca, Paris, France
| | - Jean-Sébastien Vidal
- Memory Resource and Research Centre of de Paris-Broca-Ile de France, Université de Paris, EA 4468, APHP, Hopital Broca, Paris, France
| | - Sylvain Lehmann
- CHU Montpellier, LBPC, Inserm, Université de Montpellier, Montpellier, France
| | - Stéphanie Bombois
- CHU Lille, U1172-LilNCog, LiCEND, LabEx DISTALZ, Université de Lille, Inserm, Lille, France
| | - Bernadette Allinquant
- UMR-S 1266, Université de Paris, Institute of Psychiatric and Neurosciences, Inserm, Paris, France
| | - Christiane Baret-Rose
- UMR-S 1266, Université de Paris, Institute of Psychiatric and Neurosciences, Inserm, Paris, France
| | - Jean-Marc Tréluyer
- Clinical Research Unit, Université de Paris, APHP, Hôpital Necker, Paris, France
| | - Hendy Abdoul
- Clinical Research Unit, Université de Paris, APHP, Hôpital Necker, Paris, France
| | - Patrick Gelé
- CHU Lille, CRB/CIC1403, Université de Lille, Inserm, Lille, France
| | - Christine Delmaire
- CHU Lille, U1172-LilNCog, LiCEND, LabEx DISTALZ, Université de Lille, Inserm, Lille, France
| | - Fredéric Blanc
- CM2R, pôle de Gériatrie, Laboratoire ICube, FMTS, CNRS, équipe IMIS, Université de Strasbourg, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Jean-François Mangin
- Neurospin, CEA, CNRS, cati-neuroimaging.com, CATI Multicenter Neuroimaging Platform, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Luc Buée
- CHU Lille, U1172-LilNCog, LiCEND, LabEx DISTALZ, Université de Lille, Inserm, Lille, France
| | - Jacques Touchon
- Department of Neurology, Memory Research and Resources Center of Montpellier, Inserm INM NeuroPEPs Team, Excellence Center of Neurodegenerative Disorders, Université de Montpellier, CHU Montpellier, Montpellier, France
| | - Jacques Hugon
- APHP, Groupe Hospitalier Saint Louis-Lariboisière Fernand Widal, Center of Cognitive Neurology, Université de Paris, Paris, France
| | - Bruno Vellas
- Memory Resource and Research Centre of Midi-Pyrénées, Université de Toulouse III, CHU La Grave-Casselardit, Toulouse, France
| | - Evelyne Galbrun
- Department of Gérontology 2, Sorbonne Université, APHP, Centre Hospitalier Dupuytren, Draveil, France
| | - Athanase Benetos
- Memory Resource and Research Centre of Lorraine, Université de Lorraine, CHRU de Nancy, Vandoeuvre-lès-Nancy, France
| | - Gilles Berrut
- Department of Clinical Gerontology, Memory Research Resource Center of Nantes, Université de Nantes, EA 4334 Movement-Interactions-Performance, CHU Nantes, Nantes, France
| | - Elena Paillaud
- Service de Gériatrie, Université de Paris, APHP, Hôpital Europeen Georges Pompidou, Paris, France
| | - David Wallon
- CHU de Rouen, Department of Neurology and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Normandie Univ, UNIROUEN, Inserm U1245, Rouen, France
| | | | - Lisette Volpe-Gillot
- Service de Neuro-Psycho-Gériatrie, Memory Clinic, Hôpital Léopold Bellan, Paris, France
| | - Marc Paccalin
- Memory Resource and Research Centre of Poitiers, CHU de Poitiers, Poitiers, France
| | - Philippe Robert
- Memory Research Resource Center of Nice, CoBTek lab, Université Côte d'Azur, CHU de Nice, Nice, France
| | - Olivier Godefroy
- Memory Resource and Research Centre of Amiens Picardie, CHU d'Amiens-Picardie, Amiens, France
| | - Vincent Camus
- CHRU de Tours, UMR Inserm U1253, Université François-Rabelais de Tours, Tours, France
| | - Joël Belmin
- Service de Gériatrie Ambulatoire, Sorbonne Université, APHP, Hôpitaux Universitaires Pitie-Salpêtrière-Charles Foix, Paris, France
| | - Pierre Vandel
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive, CHU de Besançon, Memory Resource and Research Centre of Besançon Franche-Comté, Université Bourgogne Franche-Comté, Besançon, France
| | - Jean-Luc Novella
- Memory Resource and Research Centre of Champagne-Ardenne, Université de Reims Champagne-Ardenne, EA 3797, CHU de Reims, Reims, France
| | - Emmanuelle Duron
- Département de gériatrie, Équipe MOODS, Inserm 1178, Université Paris-Saclay, APHP, Hôpital Paul Brousse, Villejuif, France
| | - Anne-Sophie Rigaud
- Memory Resource and Research Centre of de Paris-Broca-Ile de France, Université de Paris, EA 4468, APHP, Hopital Broca, Paris, France
| | | | - Audrey Gabelle
- Department of Neurology, Memory Research and Resources Center of Montpellier, Inserm INM NeuroPEPs Team, Excellence Center of Neurodegenerative Disorders, Université de Montpellier, CHU Montpellier, Montpellier, France
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Araki W, Kanemaru K, Hattori K, Tsukamoto T, Saito Y, Yoshida S, Takano H, Sakata M, Yokoi Y, Omachi Y, Nagaoka U, Nagao M, Komori T, Tachimori H, Murayama S, Mizusawa H. Soluble APP-α and APP-β in cerebrospinal fluid as potential biomarkers for differential diagnosis of mild cognitive impairment. Aging Clin Exp Res 2022; 34:341-347. [PMID: 34283410 DOI: 10.1007/s40520-021-01935-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 07/04/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Concentrations of soluble amyloid precursor proteins-α (sAPPα) and -β (sAPPβ) in cerebrospinal fluid (CSF) may reflect the neuropathology of Alzheimer's disease (AD). We previously reported that the concentrations of both sAPPα and sAPPβ were significantly higher in patients with mild cognitive impairment (MCI) due to AD (MCI-AD) than in control subjects without cognitive impairment. The present study analyzed whether these sAPPs are useful in the differential diagnosis of MCI. METHODS A modified and sensitive method was used to analyze concentrations of sAPPα and sAPPβ in CSF of patients with MCI-AD (n = 30) and MCI due to other causes (MCI-others) (n = 24). Phosphorylated tau (p-tau) and amyloid β-protein 42 (Aβ42) were also analyzed using standard methods. RESULTS CSF concentrations of sAPPα and sAPPβ were significantly higher in the MCI-AD than in the MCI-others group (p < 0.001). Furthermore, concentrations of both sAPPα and sAPPβ were highly correlated with the concentration of p-tau, consistent with our previous report. CONCLUSIONS Measurement of both sAPPs in CSF using sensitive methods can be helpful in the precise differential diagnosis of patients with MCI.
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Affiliation(s)
- Wataru Araki
- Department of Demyelinating Disease and Aging, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi, Kodaira, Tokyo, 187-8502, Japan.
| | - Kazutomi Kanemaru
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Itabashi-ku, Tokyo, Japan
| | | | | | - Yuko Saito
- National Center Hospital, NCNP, Kodaira, Tokyo, Japan
| | | | | | | | - Yuma Yokoi
- National Center Hospital, NCNP, Kodaira, Tokyo, Japan
| | - Yoshie Omachi
- National Center Hospital, NCNP, Kodaira, Tokyo, Japan
| | - Utako Nagaoka
- Tokyo Metropolitan Neurological Hospital, Fuchu, Tokyo, Japan
| | - Masahiro Nagao
- Tokyo Metropolitan Neurological Hospital, Fuchu, Tokyo, Japan
| | - Takashi Komori
- Tokyo Metropolitan Neurological Hospital, Fuchu, Tokyo, Japan
| | - Hisateru Tachimori
- Department of Clinical Epidemiology, Translational Medical Center, NCNP, Kodaira, Tokyo, Japan
| | - Shigeo Murayama
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Itabashi-ku, Tokyo, Japan
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Elevation of plasma soluble amyloid precursor protein beta in Alzheimer's disease. Arch Gerontol Geriatr 2019; 87:103995. [PMID: 31874328 DOI: 10.1016/j.archger.2019.103995] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/26/2019] [Accepted: 12/07/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Beta-amyloid is considered to be a pathophysiological marker in Alzheimer's disease (AD). Soluble amyloid precursor proteins (sAPPs) -α (sAPPα) and -β (sAPPβ), which are the byproducts of non-amyloidogenic and amyloidogenic process of APP, respectively, have been repeatedly observed in the cerebrospinal fluids (CSF) of AD patients. The present study focused on the determination of sAPP levels in peripheral blood. METHODS The plasma protein levels of sAPPα and sAPPβ were measured with ELISA. Plasma from 52 AD patients, 98 amnestic mild cognitive impairment (MCI) patients, and 114 cognitively normal controls were compared. RESULTS The plasma level of sAPPβ was significantly increased in AD patients than in cognitively healthy controls. However, no significant change in plasma sAPPα was observed among the three groups. Furthermore, the plasma sAPPβ levels significantly correlated with cognitive assessment scales, such as clinical dementia rating (CDR), and mini-mental status examination (MMSE). Interestingly, sAPPα and sAPPβ had a positive correlation with each other in blood plasma, similar to previous studies on CSF sAPP. This correlation was stronger in the MCI and AD groups than in the cognitively healthy controls. CONCLUSIONS These results suggest that individuals with elevated plasma sAPPβ levels are at an increased risk of AD; elevation in these levels may reflect the progression of disease.
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Milà-Alomà M, Suárez-Calvet M, Molinuevo JL. Latest advances in cerebrospinal fluid and blood biomarkers of Alzheimer's disease. Ther Adv Neurol Disord 2019; 12:1756286419888819. [PMID: 31897088 PMCID: PMC6920596 DOI: 10.1177/1756286419888819] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 10/21/2019] [Indexed: 12/12/2022] Open
Abstract
Alzheimer's disease (AD) is the most common neurodegenerative disease and its diagnosis has classically been based on clinical symptoms. Recently, a biological rather than a syndromic definition of the disease has been proposed that is based on biomarkers that reflect neuropathological changes. In AD, there are two main biomarker categories, namely neuroimaging and fluid biomarkers [cerebrospinal fluid (CSF) and blood]. As a complex and multifactorial disease, AD biomarkers are important for an accurate diagnosis and to stage the disease, assess the prognosis, test target engagement, and measure the response to treatment. In addition, biomarkers provide us with information that, even if it does not have a current clinical use, helps us to understand the mechanisms of the disease. In addition to the pathological hallmarks of AD, which include amyloid-β and tau deposition, there are multiple concomitant pathological events that play a key role in the disease. These include, but are not limited to, neurodegeneration, inflammation, vascular dysregulation or synaptic dysfunction. In addition, AD patients often have an accumulation of other proteins including α-synuclein and TDP-43, which may have a pathogenic effect on AD. In combination, there is a need to have biomarkers that reflect different aspects of AD pathogenesis and this will be important in the future to establish what are the most suitable applications for each of these AD-related biomarkers. It is unclear whether sex, gender, or both have an effect on the causes of AD. There may be differences in fluid biomarkers due to sex but this issue has often been neglected and warrants further research. In this review, we summarize the current state of the principal AD fluid biomarkers and discuss the effect of sex on these biomarkers.
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Affiliation(s)
- Marta Milà-Alomà
- Barcelonaβeta Brain Research Center (BBRC),
Pasqual Maragall Foundation, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research
Institute), Barcelona
| | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center (BBRC),
Pasqual Maragall Foundation, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research
Institute), Barcelona
- Department of Neurology, Hospital del Mar,
Barcelona
| | - José Luís Molinuevo
- Scientific Director, Alzheimer’s Prevention
Program, Barcelonaβeta Brain Research Center, Wellington 30, Barcelona,
08005, Spain
- IMIM (Hospital del Mar Medical Research
Institute), Barcelona
- CIBER Fragilidad y Envejecimiento Saludable,
Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
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Tang W, Wang Y, Cheng J, Yao J, Yao YY, Zhou Q, Guan SH. CSF sAPPα and sAPPβ levels in Alzheimer's Disease and Multiple Other Neurodegenerative Diseases: A Network Meta-Analysis. Neuromolecular Med 2019; 22:45-55. [PMID: 31414383 DOI: 10.1007/s12017-019-08561-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 07/31/2019] [Indexed: 12/31/2022]
Abstract
The soluble amyloid protein procurer α (sAPPα) and β (sAPPβ) have been postulated as promising new cerebrospinal fluid (CSF) biomarkers for Alzheimer's disease (AD) and multiple other neurodegenerative diseases, but have failed to meet expectations with their often discordant and even contradictory findings to date. The aim of the study was to systematically explore this issue. Cochrane Library, PubMed, and CNKI were systematically searched without language or date restrictions. This network meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and also adhered to the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Twenty studies, comprising ten groups, were eligible and included. Overall, 19 eligible studies with 1634 patients contributed to the analysis of CSF sAPPα levels and 16 eligible studies with 1684 patients contributed to the analysis of CSF sAPPβ levels. CSF sAPPβ levels are significantly higher in AD than in corticobasal syndrome (CBS) and progressive supranuclear palsy (PSP); higher in Control than in Depression, CBS and PSP; higher in Parkinson's disease dementia (PDD) than in CBS and PSP; higher in mild cognitive impairment progressed to AD dementia during the follow-up period (pMCI) than in Depression and PSP; higher in stable mild cognitive impairment (sMCI) than in Depression. With regard to CSF sAPPα levels, there were no significant difference among groups. However, surprisingly, the resultant rankings graphically showed that pMCI populations have the highest levels of CSF sAPPα and sAPPβ. Furthermore, it seemed there was a positive correlation between CSF sAPPα and sAPPβ levels. The measurement of CSF sAPPα and sAPPβ levels may provide an alternative method for the diagnosis of early-stage AD, pMCI, which is conducive to preventive therapy.
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Affiliation(s)
- Wei Tang
- Department of Laboratory Medicine, The Second Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, 230601, Anhui, China
| | - Yan Wang
- Department of General Surgery, The Second Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, 230601, Anhui, China
| | - Juan Cheng
- Department of Laboratory Medicine, The Second Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, 230601, Anhui, China
| | - Jie Yao
- Department of Laboratory Medicine, The Second Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, 230601, Anhui, China
| | - Yu-You Yao
- Department of Clinical Laboratory Medicine, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Qiang Zhou
- Department of Laboratory Medicine, The Second Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, 230601, Anhui, China
| | - Shi-He Guan
- Department of Laboratory Medicine, The Second Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, 230601, Anhui, China.
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Rauchmann BS, Schneider-Axmann T, Alexopoulos P, Perneczky R. CSF soluble TREM2 as a measure of immune response along the Alzheimer's disease continuum. Neurobiol Aging 2019; 74:182-190. [PMID: 30458365 PMCID: PMC6331262 DOI: 10.1016/j.neurobiolaging.2018.10.022] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/28/2018] [Accepted: 10/17/2018] [Indexed: 01/25/2023]
Abstract
TREM2 was suggested to be an important regulator of microglia during neurodegeneration, but previous studies report conflicting results in relation to soluble TREM2 (sTREM2) in cerebrospinal fluid (CSF) when using clinical criteria to classify Alzheimer's disease (AD). The present study explores sTREM2 CSF levels and their associations with other biomarkers and cognitive measures in a prospective AD cohort. Based on the available CSF biomarker information, 497 subjects were classified according to the 2018 National Institute on Aging-Alzheimer's Association research framework guidelines, which group biomarkers into those of amyloid-β deposition, tau pathology, and neurodegeneration. CSF sTREM2 concentrations were associated with markers of neurodegeneration and fibrillar tau pathology, but not amyloidosis; sTREM2 concentrations were increased in total tau-positive versus -negative individuals; sTREM2 was not related to cognitive and other biomarker changes over time; and sTREM2 concentrations increased over time in total tau-positive versus -negative individuals with AD pathophysiology. The present study provides evidence in support of sTREM2 in CSF as a marker of neuroinflammation across the spectrum of early clinical AD. sTREM2 is linked to neuronal injury and may therefore offer complementary information relevant for diagnostic purposes and novel treatment approaches targeting the immune system in AD.
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Affiliation(s)
- Boris-Stephan Rauchmann
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany; Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Thomas Schneider-Axmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Panagiotis Alexopoulos
- Department of Psychiatry, University Hospital of Rion, University of Patras, Patras, Greece; Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany
| | - Robert Perneczky
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK.
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Alexopoulos P, Thierjung N, Grimmer T, Ortner M, Economou P, Assimakopoulos K, Gourzis P, Politis A, Perneczky R. Cerebrospinal Fluid BACE1 Activity and sAβPPβ as Biomarker Candidates of Alzheimer's Disease. Dement Geriatr Cogn Disord 2018; 45:152-161. [PMID: 29788013 DOI: 10.1159/000488481] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 03/11/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND/AIMS The utility of β-site amyloid-β precursor protein (AβPP) cleaving enzyme 1 (BACE1) activity and soluble AβPP β (sAβPPβ) levels in cerebrospinal fluid (CSF) in detecting Alzheimer's disease (AD) is still elusive. METHODS BACE1 activity and sAβPPβ concentration were measured in patients with AD dementia (n = 56) and mild cognitive impairment (MCI) due to AD (n = 76) with abnormal routine AD CSF markers, in patients with MCI with normal CSF markers (n = 39), and in controls without preclinical AD (n = 48). In a subsample with available 18F-fluorodeoxyglucose positron emission tomography (FDG PET) data, ordinal regression models were employed to compare the contribution of BACE1 and sAβPPβ to correct diagnostic classification to that of FDG PET. RESULTS BACE1 activity was significantly higher in patients with MCI due to AD compared to both controls and patients with MCI with normal CSF markers. sAβPPβ did not differ between any of the studied groups. Interestingly, BACE1 activity was not found to be inferior to FDG PET as predictive covariate in differentiating between the diagnostic groups. CONCLUSIONS Further studies using biomarker-underpinned diagnoses are warranted to shed more light on the potential diagnostic utility of BACE1 activity as AD biomarker candidate in MCI.
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Affiliation(s)
- Panagiotis Alexopoulos
- Department of Psychiatry, University Hospital of Rion, University of Patras, Patras, Greece.,Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Nathalie Thierjung
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Marion Ortner
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Polychronis Economou
- Department of Civil Engineering (Statistics), University of Patras, Patras, Greece
| | | | - Philippos Gourzis
- Department of Psychiatry, University Hospital of Rion, University of Patras, Patras, Greece
| | - Antonios Politis
- First Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece.,Department of Psychiatry, Division of Geriatric Psychiatry and Neuropsychiatry, John's Hopkins Medical School, Baltimore, Maryland, USA
| | - Robert Perneczky
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany.,Neuroepidemiology and Ageing Research Unit, School of Public Health, Faculty of Medicine, The Imperial College of Science, Technology and Medicine, London, United Kingdom.,West London Mental Health NHS Trust, London, United Kingdom.,German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany
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Rose C, Dorard E, Audrain M, Gorisse-Hussonnois L, Cartier N, Braudeau J, Allinquant B. Transient increase in sAPPα secretion in response to Aβ1–42 oligomers: an attempt of neuronal self-defense? Neurobiol Aging 2018; 61:23-35. [DOI: 10.1016/j.neurobiolaging.2017.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 09/08/2017] [Accepted: 09/09/2017] [Indexed: 12/19/2022]
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9
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Araki W, Hattori K, Kanemaru K, Yokoi Y, Omachi Y, Takano H, Sakata M, Yoshida S, Tsukamoto T, Murata M, Saito Y, Kunugi H, Goto YI, Nagaoka U, Nagao M, Komori T, Arima K, Ishii K, Murayama S, Matsuda H, Tachimori H, Araki YM, Mizusawa H. Re-evaluation of soluble APP-α and APP-β in cerebrospinal fluid as potential biomarkers for early diagnosis of dementia disorders. Biomark Res 2017; 5:28. [PMID: 29018524 PMCID: PMC5610422 DOI: 10.1186/s40364-017-0108-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 09/03/2017] [Indexed: 01/14/2023] Open
Abstract
Background Because soluble (or secreted) amyloid precursor protein-β (sAPPβ) and -α (sAPPα) possibly reflect pathological features of Alzheimer’s disease (AD), they are potential biomarker candidates for dementia disorders, including AD and mild cognitive impairment (MCI) due to AD (MCI-AD). However, controversial results have been reported regarding their alterations in the cerebrospinal fluid (CSF) of AD and MCI-AD patients. In this study, we re-assessed the utility of sAPPα and sAPPβ in CSF as diagnostic biomarkers of dementia disorders. Methods We used a modified and sensitive detection method to analyze sAPPs levels in CSF in four groups of patients: AD (N = 33), MCI-AD (N = 17), non-AD dementia (N = 27), and disease controls (N = 19). Phosphorylated tau (p-tau), total tau, and Aβ42 were also analyzed using standard methods. Results A strong correlation was observed between sAPPα and sAPPβ, consistent with previous reports. Both sAPPα and sAPPβ were highly correlated with p-tau and total tau, suggesting that sAPPs possibly reflect neuropathological changes in the brain. Levels of sAPPα were significantly higher in MCI-AD cases compared with non-AD and disease control cases, and those of sAPPβ were also significantly higher in MCI-AD and AD cases relative to other cases. A logistic regression analysis indicated that sAPPα and sAPPβ have good discriminative power for the diagnosis of MCI-AD. Conclusions Our findings collectively suggest that both sAPPs are pathologically relevant and potentially useful biomarkers for early and accurate diagnosis of dementia disorders. We also suggest that careful measurement is important in assessing the diagnostic utility of CSF sAPPs. Electronic supplementary material The online version of this article (10.1186/s40364-017-0108-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wataru Araki
- Department of Demyelinating Disease and Aging, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi, Kodaira, Tokyo, 187-8502 Japan
| | - Kotaro Hattori
- Medical Genome Center, NCNP, Tokyo, Japan.,Department of Mental Disorder Research, National Institute of Neuroscience, NCNP, Tokyo, Japan
| | - Kazutomi Kanemaru
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Yuma Yokoi
- National Center Hospital, NCNP, Tokyo, Japan
| | | | | | | | | | | | - Miho Murata
- National Center Hospital, NCNP, Tokyo, Japan
| | - Yuko Saito
- National Center Hospital, NCNP, Tokyo, Japan
| | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience, NCNP, Tokyo, Japan
| | | | - Utako Nagaoka
- Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | | | | | | | - Kenji Ishii
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Shigeo Murayama
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | | | - Hisateru Tachimori
- Department of Mental Health Policy and Evaluation, National Institute of Mental Health, NCNP, Tokyo, Japan
| | - Yumiko M Araki
- Department of Demyelinating Disease and Aging, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi, Kodaira, Tokyo, 187-8502 Japan.,Department of Psychiatry and Behavioral Science, Graduate School of Medicine, Juntendo University, Tokyo, Japan
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10
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Thordardottir S, Kinhult Ståhlbom A, Almkvist O, Thonberg H, Eriksdotter M, Zetterberg H, Blennow K, Graff C. The effects of different familial Alzheimer's disease mutations on APP processing in vivo. Alzheimers Res Ther 2017; 9:9. [PMID: 28209190 PMCID: PMC5312523 DOI: 10.1186/s13195-017-0234-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 01/03/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Disturbed amyloid precursor protein (APP) processing is considered to be central to the pathogenesis of Alzheimer's disease (AD). The autosomal dominant form of the disease, familial AD (FAD), may serve as a model for the sporadic form of AD. In FAD the diagnosis of AD is reliable and presymptomatic individuals carrying FAD mutations can give valuable insights into the earliest stages of the disease where therapeutic interventions are thought to be the most effective. METHODS In the current cross-sectional study, products of APP processing (e.g., sAPPα, sAPPβ, Aβ38, Aβ40 and Aβ42) were measured in the cerebrospinal fluid (CSF) of individuals carrying one of three FAD mutations, APPswe (p.KM670/671NL), APParc (p.E693G) and PSEN1 (p.H163Y), as well as in non-mutation carriers from the same families. RESULTS We observed pathological APP processing in presymptomatic carriers of FAD mutations, with different profiles of APP and Aβ isoforms in the three mutation carrier groups, APPswe (p.KM670/671NL), APParc (p.E693G) and PSEN1 (p.H163Y), except for the well-established decrease in CSF Aβ42 that was found with all mutations. CONCLUSIONS These findings add to the current evidence that AD pathophysiology differs between disease-causing mutations and can be monitored in the presymptomatic disease stage by CSF analyses. This may also be important from a therapeutic standpoint, by opening a window to monitor effects of disease-modifying drugs on AD pathophysiology.
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Affiliation(s)
- Steinunn Thordardottir
- Department NVS, Division of Neurogeriatrics, Center for Alzheimer Disease Research, Karolinska Institutet, 141 57, Huddinge, Sweden
- Department of Geriatric Medicine, Karolinska University Hospital Huddinge, 141 86, Stockholm, Sweden
| | - Anne Kinhult Ståhlbom
- Department NVS, Division of Neurogeriatrics, Center for Alzheimer Disease Research, Karolinska Institutet, 141 57, Huddinge, Sweden
- Department of Geriatric Medicine, Karolinska University Hospital Huddinge, 141 86, Stockholm, Sweden
| | - Ove Almkvist
- Department NVS, Center for Alzheimer Research, Division of Translational Alzheimer Neurobiology, Karolinska Institutet, 141 57, Huddinge, Sweden
| | - Håkan Thonberg
- Department NVS, Division of Neurogeriatrics, Center for Alzheimer Disease Research, Karolinska Institutet, 141 57, Huddinge, Sweden
- Department of Geriatric Medicine, Karolinska University Hospital Huddinge, 141 86, Stockholm, Sweden
| | - Maria Eriksdotter
- Department of Geriatric Medicine, Karolinska University Hospital Huddinge, 141 86, Stockholm, Sweden
- Department NVS, Division for Clinical Geriatrics, Center for Alzheimer Disease Research, Karolinska Institutet, 141 57, Huddinge, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, SE-431 80 Mölndal, Sweden
- UCL Insitute of Neurology, Queen Square, London, UK
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, SE-431 80 Mölndal, Sweden
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, SE-431 80 Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, SE-431 80 Mölndal, Sweden
| | - Caroline Graff
- Department NVS, Division of Neurogeriatrics, Center for Alzheimer Disease Research, Karolinska Institutet, 141 57, Huddinge, Sweden
- Department of Geriatric Medicine, Karolinska University Hospital Huddinge, 141 86, Stockholm, Sweden
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11
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Duarte AC, Hrynchak MV, Gonçalves I, Quintela T, Santos CRA. Sex Hormone Decline and Amyloid β Synthesis, Transport and Clearance in the Brain. J Neuroendocrinol 2016; 28. [PMID: 27632792 DOI: 10.1111/jne.12432] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 09/12/2016] [Accepted: 09/12/2016] [Indexed: 12/15/2022]
Abstract
Sex hormones (SH) are essential regulators of the central nervous system. The decline in SH levels along with ageing may contribute to compromised neuroprotection and set the grounds for neurodegeneration and cognitive impairments. In Alzheimer's disease, besides other pathological features, there is an imbalance between amyloid β (Aβ) production and clearance, leading to its accumulation in the brain of older subjects. Aβ accumulation is a primary cause for brain inflammation and degeneration, as well as concomitant cognitive decline. There is mounting evidence that SH modulate Aβ production, transport and clearance. Importantly, SH regulate most of the molecules involved in the amyloidogenic pathway, their transport across brain barriers for elimination, and their degradation in the brain interstitial fluid. This review brings together data on the regulation of Aβ production, metabolism, degradation and clearance by SH.
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Affiliation(s)
- A C Duarte
- Health Sciences Research Centre - CICS-UBI, University of Beira Interior, Covilhã, Portugal
| | - M V Hrynchak
- Health Sciences Research Centre - CICS-UBI, University of Beira Interior, Covilhã, Portugal
| | - I Gonçalves
- Health Sciences Research Centre - CICS-UBI, University of Beira Interior, Covilhã, Portugal
| | - T Quintela
- Health Sciences Research Centre - CICS-UBI, University of Beira Interior, Covilhã, Portugal
| | - C R A Santos
- Health Sciences Research Centre - CICS-UBI, University of Beira Interior, Covilhã, Portugal
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12
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Alexopoulos P, Roesler J, Thierjung N, Werle L, Buck D, Yakushev I, Gleixner L, Kagerbauer S, Ortner M, Grimmer T, Kübler H, Martin J, Laskaris N, Kurz A, Perneczky R. Mapping CSF biomarker profiles onto NIA-AA guidelines for Alzheimer's disease. Eur Arch Psychiatry Clin Neurosci 2016; 266:587-97. [PMID: 26253588 DOI: 10.1007/s00406-015-0628-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 07/26/2015] [Indexed: 10/23/2022]
Abstract
The National Institute on Aging-Alzheimer's Association (NIA-AA) guidelines for Alzheimer's disease (AD) propose the categorization of individuals according to their biomarker constellation. Though the NIA-AA criteria for preclinical AD and AD dementia have already been applied in conjunction with imaging AD biomarkers, the application of the criteria using comprehensive cerebrospinal fluid (CSF) biomarker information has not been thoroughly studied yet. The study included a monocentric cohort with healthy (N = 41) and disease (N = 22) controls and patients with AD dementia (N = 119), and a multicentric sample with healthy controls (N = 116) and patients with AD dementia (N = 102). The CSF biomarkers β-amyloid 1-42, total tau, and phosphorylated tau at threonine 181 were measured with commercially available assays. Biomarker values were trichotomized into positive for AD, negative, or borderline. In controls the presence of normal CSF profiles varied between 13.6 and 25.4 % across the studied groups, while up to 8.6 % of them had abnormal CSF biomarkers. In 40.3-52.9 % of patients with AD dementia, a typical CSF profile for AD was detected. Approximately 40 % of the potential biomarker constellations are not considered in the NIA-AA guidelines, and more than 40 % of participants could not be classified into the NIA-AA categories with distinct biomarker constellations. Here, a refined scheme covering all potential biomarker constellations is proposed. These results enrich the discussion on the NIA-AA guidelines and point to a discordance between clinical symptomatology and CSF biomarkers even in patients with full-blown AD dementia, who are supposed to have a clearly positive for AD neurochemical profile.
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Affiliation(s)
- Panagiotis Alexopoulos
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. .,Department of Psychiatry, University Hospital of Rion, University of Patras, 26500, Rion, Patras, Greece.
| | - Jennifer Roesler
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Nathalie Thierjung
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Lukas Werle
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,Max Planck Institute of Psychiatry, 80804, Munich, Germany
| | - Dorothea Buck
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Igor Yakushev
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Lena Gleixner
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Simone Kagerbauer
- Department of Anaesthesiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Marion Ortner
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Hubert Kübler
- Department of Urology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Jan Martin
- Department of Anaesthesiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Nikolaos Laskaris
- Department of Informatics, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Alexander Kurz
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Robert Perneczky
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,Neuroepidemiology and Ageing Research Unit, Faculty of Medicine, School of Public Health, The Imperial College of Science, Technology and Medicine, London, UK.,West London Cognitive Disorders Treatment and Research Unit, West London Mental Health Trust, London, UK
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13
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Cicognola C, Chiasserini D, Eusebi P, Andreasson U, Vanderstichele H, Zetterberg H, Parnetti L, Blennow K. No diurnal variation of classical and candidate biomarkers of Alzheimer's disease in CSF. Mol Neurodegener 2016; 11:65. [PMID: 27605218 PMCID: PMC5013624 DOI: 10.1186/s13024-016-0130-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 08/27/2016] [Indexed: 11/10/2022] Open
Abstract
Background Cerebrospinal fluid (CSF) biomarkers have gained increasing importance in the diagnostic work-up of Alzheimer’s disease (AD). The core CSF biomarkers related to AD pathology (Aβ42, t-tau and p-tau) are currently used in CSF diagnostics, while candidate markers of amyloid metabolism (Aβ38, Aβ40, sAPPα, sAPPβ), synaptic loss (neurogranin), neuroinflammation (YKL-40), neuronal damage (VILIP-1) and genetic risk (apolipoprotein E) are undergoing evaluation. Diurnal fluctuation in the concentration of CSF biomarkers has been reported and may represent a preanalytical confounding factor in the laboratory diagnosis of AD. The aim of the present study was to investigate the diurnal variability of classical and candidate CSF biomarkers in a cohort of neurosurgical patients carrying a CSF drainage. Method Samples were collected from a cohort of 13 neurosurgical patients from either ventricular (n = 6) or lumbar (n = 7) CSF drainage at six time points during the day, 1–7 days following the neurosurgical intervention. Concentrations of the core biomarkers were determined by immunoassays. Results Although absolute values largely varied among subjects, none of the biomarkers showed significant diurnal variation. Site of drainage (lumbar vs. ventricular) did not influence this result. The different immunoassays used for tau and Aβ markers provided similar results. Conclusion Time of day at CSF collection does not ultimately affect the concentration levels of classical and candidate AD biomarkers. Similar trends were found when using different immunoassays, thus corroborating the consistency of the data. Electronic supplementary material The online version of this article (doi:10.1186/s13024-016-0130-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Claudia Cicognola
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, House V3, SU / Mölndal hospital, Göteborgsvägen 31, SE-431 80, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, SE-431 80, Mölndal, Sweden
| | - Davide Chiasserini
- Section of Neurology, Department of Medicine, Center for Memory Disturbances, University of Perugia, Sant' Andrea delle Fratte, 06132, Perugia, Italy
| | - Paolo Eusebi
- Section of Neurology, Department of Medicine, Center for Memory Disturbances, University of Perugia, Sant' Andrea delle Fratte, 06132, Perugia, Italy
| | - Ulf Andreasson
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, House V3, SU / Mölndal hospital, Göteborgsvägen 31, SE-431 80, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, SE-431 80, Mölndal, Sweden
| | | | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, House V3, SU / Mölndal hospital, Göteborgsvägen 31, SE-431 80, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, SE-431 80, Mölndal, Sweden.,UCL Institute of Neurology, Queen Square, London, UK
| | - Lucilla Parnetti
- Section of Neurology, Department of Medicine, Center for Memory Disturbances, University of Perugia, Sant' Andrea delle Fratte, 06132, Perugia, Italy.
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, House V3, SU / Mölndal hospital, Göteborgsvägen 31, SE-431 80, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, SE-431 80, Mölndal, Sweden
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14
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Hartl D, Gu W, Mayhaus M, Pichler S, Schöpe J, Wagenpfeil S, Riemenschneider M. Amyloid-β Protein Precursor Cleavage Products in Postmortem Ventricular Cerebrospinal Fluid of Alzheimer's Disease Patients. J Alzheimers Dis 2016; 47:365-72. [PMID: 26401559 DOI: 10.3233/jad-150191] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Accumulation and aggregation of amyloid-β (Aβ) are considered etiologic processes in Alzheimer's disease (AD). However, the roles of other AβPP cleavage products in disease pathology remain elusive. Here, we measured levels of the major secreted AβPP processing products sAβPPα, sAβPPβ, and Aβ species in postmortem collected ventricular CSF of 196 AD patients and 74 controls. In AD we identified Aβ₄₂ to decrease continuously with progressing Braak stages, whereas Aβ₄₀ was upregulated in early stages of the disease (Braak stage 4) and down-regulated with progressing pathology. Interestingly, both sAβPPα and sAβPPβ were upregulated in AD as compared to controls (sAβPPα, p = 0.02; sAβPPβ, p = 0.01). Moreover, we observed a strong positive correlation of both alternative AβPP processing products, sAβPPα and sAβPPβ (r²= 0.781; p < 0.0001). Together, our results argue for generally enhanced AβPP processing in AD patients and emphasize the necessity of analyzing the roles of all AβPP processing products in AD pathology.
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Affiliation(s)
- Daniela Hartl
- Department of Psychiatry and Psychotherapy, Saarland University Hospital, Saarland University, Homburg, Germany.,Institute for Human Genetics and Medical Genetics, Charité University Medicine, Berlin, Germany
| | - Wei Gu
- Department of Psychiatry and Psychotherapy, Saarland University Hospital, Saarland University, Homburg, Germany.,Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Manuel Mayhaus
- Department of Psychiatry and Psychotherapy, Saarland University Hospital, Saarland University, Homburg, Germany
| | - Sabrina Pichler
- Department of Psychiatry and Psychotherapy, Saarland University Hospital, Saarland University, Homburg, Germany
| | - Jakob Schöpe
- Institute for Biometrics, Epidemiology and Medical Informatics, Saarland University Hospital, Saarland University, Homburg, Germany
| | - Stefan Wagenpfeil
- Institute for Biometrics, Epidemiology and Medical Informatics, Saarland University Hospital, Saarland University, Homburg, Germany
| | - Matthias Riemenschneider
- Department of Psychiatry and Psychotherapy, Saarland University Hospital, Saarland University, Homburg, Germany
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15
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van Waalwijk van Doorn LJC, Koel-Simmelink MJ, Haußmann U, Klafki H, Struyfs H, Linning P, Knölker HJ, Twaalfhoven H, Kuiperij HB, Engelborghs S, Scheltens P, Verbeek MM, Vanmechelen E, Wiltfang J, Teunissen CE. Validation of soluble amyloid-β precursor protein assays as diagnostic CSF biomarkers for neurodegenerative diseases. J Neurochem 2016; 137:112-21. [PMID: 26748905 DOI: 10.1111/jnc.13527] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 12/15/2015] [Accepted: 12/28/2015] [Indexed: 12/01/2022]
Abstract
Analytical validation of a biomarker assay is essential before implementation in clinical practice can occur. In this study, we analytically validated the performance of assays detecting soluble amyloid-β precursor protein (sAPP) α and β in CSF in two laboratories according to previously standard operating procedures serving this goal. sAPPα and sAPPβ ELISA assays from two vendors (IBL-international, Meso Scale Diagnostics) were validated. The performance parameters included precision, sensitivity, dilutional linearity, recovery, and parallelism. Inter-laboratory variation, biomarker comparison (sAPPα vs. sAPPβ) and clinical performance was determined in three laboratories using 60 samples of patients with subjective memory complaints, Alzheimer's disease, or frontotemporal dementia. All performance parameters of the assays were similar between labs and within predefined acceptance criteria. The only exceptions were minor out-of-range results for recovery at low concentrations and, despite being within predefined acceptance criteria, non-comparability of the results for evaluation of the dilutional linearity and hook-effect. Based on the inter-laboratory correlation between Lab #1 and Lab #2, the IBL-international assays were more robust (sAPPα: r(2) = 0.92, sAPPβ: r(2) = 0.94) than the Meso Scale Diagnostics (MSD) assay (sAPPα: r(2) = 0.70, sAPPβ: r(2) = 0.80). Specificity of assays was confirmed using assay-specific peptide competitors. Clinical validation showed consistent results across the clinical groups in the different laboratories for all assays. The validated sAPP assays appear to be of sufficient technical quality and perform well. Moreover, the study shows that the newly developed standard operating procedures provide highly useful tools for the validation of new biomarker assays. A recommendation was made for renewed instructions to evaluate the dilutional linearity and hook-effect. We analytically validated the performance of assays detecting soluble amyloid-β precursor protein (sAPP) α and β in CSF according to SOPs in agreement with ISO15189 guidelines. The validated sAPP assays appear to be of sufficient technical quality and perform well. Moreover, this study proofs that the newly developed SOPs, with a minor modification, provide highly useful tools for the validation of new biomarker assays.
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Affiliation(s)
- Linda J C van Waalwijk van Doorn
- Department of Neurology, Department of Laboratory Medicine, Radboud University Medical Center, Radboud Alzheimer Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Marleen J Koel-Simmelink
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands
| | - Ute Haußmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, LVR-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Hans Klafki
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, LVR-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Georg-August-University, Goettingen, Germany
| | - Hanne Struyfs
- Reference Center for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Philipp Linning
- Department of Chemistry, Technische Universität Dresden, Dresden, Germany
| | | | - Harry Twaalfhoven
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands
| | - H Bea Kuiperij
- Department of Neurology, Department of Laboratory Medicine, Radboud University Medical Center, Radboud Alzheimer Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Sebastiaan Engelborghs
- Reference Center for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.,Memory Clinic and Department of Neurology, Hospital Network Antwerp (ZNA), Antwerp, Belgium
| | | | - Marcel M Verbeek
- Department of Neurology, Department of Laboratory Medicine, Radboud University Medical Center, Radboud Alzheimer Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | | | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Georg-August-University, Goettingen, Germany
| | - Charlotte E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands
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16
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Lopez-Font I, Cuchillo-Ibañez I, Sogorb-Esteve A, García-Ayllón MS, Sáez-Valero J. Transmembrane Amyloid-Related Proteins in CSF as Potential Biomarkers for Alzheimer's Disease. Front Neurol 2015; 6:125. [PMID: 26082753 PMCID: PMC4451586 DOI: 10.3389/fneur.2015.00125] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 05/17/2015] [Indexed: 02/04/2023] Open
Abstract
In the continuing search for new cerebrospinal fluid (CSF) biomarkers for Alzheimer’s disease (AD), reasonable candidates are the secretase enzymes involved in the processing of the amyloid precursor protein (APP), as well as the large proteolytic cleavage fragments sAPPα and sAPPβ. The enzymatic activities of some of these secretases, such as BACE1 and TACE, have been investigated as potential AD biomarkers, and it has been assumed that these activities present in human CSF result from the soluble truncated forms of the membrane-bound enzymes. However, we and others recently identified soluble forms of BACE1 and APP in CSF containing the intracellular domains, as well as the multi-pass transmembrane presenilin-1 (PS1) and other subunits of γ-secretase. We also review recent findings that suggest that most of these soluble transmembrane proteins could display self-association properties based on hydrophobic and/or ionic interactions leading to the formation of heteromeric complexes. The oligomerization state of these potential new biomarkers needs to be taken into consideration for assessing their real potential as CSF biomarkers for AD by adequate molecular tools.
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Affiliation(s)
- Inmaculada Lopez-Font
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-CSIC , Sant Joan d'Alacant , Spain ; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED) , Sant Joan d'Alacant , Spain
| | - Inmaculada Cuchillo-Ibañez
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-CSIC , Sant Joan d'Alacant , Spain ; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED) , Sant Joan d'Alacant , Spain
| | - Aitana Sogorb-Esteve
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-CSIC , Sant Joan d'Alacant , Spain ; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED) , Sant Joan d'Alacant , Spain
| | - María-Salud García-Ayllón
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-CSIC , Sant Joan d'Alacant , Spain ; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED) , Sant Joan d'Alacant , Spain ; Unidad de Investigación, Fundación para el Fomento de la Investigación Sanitaria Biomédica de la Comunidad Valenciana (FISABIO), Hospital General Universitario de Elche , Elche , Spain
| | - Javier Sáez-Valero
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-CSIC , Sant Joan d'Alacant , Spain ; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED) , Sant Joan d'Alacant , Spain
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17
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Höglund K, Fourier A, Perret-Liaudet A, Zetterberg H, Blennow K, Portelius E. Alzheimer's disease--Recent biomarker developments in relation to updated diagnostic criteria. Clin Chim Acta 2015; 449:3-8. [PMID: 25668231 DOI: 10.1016/j.cca.2015.01.041] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 01/26/2015] [Indexed: 10/24/2022]
Abstract
Alzheimer's disease (AD) is the most common cause of dementia and is characterized by neuroaxonal and synaptic degeneration accompanied by intraneuronal neurofibrillary tangles and accumulation of extracellular plaques in specific brain regions. These features are reflected in the AD cerebrospinal fluid (CSF) by increased concentrations of total tau (t-tau) and phosphorylated tau (p-tau), together with decreased concentrations of β-amyloid (Aβ42), respectively. In combination, Aβ42, p-tau and t-tau are 85-95% sensitive and specific for AD in both prodromal and dementia stages of the disease and they are now included in the diagnostic research criteria for AD. However, to fully implement these biomarkers into clinical practice, harmonization of data is needed. This work is ongoing through the standardization of analytical procedures between clinical laboratories and the production of reference materials for CSF Aβ42, p-tau and t-tau. To monitor other aspects of AD neuropathology, e.g., synaptic dysfunction and/or to develop markers of progression, identifying novel candidate biomarkers is of great importance. Based on knowledge from the established biomarkers, exemplified by Aβ and its many variants, and emerging data on neurogranin fragments as biomarker candidate(s), a thorough protein characterization in order to fully understand the diagnostic value of a protein is a suggested approach for successful biomarker discovery.
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Affiliation(s)
- Kina Höglund
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Anthony Fourier
- Neurobiology Department, Hospices Civils de Lyon, Lyon, France; BIORAN team INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, Lyon, France
| | - Armand Perret-Liaudet
- Neurobiology Department, Hospices Civils de Lyon, Lyon, France; BIORAN team INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, Lyon, France
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Department of Molecular Neuroscience, UCL Institute of Neurology, London WC1N 3BG, United Kingdom
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Erik Portelius
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.
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Cuchillo-Ibañez I, Lopez-Font I, Boix-Amorós A, Brinkmalm G, Blennow K, Molinuevo JL, Sáez-Valero J. Heteromers of amyloid precursor protein in cerebrospinal fluid. Mol Neurodegener 2015; 10:2. [PMID: 25573162 PMCID: PMC4298044 DOI: 10.1186/1750-1326-10-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 12/27/2014] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Soluble fragments of the amyloid precursor protein (APP) generated by α- and β-secretases, sAPPα and sAPPβ, have been postulated as promising new cerebrospinal fluid (CSF) biomarkers for the clinical diagnosis of Alzheimer's disease (AD). However, the capacity of these soluble proteins to assemble has not been explored and could be relevant. Our aim is to characterize possible sAPP oligomers that could contribute to the quantification of sAPPα and sAPPβ in CSF by ELISA, as well as to characterize the possible presence of soluble full-length APP (sAPPf). RESULTS We employed co-immunoprecipitation, native polyacrylamide gel electrophoresis and ultracentrifugation in sucrose density gradients to characterize sAPP oligomers in CSF. We have characterized the presence of sAPPf in CSF from NDC and AD subjects and demonstrated that all forms, including sAPPα and sAPPβ, are capable of assembling into heteromers, which differ from brain APP membrane-dimers. We measured sAPPf, sAPPα and sAPPβ by ELISA in CSF samples from AD (n = 13) and non-disease subjects (NDC, n = 13) before and after immunoprecipitation with antibodies against the C-terminal APP or against sAPPβ. We demonstrated that these sAPP heteromers participate in the quantification of sAPPα and sAPPβ by ELISA. Immunoprecipitation with a C-terminal antibody to remove sAPPf reduced by ~30% the determinations of sAPPα and sAPPβ by ELISA, whereas immunoprecipitation with an APPβ antibody reduced by ~80% the determination of sAPPf and sAPPα. CONCLUSIONS The presence of sAPPf and sAPP heteromers should be taken into consideration when exploring the levels of sAPPα and sAPPβ as potential CSF biomarkers.
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Affiliation(s)
| | | | | | | | | | | | - Javier Sáez-Valero
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-CSIC, Av, Ramón y Cajal s/n, Sant Joan d'Alacant, Spain.
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Abstract
BACE, a β-secretase, is an attractive potential disease-modifying therapeutic strategy for Alzheimer's disease (AD) as it results directly in the decrease of amyloid precursor protein (APP) processing through the β-secretase pathway and a lowering of CNS amyloid-β (Aβ) levels. The interaction of the β-secretase and α-secretase pathway-mediated processing of APP in the rhesus monkey (nonhuman primate; NHP) CNS is not understood. We hypothesized that CNS inhibition of BACE would result in decreased newly generated Aβ and soluble APPβ (sAPPβ), with increased newly generated sAPPα. A stable isotope labeling kinetics experiment in NHPs was performed with a (13)C6-leucine infusion protocol to evaluate effects of BACE inhibition on CNS APP processing by measuring the kinetics of sAPPα, sAPPβ, and Aβ in CSF. Each NHP received a low, medium, or high dose of MBI-5 (BACE inhibitor) or vehicle in a four-way crossover design. CSF sAPPα, sAPPβ, and Aβ were measured by ELISA and newly incorporated label following immunoprecipitation and liquid chromatography-mass spectrometry. Concentrations, kinetics, and amount of newly generated APP fragments were calculated. sAPPβ and sAPPα kinetics were similar, but both significantly slower than Aβ. BACE inhibition resulted in decreased labeled sAPPβ and Aβ in CSF, without observable changes in labeled CSF sAPPα. ELISA concentrations of sAPPβ and Aβ both decreased and sAPPα increased. sAPPα increased by ELISA, with no difference by labeled sAPPα kinetics indicating increases in product may be due to APP shunting from the β-secretase to the α-secretase pathway. These results provide a quantitative understanding of pharmacodynamic effects of BACE inhibition on NHP CNS, which can inform about target development.
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Dobrowolska JA, Kasten T, Huang Y, Benzinger TLS, Sigurdson W, Ovod V, Morris JC, Bateman RJ. Diurnal patterns of soluble amyloid precursor protein metabolites in the human central nervous system. PLoS One 2014; 9:e89998. [PMID: 24646516 PMCID: PMC3960093 DOI: 10.1371/journal.pone.0089998] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Accepted: 01/28/2014] [Indexed: 11/22/2022] Open
Abstract
The amyloid-β (Aβ) protein is diurnally regulated in both the cerebrospinal fluid and blood in healthy adults; circadian amplitudes decrease with aging and the presence of cerebral Aβ deposits. The cause of the Aβ diurnal pattern is poorly understood. One hypothesis is that the Amyloid Precursor Protein (APP) is diurnally regulated, leading to APP product diurnal patterns. APP in the central nervous system is processed either via the β-pathway (amyloidogenic), generating soluble APP-β (sAPPβ) and Aβ, or the α-pathway (non-amyloidogenic), releasing soluble APP-α (sAPPα). To elucidate the potential contributions of APP to the Aβ diurnal pattern and the balance of the α- and β- pathways in APP processing, we measured APP proteolytic products over 36 hours in human cerebrospinal fluid from cognitively normal and Alzheimer's disease participants. We found diurnal patterns in sAPPα, sAPPβ, Aβ40, and Aβ42, which diminish with increased age, that support the hypothesis that APP is diurnally regulated in the human central nervous system and thus results in Aβ diurnal patterns. We also found that the four APP metabolites were positively correlated in all participants without cerebral Aβ deposits. This positive correlation suggests that the α- and β- APP pathways are non-competitive under normal physiologic conditions where APP availability may be the limiting factor that determines sAPPα and sAPPβ production. However, in participants with cerebral Aβ deposits, there was no correlation of Aβ to sAPP metabolites, suggesting that normal physiologic regulation of cerebrospinal fluid Aβ is impaired in the presence of amyloidosis. Lastly, we found that the ratio of sAPPβ to sAPPα was significantly higher in participants with cerebral Aβ deposits versus those without deposits. Therefore, the sAPPβ to sAPPα ratio may be a useful biomarker for cerebral amyloidosis.
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Affiliation(s)
- Justyna A. Dobrowolska
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Tom Kasten
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Yafei Huang
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Tammie L. S. Benzinger
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Wendy Sigurdson
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, United States of America
- Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Vitaliy Ovod
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - John C. Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, United States of America
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, United States of America
- Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Randall J. Bateman
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, United States of America
- Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, Missouri, United States of America
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri, United States of America
- * E-mail:
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Maccecchini ML, Chang MY, Pan C, John V, Zetterberg H, Greig NH. Posiphen as a candidate drug to lower CSF amyloid precursor protein, amyloid-β peptide and τ levels: target engagement, tolerability and pharmacokinetics in humans. J Neurol Neurosurg Psychiatry 2012; 83:894-902. [PMID: 22791904 PMCID: PMC3415310 DOI: 10.1136/jnnp-2012-302589] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AIM A first in human study to evaluate tolerability and pharmacokinetics followed by an early proof of mechanism (POM) study to determine whether the small orally, available molecule, Posiphen tartrate (Posiphen), lowers secreted (s) amyloid-β precursor protein (APP) α and -β, amyloid-β peptide (Aβ), tau (τ) and inflammatory markers in CSF of patients with mild cognitive impairment (MCI). STUDY DESIGN Posiphen single and multiple ascending dose phase 1 randomised, double blind, placebo-controlled safety, tolerance, pharmacokinetic studies were undertaken in a total of 120 healthy volunteers to define a dose that was then used in a small non-randomised study of five MCI subjects, used as their own controls, to define target engagement. MAIN OUTCOME MEASURES Pharmacodynamic: sAPPα, sAPPβ, Aβ(42), τ (total (t) and phosphorylated (p)) and inflammatory marker levels were time-dependently measured over 12 h and compared prior to and following 10 days of oral Posiphen treatment in four MCI subjects who completed the study. Pharmacokinetic: plasma and CSF drug and primary metabolite concentrations with estimated brain levels extrapolated from steady-state drug administration in rats. RESULTS Posiphen proved well tolerated and significantly lowered CSF levels of sAPPα, sAPPβ, t-τ, p-τ and specific inflammatory markers, and demonstrated a trend to lower CSF Aβ(42). CONCLUSIONS These results confirm preclinical POM studies, demonstrate that pharmacologically relevant drug/metabolite levels reach brain and support the continued clinical optimisation and evaluation of Posiphen for MCI and Alzheimer's disease.
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Lahiri DK, Ray B. Abnormal cerebrospinal fluid (CSF) dynamics in Alzheimer's disease and normal pressure hydrocephalus: CSF-amyloid β precursor protein metabolites as possible biomarkers. Eur J Neurol 2012; 20:211-3. [DOI: 10.1111/j.1468-1331.2012.03832.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - B. Ray
- Department of Psychiatry, Institute of Psychiatric Research; Indiana University School of Medicine; Indianapolis; IN; USA
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