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Wohnrade C, Seeliger T, Gingele S, Bjelica B, Skripuletz T, Petri S. Diagnostic value of neurofilaments in differentiating motor neuron disease from multifocal motor neuropathy. J Neurol 2024; 271:4441-4452. [PMID: 38683209 PMCID: PMC11233354 DOI: 10.1007/s00415-024-12355-8] [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: 01/08/2024] [Revised: 03/23/2024] [Accepted: 03/26/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE To evaluate the performance of serum neurofilament light chain (NfL) and cerebrospinal fluid (CSF) phosphorylated neurofilament heavy chain (pNfH) as diagnostic biomarkers for the differentiation between motor neuron disease (MND) and multifocal motor neuropathy (MMN). METHODS This retrospective, monocentric study included 16 patients with MMN and 34 incident patients with MND. A subgroup of lower motor neuron (MN) dominant MND patients (n = 24) was analyzed separately. Serum NfL was measured using Ella automated immunoassay, and CSF pNfH was measured using enzyme-linked immunosorbent assay. Area under the curve (AUC), optimal cutoff values (Youden's index), and correlations with demographic characteristics were calculated. RESULTS Neurofilament concentrations were significantly higher in MND compared to MMN (p < 0.001), and serum NfL and CSF pNfH correlated strongly with each other (Spearman's rho 0.68, p < 0.001). Serum NfL (AUC 0.946, sensitivity and specificity 94%) and CSF pNfH (AUC 0.937, sensitivity 90.0%, specificity 100%) performed excellent in differentiating MND from MMN. Optimal cutoff values were ≥ 44.15 pg/mL (serum NfL) and ≥ 715.5 pg/mL (CSF pNfH), respectively. Similar results were found when restricting the MND cohort to lower MN dominant patients. Only one MMN patient had serum NfL above the cutoff. Two MND patients presented with neurofilament concentrations below the cutoffs, both featuring a slowly progressive disease. CONCLUSION Neurofilaments are valuable supportive biomarkers for the differentiation between MND and MMN. Serum NfL and CSF pNfH perform similarly well and elevated neurofilaments in case of diagnostic uncertainty underpin MND diagnosis.
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Affiliation(s)
- Camilla Wohnrade
- Department of Neurology, Hannover Medical School, 30625, Hannover, Germany.
| | - Tabea Seeliger
- Department of Neurology, Hannover Medical School, 30625, Hannover, Germany
| | - Stefan Gingele
- Department of Neurology, Hannover Medical School, 30625, Hannover, Germany
| | - Bogdan Bjelica
- Department of Neurology, Hannover Medical School, 30625, Hannover, Germany
| | - Thomas Skripuletz
- Department of Neurology, Hannover Medical School, 30625, Hannover, Germany
| | - Susanne Petri
- Department of Neurology, Hannover Medical School, 30625, Hannover, Germany
- Center for Systems Neuroscience (ZSN) Hannover, 30559, Hannover, Germany
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2
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Jeppsson A, Sandelius Å, Zettergren A, Kern S, Skoog I, Blennow K, Zetterberg H, Wikkelsø C, Hellström P, Tullberg M. Plasma and cerebrospinal fluid concentrations of neurofilament light protein correlate in patients with idiopathic normal pressure hydrocephalus. Fluids Barriers CNS 2023; 20:54. [PMID: 37415175 DOI: 10.1186/s12987-023-00455-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/23/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Neurofilament light chain protein (NFL), a marker of neuronal axonal degeneration, is increased in cerebrospinal fluid (CSF) of patients with idiopathic normal pressure hydrocephalus (iNPH). Assays for analysis of NFL in plasma are now widely available but plasma NFL has not been reported in iNPH patients. Our aim was to examine plasma NFL in iNPH patients and to evaluate the correlation between plasma and CSF levels, and whether NFL levels are associated with clinical symptoms and outcome after shunt surgery. METHODS Fifty iNPH patients with median age 73 who had their symptoms assessed with the iNPH scale and plasma and CSF NFL sampled pre- and median 9 months post-operatively. CSF plasma was compared with 50 healthy controls (HC) matched for age and gender. Concentrations of NFL were determined in plasma using an in-house Simoa method and in CSF using a commercially available ELISA method. RESULTS Plasma NFL was elevated in patients with iNPH compared to HC (iNPH: 45 (30-64) pg/mL; HC: 33 (26-50) (median; Q1-Q3), p = 0.029). Plasma and CSF NFL concentrations correlated in iNPH patients both pre- and postoperatively (r = 0.67 and 0.72, p < 0.001). We found only weak correlations between plasma or CSF NFL and clinical symptoms and no associations with outcome. A postoperative NFL increase was seen in CSF but not in plasma. CONCLUSIONS Plasma NFL is increased in iNPH patients and concentrations correlate with CSF NFL implying that plasma NFL can be used to assess evidence of axonal degeneration in iNPH. This finding opens a window for plasma samples to be used in future studies of other biomarkers in iNPH. NFL is probably not a very useful marker of symptomatology or for prediction of outcome in iNPH.
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Affiliation(s)
- A Jeppsson
- Hydrocephalus Research Unit, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Blå Stråket 7, 41345, Gothenburg, Sweden
| | - Å Sandelius
- Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A Zettergren
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
| | - S Kern
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
| | - I Skoog
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
| | - K Blennow
- Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - H Zetterberg
- Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - C Wikkelsø
- Hydrocephalus Research Unit, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Blå Stråket 7, 41345, Gothenburg, Sweden
| | - P Hellström
- Hydrocephalus Research Unit, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Blå Stråket 7, 41345, Gothenburg, Sweden
| | - M Tullberg
- Hydrocephalus Research Unit, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Blå Stråket 7, 41345, Gothenburg, Sweden.
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3
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Rosadas C, Taylor GP. Pre-analytical long-term stability of neopterin and neurofilament light in stored cerebrospinal fluid samples. Clin Chem Lab Med 2023; 61:1230-1234. [PMID: 36692943 DOI: 10.1515/cclm-2022-0904] [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: 09/13/2022] [Accepted: 01/11/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the impact of long-term sample storage on the concentrations of neopterin and neurofilament light (Nfl) in cerebrospinal fluid (CSF) samples. These are useful markers of neuroinflammation and neuronal damage and have been applied as biomarkers for several neurological diseases. However, different pre-analytical variables have potential to influence results. METHODS Twenty-one CSF samples donated by patients with HTLV-1-associated myelopathy (HAM) and stored for up to 11 years at -80 °C were retested after three-years for neopterin (n=10) and Nfl (n=11) by ELISA. RESULTS There was a strong correlation between the paired results (r>0.98, p<0.0001). Neopterin concentrations (nmol/L) ranged from 12.4 to 64 initially and from 11.5 to 64.4 when retested, with means (SD) of 30 (18.4) 1st test and 33 (19.1) 2nd test. Nfl concentrations (pg/mL) ranged from 79.9 to 3,733 initially and from 86.3 to 3,332, when retested with means (SD) of 1,138 (1,272) 1st test and 1,009 (1,114) at re-test. CONCLUSIONS Storing CSF samples at -80 °C appears not to impact the quantification of neopterin and Nfl allowing confidence in the reporting of archived samples.
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Affiliation(s)
- Carolina Rosadas
- Section of Virology, Department of Infectious Disease, Imperial College London, London, UK
| | - Graham P Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, London, UK
- National Centre for Human Retrovirology, St Mary's Hospital, London, UK
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4
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Hanin A, Cespedes J, Pulluru Y, Gopaul M, Aronica E, Decampo D, Helbig I, Howe CL, Huttner A, Koh S, Navarro V, Taraschenko O, Vezzani A, Wilson MR, Xian J, Gaspard N, Hirsch LJ. Review and standard operating procedures for collection of biospecimens and analysis of biomarkers in new onset refractory status epilepticus. Epilepsia 2023; 64:1444-1457. [PMID: 37039049 PMCID: PMC10756682 DOI: 10.1111/epi.17600] [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: 01/06/2023] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 04/12/2023]
Abstract
New onset refractory status epilepticus (NORSE), including its subtype with a preceding febrile illness known as febrile infection-related epilepsy syndrome (FIRES), is one of the most severe forms of status epilepticus. The exact causes of NORSE are currently unknown, and there is so far no disease-specific therapy. Identifying the underlying pathophysiology and discovering specific biomarkers, whether immunologic, infectious, genetic, or other, may help physicians in the management of patients with NORSE. A broad spectrum of biomarkers has been proposed for status epilepticus patients, some of which were evaluated for patients with NORSE. Nonetheless, none has been validated, due to significant variabilities in study cohorts, collected biospecimens, applied analytical methods, and defined outcome endpoints, and to small sample sizes. The NORSE Institute established an open NORSE/FIRES biorepository for health-related data and biological samples allowing the collection of biospecimens worldwide, promoting multicenter research and sharing of data and specimens. Here, we suggest standard operating procedures for biospecimen collection and biobanking in this rare condition. We also propose criteria for the appropriate use of previously collected biospecimens. We predict that the widespread use of standardized procedures will reduce heterogeneity, facilitate the future identification of validated biomarkers for NORSE, and provide a better understanding of the pathophysiology and best clinical management for these patients.
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Affiliation(s)
- Aurélie Hanin
- Department of Neurology and Immunobiology, Yale University School of Medicine, New Haven, Connecticut, USA
- Sorbonne Université, Institut du Cerveau ICM, Paris Brain Institute, Inserm, CNRS, Assistance Publique -Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, DMU Neurosciences 6, Paris, France
- Assistance Publique -Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, DMU Neurosciences 6, Epilepsy Unit and Department of Clinical Neurophysiology, Paris, France
| | - Jorge Cespedes
- Comprehensive Epilepsy Center, Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA
- Universidad Autonoma de Centro America, School of Medicine, San Jose, Costa Rica
| | - Yashwanth Pulluru
- Comprehensive Epilepsy Center, Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA
- Nebraska Medical Center, Omaha, Nebraska, USA
| | - Margaret Gopaul
- Comprehensive Epilepsy Center, Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Eleonora Aronica
- Department of (Neuro) Pathology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Danielle Decampo
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Epilepsy NeuroGenetics Initiative, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ingo Helbig
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Epilepsy NeuroGenetics Initiative, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Charles L. Howe
- Division of Experimental Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Anita Huttner
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Sookyong Koh
- Department of Pediatrics, Children’s Hospital Medical Center, University of Nebraska, Omaha, Nebraska, USA
| | - Vincent Navarro
- Sorbonne Université, Institut du Cerveau ICM, Paris Brain Institute, Inserm, CNRS, Assistance Publique -Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, DMU Neurosciences 6, Paris, France
- Assistance Publique -Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, DMU Neurosciences 6, Epilepsy Unit and Department of Clinical Neurophysiology, Paris, France
| | - Olga Taraschenko
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Annamaria Vezzani
- Department of Acute Brain Injury, Istituto di Recerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Michael R. Wilson
- Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, California, San Francisco, USA
| | - Julie Xian
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Epilepsy NeuroGenetics Initiative, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Nicolas Gaspard
- Comprehensive Epilepsy Center, Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA
- Université Libre de Bruxelles, Hôpital Erasme, Brussels, Belgium
| | - Lawrence J. Hirsch
- Comprehensive Epilepsy Center, Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA
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Rademacher TD, Meuth SG, Wiendl H, Johnen A, Landmeyer NC. Molecular biomarkers and cognitive impairment in multiple sclerosis: State of the field, limitations, and future direction - A systematic review and meta-analysis. Neurosci Biobehav Rev 2023; 146:105035. [PMID: 36608917 DOI: 10.1016/j.neubiorev.2023.105035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/20/2022] [Accepted: 01/02/2023] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Multiple sclerosis (MS) is associated with cognitive impairment (CI) such as slowed information processing speed (IPS). Currently, no immunocellular or molecular markers have been established in cerebrospinal fluid and serum analysis as surrogate biomarkers with diagnostic or predictive value for the development of CI. This systematic review and meta-analysis aims to sum up the evidence regarding currently discussed markers for CI in MS. METHODS A literature search was conducted on molecular biomarkers of CI in MS, such as neurofilament light chain, chitinases, and vitamin D. RESULTS 5543 publications were screened, of which 77 entered the systematic review. 13 studies were included in the meta-analysis. Neurofilament light chain (CSF: rp = -0.294, p = 0.003; serum: rp = -0.137, p = 0.001) and serum levels of vitamin D (rp = 0.190, p = 0.014) were associated with IPS outcomes. CONCLUSIONS Neurofilament light chain and vitamin D are promising biomarkers to track impairments in IPS in MS. Further longitudinal research is needed to establish the use of molecular biomarkers to monitor cognitive decline.
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Affiliation(s)
| | - Sven G Meuth
- Department of Neurology, University Hospital Düsseldorf, Germany
| | - Heinz Wiendl
- Department of Neurology, University Hospital Münster, Germany
| | - Andreas Johnen
- Department of Neurology, University Hospital Münster, Germany
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6
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Simrén J, Weninger H, Brum WS, Khalil S, Benedet AL, Blennow K, Zetterberg H, Ashton NJ. Differences between blood and cerebrospinal fluid glial fibrillary Acidic protein levels: The effect of sample stability. Alzheimers Dement 2022; 18:1988-1992. [PMID: 36102852 PMCID: PMC9826213 DOI: 10.1002/alz.12806] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/22/2022] [Accepted: 08/16/2022] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Recent evidence has shown that the marker of reactive astrogliosis, glial fibrillary acidic protein (GFAP), has a stronger relationship with cerebral amyloid beta (Aβ) pathology in blood than in cerebrospinal fluid (CSF). This study investigates if pre-analytical treatment of blood and CSF contribute to these unexpected findings. METHODS Paired CSF and serum samples from 49 individuals (Aβ-negative = 28; Aβ-positive = 21) underwent a series of seven freeze-thaw cycles (FTCs). All samples were analyzed for GFAP and neurofilament light (NfL) using single molecule array technology including a fresh unfrozen sample from each patient. RESULTS FTC significantly affected CSF GFAP concentration (-188.12 pg/ml per FTC) but not serum GFAP. In the same samples, NfL remained stable. Serum GFAP had a higher discrimination of Aβ burden than CSF GFAP, irrespective of FTC, which also included unfrozen samples. DISCUSSION This study demonstrates large stability differences of GFAP in CSF and serum. However, this disparity does not seem to fully explain the stronger association of serum GFAP with Aβ pathology. Further work should investigate mechanisms of GFAP release into the bloodstream under pathological conditions.
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Affiliation(s)
- Joel Simrén
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologyClinical Neurochemistry LaboratoryThe Sahlgrenska Academy at the University of GothenburgSahlgrenska University HospitalGothenburgSweden
| | - Haley Weninger
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologyClinical Neurochemistry LaboratoryThe Sahlgrenska Academy at the University of GothenburgSahlgrenska University HospitalGothenburgSweden
| | - Wagner S. Brum
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologyClinical Neurochemistry LaboratoryThe Sahlgrenska Academy at the University of GothenburgSahlgrenska University HospitalGothenburgSweden
- Graduate Program in Biological Sciences: BiochemistryUniversidade Federal do Rio Grande do Sul (UFRGS)Porto AlegreRio Grande do SulBrazil
| | - Shilla Khalil
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologyClinical Neurochemistry LaboratoryThe Sahlgrenska Academy at the University of GothenburgSahlgrenska University HospitalGothenburgSweden
| | - Andréa L. Benedet
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologyClinical Neurochemistry LaboratoryThe Sahlgrenska Academy at the University of GothenburgSahlgrenska University HospitalGothenburgSweden
| | - Kaj Blennow
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologyClinical Neurochemistry LaboratoryThe Sahlgrenska Academy at the University of GothenburgSahlgrenska University HospitalGothenburgSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalGothenburgSweden
| | - Henrik Zetterberg
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologyClinical Neurochemistry LaboratoryThe Sahlgrenska Academy at the University of GothenburgSahlgrenska University HospitalGothenburgSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalGothenburgSweden
- Department of Neurodegenerative DiseaseUCL Institute of NeurologyUK Dementia Research Institute at UCLLondonUK
- Hong Kong Center for Neurodegenerative DiseasesClear Water BayHong KongChina
| | - Nicholas J. Ashton
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologyClinical Neurochemistry LaboratoryThe Sahlgrenska Academy at the University of GothenburgSahlgrenska University HospitalGothenburgSweden
- Institute of Psychiatry, Maurice Wohl Clinical Neuroscience InstitutePsychology & NeuroscienceKing's College LondonLondonUK
- NIHR Biomedical Research Centre for Mental HealthBiomedical Research Unit for Dementia at South LondonMaudsley NHS FoundationLondonUK
- Centre for Age‐Related MedicineStavanger University HospitalStavangerNorway
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Yu X, Srivastava S, Huang S, Hayden EY, Teplow DB, Xie YH. The Feasibility of Early Alzheimer’s Disease Diagnosis Using a Neural Network Hybrid Platform. BIOSENSORS 2022; 12:bios12090753. [PMID: 36140138 PMCID: PMC9496690 DOI: 10.3390/bios12090753] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/03/2022] [Accepted: 09/10/2022] [Indexed: 11/18/2022]
Abstract
Early diagnosis of Alzheimer’s Disease (AD) is critical for disease prevention and cure. However, currently, techniques with the required high sensitivity and specificity are lacking. Recently, with the advances and increased accessibility of data analysis tools, such as machine learning, research efforts have increasingly focused on using these computational methods to solve this challenge. Here, we demonstrate a convolutional neural network (CNN)-based AD diagnosis approach using the surface-enhanced Raman spectroscopy (SERS) fingerprints of human cerebrospinal fluid (CSF). SERS and CNN were combined for biomarker detection to analyze disease-associated biochemical changes in the CSF. We achieved very high reproducibility in double-blind experiments for testing the feasibility of our system on human samples. We achieved an overall accuracy of 92% (100% for normal individuals and 88.9% for AD individuals) based on the clinical diagnosis. Further, we observed an excellent correlation coefficient between our test score and the Clinical Dementia Rating (CDR) score. Our findings offer a substantial indication of the feasibility of detecting AD biomarkers using the innovative combination of SERS and machine learning. We are hoping that this will serve as an incentive for future research in the field.
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Affiliation(s)
- Xinke Yu
- Department of Materials Science and Engineering, University of California, Los Angeles, CA 90095, USA
| | - Siddharth Srivastava
- Department of Materials Science and Engineering, University of California, Los Angeles, CA 90095, USA
- Correspondence:
| | - Shan Huang
- Department of Materials Science and Engineering, University of California, Los Angeles, CA 90095, USA
| | - Eric Y. Hayden
- Department of Neurology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA 90095, USA
| | - David B. Teplow
- Department of Neurology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA 90095, USA
| | - Ya-Hong Xie
- Department of Materials Science and Engineering, University of California, Los Angeles, CA 90095, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA 90095, USA
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Rojas-Núñez I, Gomez AM, Palmer S, Mohammed HO. Serum Phosphorylated Neurofilament Heavy subunit levels and its association with the Risk for Catastrophic Injury in Thoroughbred Racehorses. J Equine Vet Sci 2022; 116:104057. [PMID: 35772595 DOI: 10.1016/j.jevs.2022.104057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 06/06/2022] [Accepted: 06/24/2022] [Indexed: 11/30/2022]
Abstract
Neurofilaments are structural proteins that are concentrated in the body and axons of neurons. Damage to the neurons or axons as a result of trauma or infectious diseases leads to the release of neurofilaments into blood and cerebrospinal fluid (CSF). This case-control study was carried out to compare serum levels of phosphorylated neurofilament heavy chain (pNF-H) between clinically healthy Thoroughbred (TB) horses and TB horses that suffered catastrophic musculoskeletal injuries (cMSI), and to investigate the correlation between putative risk factors and serum concentrations of pNF-H in injured horses. Blood samples were collected from clinically healthy horses and from horses that suffered cMSI. The concentration of pNF-H in serum samples was determined using the Phosphorylated Neurofilament H Sandwich enzyme-linked immunosorbent assay kit. A total of 343 horses were enrolled in the study (148 cases and 195 controls). The median serum concentration of pNF-H for controls was 0.0 ng/ml and for cases was 0.07 ng/ml. No significant difference was observed between the two groups in racing. The number of lifetime starts was correlated with serum pNF-H concentration in case horses. The serum concentration of pNF-H was higher in case horses that experienced cMSI while training than while racing. The number of lifetime starts is a proxy measure for several risk factors related to cumulative exercise load during the career of racehorses. Measurement of serum concentrations of pNF-H in TB racehorses does not support the hypothesis that subclinical neurologic injury or conditions are associated with catastrophic injury of TB racehorses.
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Affiliation(s)
- Irene Rojas-Núñez
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine Cornell University, Ithaca, NY
| | - Adriana Morales Gomez
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine Cornell University, Ithaca, NY
| | - Scott Palmer
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine Cornell University, Ithaca, NY
| | - Hussni O Mohammed
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine Cornell University, Ithaca, NY.
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9
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Heckler I, Venkataraman I. Phosphorylated Neurofilament Heavy Chain: A Potential Diagnostic Biomarker in Amyotrophic Lateral Sclerosis. J Neurophysiol 2022; 127:737-745. [PMID: 35138963 DOI: 10.1152/jn.00398.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Neuroaxonal damage is a feature of various neurodegenerative diseases including amyotrophic lateral sclerosis (ALS). Phosphorylated neurofilament heavy chain (pNfH) is a cytoskeletal structural protein released as a result of axonal damage into the CSF, and subsequently into the blood. Due to high specificity for neuronal cell damage, pNfH is advantageous over other biomarkers, for ALS disease identification. Here, we review the structure and function of neurofilaments and their role in detection of various neurodegenerative conditions. Additionally, a retrospective meta-analysis was performed to depict the significance of pNfH as a valuable diagnostic and prognostic biomarker in ALS.
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Affiliation(s)
- Ilana Heckler
- Euroimmun Medizinische Labordiagnostika (EUROIMMUN US), Mountain Lakes, NJ, United States
| | - Iswariya Venkataraman
- Euroimmun Medizinische Labordiagnostika (EUROIMMUN US), Mountain Lakes, NJ, United States
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10
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Neurofilaments can differentiate ALS subgroups and ALS from common diagnostic mimics. Sci Rep 2021; 11:22128. [PMID: 34764380 PMCID: PMC8585882 DOI: 10.1038/s41598-021-01499-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 10/27/2021] [Indexed: 11/09/2022] Open
Abstract
Delayed diagnosis and misdiagnosis are frequent in people with amyotrophic lateral sclerosis (ALS), the most common form of motor neuron disease (MND). Neurofilament light chain (NFL) and phosphorylated neurofilament heavy chain (pNFH) are elevated in ALS patients. We retrospectively quantified cerebrospinal fluid (CSF) NFL, CSF pNFH and plasma NFL in stored samples that were collected at the diagnostic work-up of ALS patients (n = 234), ALS mimics (n = 44) and controls (n = 9). We assessed the diagnostic performance, prognostication value and relationship to the site of onset and genotype. CSF NFL, CSF pNFH and plasma NFL levels were significantly increased in ALS patients compared to patients with neuropathies & myelopathies, patients with myopathies and controls. Furthermore, CSF pNFH and plasma NFL levels were significantly higher in ALS patients than in patients with other MNDs. Bulbar onset ALS patients had significantly higher plasma NFL levels than spinal onset ALS patients. ALS patients with C9orf72HRE mutations had significantly higher plasma NFL levels than patients with SOD1 mutations. Survival was negatively correlated with all three biomarkers. Receiver operating characteristics showed the highest area under the curve for CSF pNFH for differentiating ALS from ALS mimics and for plasma NFL for estimating ALS short and long survival. All three biomarkers have diagnostic value in differentiating ALS from clinically relevant ALS mimics. Plasma NFL levels can be used to differentiate between clinical and genetic ALS subgroups.
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11
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Yuan A, Nixon RA. Neurofilament Proteins as Biomarkers to Monitor Neurological Diseases and the Efficacy of Therapies. Front Neurosci 2021; 15:689938. [PMID: 34646114 PMCID: PMC8503617 DOI: 10.3389/fnins.2021.689938] [Citation(s) in RCA: 108] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 09/02/2021] [Indexed: 01/01/2023] Open
Abstract
Biomarkers of neurodegeneration and neuronal injury have the potential to improve diagnostic accuracy, disease monitoring, prognosis, and measure treatment efficacy. Neurofilament proteins (NfPs) are well suited as biomarkers in these contexts because they are major neuron-specific components that maintain structural integrity and are sensitive to neurodegeneration and neuronal injury across a wide range of neurologic diseases. Low levels of NfPs are constantly released from neurons into the extracellular space and ultimately reach the cerebrospinal fluid (CSF) and blood under physiological conditions throughout normal brain development, maturation, and aging. NfP levels in CSF and blood rise above normal in response to neuronal injury and neurodegeneration independently of cause. NfPs in CSF measured by lumbar puncture are about 40-fold more concentrated than in blood in healthy individuals. New ultra-sensitive methods now allow minimally invasive measurement of these low levels of NfPs in serum or plasma to track disease onset and progression in neurological disorders or nervous system injury and assess responses to therapeutic interventions. Any of the five Nf subunits - neurofilament light chain (NfL), neurofilament medium chain (NfM), neurofilament heavy chain (NfH), alpha-internexin (INA) and peripherin (PRPH) may be altered in a given neuropathological condition. In familial and sporadic Alzheimer's disease (AD), plasma NfL levels may rise as early as 22 years before clinical onset in familial AD and 10 years before sporadic AD. The major determinants of elevated levels of NfPs and degradation fragments in CSF and blood are the magnitude of damaged or degenerating axons of fiber tracks, the affected axon caliber sizes and the rate of release of NfP and fragments at different stages of a given neurological disease or condition directly or indirectly affecting central nervous system (CNS) and/or peripheral nervous system (PNS). NfPs are rapidly emerging as transformative blood biomarkers in neurology providing novel insights into a wide range of neurological diseases and advancing clinical trials. Here we summarize the current understanding of intracellular NfP physiology, pathophysiology and extracellular kinetics of NfPs in biofluids and review the value and limitations of NfPs and degradation fragments as biomarkers of neurodegeneration and neuronal injury.
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Affiliation(s)
- Aidong Yuan
- Center for Dementia Research, Nathan Kline Institute, Orangeburg, NY, United States
- Department of Psychiatry, NYU Neuroscience Institute, New York, NY, United States
| | - Ralph A. Nixon
- Center for Dementia Research, Nathan Kline Institute, Orangeburg, NY, United States
- Department of Psychiatry, NYU Neuroscience Institute, New York, NY, United States
- Department of Cell Biology, New York University Grossman School of Medicine, (NYU), Neuroscience Institute, New York, NY, United States
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12
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Beerepoot S, Heijst H, Roos B, Wamelink MMC, Boelens JJ, Lindemans CA, van Hasselt PM, Jacobs EH, van der Knaap MS, Teunissen CE, Wolf NI. Neurofilament light chain and glial fibrillary acidic protein levels in metachromatic leukodystrophy. Brain 2021; 145:105-118. [PMID: 34398223 PMCID: PMC8967093 DOI: 10.1093/brain/awab304] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/22/2021] [Accepted: 07/14/2021] [Indexed: 12/02/2022] Open
Abstract
Metachromatic leukodystrophy is a lethal metabolic leukodystrophy, with emerging treatments for early disease stages. Biomarkers to measure disease activity are required for clinical assessment and treatment follow-up. This retrospective study compared neurofilament light chain and glial fibrillary acidic protein (GFAP) levels in CSF (n = 11) and blood (n = 92) samples of 40 patients with metachromatic leukodystrophy (aged 0–42 years) with 38 neurologically healthy children (aged 0–17 years) and 38 healthy adults (aged 18–45 years), and analysed the associations between these levels with clinical phenotype and disease evolution in untreated and transplanted patients. Metachromatic leukodystrophy subtype was determined based on the (expected) age of symptom onset. Disease activity was assessed by measuring gross motor function deterioration and brain MRI. Longitudinal analyses with measurements up to 23 years after diagnosis were performed using linear mixed models. CSF and blood neurofilament light chain and GFAP levels in paediatric controls were negatively associated with age (all P < 0.001). Blood neurofilament light chain level at diagnosis (median, interquartile range; picograms per millilitre) was significantly increased in both presymptomatic (14.7, 10.6–56.7) and symptomatic patients (136, 40.8–445) compared to controls (5.6, 4.5–7.1), and highest among patients with late-infantile (456, 201–854) or early-juvenile metachromatic leukodystrophy (291.0, 104–445) and those ineligible for treatment based on best practice (291, 57.4–472). GFAP level (median, interquartile range; picogram per millilitre) was only increased in symptomatic patients (591, 224–1150) compared to controls (119, 78.2–338) and not significantly associated with treatment eligibility (P = 0.093). Higher blood neurofilament light chain and GFAP levels at diagnosis were associated with rapid disease progression in late-infantile (P = 0.006 and P = 0.051, respectively) and early-juvenile patients (P = 0.048 and P = 0.039, respectively). Finally, blood neurofilament light chain and GFAP levels decreased during follow-up in untreated and transplanted patients but remained elevated compared with controls. Only neurofilament light chain levels were associated with MRI deterioration (P < 0.001). This study indicates that both proteins may be considered as non-invasive biomarkers for clinical phenotype and disease stage at clinical assessment, and that neurofilament light chain might enable neurologists to make better informed treatment decisions. In addition, neurofilament light chain holds promise assessing treatment response. Importantly, both biomarkers require paediatric reference values, given that their levels first decrease before increasing with advancing age.
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Affiliation(s)
- Shanice Beerepoot
- Amsterdam Leukodystrophy Center, Department of Child Neurology, Emma Children's Hospital, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV Amsterdam, The Netherlands.,Center for Translational Immunology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands.,Nierkens and Lindemans group, Princess Máxima Center for pediatric oncology, 3584 CS Utrecht, The Netherlands
| | - Hans Heijst
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV Amsterdam, The Netherlands
| | - Birthe Roos
- Metabolic Unit, Department of Clinical Chemistry, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam Gastroenterology & Metabolism, 1081 HV Amsterdam, The Netherlands
| | - Mirjam M C Wamelink
- Metabolic Unit, Department of Clinical Chemistry, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam Gastroenterology & Metabolism, 1081 HV Amsterdam, The Netherlands
| | - Jaap Jan Boelens
- Center for Translational Immunology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands.,Department of Pediatrics, Stem Cell Transplant and Cellular Therapies, Memorial Sloan Kettering Cancer Center, 10065 New York, USA
| | - Caroline A Lindemans
- Nierkens and Lindemans group, Princess Máxima Center for pediatric oncology, 3584 CS Utrecht, The Netherlands.,Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, 3584 EA Utrecht, The Netherlands
| | - Peter M van Hasselt
- Department of Pediatric Metabolic Diseases, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, 3584 EA Utrecht, The Netherlands
| | - Edwin H Jacobs
- Department of Clinical Genetics, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Marjo S van der Knaap
- Amsterdam Leukodystrophy Center, Department of Child Neurology, Emma Children's Hospital, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV Amsterdam, The Netherlands.,Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV Amsterdam, The Netherlands
| | - Nicole I Wolf
- Amsterdam Leukodystrophy Center, Department of Child Neurology, Emma Children's Hospital, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV Amsterdam, The Netherlands
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13
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Increased GFAP concentrations in the cerebrospinal fluid of patients with unipolar depression. Transl Psychiatry 2021; 11:308. [PMID: 34021122 PMCID: PMC8139962 DOI: 10.1038/s41398-021-01423-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/26/2021] [Accepted: 05/05/2021] [Indexed: 12/13/2022] Open
Abstract
Inflammatory processes involving altered microglial activity may play a relevant role in the pathophysiology of depressive disorders. Glial fibrillary acidic protein (GFAP) and calcium-binding protein S100B are considered microglial markers. To date, their role has been studied in the serum and tissue material of patients with unipolar depression but not in the cerebrospinal fluid (CSF). Therefore, the aim of the current study was to examine GFAP and S100B levels in the CSF of patients with major depression to better understand their role in affective disorders. In this retrospective study, 102 patients with unipolar depression and 39 mentally healthy controls with idiopathic intracranial hypertension were investigated. GFAP and S100B levels were measured using commercially available ELISA kits. CSF routine parameters were collected during routine clinical care. The mean values of GFAP and S100B were compared using age (and sex) corrected ANOVAs. Matched subgroups were analyzed by using an independent sample t-test. In addition, correlation analyses between GFAP/S100B levels and CSF routine parameters were performed within the patient group. Patients with unipolar depression had significantly higher levels of GFAP than controls (733.22 pg/ml vs. 245.56 pg/ml, p < 0.001). These results remained significant in a sub-analysis in which all controls were compared with patients suffering from depression matched 1:1 by age and sex (632.26 pg/ml vs. 245.56 pg/ml, p < 0.001). Levels of S100B did not differ significantly between patients and controls (1.06 ng/ml vs. 1.17 ng/ml, p = 0.385). GFAP levels correlated positively with albumin quotients (p < 0.050), S100B levels correlated positively with white blood cell counts (p = 0.001), total protein concentrations (p < 0.001), and albumin quotients (p = 0.001) in the CSF. The significance of the study is limited by its retrospective and open design, methodological aspects, and the control group with idiopathic intracranial hypertension. In conclusion, higher GFAP levels in patients with depression may be indicative of altered microglia activity, especially in astrocytes, in patients with unipolar depression. In addition, correlation analyses support the idea that S100B levels could be related to the integrity of the blood-brain/CSF barrier. Further multimodal and longitudinal studies are necessary to validate these findings and clarify the underlying biological processes.
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14
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Xiang Y, Kuai L, Ru Y, Jiang J, Li X, Li F, Chen Q, Li B. Transcriptional profiling and circRNA-miRNA-mRNA network analysis identify the biomarkers in Sheng-ji Hua-yu formula treated diabetic wound healing. JOURNAL OF ETHNOPHARMACOLOGY 2021; 268:113643. [PMID: 33271241 DOI: 10.1016/j.jep.2020.113643] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/14/2020] [Accepted: 11/23/2020] [Indexed: 06/12/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Sheng-ji Hua-yu (SJHY) formula is a traditional Chinese herbal which is effective in treating diabetic ulcers. It has been indicated to accelerate re-epithelialization and healing time of cutaneous wounds in a Streptozotocin (STZ)-induced diabetic mouse model. However, its mechanisms remain undetermined. AIM OF THE STUDY To reveal the molecular mechanisms of SJHY formula in treating diabetic wounds through transcriptional profiling and circRNA-miRNA-mRNA network analysis clues. MATERIALS AND METHODS Protein expressions of tumor necrosis factor (TNF-α), interleukin (IL)-6, IL-1β in skin tissues of wounds from SJHY formula-treated and untreated mice were analyzed by Bio-Plex assay. Differentially expressed (DE) genes were detected by whole transcriptome sequencing (RNA-seq). Using predicted miRNA targets, circRNA-miRNA-mRNA networks were constructed. Furthermore, quantitative real-time PCR (qRT-PCR) was utilized to validate the circRNA-miRNA-mRNA networks. RESULTS Bio-Plex assay illustrated that the protein expressions of TNF-α, IL-1β, IL-6 were downregulated in SJHY formula-treated diabetic wounds compared with untreated wounds. RNA-seq identified 11 DE circRNAs and 476 DE mRNAs between SJHY formula-treated and diabetic mice, including 4 upregulated and 7 downregulated circRNAs, 311 upregulated and 165 downregulated mRNAs. CircRNA-Krt13/miR-665-3p/Itga3 and circRNA-Krt14/miR-706/Mylk4 pathways were built, which may contribute to the healing of SJHY formula-treated diabetic wounds. CONCLUSIONS Overall, this study suggests that these 2 circRNA-miRNA-mRNA networks are potential biomarkers for evaluation of SJHY formula efficacy in diabetic wound healing, which provides evidence to support its clinical applications.
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Affiliation(s)
- Yanwei Xiang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Le Kuai
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Yi Ru
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Jingsi Jiang
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Xin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Fulun Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Qilong Chen
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
| | - Bin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China.
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15
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Verberk IMW, Koel-Simmelink M, Twaalfhoven H, Vrenken H, Korth C, Killestein J, Teunissen CE, Bridel C. Ultrasensitive immunoassay allows measurement of serum neurofilament heavy in multiple sclerosis. Mult Scler Relat Disord 2021; 50:102840. [PMID: 33626430 DOI: 10.1016/j.msard.2021.102840] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/05/2021] [Accepted: 02/07/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Neurofilament heavy (NfH) is a promising biomarker for neuro-axonal damage in Multiple Sclerosis (MS). We compared the performance of high-sensitivity serum-NfH immunoassays, with as aim to investigate the value of serum-NfH as biomarker for MS. METHODS We measured serum-NfH in 76 MS patients with Simoa (one commercial, one in-house) or Luminex assays. Serum-NfH measured by the immunoassay with greatest sensitivity was related to clinical and radiological outcomes with age and sex-adjusted linear regression analysis, and to biological outcomes cerebrospinal fluid (CSF)-NfH, serum neurofilament light (NfL) and CSF-NfL with Spearman's correlation analysis. RESULTS With the commercial Simoa assay, we obtained 100% serum-NfH detectability (in-house Simoa: 70%, Luminex: 61%), with lowest coefficient of variation (CV) between duplicates of 11%CV (in-house Simoa: 22%CV, Luminex: 30%CV). Serum-NfH quantified with the commercial Simoa assay was associated with disease duration (standardized beta (sβ) = 0.28, p = 0.034), T2 lesion volume (sβ = 0.23, p = 0.041), and tended to associate with black hole count (sβ = 0.21, p = 0.084) but not with Expanded Disease Disability Score (EDSS) or normalized brain volume (all: p>0.10). Furthermore, serum-NfH showed correlations with CSF-NfH (rho = 0.27, p = 0.018) and serum-NfL (rho=0.44, p < 0.001), but not with CSF-NfL. CONCLUSIONS Serum-NfH can be quantified with high-sensitivity technology. Cross-sectionally, we observed some weak correlations of serum-NfH with MS disease burden parameters, suggesting there might be some utility for serum-NfH as biomarker for MS disease burden.
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Affiliation(s)
- Inge M W Verberk
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
| | - Marleen Koel-Simmelink
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Harry Twaalfhoven
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Hugo Vrenken
- Department of Radiology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Carsten Korth
- Department of Neuropathology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Joep Killestein
- Multiple Sclerosis center Amsterdam, Department of neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Claire Bridel
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands; Department of Clinical Neurosciences, Neurology Unit, Geneva University Hospital, Geneva, Switzerland
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16
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Lee Y, Lee BH, Yip W, Chou P, Yip BS. Neurofilament Proteins as Prognostic Biomarkers in Neurological Disorders. Curr Pharm Des 2020; 25:4560-4569. [PMID: 31820696 DOI: 10.2174/1381612825666191210154535] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 12/07/2019] [Indexed: 12/13/2022]
Abstract
Neurofilaments: light, medium, and heavy (abbreviated as NF-L, NF-M, and NF-H, respectively), which belong to Type IV intermediate filament family (IF), are neuron-specific cytoskeletal components. Neurofilaments are axonal structural components and integral components of synapses, which are important for neuronal electric signal transmissions along the axons and post-translational modification. Abnormal assembly of neurofilaments is found in several human neurodegenerative diseases such as amyotrophic lateral sclerosis (ALS), infantile spinal muscular atrophy (SMA), and hereditary sensory-motor neuropathy (HSMN). In addition, those pathological neurofilament accumulations are known in α-synuclein in Parkinson's disease (PD), Aβ and tau in Alzheimer's disease (AD), polyglutamine in CAG trinucleotide repeat disorders, superoxide dismutase 1 (SOD1), TAR DNA-binding protein 43 (TDP43), neuronal FUS proteins, optineurin (OPTN), ubiquilin 2 (UBQLN2), and dipeptide repeat protein (DRP) in amyotrophic lateral sclerosis (ALS). When axon damage occurs in central nervous disorders, neurofilament proteins are released and delivered into cerebrospinal fluid (CSF), which are then circulated into blood. New quantitative analyses and assay techniques are well-developed for the detection of neurofilament proteins, particularly NF-L and the phosphorylated NF-H (pNF-H) in CSF and serum. This review discusses the potential of using peripheral blood NF quantities and evaluating the severity of damage in the nervous system. Intermediate filaments could be promising biomarkers for evaluating disease progression in different nervous system disorders.
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Affiliation(s)
- Yichen Lee
- Department of Neurology, National Taiwan University Hospital, Hsinchu Branch, Hsinchu, Taiwan, China
| | - Bo H Lee
- Department of Geriatrics, Northern Beaches Hospital, Frenchs Forest New South Wales, Australia
| | - William Yip
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vacover, BC V6T1Z4, Canada
| | - Pingchen Chou
- Department of Neurology, National Taiwan University Hospital, Hsinchu Branch, Hsinchu, Taiwan, China
| | - Bak-Sau Yip
- Department of Neurology, National Taiwan University Hospital, Hsinchu Branch, Hsinchu, Taiwan, China.,Institute of Biomedical Engineering, National Chiao Tung University, Hsinchu, Taiwan, China
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17
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Gray E, Oeckl P, Amador MDM, Andreasson U, An J, Blennow K, Bowser R, De Schaepdryver M, Heslegrave A, Kuhle J, Maceski A, Koel-Simmelink M, Lamari F, Lombardi V, Malaspina A, Nilsson I, Poesen K, Salachas F, Steinacker P, Teunissen CE, Van Damme P, Zetterberg H, Ludolph A, Jeromin A, Turner MR, Otto M. A multi-center study of neurofilament assay reliability and inter-laboratory variability. Amyotroph Lateral Scler Frontotemporal Degener 2020; 21:452-458. [PMID: 32558597 DOI: 10.1080/21678421.2020.1779300] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/21/2020] [Accepted: 06/03/2020] [Indexed: 12/13/2022]
Abstract
Objectives: Significantly elevated levels of neurofilament light chain (NfL) and phosphorylated neurofilament heavy chain (pNfH) have been described in the blood and cerebrospinal fluid (CSF) of amyotrophic lateral sclerosis (ALS) patients. The aim of this study was to evaluate the analytical performance of different neurofilament assays in a round robin with 10 centers across Europe/U.S. Methods: Serum, plasma and CSF samples from a group of five ALS and five neurological control patients were distributed across 10 international specialist neurochemical laboratories for analysis by a range of commercial and in-house neurofilament assays. The performance of all assays was evaluated for their ability to differentiate between the groups. The inter-assay coefficient of variation was calculated where appropriate from sample measurements performed across multiple laboratories using the same assay. Results: All assays could differentiate ALS patients from controls in CSF. Inter-assay coefficient of variation of analytical platforms performed across multiple laboratories varied between 6.5% and 41.9%. Conclusions: This study is encouraging for the growing momentum toward integration of neurofilament measurement into the specialized ALS clinic. It demonstrates the importance of 'round robin' studies necessary to ensure the analytical quality required for translation to the routine clinical setting. A standardized neurofilament probe is needed which can be used as international benchmark for analytical performance in ALS.
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Affiliation(s)
- Elizabeth Gray
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
| | - Patrick Oeckl
- Department of Neurology, University of Ulm, Ulm, Germany
| | | | - Ulf Andreasson
- Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden
| | - Jiyan An
- Iron Horse Diagnostics, Inc, Scottsdale, AZ, USA
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden
| | | | - Maxim De Schaepdryver
- Laboratory for Molecular Neurobiomarker Research, University of Leuven, Leuven, Belgium
| | | | - Jens Kuhle
- University Hospital and University of Basel, Basel, Switzerland
| | | | - Marleen Koel-Simmelink
- Amsterdam University Medical Centres, Vrije Universiteit, Amsterdam Neuroscience, Netherlands
| | | | | | | | - Irina Nilsson
- Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden
| | - Koen Poesen
- Laboratory for Molecular Neurobiomarker Research, University of Leuven, Leuven, Belgium
| | | | | | - Charlotte E Teunissen
- Amsterdam University Medical Centres, Vrije Universiteit, Amsterdam Neuroscience, Netherlands
| | - Philip Van Damme
- Laboratory for Molecular Neurobiomarker Research, University of Leuven, Leuven, Belgium
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden
- Institute of Neurology, University College London, London, UK
- UK Dementia Research Institute at UCL, London, UK
| | - Albert Ludolph
- Department of Neurology, University of Ulm, Ulm, Germany
| | | | - Martin R Turner
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany
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18
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Bergman J, Svenningsson A, Liv P, Bergenheim T, Burman J. Location matters: highly divergent protein levels in samples from different CNS compartments in a clinical trial of rituximab for progressive MS. Fluids Barriers CNS 2020; 17:49. [PMID: 32727487 PMCID: PMC7390226 DOI: 10.1186/s12987-020-00205-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/30/2020] [Indexed: 11/10/2022] Open
Abstract
Background The relationship between proteins in different CNS extracellular compartments is unknown. In this study the levels of selected proteins in three compartments in people with progressive multiple sclerosis (PMS) were compared. Methods During an open label, phase 1b study on intraventricular administration of rituximab for PMS, samples were collected from the interstitial space (ISS) of the brain through microdialysis. Samples were also obtained from ventricular and lumbar cerebrospinal fluid (CSF). These samples were analyzed with a multiplexed proximity extension assay, measuring the levels of 180 proteins split equally between two panels, detecting proteins associated with immunology and neurology, respectively. Results Considerable differences in concentrations were observed between the three analyzed compartments. Compared to ventricular CSF, ISS fluid contained statistically significant higher levels of 25 proteins (84% immunology panel and 16% neurology panel). Ventricular CSF contained significantly higher levels of 54 proteins (31% immunology panel and 69% neurology panel) compared to ISS fluid, and 17 proteins (76% immunology panel and 24% neurology panel) compared to lumbar CSF. Lumbar CSF showed significantly higher levels of 115 proteins (32% immunology panel and 68% neurology panel) compared to ventricular CSF. The three compartments displayed poor correlation with a median Spearman’s rho of -0.1 (IQR 0.4) between ISS and ventricular CSF and 0.3 (IQR 0.4) between ventricular and lumbar CSF. Conclusion A substantial heterogeneity in the protein levels of samples obtained from different CNS compartments was seen. Therefore, data obtained from analysis of lumbar CSF should be interpreted with caution when making conclusions about pathophysiological processes in brain tissue.
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Affiliation(s)
- Joakim Bergman
- Department of Clinical Sciences, Umeå University, 901 85, Umeå, Sweden.
| | - Anders Svenningsson
- Department of Clinical Sciences, Umeå University, 901 85, Umeå, Sweden.,Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden
| | - Per Liv
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Tommy Bergenheim
- Department of Clinical Sciences, Umeå University, 901 85, Umeå, Sweden
| | - Joachim Burman
- Department of Neurosciences, Uppsala University, Uppsala, Sweden
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19
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Andersson E, Janelidze S, Lampinen B, Nilsson M, Leuzy A, Stomrud E, Blennow K, Zetterberg H, Hansson O. Blood and cerebrospinal fluid neurofilament light differentially detect neurodegeneration in early Alzheimer's disease. Neurobiol Aging 2020; 95:143-153. [PMID: 32810755 PMCID: PMC7649343 DOI: 10.1016/j.neurobiolaging.2020.07.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 07/16/2020] [Accepted: 07/19/2020] [Indexed: 01/08/2023]
Abstract
Cerebrospinal fluid (CSF) neurofilament light (NfL) concentration has reproducibly been shown to reflect neurodegeneration in brain disorders, including Alzheimer's disease (AD). NfL concentration in blood correlates with the corresponding CSF levels, but few studies have directly compared the reliability of these 2 markers in sporadic AD. Herein, we measured plasma and CSF concentrations of NfL in 478 cognitively unimpaired (CU) subjects, 227 patients with mild cognitive impairment, and 113 patients with AD dementia. We found that the concentration of NfL in CSF, but not in plasma, was increased in response to Aβ pathology in CU subjects. Both CSF and plasma NfL concentrations were increased in patients with mild cognitive impairment and AD dementia. Furthermore, only NfL in CSF was associated with reduced white matter microstructure in CU subjects. Finally, in a transgenic mouse model of AD, CSF NfL increased before serum NfL in response to the development of Aβ pathology. In conclusion, NfL in CSF may be a more reliable biomarker of neurodegeneration than NfL in blood in preclinical sporadic AD.
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Affiliation(s)
- Emelie Andersson
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden.
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Björn Lampinen
- Clinical Sciences Lund, Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Markus Nilsson
- Clinical Sciences Lund, Department of Radiology, Lund University, Lund, Sweden
| | - Antoine Leuzy
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK; UK Dementia Research Institute at UCL, London, UK
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden.
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20
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Abu-Rumeileh S, Giannini G, Polischi B, Albini-Riccioli L, Milletti D, Oppi F, Stanzani-Maserati M, Capellari S, Mantovani P, Palandri G, Cortelli P, Cevoli S, Parchi P. Revisiting the Cerebrospinal Fluid Biomarker Profile in Idiopathic Normal Pressure Hydrocephalus: The Bologna Pro-Hydro Study. J Alzheimers Dis 2020; 68:723-733. [PMID: 30883350 DOI: 10.3233/jad-181012] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cerebrospinal fluid (CSF) biomarkers have been extensively investigated in idiopathic normal pressure hydrocephalus (iNPH) with the aim of a better differential diagnosis, but the pathophysiological mechanisms underlying CSF biomarker changes and the relationship between biomarker levels and clinical variables are still a matter of debate. We evaluated CSF amyloid-β (Aβ)42 and Aβ40, total (t)-tau, phosphorylated (p)-tau, total prion protein (t-PrP), and neurofilament light chain protein (NfL) in healthy controls (n = 50) and subjects with iNPH (n = 71), Alzheimer's disease (AD) (n = 60), and several other subtypes of dementia (n = 145). Patients with iNPH showed significantly lower levels of Aβ42, Aβ40, t-tau, and p-tau compared to controls. Similarly, t-PrP values showed a trend toward lower levels in iNPH patients than in controls. At variance, NfL levels were increased in iNPH as in all other neurodegenerative dementias, with no significant difference between "pure" iNPH cases and those with vascular or AD comorbidities. The Aβ42/Aβ40 ratio showed higher diagnostic value than Aβ42 alone in the differential diagnosis between iNPH and AD. There were no clinically relevant associations between neuroimaging markers, scores at clinical and cognitive scales/tests, or rates of response at tap test and CSF biomarker results. In summary, the CSF biomarker signature in patients with iNPH is mainly characterized by reduced CSF concentrations of Aβ- and tau-related proteins. The assessment of CSF neurodegenerative biomarker profile in iNPH, including the Aβ42/Aβ40 ratio, contributes to the differential diagnosis with AD and other dementias but shows poor associations with clinical variables.
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Affiliation(s)
- Samir Abu-Rumeileh
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Italy
| | - Giulia Giannini
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Italy
| | - Barbara Polischi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | - David Milletti
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Federico Oppi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | - Sabina Capellari
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Paolo Mantovani
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Giorgio Palandri
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Pietro Cortelli
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Sabina Cevoli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Piero Parchi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.,Department of Experimental Diagnostic and Specialty Medicine (DIMES), University of Bologna, Italy
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21
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Ashton NJ, Hye A, Rajkumar AP, Leuzy A, Snowden S, Suárez-Calvet M, Karikari TK, Schöll M, La Joie R, Rabinovici GD, Höglund K, Ballard C, Hortobágyi T, Svenningsson P, Blennow K, Zetterberg H, Aarsland D. An update on blood-based biomarkers for non-Alzheimer neurodegenerative disorders. Nat Rev Neurol 2020; 16:265-284. [PMID: 32322100 DOI: 10.1038/s41582-020-0348-0] [Citation(s) in RCA: 108] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2020] [Indexed: 01/11/2023]
Abstract
Cerebrospinal fluid analyses and neuroimaging can identify the underlying pathophysiology at the earliest stage of some neurodegenerative disorders, but do not have the scalability needed for population screening. Therefore, a blood-based marker for such pathophysiology would have greater utility in a primary care setting and in eligibility screening for clinical trials. Rapid advances in ultra-sensitive assays have enabled the levels of pathological proteins to be measured in blood samples, but research has been predominantly focused on Alzheimer disease (AD). Nonetheless, proteins that were identified as potential blood-based biomarkers for AD, for example, amyloid-β, tau, phosphorylated tau and neurofilament light chain, are likely to be relevant to other neurodegenerative disorders that involve similar pathological processes and could also be useful for the differential diagnosis of clinical symptoms. This Review outlines the neuropathological, clinical, molecular imaging and cerebrospinal fluid features of the most common neurodegenerative disorders outside the AD continuum and gives an overview of the current status of blood-based biomarkers for these disorders.
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Affiliation(s)
- Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.,Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK.,NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS Foundation, London, UK
| | - Abdul Hye
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK.,NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS Foundation, London, UK
| | - Anto P Rajkumar
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK.,NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS Foundation, London, UK.,Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Antoine Leuzy
- Clinical Memory Research Unit, Lund University, Malmö, Sweden
| | - Stuart Snowden
- Core Metabolomics and Lipidomics Laboratory, Metabolic Research Laboratories, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Marc Suárez-Calvet
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Catalonia, Spain.,Department of Neurology, Hospital del Mar, Barcelona, Catalonia, Spain
| | - Thomas K Karikari
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Michael Schöll
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.,Clinical Memory Research Unit, Lund University, Malmö, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Renaud La Joie
- Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Gil D Rabinovici
- Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Kina Höglund
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Disease Research, Neurogeriatrics Division, Karolinska Institutet, Novum, Huddinge, Stockholm, Sweden
| | | | - Tibor Hortobágyi
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK.,MTA-DE Cerebrovascular and Neurodegenerative Research Group, Department of Neurology, University of Debrecen, Debrecen, Hungary
| | - Per Svenningsson
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK.,Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK. .,NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS Foundation, London, UK. .,Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway.
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22
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Barstad B, Henningsson AJ, Tveitnes D, Ushakova A, Noraas S, Ask IS, Bosse FJ, Øymar K. Cerebrospinal fluid cytokines and chemokines in children with Lyme neuroborreliosis; pattern and diagnostic utility. Cytokine 2020; 130:155023. [PMID: 32199247 DOI: 10.1016/j.cyto.2020.155023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 12/14/2019] [Accepted: 01/29/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Lyme neuroborreliosis (LNB) is characterized by cerebrospinal fluid (CSF) inflammation with several cytokines/chemokines and B-lymphocytes. Clinically, LNB in children may be difficult to discriminate from non-Lyme aseptic meningitis (NLAM). We aimed to identify CSF cytokine/chemokine patterns in children with LNB, NLAM and controls and elucidate the diagnostic value of these cytokines/chemokines alone or in combination to discriminate between LNB and NLAM. METHODS Children with symptoms suggestive of LNB were included prospectively and categorized as LNB, NLAM or controls (no pleocytosis). Cytokines/chemokines in CSF were measured by multiplex bead assays and levels were compared between the three groups by nonparametric statistical tests. Previous results from the same children on the established biomarker, CXCL13, were included in the statistical analyses. The diagnostic properties of cytokines/chemokines to discriminate between LNB and NLAM were determined by receiver operating characteristic curve analyses with estimates of area under curve (AUC). To explore diagnostic properties of combinations of cytokines/chemokines, prediction models based on logistic regression were used. RESULTS We included 195 children with LNB (n = 77), NLAM (n = 12) and controls (n = 106). Children with LNB had higher CSF levels of CCL19, CCL22 and CXCL13 compared to NLAM and controls, whereas INFγ was higher in NLAM than in LNB and controls. CXCL13 was the superior single cytokine/chemokine to discriminate LNB from NLAM (AUC 0.978). The combination CXCL13/CCL19 (AUC 0.992) may possibly improve the specificity for LNB, especially for children with moderate CXCL13 levels. CONCLUSIONS The intrathecal immune reaction in LNB is characterized by B cell associated chemokines. Whether the combination CXCL13/CCL19 further improves discrimination between LNB and NLAM beyond the diagnostic improvements by CXCL13 alone needs to be tested in new studies.
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Affiliation(s)
- Bjørn Barstad
- Department of Pediatric and Adolescent Medicine, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway.
| | - Anna J Henningsson
- Division of Clinical Microbiology, Laboratory Medicine, Jönköping Region Jönköping County, Sweden; Department of Clinical and Experimental Medicine, Linköping University, Sweden; Division of Clinical Microbiology, Department of Clinical and Experimental Medicine, Linköping University Hospital, Linköping, Sweden.
| | - Dag Tveitnes
- Department of Pediatric and Adolescent Medicine, Stavanger University Hospital, Stavanger, Norway.
| | - Anastasia Ushakova
- Department of Research, Section of Biostatistics, Stavanger University Hospital, Stavanger, Norway.
| | - Sølvi Noraas
- Department of Medical Microbiology, Hospital of Southern Norway Trust, Kristiansand, Norway.
| | - Ingvild S Ask
- Department of Pediatric and Adolescent Medicine, Hospital of Southern Norway Trust, Kristiansand, Norway.
| | - Franziskus J Bosse
- Department of Pediatric and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway.
| | - Knut Øymar
- Department of Pediatric and Adolescent Medicine, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway.
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23
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Ziemssen T, Akgün K, Brück W. Molecular biomarkers in multiple sclerosis. J Neuroinflammation 2019; 16:272. [PMID: 31870389 PMCID: PMC6929340 DOI: 10.1186/s12974-019-1674-2] [Citation(s) in RCA: 130] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 12/16/2019] [Indexed: 11/30/2022] Open
Abstract
Multiple sclerosis (MS) is an inflammatory-neurodegenerative disease of the central nervous system presenting with significant inter- and intraindividual heterogeneity. However, the application of clinical and imaging biomarkers is currently not able to allow individual characterization and prediction. Complementary, molecular biomarkers which are easily quantifiable come from the areas of immunology and neurobiology due to the causal pathomechanisms and can excellently complement other disease characteristics. Only a few molecular biomarkers have so far been routinely used in clinical practice as their validation and transfer take a long time. This review describes the characteristics that an ideal MS biomarker should have and the challenges of establishing new biomarkers. In addition, clinically relevant and promising biomarkers from the blood and cerebrospinal fluid are presented which are useful for MS diagnosis and prognosis as well as for the assessment of therapy response and side effects.
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Affiliation(s)
- Tjalf Ziemssen
- MS center, Center of Clinical Neuroscience, University Clinic Carl-Gustav Carus, Dresden University of Technology, Dresden, Germany.
| | - Katja Akgün
- MS center, Center of Clinical Neuroscience, University Clinic Carl-Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Wolfgang Brück
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
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24
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Abu-Rumeileh S, Mometto N, Bartoletti-Stella A, Polischi B, Oppi F, Poda R, Stanzani-Maserati M, Cortelli P, Liguori R, Capellari S, Parchi P. Cerebrospinal Fluid Biomarkers in Patients with Frontotemporal Dementia Spectrum: A Single-Center Study. J Alzheimers Dis 2019; 66:551-563. [PMID: 30320576 DOI: 10.3233/jad-180409] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cerebrospinal fluid (CSF) neurofilament light chain protein (NfL) and Alzheimer's disease (AD) core biomarker levels have been evaluated in cohorts of patients with frontotemporal dementia spectrum (FTD), but the distribution of values across the different clinical syndromes and underlying proteinopathies, and the relative diagnostic accuracy appear discordant among studies. We measured CSF NfL, total (t)-tau, phosphorylated (p)-tau, and amyloid-β (Aβ)42 in healthy controls (n = 38) and subjects with a clinical, genetic, CSF biomarker-based, and/or neuropathological diagnosis of FTD (n = 141) or AD (n = 60). Sub-analyses were conducted in a proportion of subjects with definite and/or probable frontotemporal lobar degeneration with tau (FTLD-TAU) (n = 42) or TDP43 pathology (FTLD-TDP) (n = 36). Both FTD and AD groups showed significantly increased CSF NfL levels in comparison to controls (p < 0.001). CSF NfL levels were significantly higher in FTD patients than in AD (p < 0.001), reaching the highest values in amyotrophic lateral sclerosis associated with FTD. Patients with probable and definite FTLD-TDP had significantly higher NfL levels (p < 0.001) and lower p-tau/t-tau values (p < 0.001) in comparison with probable and definite FTLD-TAU cases. NfL showed good diagnostic accuracy in the distinction between FTD and controls (AUC 0.862±0.027) and yielded an accuracy (AUC 0.861±0.045) comparable to that of the p-tau/t-tau ratio (AUC 0.814±0.050), with 80.0% sensitivity and 81.0% specificity, in the discrimination between probable/definite FTLD-TAU and FTLD-TDP. Our data further validate CSF NfL as a surrogate biomarker of neurodegeneration and disease severity in patients with FTD spectrum. Moreover, they demonstrate a good diagnostic value for NfL and p-tau/t-tau ratio in the discrimination between FTLD-TAU and FTLD-TDP.
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Affiliation(s)
- Samir Abu-Rumeileh
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Nicola Mometto
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | | | - Barbara Polischi
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
| | - Federico Oppi
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
| | - Roberto Poda
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
| | | | - Pietro Cortelli
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.,IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
| | - Rocco Liguori
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.,IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
| | - Sabina Capellari
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.,IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
| | - Piero Parchi
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
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25
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Meeter LHH, Steketee RME, Salkovic D, Vos ME, Grossman M, McMillan CT, Irwin DJ, Boxer AL, Rojas JC, Olney NT, Karydas A, Miller BL, Pijnenburg YAL, Barkhof F, Sánchez-Valle R, Lladó A, Borrego-Ecija S, Diehl-Schmid J, Grimmer T, Goldhardt O, Santillo AF, Hansson O, Vestberg S, Borroni B, Padovani A, Galimberti D, Scarpini E, Rohrer JD, Woollacott IOC, Synofzik M, Wilke C, de Mendonca A, Vandenberghe R, Benussi L, Ghidoni R, Binetti G, Niessen WJ, Papma JM, Seelaar H, Jiskoot LC, de Jong FJ, Donker Kaat L, Del Campo M, Teunissen CE, Bron EE, Van den Berg E, Van Swieten JC. Clinical value of cerebrospinal fluid neurofilament light chain in semantic dementia. J Neurol Neurosurg Psychiatry 2019; 90:997-1004. [PMID: 31123142 PMCID: PMC6820157 DOI: 10.1136/jnnp-2018-319784] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 02/12/2019] [Accepted: 04/10/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Semantic dementia (SD) is a neurodegenerative disorder characterised by progressive language problems falling within the clinicopathological spectrum of frontotemporal lobar degeneration (FTLD). The development of disease-modifying agents may be facilitated by the relative clinical and pathological homogeneity of SD, but we need robust monitoring biomarkers to measure their efficacy. In different FTLD subtypes, neurofilament light chain (NfL) is a promising marker, therefore we investigated the utility of cerebrospinal fluid (CSF) NfL in SD. METHODS This large retrospective multicentre study compared cross-sectional CSF NfL levels of 162 patients with SD with 65 controls. CSF NfL levels of patients were correlated with clinical parameters (including survival), neuropsychological test scores and regional grey matter atrophy (including longitudinal data in a subset). RESULTS CSF NfL levels were significantly higher in patients with SD (median: 2326 pg/mL, IQR: 1628-3593) than in controls (577 (446-766), p<0.001). Higher CSF NfL levels were moderately associated with naming impairment as measured by the Boston Naming Test (rs =-0.32, p=0.002) and with smaller grey matter volume of the parahippocampal gyri (rs =-0.31, p=0.004). However, cross-sectional CSF NfL levels were not associated with progression of grey matter atrophy and did not predict survival. CONCLUSION CSF NfL is a promising biomarker in the diagnostic process of SD, although it has limited cross-sectional monitoring or prognostic abilities.
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Affiliation(s)
- Lieke H H Meeter
- Alzheimer Center and Department of Neurology, Erasmus MC, Rotterdam, The Netherlands
| | - Rebecca M E Steketee
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
| | - Dina Salkovic
- Alzheimer Center and Department of Neurology, Erasmus MC, Rotterdam, The Netherlands
| | - Maartje E Vos
- Alzheimer Center and Department of Neurology, Erasmus MC, Rotterdam, The Netherlands
| | - Murray Grossman
- Penn FTD Center, Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Corey T McMillan
- Penn FTD Center, Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - David J Irwin
- Penn FTD Center, Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Adam L Boxer
- Neurology, Memory and Aging Center University of California San Francisco, San Francisco, California, USA
| | - Julio C Rojas
- Neurology, Memory and Aging Center University of California San Francisco, San Francisco, California, USA
| | - Nicholas T Olney
- Neurology, University of California San Francisco Memory and Aging Center, San Francisco, California, USA
| | - Anna Karydas
- Neurology, University of California San Francisco Memory and Aging Center, San Francisco, California, USA
| | - Bruce L Miller
- Neurology, Memory and Aging Center University of California San Francisco, San Francisco, California, USA
| | - Yolande A L Pijnenburg
- Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Neurology and Healthcare Engineering, University College London Medical School, London, UK
| | - Raquel Sánchez-Valle
- Department of Neurology, Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Albert Lladó
- Department of Neurology, Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Sergi Borrego-Ecija
- Department of Neurology, Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Oliver Goldhardt
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Alexander F Santillo
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
| | | | - Barbara Borroni
- Centre for Ageing Brain and Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Alessandro Padovani
- Centre for Ageing Brain and Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Daniela Galimberti
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca' Granda, Ospedale Policlinico, Milan, Italy
- Biomedical, Surgical and Dental Sciences, University of Milan, Centro Dino Ferrari, Milan, Italy
| | - Elio Scarpini
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca' Granda, Ospedale Policlinico, Milan, Italy
- Pathophysiology and Transplantation, University of Milan, Centro Dino Ferrari, Milan, Italy
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Diseases, UCL Institute of Neurology, London, UK
| | - Ione O C Woollacott
- Dementia Research Centre, Department of Neurodegenerative Diseases, UCL Institute of Neurology, London, UK
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Carlo Wilke
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Alexandre de Mendonca
- Institute of Molecular Medicine and Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Rik Vandenberghe
- Department of Neurology, University Hospital Leuven, Leuven, Belgium
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Vlaanderen, Belgium
| | - Luisa Benussi
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Roberta Ghidoni
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Giuliano Binetti
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- MAC Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Wiro J Niessen
- Biomedical Imaging Group Rotterdam, Departments of Medical Informatics and Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
- Imaging Physics, Applied Sciences, Delft University of Technology, Delft, The Netherlands
| | - Janne M Papma
- Alzheimer Center and Department of Neurology, Erasmus MC, Rotterdam, The Netherlands
| | - Harro Seelaar
- Alzheimer Center and Department of Neurology, Erasmus MC, Rotterdam, The Netherlands
| | - Lize C Jiskoot
- Alzheimer Center and Department of Neurology, Erasmus MC, Rotterdam, The Netherlands
| | - Frank Jan de Jong
- Alzheimer Center and Department of Neurology, Erasmus MC, Rotterdam, The Netherlands
| | - Laura Donker Kaat
- Alzheimer Center and Department of Neurology, Erasmus MC, Rotterdam, The Netherlands
- Department of Clinical Genetics, Leids Universitair Medisch Centrum, Leiden, Zuid-Holland, The Netherlands
| | - Marta Del Campo
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Esther E Bron
- Biomedical Imaging Group Rotterdam, Departments of Medical Informatics and Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
| | - Esther Van den Berg
- Alzheimer Center and Department of Neurology, Erasmus MC, Rotterdam, The Netherlands
| | - John C Van Swieten
- Alzheimer Center and Department of Neurology, Erasmus MC, Rotterdam, The Netherlands
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Wilke C, Pujol-Calderón F, Barro C, Stransky E, Blennow K, Michalak Z, Deuschle C, Jeromin A, Zetterberg H, Schüle R, Höglund K, Kuhle J, Synofzik M. Correlations between serum and CSF pNfH levels in ALS, FTD and controls: a comparison of three analytical approaches. ACTA ACUST UNITED AC 2019; 57:1556-1564. [DOI: 10.1515/cclm-2019-0015] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 04/05/2019] [Indexed: 12/13/2022]
Abstract
Abstract
Background
Phosphorylated neurofilament heavy (pNfH), a neuronal cytoskeleton protein, might provide a promising blood biomarker of neuronal damage in neurodegenerative diseases (NDDs). The best analytical approaches to measure pNfH levels and whether serum levels correlate with cerebrospinal fluid (CSF) levels in NDDs remain to be determined.
Methods
We here compared analytical sensitivity and reliability of three novel analytical approaches (homebrew Simoa, commercial Simoa and ELISA) for quantifying pNfH in both CSF and serum in samples of amyotrophic lateral sclerosis (ALS), frontotemporal dementia (FTD) and control subjects.
Results
While all three assays showed highly correlated CSF measurements, Simoa assays also yielded high between-assay correlations for serum measurements (ϱ = 0.95). Serum levels also correlated strongly with CSF levels for Simoa-based measurements (both ϱ = 0.62). All three assays allowed distinguishing ALS from controls by increased CSF pNfH levels, and Simoa assays also by increased serum pNfH levels. pNfH levels were also increased in FTD.
Conclusions
pNfH concentrations in CSF and, if measured by Simoa assays, in blood might provide a sensitive and reliable biomarker of neuronal damage, with good between-assay correlations. Serum pNfH levels measured by Simoa assays closely reflect CSF levels, rendering serum pNfH an easily accessible blood biomarker of neuronal damage in NDDs.
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Affiliation(s)
- Carlo Wilke
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology , University of Tübingen , Tübingen , Germany
- German Center for Neurodegenerative Diseases (DZNE) , University of Tübingen , Tübingen , Germany
| | - Fani Pujol-Calderón
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology , The Sahlgrenska Academy at University of Gothenburg , Gothenburg , Sweden
| | - Christian Barro
- Neurologic Clinic, MS Centre and Policlinic, Departments of Medicine, Biomedicine and Clinical Research , University Hospital Basel, University of Basel , Basel , Switzerland
| | - Elke Stransky
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology , University of Tübingen , Tübingen , Germany
- German Center for Neurodegenerative Diseases (DZNE) , University of Tübingen , Tübingen , Germany
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology , The Sahlgrenska Academy at University of Gothenburg , Gothenburg , Sweden
- Clinical Neurochemistry Laboratory , Sahlgrenska University Hospital , Mölndal , Sweden
| | - Zuzanna Michalak
- Neurologic Clinic, MS Centre and Policlinic, Departments of Medicine, Biomedicine and Clinical Research , University Hospital Basel, University of Basel , Basel , Switzerland
| | - Christian Deuschle
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology , University of Tübingen , Tübingen , Germany
- German Center for Neurodegenerative Diseases (DZNE) , University of Tübingen , Tübingen , Germany
| | | | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology , The Sahlgrenska Academy at University of Gothenburg , Gothenburg , Sweden
- Clinical Neurochemistry Laboratory , Sahlgrenska University Hospital , Mölndal , Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology , University College London, Queen Square , London , UK
- UK Dementia Research Institute at UCL , London , UK
| | - Rebecca Schüle
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology , University of Tübingen , Tübingen , Germany
- German Center for Neurodegenerative Diseases (DZNE) , University of Tübingen , Tübingen , Germany
| | - Kina Höglund
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology , The Sahlgrenska Academy at University of Gothenburg , Gothenburg , Sweden
- Clinical Neurochemistry Laboratory , Sahlgrenska University Hospital , Mölndal , Sweden
| | - Jens Kuhle
- Neurologic Clinic, MS Centre and Policlinic, Departments of Medicine, Biomedicine and Clinical Research , University Hospital Basel, University of Basel , Basel , Switzerland
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology , University of Tübingen , Tübingen , Germany
- German Center for Neurodegenerative Diseases (DZNE) , University of Tübingen , Tübingen , Germany
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Poesen K, Van Damme P. Diagnostic and Prognostic Performance of Neurofilaments in ALS. Front Neurol 2019; 9:1167. [PMID: 30713520 PMCID: PMC6345692 DOI: 10.3389/fneur.2018.01167] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 12/17/2018] [Indexed: 01/03/2023] Open
Abstract
There is a need for biomarkers for amyotrophic lateral sclerosis (ALS), to support the diagnosis of the disease, to predict disease progression and to track disease activity and treatment responses. Over the last decade multiple studies have investigated the potential of neurofilament levels, both in cerebrospinal fluid and blood, as biomarker for ALS. The most widely studied neurofilament subunits are neurofilament light chain (NfL) and phosphorylated neurofilament heavy chain (pNfH). Neurofilament levels are reflecting neuronal injury and therefore potentially of value in ALS and other neurological disorders. In this mini-review, we summarize and discuss the available evidence about neurofilaments as diagnostic and prognostic biomarker for human ALS.
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Affiliation(s)
- Koen Poesen
- Department of Neurosciences, Laboratory for Molecular Neurobiomarker Research, KU Leuven, Leuven, Belgium.,Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Philip Van Damme
- Laboratory of Neurobiology, Department of Neurosciences, KU Leuven and Center for Brain & Disease Research VIB Leuven, Leuven, Belgium.,Department of Neurology, Neuromuscular Reference Centre, University Hospitals Leuven, Leuven, Belgium
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Hok-A-Hin YS, Willemse EAJ, Teunissen CE, Del Campo M. Guidelines for CSF Processing and Biobanking: Impact on the Identification and Development of Optimal CSF Protein Biomarkers. Methods Mol Biol 2019; 2044:27-50. [PMID: 31432404 DOI: 10.1007/978-1-4939-9706-0_2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The field of neurological diseases strongly needs biomarkers for early diagnosis and optimal stratification of patients in clinical trials or to monitor disease progression. Cerebrospinal fluid (CSF) is one of the main sources for the identification of novel protein biomarkers for neurological diseases. Despite the enormous efforts employed to identify novel CSF biomarkers, the high variability observed across different studies has hampered their validation and implementation in clinical practice. Such variability is partly caused by the effect of different pre-analytical confounding factors on protein stability, highlighting the importance to develop and comply with standardized operating procedures. In this chapter, we describe the international consensus pre-analytical guidelines for CSF processing and biobanking that have been established during the last decade, with a special focus on the influence of pre-analytical confounders on the global CSF proteome. In addition, we provide novel results on the influence of different delayed storage and freeze/thaw conditions on the CSF proteome using two novel large multiplex protein arrays (SOMAscan and Olink). Compliance to consensus guidelines will likely facilitate the successful development and implementation of CSF protein biomarkers in both research and clinical settings, ultimately facilitating the successful development of disease-modifying therapies.
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Affiliation(s)
- Yanaika S Hok-A-Hin
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center, Amsterdam UMC, Amsterdam, The Netherlands.
| | - Eline A J Willemse
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center, Amsterdam UMC, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center, Amsterdam UMC, Amsterdam, The Netherlands
| | - Marta Del Campo
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center, Amsterdam UMC, Amsterdam, The Netherlands
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Abstract
Background The purpose of this study was to analyze tear inflammatory cytokines of different subclasses of dry eye disease (DED) patients using Luminex technology. Material/Methods Forty-five DED patients including 20 Sjogren syndrome aqueous tear deficiency (SS-ATD) patients, 20 non-Sjogren syndrome aqueous tear deficiency (NSS-ATD) patients, 15 meibomian gland dysfunction (MGD) patients, and 15 normal participants were enrolled in this study. Concentrations of 11 inflammatory cytokines in tear samples of study participants were measured by Luminex assay; ELISA assay was further applied for validation. Results The levels of cytokines were mostly increased (TNF-α, IL-1α, IL-1β, IL-6, IL-8, IL-12P70, IL-13, IFN-γ, and MIP-1α) in DED patients compared with normal participants. And the levels of TNF-α, IL-6, IL-8, and IL-12P70 were significantly elevated in tears of the patient groups compared to tears of participants in the normal group (P<0.05). Statistical differences were also observed among the patient groups (SS-ATD, NSS-ATD, and MGD) for the level of IL-8 and TNF-α. The results of ELISA assay demonstrated the consistence with Luminex assay, confirming the practicality of Luminex technology for the analysis of multiple cytokines in DED patient tears. Conclusions The levels of inflammatory cytokines were mostly elevated in DED patients, and statistical differences of some cytokines were also found between SS-ATD, NSS-ATD, and MGD groups, suggesting that inflammatory cytokines could be potential supplements for the diagnosis of DED subclasses and therapeutic targets for DED patients.
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Affiliation(s)
- Hailan Zhao
- Department of Ophthalmology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China (mainland)
| | - Qiushi Li
- Department of Ophthalmology, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, China (mainland)
| | - Mingxia Ye
- Department of Ophthalmology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China (mainland)
| | - Jie Yu
- Department of Ophthalmology, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, China (mainland)
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Keshavan A, Heslegrave A, Zetterberg H, Schott JM. Stability of blood-based biomarkers of Alzheimer's disease over multiple freeze-thaw cycles. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2018; 10:448-451. [PMID: 30211292 PMCID: PMC6131984 DOI: 10.1016/j.dadm.2018.06.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction Freeze-thaw instability may contribute to preanalytical variation in blood-based biomarker studies. We investigated the effects of up to four freeze-thaw cycles on single molecule array immunoassays of serum neurofilament light chain and plasma total tau, amyloid β 1–40 (Aß40), and Aβ 1–42 (Aβ42). Methods Individuals who had peripheral venepuncture during investigation of suspected neurodegenerative disease were recruited. After standardized preprocessing, 200 μL of plasma and serum aliquots were stored at −80°C within 60 minutes. Aliquots underwent one to four freeze-thaw cycles. Results There was no significant difference across four freeze-thaw cycles for serum neurofilament light chain (n = 12), plasma total tau (n = 11), or plasma Aβ42 (n = 12). For plasma Aβ40 (n = 14), there were significant median reductions by ratios of .96 and .92 at the third and fourth cycles, respectively. Discussion Up to four freeze-thaw cycles do not influence single molecule array blood biomarkers of neurofilament light chain, total tau, or Aβ42, with at most minor reductions in Aβ40.
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Affiliation(s)
- Ashvini Keshavan
- Dementia Research Centre, Box 16 National Hospital for Neurology and Neurosurgery, London, UK
- Leonard Wolfson Biomarkers Laboratory, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- Corresponding author. Tel.: (+44) 2034 483011; Fax: (+44) 2034 483104.
| | - Amanda Heslegrave
- Leonard Wolfson Biomarkers Laboratory, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- The DRI Fluid Biomarker Laboratory, UK Dementia Research Institute at UCL, London, UK
| | - Henrik Zetterberg
- Leonard Wolfson Biomarkers Laboratory, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- The DRI Fluid Biomarker Laboratory, UK Dementia Research Institute at UCL, London, UK
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Jonathan M. Schott
- Dementia Research Centre, Box 16 National Hospital for Neurology and Neurosurgery, London, UK
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Serum neurofilament light chain in progressive supranuclear palsy. Parkinsonism Relat Disord 2018; 56:98-101. [PMID: 29937097 DOI: 10.1016/j.parkreldis.2018.06.018] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 06/08/2018] [Accepted: 06/11/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Neurofilament light chain (NfL) is a promising biomarker in neurodegenerative diseases. Elevated NfL levels in CSF and blood have been observed in a growing number of neurodegenerative disorders, including frontotemporal dementia and Alzheimer's disease. We studied serum NfL levels in patients with progressive supranuclear palsy (PSP) in relation to disease severity and survival. METHODS Serum NfL levels were determined cross-sectionally in a retrospective cohort of 131 patients with PSP and 95 healthy controls. Detailed clinical examination was performed and disease severity was assessed by several rating scales. RESULTS We found that serum NfL levels in PSP were twice as high as those in controls, and that NfL levels correlated with worse functional, motor and cognitive functioning. During follow-up, 119 PSP patients had died, and higher NfL levels were associated with a shorter survival. CONCLUSION This study provides evidence that serum NfL is a relevant and promising biomarker in PSP for disease severity, and may be used as a prognostic tool to predict survival in clinical practice.
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Bergman L, Zetterberg H, Kaihola H, Hagberg H, Blennow K, Åkerud H. Blood-based cerebral biomarkers in preeclampsia: Plasma concentrations of NfL, tau, S100B and NSE during pregnancy in women who later develop preeclampsia - A nested case control study. PLoS One 2018; 13:e0196025. [PMID: 29719006 PMCID: PMC5931625 DOI: 10.1371/journal.pone.0196025] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 03/23/2018] [Indexed: 11/26/2022] Open
Abstract
Objective To evaluate if concentrations of the neuronal proteins neurofilament light chain and tau are changed in women developing preeclampsia and to evaluate the ability of a combination of neurofilament light chain, tau, S100B and neuron specific enolase in identifying neurologic impairment before diagnosis of preeclampsia. Methods A nested case-control study within a longitudinal study cohort was performed. 469 healthy pregnant women were enrolled between 2004–2007 and plasma samples were collected at gestational weeks 10, 25, 28, 33 and 37. Plasma concentrations of tau and neurofilament light chain were analyzed in 16 women who eventually developed preeclampsia and 36 controls throughout pregnancy with single molecule array (Simoa) method and compared within and between groups. S100B and NSE had been analyzed previously in the same study population. A statistical model with receiving characteristic operation curve was constructed with the four biomarkers combined. Results Plasma concentrations of neurofilament light chain were significantly increased in women who developed preeclampsia in gestational week 33 (11.85 ng/L, IQR 7.48–39.93 vs 6.80 ng/L, IQR 5.65–11.40) and 37 (22.15 ng/L, IQR 10.93–35.30 vs 8.40 ng/L, IQR 6.40–14.30) and for tau in gestational week 37 (4.33 ng/L, IQR 3.97–12.83 vs 3.77 ng/L, IQR 1.91–5.25) in contrast to healthy controls. A combined model for preeclampsia with tau, neurofilament light chain, S100B and neuron specific enolase in gestational week 25 displayed an area under the curve of 0.77, in week 28 it was 0.75, in week 33 it was 0.89 and in week 37 it was 0.83. Median week for diagnosis of preeclampsia was at 38 weeks of gestation. Conclusion Concentrations of both tau and neurofilament light chain are increased in the end of pregnancy in women developing preeclampsia in contrast to healthy pregnancies. Cerebral biomarkers might reflect cerebral involvement before onset of disease.
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Affiliation(s)
- Lina Bergman
- Department for Women’s and Children’s health, Uppsala University, Uppsala, Sweden
- Center for Clinical Research, Falun, Sweden
- * E-mail:
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- UCL Institute of Neurology, Queen Square, London, United Kingdom
- UK Dementia Research Institute, London, United Kingdom
| | - Helena Kaihola
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Henrik Hagberg
- Perinatal Center, Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for the Developing Brain, King's College, London, United Kingdom
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Helena Åkerud
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
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Abu-Rumeileh S, Capellari S, Stanzani-Maserati M, Polischi B, Martinelli P, Caroppo P, Ladogana A, Parchi P. The CSF neurofilament light signature in rapidly progressive neurodegenerative dementias. ALZHEIMERS RESEARCH & THERAPY 2018; 10:3. [PMID: 29368621 PMCID: PMC5784714 DOI: 10.1186/s13195-017-0331-1] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 12/05/2017] [Indexed: 12/13/2022]
Abstract
Background Neurofilament light chain protein (NfL) is a surrogate biomarker of neurodegeneration that has never been systematically tested, either alone or in combination with other biomarkers, in atypical/rapidly progressive neurodegenerative dementias (NDs). Methods Using validated, commercially available enzyme-linked immunosorbent assay kits, we measured cerebrospinal fluid (CSF) NfL, total tau (t-tau), phosphorylated tau, and β-amyloid 42 in subjects with a neuropathological or clinical diagnosis of prion disease (n = 141), Alzheimer’s disease (AD) (n = 73), dementia with Lewy bodies (DLB) (n = 35), or frontotemporal lobar degeneration (FTLD) (n = 44). Several cases with an atypical/rapidly progressive course were included in each group. We evaluated the diagnostic accuracy of every CSF biomarker and their combinations by ROC curve analyses. Results In each patient group CSF NfL showed higher levels than in control subjects, reaching the highest values in those with Creutzfeldt-Jakob disease (CJD). In the latter, NfL showed a divergent, subtype-specific correlation with t-tau, depending on the degree of subcortical involvement and disease duration. Most significantly, patients with classic sporadic CJD (sCJD) MM1 showed a significantly lower concentration of CSF NfL than those with sCJD MV2, despite the much higher t-tau levels and the more rapid clinical course. High NfL levels were also detected in most atypical CJD cases, showing a disease duration longer than 2 years and/or borderline/negative results in other CSF assays (e.g., 14-3-3, t-tau, and prion real-time quaking-induced conversion). Rapidly progressive/atypical cases showed higher NfL levels than typical patients in FTLD, but not in AD or DLB. NfL showed accuracy similar to that of t-tau in discriminating CJD from other NDs, but it had higher efficacy in differentiating atypical forms, especially in regard to Alzheimer’s disease. Conclusions The present data indicate that CSF NfL and t-tau levels reflect distinct pathophysiological mechanisms of neurodegeneration and support the clinical use of NfL as a fast screening biomarker for the differential diagnosis of atypical/rapidly progressive NDs. Electronic supplementary material The online version of this article (doi:10.1186/s13195-017-0331-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Samir Abu-Rumeileh
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, 40123, Bologna, Italy
| | - Sabina Capellari
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, 40123, Bologna, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Institute of Neurological Sciences of Bologna, Bellaria Hospital, 40139, Bologna, Italy
| | - Michelangelo Stanzani-Maserati
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Institute of Neurological Sciences of Bologna, Bellaria Hospital, 40139, Bologna, Italy
| | - Barbara Polischi
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Institute of Neurological Sciences of Bologna, Bellaria Hospital, 40139, Bologna, Italy
| | - Paolo Martinelli
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, 40123, Bologna, Italy
| | - Paola Caroppo
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Foundation "Carlo Besta" Neurological Institute, 20133, Milan, Italy
| | - Anna Ladogana
- Department of Neurosciences, Istituto Superiore di Sanità, Rome, Italy
| | - Piero Parchi
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Institute of Neurological Sciences of Bologna, Bellaria Hospital, 40139, Bologna, Italy. .,Department of Diagnostic Experimental and Specialty Medicine (DIMES), University of Bologna, 40138, Bologna, Italy.
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Cerebrospinal Fluid B-lymphocyte Chemoattractant CXCL13 in the Diagnosis of Acute Lyme Neuroborreliosis in Children. Pediatr Infect Dis J 2017; 36:e286-e292. [PMID: 28661964 DOI: 10.1097/inf.0000000000001669] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Current markers of Lyme neuroborreliosis (LNB) in children have insufficient sensitivity in the early stage of disease. The B-lymphocyte chemoattractant CXCL13 in the cerebrospinal fluid (CSF) may be useful in diagnosing LNB, but its specificity has not been evaluated in studies including children with clinically relevant differential diagnoses. The aim of this study was to elucidate the diagnostic value of CSF CXCL13 in children with symptoms suggestive of LNB. METHODS Children with symptoms suggestive of LNB were included prospectively into predefined groups with a high or low likelihood of LNB based on CSF pleocytosis and the detection of Borrelia antibodies or other causative agents. CSF CXCL13 levels were compared between the groups, and receiver-operating characteristic analyses were performed to indicate optimal cutoff levels to discriminate LNB from non-LNB conditions. RESULTS Two hundred and ten children were included. Children with confirmed LNB (n=59) and probable LNB (n=18) had higher CSF CXCL13 levels than children with possible LNB (n=7), possible peripheral LNB (n=7), non-Lyme aseptic meningitis (n=12), non-meningitis (n=91) and negative controls (n=16). Using 18 pg/mL as a cutoff level, both the sensitivity and specificity of CSF CXCL13 for LNB (confirmed and probable) were 97%. Comparing only children with LNB and non-Lyme aseptic meningitis, the sensitivity and specificity with the same cutoff level were 97% and 83%, respectively. CONCLUSION CSF CXCL13 is a sensitive marker of LNB in children. The specificity to discriminate LNB from non-Lyme aseptic meningitis may be more moderate, suggesting that CSF CXCL13 should be used together with other variables in diagnosing LNB in children.
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Lycke J, Zetterberg H. The role of blood and CSF biomarkers in the evaluation of new treatments against multiple sclerosis. Expert Rev Clin Immunol 2017; 13:1143-1153. [PMID: 29090607 DOI: 10.1080/1744666x.2017.1400380] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Multiple sclerosis (MS) is an immune-mediated chronic neurodegenerative disease of the central nervous system (CNS). Therapeutic interventions with immunomodulatory agents reduce disease activity and disability development, which are monitored clinically and by magnetic resonance imaging (MRI). However, these measures largely lack information on the impact from these therapies on inflammation, demyelination and axonal injury, the essential pathophysiological features of MS. Several biomarkers for inflammation and neurodegeneration have been detected in cerebrospinal fluid (CSF). In MS, some of these biomarkers seem to reflect disease activity, disability progression, and therapeutic response. Areas covered: In this review, we describe the most promising CSF biomarkers of inflammation and degeneration for monitoring therapeutic interventions in MS. We also describe the evolution of highly sensitive immunoassays that enable determination of neuron-specific biomarkers in blood. Expert commentary: Together with clinical and MRI measures, CSF biomarkers may improve the assessment of therapeutic efficacy and make personalized treatment possible. One disadvantage has been the need of repetitive lumbar punctures to obtain CSF. However, the technical development of highly sensitive immunoassays allows determination of extremely low quantities of neuron-specific proteins in blood. This will potentially open a new era for monitoring disease activity and treatment response in MS.
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Affiliation(s)
- Jan Lycke
- a Department of Clinical Neuroscience, Institute of Neuroscience and Physiology , The Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden
| | - Henrik Zetterberg
- b Department of Psychiatry and Neurochemistry; Institute of Neuroscience and Physiology at Sahlgrenska Academy , University of Gothenburg , Gothenburg , Sweden.,c Clinical Neurochemistry Laboratory , Sahlgrenska University Hospital , Mölndal , Sweden.,d Department of Molecular Neuroscience , UCL Institute of Neurology , London , UK.,e UK Dementia Research Institute , London , UK
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Vijverberg EGB, Dols A, Krudop WA, Del Campo Milan M, Kerssens CJ, Gossink F, Prins ND, Stek ML, Scheltens P, Teunissen CE, Pijnenburg YAL. Cerebrospinal fluid biomarker examination as a tool to discriminate behavioral variant frontotemporal dementia from primary psychiatric disorders. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2017; 7:99-106. [PMID: 28337476 PMCID: PMC5352718 DOI: 10.1016/j.dadm.2017.01.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION To prospectively determine the diagnostic value of cerebrospinal fluid (CSF) levels total-tau (tau) to amyloid-β1-42 ratio (Aβ1-42) ratio (tau/Aβ1-42 ratio), phosphorylated-tau (p-tau) to tau ratio (p-tau/tau ratio), neurofilament light chain (NfL) and YKL40 in the late-onset frontal lobe syndrome, in particular for the differential diagnosis of behavioral variant frontotemporal dementia (bvFTD) versus primary psychiatric disorders (PSY). METHOD We included patients with a multidisciplinary 2-year-follow-up diagnosis of probable/definite bvFTD (n = 22) or PSY (n = 25), who underwent a detailed neuropsychiatric clinical examination, neuropsychological test battery, and magnetic resonance imaging at baseline. In all cases, CSF was collected through lumbar puncture at baseline. We compared CSF biomarker levels between the two groups and measured the diagnostic accuracy for probable/definite bvFTD, using the follow-up diagnosis as the reference standard. RESULTS The best discriminators between probable/definite bvFTD and PSY were the levels of CSF NfL (area under the curve [AUC] 0.93, P < .001, 95% confidence interval [CI] 0.85-1.00), p-tau/tau ratio (AUC 0.87, P < .001, 95% CI 0.77-0.97), and YKL40 (AUC 0.82, P = .001, 95% CI 0.68-0.97). The combination of these three biomarkers had a sensitivity of 91% (95% CI 66%-100%) at a specificity of 83% (95% CI 65%-95%) with an AUC of 0.94 (P < .001, 95% CI 0.87-1.00) for bvFTD. CSF tau/Aβ1-42 ratio was less accurate in differentiating between bvFTD and PSY. DISCUSSION We found a good diagnostic accuracy for higher levels of CSF NfL and YKL40 and reduced p-tau/tau ratio in distinguishing bvFTD from PSY. We advocate the use of these CSF biomarkers as potential additional tools to neuroimaging in the diagnosis of bvFTD versus PSY.
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Affiliation(s)
- Everard G B Vijverberg
- Alzheimer Centre and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands; Department of Neurology, HagaZiekenhuis, The Hague, The Netherlands
| | - Annemiek Dols
- Department of Old Age Psychiatry, GGZ InGeest, Amsterdam, The Netherlands
| | - Welmoed A Krudop
- Alzheimer Centre and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands
| | - Marta Del Campo Milan
- Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands
| | - Cora J Kerssens
- Department of Old Age Psychiatry, GGZ InGeest, Amsterdam, The Netherlands
| | - Flora Gossink
- Department of Old Age Psychiatry, GGZ InGeest, Amsterdam, The Netherlands
| | - Niels D Prins
- Alzheimer Centre and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands
| | - Max L Stek
- Department of Old Age Psychiatry, GGZ InGeest, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Centre and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Centre and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands
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Li D, Shen D, Tai H, Cui L. Neurofilaments in CSF As Diagnostic Biomarkers in Motor Neuron Disease: A Meta-Analysis. Front Aging Neurosci 2016; 8:290. [PMID: 27965574 PMCID: PMC5126108 DOI: 10.3389/fnagi.2016.00290] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 11/16/2016] [Indexed: 11/13/2022] Open
Abstract
Objective: Neurofilaments in CSF are promising biomarkers which might help in the diagnosis of motor neuron disease (MND). We aim to assess the diagnostic value of neurofilaments in CSF for MND. Methods: Pubmed, Emabase, and Web of Science were searched for relevant studies systematically. Articles in English that evaluated the utility of neurofilaments in CSF in the diagnosis of MND were included. Data were extracted by two independent investigators. Diagnostic indexes for neurofilament light chain (NFL) and phosphorylated neurofilament heavy chain (pNFH) were calculated separately. Stata 12.0 software with a bivariate mixed-effects model was used to summarize the diagnostic indexes from eligible studies. Results: Five studies on NFL and eight studies on pNFH met inclusion criteria. For NFL, the pooled sensitivity and specificity were 81% (95% confidence interval [CI], 72–88%) and 85% (95% CI, 76–91%), respectively; the positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 5.5 (95% CI, 3.1–9.8) and 0.22 (95% CI, 0.14–0.35), respectively; the summary diagnostic odds ratio (DOR) was 25 (95% CI, 9–70), and the area under summary receiver operator characteristic curve (AUC) was 0.90 (95% CI, 0.87–0.92). For pNFH, the pooled sensitivity, specificity, PLR and NLR were 85% (95% CI, 80–88%), 85% (95% CI, 77–90%), 5.5 (95% CI, 3.6–8.4), and 0.18 (95% CI, 0.13–0.25), respectively; the DOR was 30 (95% CI, 16–58), and the AUC was 0.91 (95% CI, 0.88–0.93). Conclusion: Neurofilaments in CSF have a high value in the diagnosis of MND, though the optimal cutoff value remains to be further investigated.
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Affiliation(s)
- Dawei Li
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China
| | - Dongchao Shen
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China
| | - Hongfei Tai
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China
| | - Liying Cui
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing, China; Neuroscience Center, Chinese Academy of Medical SciencesBeijing, China
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Multicenter immunoassay validation of cerebrospinal fluid neurofilament light: a biomarker for neurodegeneration. Bioanalysis 2016; 8:2243-2254. [PMID: 27684648 DOI: 10.4155/bio-2016-0114] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
AIM Neurofilament light (NfL) chain, a putative cerebrospinal fluid biomarker, can support neurodegenerative disease diagnosis and indicate disease severity and prognosis. Universal validation protocols when used to measure biomarkers can reduce pre and analytical laboratory variation, thus increasing end-user confidence in the consistency of validation data across sites. METHODOLOGY Here, a commercially available NfL ELISA (UmanDiagnostics, Umeå, Sweden) was validated in a multicentered setting using comprehensive newly developed standard operating procedures. RESULTS The data showed good assay sensitivity and intra and interassay precision. Interlaboratory precision was, however, suboptimal. CONCLUSION The UmanDiagnostics assay is suitable for the quantification of NfL in human cerebrospinal fluid. However, sources of interlaboratory variation in the data require further investigation.
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Meeter LH, Dopper EG, Jiskoot LC, Sanchez-Valle R, Graff C, Benussi L, Ghidoni R, Pijnenburg YA, Borroni B, Galimberti D, Laforce RJ, Masellis M, Vandenberghe R, Ber IL, Otto M, van Minkelen R, Papma JM, Rombouts SA, Balasa M, Öijerstedt L, Jelic V, Dick KM, Cash DM, Harding SR, Jorge Cardoso M, Ourselin S, Rossor MN, Padovani A, Scarpini E, Fenoglio C, Tartaglia MC, Lamari F, Barro C, Kuhle J, Rohrer JD, Teunissen CE, van Swieten JC. Neurofilament light chain: a biomarker for genetic frontotemporal dementia. Ann Clin Transl Neurol 2016; 3:623-36. [PMID: 27606344 PMCID: PMC4999594 DOI: 10.1002/acn3.325] [Citation(s) in RCA: 200] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 05/23/2016] [Accepted: 05/25/2016] [Indexed: 12/12/2022] Open
Abstract
Objective To evaluate cerebrospinal fluid (CSF) and serum neurofilament light chain (NfL) levels in genetic frontotemporal dementia (FTD) as a potential biomarker in the presymptomatic stage and during the conversion into the symptomatic stage. Additionally, to correlate NfL levels to clinical and neuroimaging parameters. Methods In this multicenter case–control study, we investigated CSF NfL in 174 subjects (48 controls, 40 presymptomatic carriers and 86 patients with microtubule‐associated protein tau (MAPT), progranulin (GRN), and chromosome 9 open reading frame 72 (C9orf72) mutations), and serum NfL in 118 subjects (39 controls, 44 presymptomatic carriers, 35 patients). In 55 subjects both CSF and serum was determined. In two subjects CSF was available before and after symptom onset (converters). Additionally, NfL levels were correlated with clinical parameters, survival, and regional brain atrophy. Results CSF NfL levels in patients (median 6762 pg/mL, interquartile range 3186–9309 pg/mL) were strongly elevated compared with presymptomatic carriers (804 pg/mL, 627–1173 pg/mL, P < 0.001), resulting in a good diagnostic performance to discriminate both groups. Serum NfL correlated highly with CSF NfL (rs= 0.87, P < 0.001) and was similarly elevated in patients. Longitudinal samples in the converters showed a three‐ to fourfold increase in CSF NfL after disease onset. Additionally, NfL levels in patients correlated with disease severity, brain atrophy, annualized brain atrophy rate and survival. Interpretation NfL in both serum and CSF has the potential to serve as a biomarker for clinical disease onset and has a prognostic value in genetic FTD.
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Affiliation(s)
- Lieke H Meeter
- Alzheimer Center Rotterdam and Department of Neurology Erasmus Medical Center PO Box 2040, 3000 CA Rotterdam The Netherlands
| | - Elise G Dopper
- Alzheimer Center Rotterdam and Department of Neurology Erasmus Medical Center PO Box 2040, 3000 CA Rotterdam The Netherlands
| | - Lize C Jiskoot
- Alzheimer Center Rotterdam and Department of Neurology Erasmus Medical Center PO Box 2040, 3000 CA Rotterdam The Netherlands
| | - Raquel Sanchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit Department of Neurology Hospital Clínic Institut d'Investigació Biomèdica August Pi i Sunyer Villarroel, 170 Barcelona 08036 Spain
| | - Caroline Graff
- Division of Neurogeriatrics Department NVS, Karolinska Institutet Center for Alzheimer Research Huddinge 141 57 Sweden; Department of Geriatric Medicine Karolinska University Hospital- Huddinge Stockholm 141 86 Sweden
| | - Luisa Benussi
- Molecular Markers Laboratory IRCCS Centro San Giovanni di Dio Fatebenefratelli via Pilastroni 4 Brescia 25125 Italy
| | - Roberta Ghidoni
- Molecular Markers Laboratory IRCCS Centro San Giovanni di Dio Fatebenefratelli via Pilastroni 4 Brescia 25125 Italy
| | - Yolande A Pijnenburg
- Alzheimer Center and Department of Neurology Neuroscience Campus Amsterdam VU University Medical Center PO Box 7057, 1007 MB Amsterdam The Netherlands
| | - Barbara Borroni
- Neurology Unit Department of Clinical and Experimental Sciences Centre for Neurodegenerative Diseases University of Brescia Brescia Italy
| | - Daniela Galimberti
- University of Milan Fondazione Ca' Granda IRCSS Ospedale Policlinico Milan Italy
| | - Robert Jr Laforce
- Département des Sciences Neurologiques Clinique Interdisciplinaire de Mémoire (CIME) CHU de Québec Université Laval Québec Canada
| | - Mario Masellis
- Division of Neurology Department of Medicine Sunnybrook Health Sciences Centre University of Toronto Toronto Canada; Hurvitz Brain Sciences Research Program Sunnybrook Research Institute Toronto Canada
| | - Rik Vandenberghe
- Neurology University Hospitals Leuven Herestraat 49 Leuven Belgium; Laboratory for Cognitive Neurology Department of Neurosciences KU Leuven Leuven Belgium
| | - Isabelle Le Ber
- Institut du Cerveau et de la Moelle épinière (ICM) Inserm U1127 CNRS UMR 7225 Sorbonne Universités Université Pierre et Marie Curie Univ Paris 06U PMC-P6 UMR S 1127 - Hôpital Pitié-Salpêtrière Paris France; Centre de Référence des Démences Rares AP-HP Hôpital de la Pitié-Salpêtrière Paris France; Département des maladies du système nerveux AP-HP Hôpital de la Pitié-Salpêtrière Paris France
| | - Markus Otto
- Department of Neurology Ulm University Ulm Germany; German FTLD consortium Department of Neurology University of Ulm Ulm Germany
| | - Rick van Minkelen
- Department of Clinical Genetics Erasmus Medical Center PO Box 2040, 3000 CA Rotterdam The Netherlands
| | - Janne M Papma
- Alzheimer Center Rotterdam and Department of Neurology Erasmus Medical Center PO Box 2040, 3000 CA Rotterdam The Netherlands
| | - Serge A Rombouts
- Institute of Psychology Leiden University Leiden The Netherlands; Department of Radiology Leiden University Medical Center Leiden The Netherlands
| | - Mircea Balasa
- Alzheimer's Disease and Other Cognitive Disorders Unit Department of Neurology Hospital Clínic Institut d'Investigació Biomèdica August Pi i Sunyer Villarroel, 170 Barcelona 08036 Spain
| | - Linn Öijerstedt
- Division of Neurogeriatrics Department NVS, Karolinska Institutet Center for Alzheimer Research Huddinge 141 57 Sweden; Department of Geriatric Medicine Karolinska University Hospital- Huddinge Stockholm 141 86 Sweden
| | - Vesna Jelic
- Department of Geriatric Medicine Karolinska University Hospital- Huddinge Stockholm 141 86 Sweden; Division of clinical geriatrics Deptartment NVS Karolinska Institutet Center for Alzheimer Research Huddinge 141 57 Sweden
| | - Katrina M Dick
- Dementia Research Centre Department of Neurodegenerative Disease Institute of Neurology University College London WC1N 3BG London United Kingdom
| | - David M Cash
- Division of clinical geriatrics Department NVS Karolinska Institutet Center for Alzheimer Research Huddinge 141 57 Sweden; Translational Imaging Group Centre for Medical Image Computing University College London NW1 2HE London United Kingdom
| | - Sophie R Harding
- Dementia Research Centre Department of Neurodegenerative Disease Institute of Neurology University College London WC1N 3BG London United Kingdom
| | - M Jorge Cardoso
- Dementia Research Centre Department of Neurodegenerative Disesase Institute of Neurology University College London WC1N 3BG London United Kingdom; Translational Imaging Group Centre for Medical Image Computing University College London NW1 2HE London United Kingdom
| | - Sebastien Ourselin
- Translational Imaging Group Centre for Medical Image Computing University College London NW1 2HE London United Kingdom
| | - Martin N Rossor
- Dementia Research Centre Department of Neurodegenerative Disease Institute of Neurology University College London WC1N 3BG London United Kingdom
| | - Alessandro Padovani
- Neurology Unit Department of Clinical and Experimental Sciences Centre for Neurodegenerative Diseases University of Brescia Brescia Italy
| | - Elio Scarpini
- University of Milan Fondazione Ca' Granda IRCSS Ospedale Policlinico Milan Italy
| | - Chiara Fenoglio
- University of Milan Fondazione Ca' Granda IRCSS Ospedale Policlinico Milan Italy
| | - Maria C Tartaglia
- Laboratoire de Biochimie AP-HP Hopital Pitié-Salpétrière Paris France
| | - Foudil Lamari
- Tanz Center for Research in Neurodegenerative Diseases University of Toronoto Toronoto Canada
| | - Christian Barro
- Neurology Departments of Medicine Biomedicine and Clinical Research University Hospital Basel Basel Switzerland
| | - Jens Kuhle
- Neurology Departments of Medicine Biomedicine and Clinical Research University Hospital Basel Basel Switzerland
| | - Jonathan D Rohrer
- Dementia Research Centre Department of Neurodegenerative Disease Institute of Neurology University College London WC1N 3BG London United Kingdom
| | - Charlotte E Teunissen
- Neurochemistry Lab and Biobank Department of Clinical Chemistry Neuroscience Campus VU University Medical Center PO Box 7057, 1007 MB Amsterdam The Netherlands
| | - John C van Swieten
- Alzheimer Center Rotterdam and Department of Neurology Erasmus Medical Center PO Box 2040, 3000 CA Rotterdam The Netherlands; Department of Clinical Genetics VU University Medical Center PO Box 7057, 1007 MB Amsterdam The Netherlands
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Oeckl P, Jardel C, Salachas F, Lamari F, Andersen PM, Bowser R, de Carvalho M, Costa J, van Damme P, Gray E, Grosskreutz J, Hernández-Barral M, Herukka SK, Huss A, Jeromin A, Kirby J, Kuzma-Kozakiewicz M, Amador MDM, Mora JS, Morelli C, Muckova P, Petri S, Poesen K, Rhode H, Rikardsson AK, Robberecht W, Rodríguez Mahillo AI, Shaw P, Silani V, Steinacker P, Turner MR, Tüzün E, Yetimler B, Ludolph AC, Otto M. Multicenter validation of CSF neurofilaments as diagnostic biomarkers for ALS. Amyotroph Lateral Scler Frontotemporal Degener 2016; 17:404-13. [DOI: 10.3109/21678421.2016.1167913] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Patrick Oeckl
- Department of Neurology, Ulm University Hospital, 89081 Ulm, Germany
| | - Claude Jardel
- Department of Metabolic Biochemistry, Hôpitaux universitaires Pitié Salpétrière-Charles Foix, 75651 Paris, France,
| | - François Salachas
- Paris ALS Reference Center, Neurological Diseases Department, Hôpitaux universitaires La Pitié Salpêtrière-Charles Foix, 75651 Paris, France,
| | - Foudil Lamari
- Department of Metabolic Biochemistry, Hôpitaux universitaires Pitié Salpétrière-Charles Foix, 75651 Paris, France,
| | | | - Robert Bowser
- Iron Horse Diagnostics, Inc., 85255 Scottsdale, Arizona, USA,
- Divisions of Neurology and Neurobiology, Barrow Neurological Institute, 85013 Phoenix, Arizona, USA,
| | - Mamede de Carvalho
- Faculty of Medicine - Instituto de Medicina Molecular, University of Lisbon, 1649-028 Lisbon, Portugal,
| | - Júlia Costa
- Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, 2780-157 Oeiras, Portugal,
| | - Philip van Damme
- University Hospitals Leuven, Department of Neurology, 3000 Leuven, Belgium,
- KU Leuven - University of Leuven, Department of Neurosciences, VIB - Vesalius Research Center, Experimental Neurology - Laboratory of Neurobiology, Leuven, Belgium,
| | - Elizabeth Gray
- Nuffield Department of Clinical Neurosciences, University of Oxford, OX3 9DU Oxford, UK,
| | | | | | - Sanna-Kaisa Herukka
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, 70211 Kuopio, Finland,
| | - André Huss
- Department of Neurology, Ulm University Hospital, 89081 Ulm, Germany
| | - Andreas Jeromin
- Iron Horse Diagnostics, Inc., 85255 Scottsdale, Arizona, USA,
| | - Janine Kirby
- Department of Neuroscience, Sheffield Institute for Translational Neuroscience, University of Sheffield, S10 2HQ Sheffield, UK,
| | | | - Maria del Mar Amador
- Paris ALS Reference Center, Neurological Diseases Department, Hôpitaux universitaires La Pitié Salpêtrière-Charles Foix, 75651 Paris, France,
| | - Jesús S. Mora
- ALS Unit, Hospital Carlos III, Madrid, 28029 Madrid, Spain,
| | - Claudia Morelli
- IRCCS Istituto Auxologico Italiano, Department of Neurology and Laboratory of Neuroscience, 20149 Milano, Italy,
| | - Petra Muckova
- Institute of Biochemistry I, Jena University Hospital, 07743 Jena, Germany,
| | - Susanne Petri
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany,
| | - Koen Poesen
- Laboratory of molecular neurobiomarker research, University of Leuven and Laboratory Medicine, University Hospitals of Leuven, 3000 Leuven, Belgium,
| | - Heidrun Rhode
- Institute of Biochemistry I, Jena University Hospital, 07743 Jena, Germany,
| | | | - Wim Robberecht
- KU Leuven - University of Leuven, Department of Neurosciences, VIB - Vesalius Research Center, Experimental Neurology - Laboratory of Neurobiology, Leuven, Belgium,
| | | | - Pamela Shaw
- Department of Neuroscience, Sheffield Institute for Translational Neuroscience, University of Sheffield, S10 2HQ Sheffield, UK,
| | - Vincenzo Silani
- IRCCS Istituto Auxologico Italiano, Department of Neurology and Laboratory of Neuroscience, 20149 Milano, Italy,
- Department “Dino Ferrari” Center, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milano, Italy
| | - Petra Steinacker
- Department of Neurology, Ulm University Hospital, 89081 Ulm, Germany
| | - Martin R. Turner
- Nuffield Department of Clinical Neurosciences, University of Oxford, OX3 9DU Oxford, UK,
| | - Erdem Tüzün
- Neuroscience Department, Institute of Experimental Medical Research, Istanbul University, 34393 Istanbul, Turkey, and
| | - Berrak Yetimler
- Neuroscience Department, Institute of Experimental Medical Research, Istanbul University, 34393 Istanbul, Turkey, and
| | - Albert C. Ludolph
- Department of Neurology, Ulm University Hospital, 89081 Ulm, Germany
| | - Markus Otto
- Department of Neurology, Ulm University Hospital, 89081 Ulm, Germany
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Van Dalen YW, Blokhuis C, Cohen S, Ter Stege JA, Teunissen CE, Kuhle J, Kootstra NA, Scherpbier HJ, Kuijpers TW, Reiss P, Majoie CBLM, Caan MWA, Pajkrt D. Neurometabolite Alterations Associated With Cognitive Performance in Perinatally HIV-Infected Children. Medicine (Baltimore) 2016; 95:e3093. [PMID: 27015179 PMCID: PMC4998374 DOI: 10.1097/md.0000000000003093] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Despite treatment with combination antiretroviral therapy (cART), cognitive impairment is still observed in perinatally HIV-infected children. We aimed to evaluate potential underlying cerebral injury by comparing neurometabolite levels between perinatally HIV-infected children and healthy controls. This cross-sectional study evaluated neurometabolites, as measured by Magnetic Resonance Spectroscopy (MRS), in perinatally HIV-infected children stable on cART (n = 26) and healthy controls (n = 36).Participants were included from a cohort of perinatally HIV-infected children and healthy controls, matched group-wise for age, gender, ethnicity, and socio-economic status. N-acetylaspartate (NAA), glutamate (Glu), myo-inositol (mI), and choline (Cho) levels were studied as ratios over creatine (Cre). Group differences and associations with HIV-related parameters, cognitive functioning, and neuronal damage markers (neurofilament and total Tau proteins) were determined using age-adjusted linear regression analyses.HIV-infected children had increased Cho:Cre in white matter (HIV-infected = 0.29 ± 0.03; controls = 0.27 ± 0.03; P value = 0.045). Lower nadir CD4+ T-cell Z-scores were associated with reduced neuronal integrity markers NAA:Cre and Glu:Cre. A Centers for Disease Control and Prevention (CDC) stage C diagnosis was associated with higher glial markers Cho:Cre and mI:Cre. Poorer cognitive performance was mainly associated with higher Cho:Cre in HIV-infected children, and with lower NAA:Cre and Glu:Cre in healthy controls. There were no associations between neurometabolites and neuronal damage markers in blood or CSF.Compared to controls, perinatally HIV-infected children had increased Cho:Cre in white matter, suggestive of ongoing glial proliferation. Levels of several neurometabolites were associated with cognitive performance, suggesting that MRS may be a useful method to assess cerebral changes potentially linked to cognitive outcomes.
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Affiliation(s)
- Yvonne W Van Dalen
- From the Department of Pediatric Hematology, Immunology and Infectious Diseases, (YWVD, CB, SC, JATS, HJS, TWK, DP); Psychosocial Department (JATS), Emma Children's Hospital/Academic Medical Center; Neurochemistry Laboratory and Biobank (CET), Department of Clinical Chemistry, VU University Medical Center and Neurocampus Amsterdam, the Netherlands; Neurology (JK), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, Basel, Switzerland; Department of Experimental Immunology (NAK); Department of Global Health and Amsterdam Institute of Global Health and Development (PR), Academic Medical Center; HIV Monitoring Foundation (PR); Department of Internal Medicine (PR), Division of Infectious Diseases, Center for Infection and Immunity Amsterdam (CINIMA); and Department of Radiology (CBLMM, MWAC), Academic Medical Center, Amsterdam, the Netherlands
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Abstract
Existing clinical outcomes of disease activity, including relapse rates, are inherently insensitive to the underlying pathological process in MS. Moreover, it is extremely difficult to measure clinical disability in patients, which is often a retrospective assessment, and definitely not within the time frame of a clinical trial. Biomarkers , conversely are more specific for a pathologic process and if used correctly can prove invaluable in the diagnosis, stratification and monitoring of disease activity, including any subclinical activity which is not visible to the naked eye. In this chapter, we discuss the development of neurofilaments as surrogate outcomes of disability in MS. The validation and qualification are vital steps in biomarker development and to gaining acceptance in scientific community, and the pitfalls leading up to this are also discussed.
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Pijnenburg YA, Verwey NA, van der Flier WM, Scheltens P, Teunissen CE. Discriminative and prognostic potential of cerebrospinal fluid phosphoTau/tau ratio and neurofilaments for frontotemporal dementia subtypes. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2015; 1:505-12. [PMID: 27239528 PMCID: PMC4879490 DOI: 10.1016/j.dadm.2015.11.001] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION A decreased cerebrospinal fluid (CSF) p-Tau181 to total tau ratio (p/t-tau) is a biomarker for frontotemporal lobar degeneration with TDP43 inclusions (FTLD-TDP) and for amyotrophic lateral sclerosis (ALS). CSF light chain neurofilaments (NfL) are increased in ALS. We examined whether CSF p/t-tau and NfL are related to ALS status in FTLD-TDP. METHODS We compared CSF p/t-tau and NfL levels between patients with FTLD-TDP with ALS (n = 15), FTLD-TDP without ALS (n = 17), FTLD-Tau (n = 6), Alzheimer's disease (AD; n = 25), and subjective memory complaints (SMC, n = 24). RESULTS Apart from FTLD-Tau, all groups differed significantly with increasing p/t-tau ratios from FTLD-TDP with ALS to FTLD-TDP without ALS to AD and SMC. CSF NfL was very high in FTLD-TDP with ALS followed by FTLD-TDP without ALS, AD, and SMC. Both biomarkers correlated with survival. DISCUSSION CSF p/t-tau ratio and NfL levels are strongly driven by ALS status. These markers, therefore, appear to be more of prognostic than diagnostic significance.
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Affiliation(s)
- Yolande A.L. Pijnenburg
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Nicolaas A. Verwey
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - Wiesje M. van der Flier
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Charlotte E. Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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Del Campo M, Jongbloed W, Twaalfhoven HAM, Veerhuis R, Blankenstein MA, Teunissen CE. Facilitating the Validation of Novel Protein Biomarkers for Dementia: An Optimal Workflow for the Development of Sandwich Immunoassays. Front Neurol 2015; 6:202. [PMID: 26483753 PMCID: PMC4586418 DOI: 10.3389/fneur.2015.00202] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 08/31/2015] [Indexed: 01/11/2023] Open
Abstract
Different neurodegenerative disorders, such as Alzheimer’s disease (AD) and frontotemporal dementia (FTD), lead to dementia syndromes. Dementia will pose a huge impact on society and thus it is essential to develop novel tools that are able to detect the earliest, most sensitive, discriminative, and dynamic biomarkers for each of the disorders. To date, the most common assays used in large-scale protein biomarker analysis are enzyme-linked immunosorbent assays (ELISA), such as the sandwich immunoassays, which are sensitive, practical, and easily implemented. However, due to the novelty of many candidate biomarkers identified during proteomics screening, such assays or the antibodies that specifically recognize the desired marker are often not available. The development and optimization of a new ELISA should be carried out with considerable caution since a poor planning can be costly, ineffective, time consuming, and it may lead to a misinterpretation of the findings. Previous guidelines described either the overall biomarker development in more general terms (i.e., the process from biomarker discovery to validation) or the specific steps of performing an ELISA procedure. However, a workflow describing and guiding the main issues in the development of a novel ELISA is missing. Here, we describe a specific and detailed workflow to develop and validate new ELISA for a successful and reliable validation of novel dementia biomarkers. The proposed workflow highlights the main issues in the development of an ELISA and covers several critical aspects, including production, screening, and selection of specific antibodies until optimal fine-tuning of the assay. Although these recommendations are designed to analyze novel biomarkers for dementia in cerebrospinal fluid, they are generally applicable for the development of immunoassays for biomarkers in other human body fluids or tissues. This workflow is designed to maximize the quality of the developed ELISA using a time- and cost-efficient strategy. This will facilitate the validation of the dementia biomarker candidates ultimately allowing accurate diagnostic conclusions.
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Affiliation(s)
- Marta Del Campo
- Neurochemistry Laboratory, VU University Medical Center , Amsterdam , Netherlands ; Department of Clinical Chemistry, VU University Medical Center , Amsterdam , Netherlands
| | - Wesley Jongbloed
- Department of Clinical Chemistry, VU University Medical Center , Amsterdam , Netherlands
| | - Harry A M Twaalfhoven
- Neurochemistry Laboratory, VU University Medical Center , Amsterdam , Netherlands ; Department of Clinical Chemistry, VU University Medical Center , Amsterdam , Netherlands
| | - Robert Veerhuis
- Neurochemistry Laboratory, VU University Medical Center , Amsterdam , Netherlands ; Department of Psychiatry, VU University Medical Center , Amsterdam , Netherlands
| | - Marinus A Blankenstein
- Department of Clinical Chemistry, VU University Medical Center , Amsterdam , Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, VU University Medical Center , Amsterdam , Netherlands ; Department of Clinical Chemistry, VU University Medical Center , Amsterdam , Netherlands
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Kruse N, Persson S, Alcolea D, Bahl JMC, Baldeiras I, Capello E, Chiasserini D, Bocchio Chiavetto L, Emersic A, Engelborghs S, Eren E, Fladby T, Frisoni G, García-Ayllón MS, Genc S, Gkatzima O, Heegaard NHH, Janeiro AM, Kováčech B, Kuiperij HB, Leitão MJ, Lleó A, Martins M, Matos M, Mollergard HM, Nobili F, Öhrfelt A, Parnetti L, de Oliveira CR, Rot U, Sáez-Valero J, Struyfs H, Tanassi JT, Taylor P, Tsolaki M, Vanmechelen E, Verbeek MM, Zilka N, Blennow K, Zetterberg H, Mollenhauer B. Validation of a quantitative cerebrospinal fluid alpha-synuclein assay in a European-wide interlaboratory study. Neurobiol Aging 2015; 36:2587-96. [PMID: 26093515 DOI: 10.1016/j.neurobiolaging.2015.05.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 03/17/2015] [Accepted: 05/10/2015] [Indexed: 11/30/2022]
Abstract
Decreased levels of alpha-synuclein (aSyn) in cerebrospinal fluid (CSF) in Parkinson's disease and related synucleinopathies have been reported, however, not consistently in all cross-sectional studies. To test the performance of one recently released human-specific enzyme-linked immunosorbent assay (ELISA) for the quantification of aSyn in CSF, we carried out a round robin trial with 18 participating laboratories trained in CSF ELISA analyses within the BIOMARKAPD project in the EU Joint Program - Neurodegenerative Disease Research. CSF samples (homogeneous aliquots from pools) and ELISA kits (one lot) were provided centrally and data reported back to one laboratory for data analysis. Our study showed that although factors such as preanalytical sample handling and lot-to-lot variability were minimized by our study design, we identified high variation in absolute values of CSF aSyn even when the same samples and same lots of assays were applied. We further demonstrate that although absolute concentrations differ between laboratories the quantitative results are comparable. With further standardization this assay may become an attractive tool for comparing aSyn measurements in diverse settings. Recommendations for further validation experiments and improvement of the interlaboratory results obtained are given.
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Affiliation(s)
- Niels Kruse
- Department of Neuropathology, University Medical Center, Göttingen, Germany.
| | - Staffan Persson
- Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Daniel Alcolea
- Department of Neurology, Institut Investigacions Biomediques, Hospital de Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red en enfermedades Neurodegenerativas-CIBERNED, Madrid, Spain
| | - Justyna M C Bahl
- Department of Autoimmunology & Biomarkers, Statens Serum Institut, Copenhagen S, Denmark
| | - Ines Baldeiras
- Neurochemistry Laboratory, Department of Neurology, Faculty of Medicine, CHUC-Centro Hospitalar e Universitário de Coimbra, CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Elisabetta Capello
- Department of Neuroscience (DINOGMI), Clinical Neurology Unit, Genoa, Italy
| | - Davide Chiasserini
- Centre for Memory Disturbances and Alzheimer's Centre-Laboratory of Clinical Neurochemistry, Department of Medicine, Section of Neurology, University of Perugia, Perugia, Italy
| | - Luisella Bocchio Chiavetto
- Neuropsychopharmacology Unit, IRCCS Cento S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; Faculty of Psychology, eCampus University, Novedrate (Como), Italy
| | - Andreja Emersic
- Department of Neurology, University Medical Centre, Ljubljana, Slovenia
| | - Sebastiaan Engelborghs
- Reference Centre for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Erden Eren
- Department of Neuroscience, Health Science Institute, Dokuz Eylül University, Izmir, Turkey
| | - Tormod Fladby
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Giovanni Frisoni
- Laboratory of Alzheimer´s Neuroimaging and Epidemiology, IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; Departments of Psychiatry and Internal Medicine, University Hospitals and University of Geneva, Geneva, Switzerland
| | - María-Salud García-Ayllón
- Centro de Investigación Biomédica en Red en enfermedades Neurodegenerativas-CIBERNED, Madrid, Spain; Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-CSIC, Sant Joan d´Alcant, Spain
| | - Sermin Genc
- Department of Neuroscience, Health Science Institute, Dokuz Eylül University, Izmir, Turkey
| | - Olymbia Gkatzima
- 3rd Neurology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Niels H H Heegaard
- Department of Autoimmunology & Biomarkers, Statens Serum Institut, Copenhagen S, Denmark; Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense C, Denmark
| | - André M Janeiro
- Genomed, Diagnósticos de Medicina Molecular, Instituto de Medicina Molecular, Edificio Egas Moniz, Lisbon, Portugal
| | - Branislav Kováčech
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - H Bea Kuiperij
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands; Department of Laboratory Medicine, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Maria J Leitão
- Neurochemistry Laboratory, Department of Neurology, Faculty of Medicine, CHUC-Centro Hospitalar e Universitário de Coimbra, CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Alberto Lleó
- Department of Neurology, Institut Investigacions Biomediques, Hospital de Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red en enfermedades Neurodegenerativas-CIBERNED, Madrid, Spain
| | - Madalena Martins
- Instituto de Medicina Molecular, Edificio Egas Moniz, Lisbon, Portugal; Instituto Gulbenkian de Ciência, Oeiras, Portugal
| | - Mafalda Matos
- Instituto de Medicina Molecular, Edificio Egas Moniz, Lisbon, Portugal
| | - Hanne M Mollergard
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Flavio Nobili
- Department of Neuroscience (DINOGMI), Clinical Neurology Unit, Genoa, Italy
| | - Annika Öhrfelt
- Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Lucilla Parnetti
- Centre for Memory Disturbances and Alzheimer's Centre-Laboratory of Clinical Neurochemistry, Department of Medicine, Section of Neurology, University of Perugia, Perugia, Italy
| | - Catarina Resende de Oliveira
- Neurochemistry Laboratory, Department of Neurology, Faculty of Medicine, CHUC-Centro Hospitalar e Universitário de Coimbra, CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Uros Rot
- Department of Neurology, University Medical Centre, Ljubljana, Slovenia
| | - Javier Sáez-Valero
- Centro de Investigación Biomédica en Red en enfermedades Neurodegenerativas-CIBERNED, Madrid, Spain; Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-CSIC, Sant Joan d´Alcant, Spain
| | - Hanne Struyfs
- Reference Centre for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Julia T Tanassi
- Department of Autoimmunology & Biomarkers, Statens Serum Institut, Copenhagen S, Denmark
| | | | - Magda Tsolaki
- 3rd Neurology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Marcel M Verbeek
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands; Department of Laboratory Medicine, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Norbert Zilka
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden; Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Brit Mollenhauer
- Department of Neuropathology, University Medical Center, Göttingen, Germany; Paracelsus-Elena-Klinik, Kassel, Germany; Department of Neurosurgery, University Medical Center, Göttingen, Germany
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Biobanking of Cerebrospinal Fluid for Biomarker Analysis in Neurological Diseases. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 864:79-93. [PMID: 26420615 DOI: 10.1007/978-3-319-20579-3_7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Cerebrospinal fluid (CSF) reflects pathophysiological aspects of neurological diseases, where neuroprotective strategies and biomarkers are urgently needed. Therefore, biobanking is very relevant for biomarker discovery and evaluation for these neurological diseases.An important aspect of CSF biobanking is quality control, needed for e.g. consistent patient follow-up and the exchange of patient samples between research centers. Systematic studies to address effects of pre-analytical and storage variation on a broad range of CSF proteins are needed and initiated.Important features of CSF biobanking are intensive collaboration in international networks and the tight application of standardized protocols. The current adoption of standardized protocols for CSF and blood collection and for biobanking of these samples, as presented in this chapter, enables biomarker studies in large cohorts of patients and controls.In conclusion, biomarker research in neurodegenerative diseases has entered a new era due to the collaborative and multicenter efforts of many groups. The streamlining of biobanking procedures, including sample collection, quality control, and the selection of optimal control groups for investigating biomarkers is an important improvement to perform high quality biomarker studies.
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Abstract
Multiple sclerosis (MS) is an autoimmune disease of unknown cause, in which chronic inflammation drives multifocal demyelination of axons in both white and gray matter in the CNS. The pathological course of the disease is heterogeneous and involves an early, predominantly inflammatory demyelinating disease phase of relapsing-remitting MS (RRMS), which, over a variable period of time, evolves into a progressively degenerative stage associated with axonal loss and scar formation, causing physical and cognitive disability. For patients with RRMS, there is a growing arsenal of disease-modifying agents (DMAs), with varying degrees of efficacy, as defined by reduced relapse rates, improved magnetic resonance imaging outcomes, and preservation of neurological function. Establishment of personalized treatment plans remains one of the biggest challenges in therapeutic decision-making in MS because the disease prognosis and individual therapeutic outcomes are extremely difficult to predict. Current research is aimed at discovery and validation of biomarkers that reliably measure disease progression and effective therapeutic intervention. Individual biomarker candidates with evident clinical utility are highlighted in this review and include neutralizing autoantibodies against DMAs, fetuin-A, osteopontin, isoprostanes, chemokine (C-X-C motif) ligand 13 (CXCL13), neurofilament light and heavy, and chitinase 3-like protein. In addition, application of more advanced screening technologies has opened up new categories of biomarkers that move beyond detection of individual soluble proteins, including gene expression and autoantibody arrays, microRNAs, and circulating microvesicles/exosomes. Development of clinically useful biomarkers in MS will not only shape the practice of personalized medicine but will also serve as surrogate markers to enable investigation of innovative treatments within clinical trials that are less costly, are of shorter duration, and have more certainty of outcomes.
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Affiliation(s)
- Violaine K. Harris
- Tisch Multiple Sclerosis Research Center of New York, 521 West 57th Street, New York, NY 10019 USA
| | - Saud A. Sadiq
- Tisch Multiple Sclerosis Research Center of New York, 521 West 57th Street, New York, NY 10019 USA
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Trentini A, Comabella M, Tintoré M, Koel-Simmelink MJA, Killestein J, Roos B, Rovira A, Korth C, Ottis P, Blankenstein MA, Montalban X, Bellini T, Teunissen CE. N-Acetylaspartate and neurofilaments as biomarkers of axonal damage in patients with progressive forms of multiple sclerosis. J Neurol 2014; 261:2338-43. [DOI: 10.1007/s00415-014-7507-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 09/10/2014] [Accepted: 09/12/2014] [Indexed: 10/24/2022]
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49
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Fiandaca MS, Mapstone ME, Cheema AK, Federoff HJ. The critical need for defining preclinical biomarkers in Alzheimer's disease. Alzheimers Dement 2014; 10:S196-212. [DOI: 10.1016/j.jalz.2014.04.015] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Massimo S. Fiandaca
- Department of NeurologyGeorgetown University Medical CenterWashingtonDCUSA
- Department of NeuroscienceGeorgetown University Medical CenterWashingtonDCUSA
| | - Mark E. Mapstone
- Department of NeurologyUniversity of Rochester School of MedicineRochesterNYUSA
| | - Amrita K. Cheema
- Department of OncologyGeorgetown University Medical CenterWashingtonDCUSA
- Department of BiochemistryGeorgetown University Medical CenterWashingtonDCUSA
| | - Howard J. Federoff
- Department of NeurologyGeorgetown University Medical CenterWashingtonDCUSA
- Department of NeuroscienceGeorgetown University Medical CenterWashingtonDCUSA
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