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Zou Y, Yu S, Ma X, Ma C, Mao C, Mu D, Li L, Gao J, Qiu L. How far is the goal of applying β-amyloid in cerebrospinal fluid for clinical diagnosis of Alzheimer's disease with standardization of measurements? Clin Biochem 2023; 112:33-42. [PMID: 36473516 DOI: 10.1016/j.clinbiochem.2022.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 11/02/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
Cerebrospinal fluid (CSF) β-amyloid (Aβ) is important for early diagnosis of Alzheimer's disease (AD). However, the cohort distributions and cut-off values have large variation across different analytical assays, kits, and laboratories. In this review, we summarize the cut-off values and diagnostic performance for CSF Aβ1-42 and Aβ1-42/Aβ1-40, and explore the important effect factors. Based on the Alzheimer's Association external quality control program (AAQC program), the peer group coefficient of variation of manual ELISA assays for CSF Aβ1-42 was unsatisfied (>20%). Fully automated platforms with better performance have recently been developed, but still not widely applied. In 2020, the certified reference material (CRM) for CSF Aβ1-42 was launched; however, the AAQC 2021-round results did not show effective improvements. Thus, further development and popularization of CRM for CSF Aβ1-42 and Aβ1-40 are urgently required. Standardizing the diagnostic procedures of AD and related status and the pre-analytical protocols of CSF samples, improving detection performance of analytical assays, and popularizing the application of fully automated platforms are also important for the establishment of uniform cut-off values. Moreover, each laboratory should verify the applicability of uniform cut-off values, and evaluate whether it is necessary to establish its own population- and assay-specific cut-off values.
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Affiliation(s)
- Yutong Zou
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China
| | - Songlin Yu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China
| | - Xiaoli Ma
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China; Medical Science Research Center, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China
| | - Chaochao Ma
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China
| | - Chenhui Mao
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Danni Mu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China
| | - Lei Li
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China
| | - Jing Gao
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China.
| | - Ling Qiu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China.
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A Systematic Review and Meta-Analysis of Cerebrospinal Fluid Amyloid and Tau Levels Identifies Mild Cognitive Impairment Patients Progressing to Alzheimer's Disease. Biomedicines 2022; 10:biomedicines10071713. [PMID: 35885018 PMCID: PMC9313367 DOI: 10.3390/biomedicines10071713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 11/17/2022] Open
Abstract
Reported levels of amyloid-beta and tau in human cerebrospinal fluid (CSF) were evaluated to discover if these biochemical markers can predict the transition from Mild Cognitive Impairment (MCI) to Alzheimer’s disease (AD). A systematic review of the literature in PubMed and Web of Science (April 2021) was performed by a single researcher to identify studies reporting immunologically-based (xMAP or ELISA) measures of CSF analytes Aβ(1-42) and/or P-tau and/or T-tau in clinical studies with at least two timepoints and a statement of diagnostic criteria. Of 1137 screened publications, 22 met the inclusion criteria for CSF Aβ(1-42) measures, 20 studies included T-tau, and 17 included P-tau. Six meta-analyses were conducted to compare the analytes for healthy controls (HC) versus progressive MCI (MCI_AD) and for non-progressive MCI (Stable_MCI) versus MCI_AD; effect sizes were determined using random effects models. The heterogeneity of effect sizes across studies was confirmed with very high significance (p < 0.0001) for all meta-analyses except HC versus MCI_AD T-tau (p < 0.05) and P-tau (non-significant). Standard mean difference (SMD) was highly significant (p < 0.0001) for all comparisons (Stable_MCI versus MCI_AD: SMD [95%-CI] Aβ(1-42) = 1.19 [0.96,1.42]; T-tau = −1.03 [−1.24,−0.82]; P-tau = −1.03 [−1.47,−0.59]; HC versus MCI_AD: SMD Aβ(1-42) = 1.73 [1.39,2.07]; T-tau = −1.13 [−1.33,−0.93]; P-tau = −1.10 [−1.23,−0.96]). The follow-up interval in longitudinal evaluations was a critical factor in clinical study design, and the Aβ(1−42)/P-tau ratio most robustly differentiated progressive from non-progressive MCI. The value of amyloid-beta and tau as markers of patient outcome are supported by these findings.
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Ma Y, Norton DL, Van Hulle CA, Chappell RJ, Lazar KK, Jonaitis EM, Koscik RL, Clark LR, Krause R, Andreasson U, Chin NA, Bendlin BB, Asthana S, Okonkwo OC, Gleason CE, Johnson SC, Zetterberg H, Blennow K, Carlsson CM. Measurement batch differences and between-batch conversion of Alzheimer's disease cerebrospinal fluid biomarker values. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12194. [PMID: 34084888 PMCID: PMC8144935 DOI: 10.1002/dad2.12194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 04/06/2021] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Batch differences in cerebrospinal fluid (CSF) biomarker measurement can introduce bias into analyses for Alzheimer's disease studies. We evaluated and adjusted for batch differences using statistical methods. METHODS A total of 792 CSF samples from 528 participants were assayed in three batches for 12 biomarkers and 3 biomarker ratios. Batch differences were assessed using Bland-Altman plot, paired t test, Pitman-Morgan test, and linear regression. Generalized linear models were applied to convert CSF values between batches. RESULTS We found statistically significant batch differences for all biomarkers and ratios, except that neurofilament light was comparable between batches 1 and 2. The conversion models generally had high R 2 except for converting P-tau between batches 1 and 3. DISCUSSION Between-batch conversion allows harmonized CSF values to be used in the same analysis. Such method may be applied to adjust for other sources of variability in measuring CSF or other types of biomarkers.
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Lim HJ, Park JE, Kim BC, Choi SM, Song MK, Cho SH, Seo HJ, Kim J, Song HC, Choi KY, Lee JJ, Kim HW, Ha JM, Song WK, Park SG, Lee JS, Lee KH. Comparison of Two Analytical Platforms in Cerebrospinal Fluid Biomarkers for the Classification of Alzheimer's Disease Spectrum with Amyloid PET Imaging. J Alzheimers Dis 2021; 75:949-958. [PMID: 32390627 DOI: 10.3233/jad-191331] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Cerebrospinal fluid (CSF) amyloid-β1-42 (Aβ1-42), total tau protein (t-Tau), and phosphorylated Tau (p-Tau) are ATN biomarkers for Alzheimer's disease (AD) and reflect pathogenic changes in the brain. CSF biomarkers of AD are considered for inclusion in the diagnostic criteria for research and clinical purposes to reduce the uncertainty of clinical diagnosis and to distinguish among AD stages. OBJECTIVE This study aims to compare two commercially available analytical platforms with respect to accuracy and the potential for early diagnosis of AD. METHODS A total of 211 CSF samples from healthy control (HC) and AD subjects were analyzed using two analytical platforms, INNOTEST ELISA and INNOBIA AlzBio3 xMAP kits. The accuracy of diagnosis and AUC values distinguishing study groups were compared between the two analytical platforms. RESULTS The absolute values for Aβ1-42, t-Tau, and p-Tau181 levels differed between the two platforms. The Aβ1-42 levels decreased, while t-Tau and p-Tau levels increased according to the AD stages. The AUC of Aβ1-42 and t-Tau, which distinguish the early stages of AD (preclinical and prodromal AD), were similar between the two platforms, whereas there were significant differences in p-Tau AUC values. CSF p-Tau using the INNOBIA was highly accurate for distinguishing both preclinical AD (AUC = 0.826, cut-off score≥38.89) and prodromal AD (AUC = 0.862, cut-off score≥41.88) from HC. CONCLUSION The accuracy of CSF p-Tau levels in the preclinical and prodromal AD is higher for the INNOBIA than the INNOTEST, and the early stage AD can be accurately distinguished from HC.
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Affiliation(s)
- Ho Jae Lim
- Department of Biomedical Science, Chosun University, Gwangju, Republic of Korea
| | - Jung Eun Park
- Department of Biomedical Science, Chosun University, Gwangju, Republic of Korea.,BK21-plus Research Team for Bioactive Control Technology, Chosun University, Gwangju, Republic of Korea
| | - Byeong C Kim
- Department of Neurology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Seong-Min Choi
- Department of Neurology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Min-Kyung Song
- Department of Neurology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Soo Hyun Cho
- Department of Neurology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Hyeon Jeong Seo
- Department of Neurology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Jahae Kim
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Ho-Chun Song
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Kyu Yeong Choi
- Gwangju Alzheimer's Disease and Related Dementias Cohort Center, Chosun University, Gwangju, Republic of Korea
| | - Jang Jae Lee
- Gwangju Alzheimer's Disease and Related Dementias Cohort Center, Chosun University, Gwangju, Republic of Korea
| | - Hoo-Won Kim
- Department of Neurology, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Jung-Min Ha
- Department of Nuclear Medicine, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Woo Keun Song
- Department of Life Science, Bioimaging and Cell Dynamics Research Center, Gwangju Institute of Science and Technology, Gwangju, Republic of Korea
| | - Sung-Gyoo Park
- Department of Life Science, Bioimaging and Cell Dynamics Research Center, Gwangju Institute of Science and Technology, Gwangju, Republic of Korea
| | - Jung Sup Lee
- Department of Biomedical Science, Chosun University, Gwangju, Republic of Korea.,BK21-plus Research Team for Bioactive Control Technology, Chosun University, Gwangju, Republic of Korea
| | - Kun Ho Lee
- Department of Biomedical Science, Chosun University, Gwangju, Republic of Korea.,Gwangju Alzheimer's Disease and Related Dementias Cohort Center, Chosun University, Gwangju, Republic of Korea.,Department of Neural Development and Disease, Korea Brain Research Institute, Daegu, Republic of Korea
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Significance of Blood and Cerebrospinal Fluid Biomarkers for Alzheimer's Disease: Sensitivity, Specificity and Potential for Clinical Use. J Pers Med 2020; 10:jpm10030116. [PMID: 32911755 PMCID: PMC7565390 DOI: 10.3390/jpm10030116] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 08/21/2020] [Accepted: 09/01/2020] [Indexed: 12/16/2022] Open
Abstract
Alzheimer's disease (AD) is the most common type of dementia, affecting more than 5 million Americans, with steadily increasing mortality and incredible socio-economic burden. Not only have therapeutic efforts so far failed to reach significant efficacy, but the real pathogenesis of the disease is still obscure. The current theories are based on pathological findings of amyloid plaques and tau neurofibrillary tangles that accumulate in the brain parenchyma of affected patients. These findings have defined, together with the extensive neurodegeneration, the diagnostic criteria of the disease. The ability to detect changes in the levels of amyloid and tau in cerebrospinal fluid (CSF) first, and more recently in blood, has allowed us to use these biomarkers for the specific in-vivo diagnosis of AD in humans. Furthermore, other pathological elements of AD, such as the loss of neurons, inflammation and metabolic derangement, have translated to the definition of other CSF and blood biomarkers, which are not specific of the disease but, when combined with amyloid and tau, correlate with the progression from mild cognitive impairment to AD dementia, or identify patients who will develop AD pathology. In this review, we discuss the role of current and hypothetical biomarkers of Alzheimer's disease, their specificity, and the caveats of current high-sensitivity platforms for their peripheral detection.
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Novel ELISAs to measure total and phosphorylated tau in cerebrospinal fluid. Neurosci Lett 2020; 722:134826. [DOI: 10.1016/j.neulet.2020.134826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 11/21/2019] [Accepted: 02/05/2020] [Indexed: 11/23/2022]
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Cerebrospinal Fluid and Plasma Tau as a Biomarker for Brain Tauopathy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1184:393-405. [PMID: 32096052 DOI: 10.1007/978-981-32-9358-8_29] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Cerebrospinal fluid (CSF) tau and phosphorylated tau (ptau) are definite biomarkers of Alzheimer's disease (AD). After discovery of presence and increased levels tau in CSF from AD patients using specific ELISA, numerous reports revealed that CSF levels of tau are increased in AD and brain injury, phosphorylated tau are specifically increased in AD. Many large cohort studies also confirmed that natural course of CSF tau and ptau levels initiated from cognitively unimpaired AD stage after longstanding progress of brain Aß amyloidosis. Close correlation with neuroimaging findings of Tau PET and with deterioration of cognitive function domains have been elucidated. CSF tau also increase in neurodegeneration and acute brain injury. Global standardization, assay technology inventions, and research of tau kinetics from brain synthesis and clearance into CSF are developing. Trace amount of plasma p-tau assay are also validated. Development of these studies provide that CSF tau is the biomarker of CNS neurodegeneration and CSF ptau is the specific biomarker of CNS tauopathy. Assays of CSF and plasma tau and ptau are essential tools not only for prediction and diagnosis of AD and but for newly developing disease modified therapies of AD.
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Del Campo M, Galimberti D, Elias N, Boonkamp L, Pijnenburg YA, van Swieten JC, Watts K, Paciotti S, Beccari T, Hu W, Teunissen CE. Novel CSF biomarkers to discriminate FTLD and its pathological subtypes. Ann Clin Transl Neurol 2018; 5:1163-1175. [PMID: 30349851 PMCID: PMC6186934 DOI: 10.1002/acn3.629] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 06/19/2018] [Accepted: 07/05/2018] [Indexed: 12/12/2022] Open
Abstract
Objective Frontotemporal lobar degeneration (FTLD) is the second most prevalent dementia in young patients and is characterized by the presence of two main protein aggregates in the brain, tau (FTLD‐Tau) or TDP43 (FTLD‐TDP), which likely require distinct pharmacological therapy. However, specific diagnosis of FTLD and its subtypes remains challenging due to largely overlapping clinical phenotypes. Here, we aimed to assess the clinical performance of novel cerebrospinal fluid (CSF) biomarkers for discrimination of FTLD and its pathological subtypes. Methods YKL40, FABP4, MFG‐E8, and the activities of catalase and specific lysosomal enzymes were analyzed in patients with FTLD‐TDP (n = 30), FTLD‐Tau (n = 20), AD (n = 30), DLB (n = 29), and nondemented controls (n = 29) obtained from two different centers. Models were validated in an independent CSF cohort (n = 188). Results YKL40 and catalase activity were increased in FTLD‐TDP cases compared to controls. YKL40 levels were also higher in FTLD‐TDP compared to FTLD‐Tau. We identified biomarker models able to discriminate FTLD from nondemented controls (MFG‐E8, tTau, and Aβ42; 78% sensitivity and 83% specificity) and non‐FTLD dementia (YKL40, pTau, p/tTau ratio, and age; 90% sensitivity, 78% specificity), which were validated in an independent cohort. In addition, we identified a biomarker model differentiating FTLD‐TDP from FTLD‐Tau (YKL40, MFGE‐8, βHexA together with βHexA/tHex and p/tTau ratios and age) with 80% sensitivity and 82% specificity. Interpretation This study identifies CSF protein signatures distinguishing FTLD and the two main pathological subtypes with optimal accuracy (specificity/sensitivity > 80%). Validation of these models may allow appropriate selection of cases for clinical trials targeting the accumulation of Tau or TDP43, thereby increasing their efficiency and facilitating the development of successful therapies.
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Affiliation(s)
- Marta Del Campo
- Neurochemistry Laboratory and Biobank Department of Clinical Chemistry Neuroscience Campus Amsterdam VU University Medical Center Amsterdam The Netherlands
| | - Daniela Galimberti
- Department of Neurological Sciences, Pathophysiology and Transplantation "Dino Ferrari" Center University of Milan Fondazione Ca' Granda IRCCS Ospedale Policlinico Milan Italy
| | - Naura Elias
- Neurochemistry Laboratory and Biobank Department of Clinical Chemistry Neuroscience Campus Amsterdam VU University Medical Center Amsterdam The Netherlands
| | - Lynn Boonkamp
- Neurochemistry Laboratory and Biobank Department of Clinical Chemistry Neuroscience Campus Amsterdam VU University Medical Center Amsterdam The Netherlands
| | - Yolande A Pijnenburg
- Alzheimer Centre and Department of Neurology Neuroscience Campus Amsterdam VU University Medical Centre Amsterdam The Netherlands
| | - John C van Swieten
- Alzheimer Centre and Department of Neurology Neuroscience Campus Amsterdam VU University Medical Centre Amsterdam The Netherlands.,Department of Neurology Erasmus Medical Center Rotterdam The Netherlands
| | - Kelly Watts
- Department of Neurology Center for Neurodegenerative Diseases Research Alzheimer's Disease Research Center Emory University School of Medicine Atlanta Georgia
| | - Silvia Paciotti
- Department of Pharmaceutical Sciences University of Perugia Perugia Italy
| | - Tommaso Beccari
- Department of Pharmaceutical Sciences University of Perugia Perugia Italy
| | - William Hu
- Department of Neurology Center for Neurodegenerative Diseases Research Alzheimer's Disease Research Center Emory University School of Medicine Atlanta Georgia
| | - 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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Wei TY, Fu Y, Chang KH, Lin KJ, Lu YJ, Cheng CM. Point-of-Care Devices Using Disease Biomarkers To Diagnose Neurodegenerative Disorders. Trends Biotechnol 2017; 36:290-303. [PMID: 29242004 DOI: 10.1016/j.tibtech.2017.11.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 11/16/2017] [Accepted: 11/17/2017] [Indexed: 12/16/2022]
Abstract
Neurodegenerative disorders such as Alzheimer's, Parkinson's, and Huntington's diseases are highly prevalent and immensely destructive to the health and well-being of individuals and their families across the globe. Neurodegenerative diseases are characterized by the gradual loss of neural tissue in the central nervous system. Clearly, early diagnosis of the onset of neurodegeneration is vital and beneficial. Current diagnostic methods rely heavily on symptoms or autopsy results, thus overlooking early diagnosis, the only opportunity for amelioration. However, appropriately selected and used biomarker diagnostics provide a solution. This article reviews the development and application of biomarker-related diagnostics for neurodegenerative disease with specific recommendations for point-of-care (POC) methodology. These advantageous approaches may offer a solution to existing obstacles and limitations to neurodegenerative disease treatment.
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Affiliation(s)
- Ting-Yen Wei
- Interdisciplinary Program of Life Science, National Tsing Hua University, Hsinchu 30013, Taiwan; These authors contributed equally
| | - Yun Fu
- Department of Dermatology, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan 33305, Taiwan; These authors contributed equally
| | - Kuo-Hsuan Chang
- Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan
| | - Kun-Ju Lin
- Animal Molecular Imaging Center and Department of Nuclear Medicine, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan 33305, Taiwan
| | - Yu-Jen Lu
- Department of Neurosurgery, Chang Gung Memorial Hospital Linkou Medical Center and College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan.
| | - Chao-Min Cheng
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan.
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Mo Y, Stromswold J, Wilson K, Holder D, Sur C, Laterza O, Savage MJ, Struyk A, Scheltens P, Teunissen CE, Burke J, Macaulay SL, Bråthen G, Sando SB, White LR, Weiss C, Cowes A, Bush MM, DeSilva G, Darby DG, Rainey-Smith SR, Surls J, Sagini E, Tanen M, Altman A, Luthman J, Egan MF. A multinational study distinguishing Alzheimer's and healthy patients using cerebrospinal fluid tau/Aβ42 cutoff with concordance to amyloid positron emission tomography imaging. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2017; 6:201-209. [PMID: 28349119 PMCID: PMC5357677 DOI: 10.1016/j.dadm.2017.02.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Introduction Changes in cerebrospinal fluid (CSF) tau and amyloid β (Aβ)42 accompany development of Alzheimer's brain pathology. Robust tau and Aβ42 immunoassays were developed to establish a tau/Aβ42 cutoff distinguishing mild-to-moderate Alzheimer's disease (AD) subjects from healthy elderly control (HC) subjects. Methods A CSF tau/Aβ42 cutoff criteria was chosen, which distinguished the groups and maximized concordance with amyloid PET. Performance was assessed using an independent validation cohort. Results A tau/Aβ42 = 0.215 cutoff provided 94.8% sensitivity and 77.7% specificity. Concordance with PET visual reads was estimated at 86.9% in a ∼50% PET positive population. In the validation cohort, the cutoff demonstrated 78.4% sensitivity and 84.9% specificity to distinguish the AD and HC populations. Discussion A tau/Aβ42 cutoff with acceptable sensitivity and specificity distinguished HC from mild-to-moderate AD subjects and maximized concordance to brain amyloidosis. The defined cutoff demonstrated that CSF analysis may be useful as a surrogate to imaging assessment of AD pathology.
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Affiliation(s)
- Yi Mo
- Merck & Co. Inc., Kenilworth, NJ, USA
| | | | | | | | | | | | | | | | - Philip Scheltens
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands
| | - James Burke
- Duke Neurology, Duke University, Durham, NC, USA
| | - S Lance Macaulay
- Commonwealth Scientific and Industrial Research Organization, Parkville, Victoria, Australia
| | - Geir Bråthen
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Neurology, University Hospital of Trondheim, Trondheim, Norway
| | - Sigrid Botne Sando
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Neurology, University Hospital of Trondheim, Trondheim, Norway
| | - Linda R White
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Neurology, University Hospital of Trondheim, Trondheim, Norway
| | | | | | | | | | - David G Darby
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Stephanie R Rainey-Smith
- Centre of Excellence for Alzheimer's Disease Research and Care, Edith Cowan University, Joondalup, Western Australia, Australia
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Nabers A, Ollesch J, Schartner J, Kötting C, Genius J, Haußmann U, Klafki H, Wiltfang J, Gerwert K. An infrared sensor analysing label-free the secondary structure of the Abeta peptide in presence of complex fluids. JOURNAL OF BIOPHOTONICS 2016; 9:224-234. [PMID: 25808829 DOI: 10.1002/jbio.201400145] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 02/19/2015] [Accepted: 03/01/2015] [Indexed: 06/04/2023]
Abstract
The secondary structure change of the Abeta peptide to beta-sheet was proposed as an early event in Alzheimer's disease. The transition may be used for diagnostics of this disease in an early state. We present an Attenuated Total Reflection (ATR) sensor modified with a specific antibody to extract minute amounts of Abeta peptide out of a complex fluid. Thereby, the Abeta peptide secondary structure was determined in its physiological aqueous environment by FTIR-difference-spectroscopy. The presented results open the door for label-free Alzheimer diagnostics in cerebrospinal fluid or blood. It can be extended to further neurodegenerative diseases. An immunologic ATR-FTIR sensor for Abeta peptide secondary structure analysis in complex fluids is presented.
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Affiliation(s)
- Andreas Nabers
- Protein Research Unit Ruhr within Europe (PURE), Ruhr-University Bochum, Department of Biophysics ND04-596, Universitätsstraße 150, 44780, Bochum, Germany
| | - Julian Ollesch
- Protein Research Unit Ruhr within Europe (PURE), Ruhr-University Bochum, Department of Biophysics ND04-596, Universitätsstraße 150, 44780, Bochum, Germany
| | - Jonas Schartner
- Protein Research Unit Ruhr within Europe (PURE), Ruhr-University Bochum, Department of Biophysics ND04-596, Universitätsstraße 150, 44780, Bochum, Germany
| | - Carsten Kötting
- Protein Research Unit Ruhr within Europe (PURE), Ruhr-University Bochum, Department of Biophysics ND04-596, Universitätsstraße 150, 44780, Bochum, Germany
| | - Just Genius
- Protein Research Unit Ruhr within Europe (PURE), LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Medical Faculty University of Duisburg-Essen, 45147, Essen, Germany
| | - Ute Haußmann
- Protein Research Unit Ruhr within Europe (PURE), LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Medical Faculty University of Duisburg-Essen, 45147, Essen, Germany
| | - Hans Klafki
- Protein Research Unit Ruhr within Europe (PURE), LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Medical Faculty University of Duisburg-Essen, 45147, Essen, Germany
| | - Jens Wiltfang
- Protein Research Unit Ruhr within Europe (PURE), LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Medical Faculty University of Duisburg-Essen, 45147, Essen, Germany
- University Medical Center, Department of Psychiatry and Psychotherapy, Georg-August-University, 37073, Göttingen, Germany
| | - Klaus Gerwert
- Protein Research Unit Ruhr within Europe (PURE), Ruhr-University Bochum, Department of Biophysics ND04-596, Universitätsstraße 150, 44780, Bochum, Germany.
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Koper OM, Kaminska J, Kemona H, Dymicka-Piekarska V. Application of the Bead-Based Technique in Neurodegeneration: A Literature Review. NEURODEGENER DIS 2015; 15:281-93. [DOI: 10.1159/000433439] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 05/12/2015] [Indexed: 11/19/2022] Open
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Ewers M, Mattsson N, Minthon L, Molinuevo JL, Antonell A, Popp J, Jessen F, Herukka SK, Soininen H, Maetzler W, Leyhe T, Bürger K, Taniguchi M, Urakami K, Lista S, Dubois B, Blennow K, Hampel H. CSF biomarkers for the differential diagnosis of Alzheimer's disease: A large-scale international multicenter study. Alzheimers Dement 2015; 11:1306-15. [PMID: 25804998 DOI: 10.1016/j.jalz.2014.12.006] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 12/02/2014] [Accepted: 12/05/2014] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The aim of this study was to test the diagnostic value of cerebrospinal fluid (CSF) beta-amyloid (Aβ1-42), phosphorylated tau, and total tau (tau) to discriminate Alzheimer's disease (AD) dementia from other forms of dementia. METHODS A total of 675 CSF samples collected at eight memory clinics were obtained from healthy controls, AD dementia, subjective memory impairment, mild cognitive impairment, vascular dementia, Lewy body dementia (LBD), fronto-temporal dementia (FTD), depression, or other neurological diseases. RESULTS CSF Aβ1-42 showed the best diagnostic accuracy among the CSF biomarkers. At a sensitivity of 85%, the specificity to differentiate AD dementia against other diagnoses ranged from 42% (for LBD, 95% confidence interval or CI = 32-62) to 77% (for FTD, 95% CI = 62-90). DISCUSSION CSF Aβ1-42 discriminates AD dementia from FTD, but shows significant overlap with other non-AD forms of dementia, possibly reflecting the underlying mixed pathologies.
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Affiliation(s)
- Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilian-University, Munich, Bayern, Germany.
| | - Niklas Mattsson
- Department of Radiology, University of California San Francisco, San Francisco, CA, USA; Institute of Neuroscience & Physiology, Department of Psychiatry & Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Lennart Minthon
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden; Neuropsychiatric Clinic, Malmö University Hospital, Malmö, Sweden
| | - José L Molinuevo
- Alzheimer's disease and other cognitive disorders unit, Neurology Service, ICN Hospital Clinic i Universitari and Pasqual Maragall Foundation, Barcelona, Spain
| | - Anna Antonell
- Alzheimer's disease and other cognitive disorders unit, Neurology Service, ICN Hospital Clinic i Universitari and Pasqual Maragall Foundation, Barcelona, Spain
| | - Julius Popp
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Nordrhein-Westfalen, Germany; Department of Psychiatry, University Hospital of Lausanne, Lausanne, Waadt, Switzerland
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Nordrhein-Westfalen, Germany
| | - Sanna-Kaisa Herukka
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Hilka Soininen
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Walter Maetzler
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tuebingen, Tuebingen, Germany; DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Thomas Leyhe
- Department of Psychiatry and Psychotherapy, University Hospital, Tübingen, Germany
| | - Katharina Bürger
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilian-University, Munich, Bayern, Germany
| | - Miyako Taniguchi
- Center of Old Age Psychiatry, Psychiatric University Hospital, Basel, Switzerland
| | - Katsuya Urakami
- Department of Biological Regulation, School of Health Science, Tottori University Faculty of Medicine, Yonago, Japan
| | - Simone Lista
- AXA Research Fund & UPMC Chair, Paris, France; Sorbonne Universités, Université Pierre et Marie Curie, Paris 06, Institut de la Mémoire et de la Maladie d'Alzheimer & Institut du Cerveau et de la Moelle épinière (ICM), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France
| | - Bruno Dubois
- Sorbonne Universités, Université Pierre et Marie Curie, Paris 06, Institut de la Mémoire et de la Maladie d'Alzheimer & Institut du Cerveau et de la Moelle épinière (ICM), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France
| | - Kaj Blennow
- Institute of Neuroscience & Physiology, Department of Psychiatry & Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Harald Hampel
- AXA Research Fund & UPMC Chair, Paris, France; Sorbonne Universités, Université Pierre et Marie Curie, Paris 06, Institut de la Mémoire et de la Maladie d'Alzheimer & Institut du Cerveau et de la Moelle épinière (ICM), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France
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Lewczuk P, Mroczko B, Fagan A, Kornhuber J. Biomarkers of Alzheimer's disease and mild cognitive impairment: a current perspective. Adv Med Sci 2015; 60:76-82. [PMID: 25579841 DOI: 10.1016/j.advms.2014.11.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 09/12/2014] [Accepted: 11/28/2014] [Indexed: 11/16/2022]
Abstract
A growing body of evidence supports the application of the neurochemical dementia diagnostics (NDD) biomarkers for the diagnosis of dementing conditions. Biomarkers of Alzheimer's disease (AD) were recently classified as these reflecting amyloid β pathology (decreased CSF concentrations of Aβ42 and/or positive Aβ PET scan) and these reflecting neurodegeneration (increased CSF Tau concentrations, decreased uptake of FDG on FDG-PET, and cerebral atrophy on structural MRI). Particularly important seems the role of the biomarkers in the early diagnosis of AD, as the first pathophysiologic events observable in the CSF and amyloid β-PET occur years and perhaps decades before the onset of the earliest clinical symptoms. Therefore, the NDD tools enable the diagnosis of AD already in the early preclinical stage. This review summarizes pathophysiology underlying the CSF biomarkers, following a discussion of their role in the current guidelines for the diagnostic procedures.
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Affiliation(s)
- Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen and Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Barbara Mroczko
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, Bialystok, Poland; Department of Biochemical Diagnostics, University Hospital in Bialystok, Bialystok, Poland
| | - Anne Fagan
- The Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University, St. Louis, MO, USA
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen and Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
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15
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Mo JA, Lim JH, Sul AR, Lee M, Youn YC, Kim HJ. Cerebrospinal fluid β-amyloid1-42 levels in the differential diagnosis of Alzheimer's disease--systematic review and meta-analysis. PLoS One 2015; 10:e0116802. [PMID: 25710596 PMCID: PMC4339391 DOI: 10.1371/journal.pone.0116802] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Accepted: 12/15/2014] [Indexed: 01/01/2023] Open
Abstract
Objectives The purpose of this study was to carry out systematic review of the literature and meta-analysis to evaluate the diagnostic utility of cerebrospinal fluid (CSF) levels of the 42 amino acid form of amyloid-beta (Aβ1–42) as a biomarker for differentiating Alzheimer’s disease (AD) from non-AD dementia. Methods Design. Systematic literature review was used to evaluate the effectiveness of the Aβ for the diagnosis of AD. The Scottish Intercollegiate Guidelines Network (SIGN) tool was used to evaluate independently the quality of the studies. Data sources. The literature review covered from January 1, 2004, to October 22, 2013, and searched eight domestic databases including Korea Med and international databases including Ovid-MEDLINE, EMBASE, and Cochrane Library. Data Extraction and Synthesis. Primary criteria for inclusion were valid studies on (i) patients with mild cognitive impairment with confirmed or suspected AD and non-AD dementia, and (ii) assessment of Aβ1–42 levels using appropriate comparative tests. Results A total of 17 diagnostic evaluation studies were identified in which levels of CSF Aβ1–42 were assessed. Meta-analysis was performed on 11 robust studies that compared confirmed AD (n = 2211) with healthy individuals (n = 1030), 10 studies that compared AD with non-AD dementias (n = 627), and 5 studies that compared amnestic mild cognitive impairment (n = 1133) with non-amnestic type subjects (n = 1276). Overall, the CSF Aβ1–42 levels were reduced in AD compared to controls or non-AD dementia. The effectiveness of test was evaluated for diagnostic accuracy (pooled sensitivity, 0.80 (95% CI 0.78–0.82); pooled specificity, 0.76 (95% CI 0.74–0.78). Conclusions Reduced CSF Aβ1–42 levels are of potential utility in the differential diagnosis of AD versus non-AD dementias and controls. Diagnostic accuracy was high in AD versus healthy controls. However, differential diagnosis for MCI or non-AD might be evaluated by other biomarkers.
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Affiliation(s)
- Jin-A Mo
- National Evidence-Based Health Care Collaborating Agency, Seoul, Korea
- Department of Nursing, Inha University College of Medicine, Incheon, Korea
| | - Ju-Hee Lim
- National Evidence-Based Health Care Collaborating Agency, Seoul, Korea
| | - Ah-Ram Sul
- National Evidence-Based Health Care Collaborating Agency, Seoul, Korea
| | - Min Lee
- National Evidence-Based Health Care Collaborating Agency, Seoul, Korea
| | - Young Chul Youn
- Department of Neurology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Hee-Jin Kim
- Department of Neurology, Hanyang University College of Medicine, Seoul, Korea
- * E-mail:
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16
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Paterson RW, Toombs J, Slattery CF, Schott JM, Zetterberg H. Biomarker modelling of early molecular changes in Alzheimer's disease. Mol Diagn Ther 2014; 18:213-27. [PMID: 24281842 DOI: 10.1007/s40291-013-0069-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The preclinical phase of Alzheimer's disease (AD) occurs years, possibly decades, before the onset of clinical symptoms. Being able to detect the very earliest stages of AD is critical to improving understanding of AD biology, and identifying individuals at greatest risk of developing clinical symptoms with a view to treating AD pathophysiology before irreversible neurodegeneration occurs. Studies of dominantly inherited AD families and longitudinal studies of sporadic AD have contributed to knowledge of the earliest AD biomarkers. Here we appraise this evidence before reviewing novel, particularly fluid, biomarkers that may provide insights into AD pathogenesis and relate these to existing hypothetical disease models.
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Affiliation(s)
- Ross W Paterson
- Dementia Research Centre, Department of Neurodegeneration, UCL Institute of Neurology, London, UK,
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17
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Fagan AM, Xiong C, Jasielec MS, Bateman RJ, Goate AM, Benzinger TLS, Ghetti B, Martins RN, Masters CL, Mayeux R, Ringman JM, Rossor MN, Salloway S, Schofield PR, Sperling RA, Marcus D, Cairns NJ, Buckles VD, Ladenson JH, Morris JC, Holtzman DM. Longitudinal change in CSF biomarkers in autosomal-dominant Alzheimer's disease. Sci Transl Med 2014; 6:226ra30. [PMID: 24598588 DOI: 10.1126/scitranslmed.3007901] [Citation(s) in RCA: 283] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Clinicopathological evidence suggests that the pathology of Alzheimer's disease (AD) begins many years before the appearance of cognitive symptoms. Biomarkers are required to identify affected individuals during this asymptomatic ("preclinical") stage to permit intervention with potential disease-modifying therapies designed to preserve normal brain function. Studies of families with autosomal-dominant AD (ADAD) mutations provide a unique and powerful means to investigate AD biomarker changes during the asymptomatic period. In this biomarker study, we collected cerebrospinal fluid (CSF), plasma, and in vivo amyloid imaging cross-sectional data at baseline in individuals from ADAD families enrolled in the Dominantly Inherited Alzheimer Network. Our study revealed reduced concentrations of CSF amyloid-β1-42 (Aβ1-42) associated with the presence of Aβ plaques, and elevated concentrations of CSF tau, ptau181 (phosphorylated tau181), and VILIP-1 (visinin-like protein-1), markers of neurofibrillary tangles and neuronal injury/death, in asymptomatic mutation carriers 10 to 20 years before their estimated age at symptom onset (EAO) and before the detection of cognitive deficits. When compared longitudinally, however, the concentrations of CSF biomarkers of neuronal injury/death within individuals decreased after their EAO, suggesting a slowing of acute neurodegenerative processes with symptomatic disease progression. These results emphasize the importance of longitudinal, within-person assessment when modeling biomarker trajectories across the course of the disease. If corroborated, this pattern may influence the definition of a positive neurodegenerative biomarker outcome in clinical trials.
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Affiliation(s)
- Anne M Fagan
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA
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18
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Condic M, Oberstein TJ, Herrmann M, Reimann MC, Kornhuber J, Maler JM, Spitzer P. N-truncation and pyroglutaminylation enhances the opsonizing capacity of Aβ-peptides and facilitates phagocytosis by macrophages and microglia. Brain Behav Immun 2014; 41:116-25. [PMID: 24876064 DOI: 10.1016/j.bbi.2014.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Revised: 04/18/2014] [Accepted: 05/03/2014] [Indexed: 10/25/2022] Open
Abstract
Abnormal accumulations of amyloid-β (Aβ)-peptides are one of the pathological hallmarks of Alzheimer's disease (AD). The precursor of the Aβ-peptides, the amyloid precursor protein (APP), is also found in peripheral blood cells, but its function in these cells remains elusive. We previously observed that mononuclear phagocytes release Aβ-peptides during activation and phagocytosis, suggesting a physiologic role in inflammatory processes. Here, we show that supplementing the media with soluble N-terminally truncated Aβ(2-40) and Aβ(2-42) as well as Aβ(1-42) induced the phagocytosis of polystyrene particles (PSPs) by primary human monocytes. If the PSPs were pre-incubated with Aβ-peptides, phagocytosis was induced by all tested Aβ-peptide species. N-terminally truncated Aβ(x-42) induced the phagocytosis of PSPs significantly more effectively than did Aβ(x-40). Similarly, the phagocytosis of Escherichia coli by GM-CSF- and M-CSF-elicited macrophages as well as microglia was particularly facilitated by pre-incubation with N-terminally truncated Aβ(x-42). The proinflammatory polarization of monocytes was indicated by the reduced MSRI expression and IL-10 secretion after phagocytosis of PSPs coated with Aβ(1-42), Aβ(2-42) and Aβ(3p-42). Polarization of the macrophages by GM-CSF reduced the phagocytic activity, but it did not affect the capabilities of Aβ-peptides to opsonize prey. Taken together, Aβ-peptides support phagocytosis as soluble factors and act as opsonins. Differential effects among the Aβ-peptide variants point to distinct mechanisms of interaction among monocytes/macrophages, prey and Aβ-peptides. A proinflammatory polarization induced by the phagocytosis of Aβ-peptide coated particles may provide a model for the chronic inflammatory reaction and sustained plaque deposition in AD.
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Affiliation(s)
- Mateja Condic
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, D-91054 Erlangen, Germany
| | - Timo Jan Oberstein
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, D-91054 Erlangen, Germany
| | - Martin Herrmann
- Department of Medicine III, Institute for Clinical Immunology, Friedrich-Alexander-University Erlangen-Nuremberg, Gluecksstraße 4a, D-91054 Erlangen, Germany
| | - Mareike Carola Reimann
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, D-91054 Erlangen, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, D-91054 Erlangen, Germany
| | - Juan Manuel Maler
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, D-91054 Erlangen, Germany
| | - Philipp Spitzer
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, D-91054 Erlangen, Germany.
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19
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Fu Y, Zhao D, Yang L. Protein-Based Biomarkers in Cerebrospinal Fluid and Blood for Alzheimer’s Disease. J Mol Neurosci 2014; 54:739-47. [DOI: 10.1007/s12031-014-0356-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 06/11/2014] [Indexed: 12/21/2022]
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20
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Efficacy of the Phosphorylated tau 181 in Differential Diagnosis of the Alzheimer's Disease: A Systematic Review and Meta-Analysis. Dement Neurocogn Disord 2014. [DOI: 10.12779/dnd.2014.13.4.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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21
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Shea YF, Chu LW, Zhou L, Li WM, Lin OY, Chan MNY, Xu A, Wong R, Ho TY, Liu KW, Ha J, Daniel T, Song YQ, Lam KS. Cerebrospinal fluid biomarkers of Alzheimer's disease in Chinese patients: a pilot study. Am J Alzheimers Dis Other Demen 2013; 28:769-75. [PMID: 24085246 PMCID: PMC10852804 DOI: 10.1177/1533317513504615] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
In view of the paucity of data on cerebrospinal fluid (CSF) biomarkers in Chinese patients, we evaluated the validity of tau, phosphorylated tau 181 (p-tau-181), amyloid β 42 (Aβ42), and Aβ40 proteins in Chinese patients with Alzheimer's disease (AD). We recruited 24 patients with AD, 12 nondemented controls, and 12 patients with non-AD dementia. We found the CSF levels of Aβ42, tau, p-tau, Aβ42-tau, and Aβ42-p-tau ratios, except the Aβ40 protein level, were significantly different among the 3 groups of patients. Patients with AD had higher levels of CSF tau and p-tau but lower levels of Aβ42 proteins, Aβ42-tau, and Aβ42-p-tau ratios than the nondemented controls. In the diagnosis of AD versus nondementia, the sensitivity and specificity of the ratios of Aβ42-tau and Aβ42-p-tau were 96% and 83% versus 92% and 83%, respectively. Only the Aβ42-p-tau ratio showed satisfactory sensitivity and specificity in the diagnosis of AD versus other dementia.
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Affiliation(s)
- Yat Fung Shea
- Division of Geriatrics, Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Leung-Wing Chu
- Division of Geriatrics, Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
- Research Centre of Heart, Brain, Hormone & Healthy Aging, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- Alzheimer’s Disease Research Network, SRT Healthy Aging, The University of Hong Kong, Hong Kong
| | - Lin Zhou
- Division of Geriatrics, Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Wing-Man Li
- Division of Geriatrics, Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Oi Yee Lin
- Division of Geriatrics, Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - May N. Y. Chan
- Division of Geriatrics, Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Aimin Xu
- Department of Medicine, Division of Endocrinology and Metabolism, LKS Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Rachel Wong
- Department of Medicine, Division of Endocrinology and Metabolism, LKS Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Tip Yin Ho
- Division of Geriatrics, Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Kin Wah Liu
- Division of Geriatrics, Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Joyce Ha
- Division of Geriatrics, Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - T.W. Daniel
- Division of Geriatrics, Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - You-Qiang Song
- Department of Biochemistry, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Karen S. Lam
- Research Centre of Heart, Brain, Hormone & Healthy Aging, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- Alzheimer’s Disease Research Network, SRT Healthy Aging, The University of Hong Kong, Hong Kong
- Department of Medicine, Division of Endocrinology and Metabolism, LKS Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
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22
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Hampel H, Lista S, Teipel SJ, Garaci F, Nisticò R, Blennow K, Zetterberg H, Bertram L, Duyckaerts C, Bakardjian H, Drzezga A, Colliot O, Epelbaum S, Broich K, Lehéricy S, Brice A, Khachaturian ZS, Aisen PS, Dubois B. Perspective on future role of biological markers in clinical therapy trials of Alzheimer's disease: a long-range point of view beyond 2020. Biochem Pharmacol 2013; 88:426-49. [PMID: 24275164 DOI: 10.1016/j.bcp.2013.11.009] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 11/13/2013] [Accepted: 11/13/2013] [Indexed: 10/26/2022]
Abstract
Recent advances in understanding the molecular mechanisms underlying various paths toward the pathogenesis of Alzheimer's disease (AD) has begun to provide new insight for interventions to modify disease progression. The evolving knowledge gained from multidisciplinary basic research has begun to identify new concepts for treatments and distinct classes of therapeutic targets; as well as putative disease-modifying compounds that are now being tested in clinical trials. There is a mounting consensus that such disease modifying compounds and/or interventions are more likely to be effectively administered as early as possible in the cascade of pathogenic processes preceding and underlying the clinical expression of AD. The budding sentiment is that "treatments" need to be applied before various molecular mechanisms converge into an irreversible pathway leading to morphological, metabolic and functional alterations that characterize the pathophysiology of AD. In light of this, biological indicators of pathophysiological mechanisms are desired to chart and detect AD throughout the asymptomatic early molecular stages into the prodromal and early dementia phase. A major conceptual development in the clinical AD research field was the recent proposal of new diagnostic criteria, which specifically incorporate the use of biomarkers as defining criteria for preclinical stages of AD. This paradigm shift in AD definition, conceptualization, operationalization, detection and diagnosis represents novel fundamental opportunities for the modification of interventional trial designs. This perspective summarizes not only present knowledge regarding biological markers but also unresolved questions on the status of surrogate indicators for detection of the disease in asymptomatic people and diagnosis of AD.
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Affiliation(s)
- Harald Hampel
- Université Pierre et Marie Curie, Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Pavillon François Lhermitte, Hôpital de la Salpêtrière, Paris, France.
| | - Simone Lista
- Department of Psychiatry, Psychotherapy and Psychosomatics, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany.
| | - Stefan J Teipel
- Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany; German Center for Neurodegenerative Diseases (DZNE) Rostock/Greifswald, Rostock, Germany
| | - Francesco Garaci
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology, and Radiotherapy, University of Rome "Tor Vergata", Rome, Italy; IRCCS San Raffaele Pisana, Rome and San Raffaele Cassino, Cassino, Italy
| | - Robert Nisticò
- Department of Physiology and Pharmacology, University of Rome "La Sapienza", Rome, Italy; IRCSS Santa Lucia Foundation, Rome, Italy
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; University College London Institute of Neurology, Queen Square, London, UK
| | - Lars Bertram
- Department of Vertebrate Genomics, Max Planck Institute for Molecular Genetics, Berlin, Germany
| | - Charles Duyckaerts
- Laboratoire de Neuropathologie Raymond-Escourolle, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - Hovagim Bakardjian
- IM2A - Institute of Memory and Alzheimer's Disease, Paris, France; IHU-A-ICM - Paris Institute of Translational Neurosciences Pitié-Salpêtrière University Hospital, Paris, France
| | - Alexander Drzezga
- Department of Nuclear Medicine, University Hospital of Cologne, Cologne, Germany
| | - Olivier Colliot
- Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle Épinière, UMR-S975 Paris, France; Inserm, U975, Paris, France; CNRS, UMR 7225, Paris, France; ICM - Institut du Cerveau et de la Moelle Épinière, Paris, France; INRIA, Aramis Team, Centre de Recherche Paris-Rocquencourt, France
| | - Stéphane Epelbaum
- Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Département de Neurologie, Hôpital de la Pitié Salpêtrière, Paris, France; Université Pierre et Marie Curie, Paris, France
| | - Karl Broich
- Federal Institute of Drugs and Medical Devices (BfArM), Bonn, Germany
| | - Stéphane Lehéricy
- IHU-A-ICM - Paris Institute of Translational Neurosciences Pitié-Salpêtrière University Hospital, Paris, France; Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle Épinière, UMR-S975 Paris, France; Inserm, U975, Paris, France; CNRS, UMR 7225, Paris, France; ICM - Institut du Cerveau et de la Moelle Épinière, Paris, France
| | - Alexis Brice
- Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle Épinière, UMR-S975 Paris, France; Inserm, U975, Paris, France; CNRS, UMR 7225, Paris, France; ICM - Institut du Cerveau et de la Moelle Épinière, Paris, France; AP-HP, Hôpital de la Salpêtrière, Département de Génétique et Cytogénétique, Paris, France
| | | | - Paul S Aisen
- Department of Neurosciences, University of California, San Diego, San Diego, CA, USA
| | - Bruno Dubois
- Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Département de Neurologie, Hôpital de la Pitié Salpêtrière, Paris, France; Université Pierre et Marie Curie, Paris, France
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23
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Wang LS, Leung YY, Chang SK, Leight S, Knapik-Czajka M, Baek Y, Shaw LM, Lee VMY, Trojanowski JQ, Clark CM. Comparison of xMAP and ELISA assays for detecting cerebrospinal fluid biomarkers of Alzheimer's disease. J Alzheimers Dis 2013; 31:439-45. [PMID: 22571982 DOI: 10.3233/jad-2012-120082] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The best-studied biomarkers of Alzheimer's disease (AD) are the pathologically-linked cerebrospinal fluid (CSF) proteins amyloid-β 42 (Aβ(1-42)), total tau (t-tau), and tau phosphorylated on amino acid 181 (p-tau(181)). Many laboratories measure these proteins using enzyme-linked immunosorbent assay (ELISA). Multiplex xMAP Luminex is a semi-automated assay platform with reduced intra-sample variance, which could facilitate its use in CLIA-approved clinical laboratories. CSF concentrations of these three biomarkers reported using xMAP technology differ from those measured by the most commonly used ELISA, confounding attempts to compare results. To develop a model for converting between xMAP and ELISA levels of the three biomarkers, we analyzed CSF samples from 140 subjects (59 AD, 30 controls, 34 with mild cognitive impairment, and 17 with Parkinson's disease, including 1 with dementia). Log-transformation of ELISA and xMAP levels made the variance constant in all three biomarkers and improved the linear regression: t-tau concentrations were highly correlated (r = 0.94); p-tau(181) concentrations by ELISA can be better predicted using both the t-tau and p-tau(181) xMAP values (r = 0.96) as compared to p-tau(181) concentrations alone (r = 0.82); correlation of Aβ(1-42) concentrations was relatively weaker but still high (r = 0.77). Among all six protein/assay combinations, xMAP Aβ(1-42) had the best accuracy for diagnostic classification (88%) between AD and control subjects. In conclusion, our study demonstrates that multiplex xMAP is an appropriate assay platform providing results that can be correlated with research-based ELISA values, facilitating the incorporation of this diagnostic biomarker into routine clinical practice.
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Affiliation(s)
- Li-San Wang
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Zürbig P, Jahn H. Use of proteomic methods in the analysis of human body fluids in Alzheimer research. Electrophoresis 2013; 33:3617-30. [PMID: 23160951 DOI: 10.1002/elps.201200360] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 09/27/2012] [Accepted: 09/27/2012] [Indexed: 01/23/2023]
Abstract
Proteomics is the study of the entire population of proteins and peptides in an organism or a part of it, such as a cell, tissue, or fluids like cerebrospinal fluid, plasma, serum, urine, or saliva. It is widely assumed that changes in the composition of the proteome may reflect disease states and provide clues to its origin, eventually leading to targets for new treatments. The ability to perform large-scale proteomic studies now is based jointly on recent advances in our analytical methods. Separation techniques like CE and 2DE have developed and matured. Detection methods like MS have also improved greatly in the last 5 years. These developments have also driven the fields of bioinformatics, needed to deal with the increased data production and systems biology. All these developing methods offer specific advantages but also come with certain limitations. This review describes the different proteomic methods used in the field, their limitations, and their possible pitfalls. Based on a literature search in PubMed, we identified 112 studies that applied proteomic techniques to identify biomarkers for Alzheimer disease. This review describes the results of these studies on proteome changes in human body fluids of Alzheimer patients reviewing the most important studies. We extracted a list of 366 proteins and peptides that were identified by these studies as potential targets in Alzheimer research.
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Kang JH, Korecka M, Toledo JB, Trojanowski JQ, Shaw LM. Clinical utility and analytical challenges in measurement of cerebrospinal fluid amyloid-β(1-42) and τ proteins as Alzheimer disease biomarkers. Clin Chem 2013; 59:903-16. [PMID: 23519967 DOI: 10.1373/clinchem.2013.202937] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Over the past 2 decades, clinical studies have provided evidence that cerebrospinal fluid (CSF) amyloid β(1-42) (Aβ(1-42)), total τ (t-τ), and τ phosphorylated at Thr181 (p-τ(181)) are reliable biochemical markers of Alzheimer disease (AD) neuropathology. CONTENT In this review, we summarize the clinical performance and describe the major challenges for the analytical performance of the most widely used immunoassay platforms [based on ELISA or microbead-based multianalyte profiling (xMAP) technology] for the measurement of CSF AD biomarkers (Aβ(1-42), t-τ, and p-τ(181)). With foundational immunoassay data providing the diagnostic and prognostic values of CSF AD biomarkers, the newly revised criteria for the diagnosis of AD include CSF AD biomarkers for use in research settings. In addition, it has been suggested that the selection of AD patients at the predementia stage by use of CSF AD biomarkers can improve the statistical power of clinical trial design. Owing to the lack of a replenishable and commutable human CSF-based standardized reference material (SRM) and significant differences across different immunoassay platforms, the diagnostic-prognostic cutpoints of CSF AD biomarker concentrations are not universal at this time. These challenges can be effectively met in the future, however, through collaborative ongoing standardization efforts to minimize the sources of analytical variability and to develop reference methods and SRMs. SUMMARY Measurements of CSF Aβ(1-42), t-τ, and p-τ(181) with analytically qualified immunoassays reliably reflect the neuropathologic hallmarks of AD in patients at the early predementia stage of the disease and even in presymptomatic patients. Thus these CSF biomarker tests are useful for early diagnosis of AD, prediction of disease progression, and efficient design of drug intervention clinical trials.
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Affiliation(s)
- Ju-Hee Kang
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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King EM, Filep S, Smith B, Platts-Mills T, Hamilton RG, Schmechel D, Sordillo JE, Milton D, van Ree R, Krop EJM, Heederik DJJ, Metwali N, Thorne PS, Zeldin DC, Sever ML, Calatroni A, Arbes SJ, Mitchell HE, Chapman MD. A multi-center ring trial of allergen analysis using fluorescent multiplex array technology. J Immunol Methods 2013; 387:89-95. [PMID: 23085532 PMCID: PMC3955085 DOI: 10.1016/j.jim.2012.09.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Revised: 09/07/2012] [Accepted: 09/10/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Consistent performance of allergen assays is essential to ensure reproducibility of exposure assessments for investigations of asthma and occupational allergic disease. This study evaluated intra- and inter-laboratory reproducibility of a fluorescent multiplex array, which simultaneously measures eight indoor allergens in a single reaction well. METHODS A multi-center study was performed in nine laboratories in the US and Europe to determine the inter-laboratory variability of an 8-plex array for dust mite, cat, dog, rat, mouse and cockroach allergens. Aliquots of 151 dust extract samples were sent to participating centers and analyzed by each laboratory on three separate occasions. Agreement within and between laboratories was calculated by the concordance correlation coefficient (CCC). RESULTS Results were obtained for over 32,000 individual allergen measurements. Levels covered a wide range for all allergens from below the lower limit of detection (LLOD = 0.1-9.8 ng/ml) to higher than 6800 ng/ml for all allergens except Mus m 1, which was up to 1700 ng/ml. Results were reproducible within as well as between laboratories. Within laboratories, 94% of CCC were ≥ 0.90, and 80% of intra-laboratory results fell within a 10% coefficient of variance (CV%). Results between laboratories also showed highly significant positive correlations for all allergens (~0.95, p<0.001). Overall means of results were comparable, and inter-laboratory CV% for all allergens except Rat n 1 ranged between 17.6% and 26.6%. CONCLUSION The data indicate that performance criteria for fluorescent multiplex array technology are reproducible within and between laboratories. Multiplex technology provides standardized and consistent allergen measurements that will streamline environmental exposure assessments in allergic disease.
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Affiliation(s)
- Eva M King
- INDOOR Biotechnologies Inc, Charlottesville, VA 22903, USA.
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Comparison of two commercial enzyme-linked immunosorbent assays for cerebrospinal fluid measurement of amyloid β 1-42 and total tau. Transl Neurosci 2013; 4. [PMID: 24376914 DOI: 10.2478/s13380-013-0123-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Amyloid β1-42 (Aβ1-42), total tau (t-tau), and phosphorylated tau (p-tau) are the main cerebrospinal fluid (CSF) biomarkers for early diagnosis of Alzheimer's disease (AD). Detection of AD is critically important in view of the growing number of potential new drugs that may influence the course of the disease in its early phases. However, cut-off levels for these CSF biomarkers have not yet been established. Variability in absolute concentrations of AD biomarkers is high among studies and significant differences were noticed even within the same datasets. Variability in biomarkers levels in these assays may be due to many aspects of operating procedures. Standardization of pre-analytical and analytical procedures in collection, treatment, and storage of CSF samples is crucial because differences in sample handling can drastically influence results. Multicenter studies showed that usage of ELISA kits from different manufacturers also affects outcome. So far only very few studies tested the efficiency of ELISA kits produced by different vendors. In this study, the performance of Innogenetics (Gent, Belgium) and Invitrogen (Camarillo, CA, USA) ELISA kits for t-tau and Aβ1-42 was tested. Passing-Bablok analysis showed significant differences between Invitrogen and Innogenetics ELISA methods, making it impossible to use them interchangeably.
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Jayaraman A, Carroll JC, Morgan TE, Lin S, Zhao L, Arimoto JM, Murphy MP, Beckett TL, Finch CE, Brinton RD, Pike CJ. 17β-estradiol and progesterone regulate expression of β-amyloid clearance factors in primary neuron cultures and female rat brain. Endocrinology 2012; 153:5467-79. [PMID: 22962256 PMCID: PMC3473201 DOI: 10.1210/en.2012-1464] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Accepted: 08/06/2012] [Indexed: 02/04/2023]
Abstract
The accumulation of β-amyloid protein (Aβ) is a key risk factor in the development of Alzheimer's disease. The ovarian sex steroid hormones 17β-estradiol (E(2)) and progesterone (P(4)) have been shown to regulate Aβ accumulation, although the underlying mechanism(s) remain to be fully elucidated. In this study, we investigate the effects of E(2) and P(4) treatment on the expression levels of Aβ clearance factors including insulin-degrading enzyme, neprilysin, endothelin-converting enzyme 1 and 2, angiotensin-converting enzyme, and transthyretin, both in primary neuron cultures and female rat brains. Our results show that E(2) and P(4) affect the expression levels of several Aβ clearance factors in dose- and time-dependent manners. Most notably, expression of insulin-degrading enzyme is significantly increased by both hormones in cultured neurons and in vivo and is inversely associated with the soluble Aβ levels in vivo. These findings further define sex steroid hormone actions involved in regulation of Aβ, a relationship potentially important to therapeutic approaches aimed at reducing risk of Alzheimer's disease.
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Affiliation(s)
- Anusha Jayaraman
- Neuroscience Graduate Program, University of Southern California, Los Angeles, California 90089, USA
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Bibl M, Esselmann H, Wiltfang J. Neurochemical biomarkers in Alzheimer's disease and related disorders. Ther Adv Neurol Disord 2012; 5:335-48. [PMID: 23139704 PMCID: PMC3487531 DOI: 10.1177/1756285612455367] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Neurochemical biomarkers for diagnosing dementias are currently under intensive investigation and the field is rapidly expanding. The main protagonists and the best defined among them are cerebrospinal fluid levels of Aβ42, tau and its phosphorylated forms (p-tau). In addition, novel cerebrospinal fluid biomarkers are emerging and their multiparametric assessment seems most promising for increasing the accuracy in neurochemical dementia diagnostics. The combined assessment of Aβ42 and p-tau has recently shown value for diagnosing prodromal states of Alzheimer's dementia, that is, mild cognitive impairment. Disease-specific biomarkers for other degenerative dementias are still missing, but some progress has recently been made. As lumbar puncture is an additional burden for the patient, blood-based neurochemical biomarkers are definitely warranted and promising new discoveries have been made in this direction. These diagnostic developments have implicit therapeutic consequences and give rise to new requirements for future neurochemical dementia diagnostics.
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Affiliation(s)
- Mirko Bibl
- Department of Psychiatry, Psychotherapy and Addiction Medicine, Kliniken Essen-Mitte; University of Duisburg-Essen, Essen, Germany
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30
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Jongbloed W, Kester MI, Flier WM, Veerhuis R, Scheltens P, Blankenstein MA, Teunissen CE. Discriminatory and predictive capabilities of enzyme‐linked immunosorbent assay and multiplex platforms in a longitudinal Alzheimer's disease study. Alzheimers Dement 2012; 9:276-83. [DOI: 10.1016/j.jalz.2012.01.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 12/02/2011] [Accepted: 01/13/2012] [Indexed: 10/27/2022]
Affiliation(s)
- Wesley Jongbloed
- Department of Clinical Chemistry Neurological LaboratoryVU University Medical CenterAmsterdamThe Netherlands
| | - Maartje I. Kester
- Department of Neurology and Alzheimer CenterVU University Medical CenterAmsterdamThe Netherlands
| | - Wiesje M. Flier
- Department of Neurology and Alzheimer CenterVU University Medical CenterAmsterdamThe Netherlands
- Department of Epidemiology and BiostatisticsVU University Medical CenterAmsterdamThe Netherlands
| | - Robert Veerhuis
- Department of Clinical Chemistry Neurological LaboratoryVU University Medical CenterAmsterdamThe Netherlands
| | - Philip Scheltens
- Department of Neurology and Alzheimer CenterVU University Medical CenterAmsterdamThe Netherlands
| | - Marinus A. Blankenstein
- Department of Clinical Chemistry Neurological LaboratoryVU University Medical CenterAmsterdamThe Netherlands
| | - Charlotte E. Teunissen
- Department of Clinical Chemistry Neurological LaboratoryVU University Medical CenterAmsterdamThe Netherlands
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Abstract
Research progress has provided detailed understanding of the molecular pathogenesis of Alzheimer disease (AD). This knowledge has been translated into new drug candidates with putative disease-modifying effects, which are now being tested in clinical trials. The promise of effective therapy has created a great need for biomarkers able to detect AD in the predementia phase, because drugs will probably be effective only if neurodegeneration is not too advanced. In this chapter, cerebrospinal fluid (CSF) and plasma biomarkers are reviewed. The core CSF biomarkers total tau (T-tau), phosphorylated tau (P-tau) and the 42 amino acid form of β-amyloid (Aβ42) reflect AD pathology, and have high diagnostic accuracy to diagnose AD with dementia and prodromal AD in mild cognitive impairment cases. The rationale for the use of CSF biomarkers to identify and monitor the mechanism of action of new drug candidates is also outlined in this chapter.
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Affiliation(s)
- Kaj Blennow
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, SE-431 80 Mölndal, Sweden.
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Mao P. Oxidative Stress and Its Clinical Applications in Dementia. JOURNAL OF NEURODEGENERATIVE DISEASES 2012; 2013:319898. [PMID: 26316986 PMCID: PMC4437276 DOI: 10.1155/2013/319898] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 07/16/2012] [Indexed: 02/08/2023]
Abstract
Dementia is a complex disorder that mostly affects the elderly and represents a significant and growing public health burden in the world. Alzheimer's disease (AD)- associated dementia and dementia with Lewy bodies (DLB) are the most common forms of dementia, in which oxidative stress is significantly involved. Oxidative stress mechanisms may have clinical applications, that is, providing information for potential biomarkers. Thus brain-rich peptides with an antioxidant property, such as CART (cocaine- and amphetamine-regulated transcript), may be promising new markers. This paper summarizes the progress in research regarding oxidative stress in dementia with a focus on potential biomarkers in the cerebrospinal fluid (CSF) in the main forms of dementia. Other central and peripheral biomarkers, especially those considered oxidative stress related, are also discussed. This paper aims to provide information to improve current understanding of the pathogenesis and progression of dementia. It also offers insight into the differential diagnosis of AD and DLB.
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Affiliation(s)
- Peizhong Mao
- The Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, 505 NW 185th Avenue, Beaverton, OR 97006, USA
- The Departments of Physiology and Pharmacology, Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR 97239, USA
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Pesini P, Pérez-Grijalba V, Monleón I, Boada M, Tárraga L, Martínez-Lage P, San-José I, Sarasa M. Reliable Measurements of the β-Amyloid Pool in Blood Could Help in the Early Diagnosis of AD. Int J Alzheimers Dis 2012; 2012:604141. [PMID: 22957297 PMCID: PMC3431090 DOI: 10.1155/2012/604141] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Revised: 05/07/2012] [Accepted: 05/09/2012] [Indexed: 12/29/2022] Open
Abstract
The present study was aimed at assessing the capability of Aβ1-40 and Aβ1-42 levels in undiluted plasma (UP), diluted plasma (DP), and cell bound (CB) to distinguish between early stages of Alzheimer's disease (AD), amnesic mild cognitive impairment (MCI), and healthy control (HC). Four blood samples from each participant were collected during one month and the levels of Aβ1-40 and Aβ1-42 were determined by a blinded proprietary ELISA sandwich (Araclon Biotech. Zaragoza, Spain). First striking result was that the amount of Aβ1-40 and Aβ1-42 in UP represented only a small proportion (~15%) of the total beta-amyloid pool in blood (βAPB) described here as the sum of Aβ1-40 and Aβ1-42 in blood where they are free in plasma, bound to plasma proteins, and bound to blood cells. Furthermore, we found that levels of Aβ1-40 and Aβ1-42 in UP, DP, and CB were significantly higher in MCI when compared to HC. On average, the total βAPB was 1.8 times higher in MCI than in HC (P = 0.03) and allowed to discriminate between MCI and HC with a sensitivity and specificity over 80%. Thus, quantification of several markers of the βAPB could be useful and reliable in the discrimination between MCI and HC.
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Affiliation(s)
- Pedro Pesini
- Araclon Biotech Ltd., I + D Laboratory, Zaragoza, Spain
- Araclon Biotech Ltd., Proteomic Laboratory, CIBIR Logroño, Spain
| | | | | | - Mercè Boada
- Alzheimer Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurciències Aplicades, Barcelona, Spain
| | - Lluís Tárraga
- Alzheimer Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurciències Aplicades, Barcelona, Spain
| | - Pablo Martínez-Lage
- Alzheimer Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurciències Aplicades, Barcelona, Spain
| | | | - Manuel Sarasa
- Araclon Biotech Ltd., I + D Laboratory, Zaragoza, Spain
- Araclon Biotech Ltd., Proteomic Laboratory, CIBIR Logroño, Spain
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Lewczuk P, Kornhuber J. Neurochemical dementia diagnostics in Alzheimer's disease: where are we now and where are we going? Expert Rev Proteomics 2012; 8:447-58. [PMID: 21819301 DOI: 10.1586/epr.11.37] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Neurochemical dementia diagnostics (NDD) is a routine laboratory tool used in the diagnostic process for patients with neurodegenerative disorders, such as Alzheimer's disease. Currently, two groups of biomarkers analyzed in the cerebrospinal fluid are considered - namely amyloid-β peptides and Tau proteins - along with the hyperphosphorylated forms of the latter (pTau). Current directions in the development of NDD include the following: search for novel biomarkers with improved analytical or diagnostic performance; optimization of the analysis of the biomarkers already available (e.g., by improved quality control and interlaboratory comparison of results); applications of novel technologies enabling better management of patient samples; and search for biomarkers in the blood. This article presents the state-of-the-art in the field of cerebrospinal fluid-based NDD, and also summarizes some of the hypotheses of how the future development of NDD tools might look.
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Affiliation(s)
- Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen and Friedrich-Alexander Universität Erlangen-Nürnberg, Germany.
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Lewczuk P. Biomarkers of neurodegeneration – not only Alzheimer’s disease and not only cerebrospinal fluid: a guest-editor’s introduction. J Neural Transm (Vienna) 2012; 119:735-7. [DOI: 10.1007/s00702-012-0836-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Simultaneous analysis of cerebrospinal fluid biomarkers using microsphere-based xMAP multiplex technology for early detection of Alzheimer's disease. Methods 2012; 56:484-93. [PMID: 22503777 DOI: 10.1016/j.ymeth.2012.03.023] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Revised: 03/16/2012] [Accepted: 03/17/2012] [Indexed: 12/20/2022] Open
Abstract
The xMAP-Luminex multiplex platform for measurement of Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers using Innogenetics AlzBio3 immunoassay reagents that are for research use only has been shown to be an effective tool for early detection of an AD-like biomarker signature based on concentrations of CSF Aβ(1-42), t-tau and p-tau(181). Among the several advantages of the xMAP-Luminex platform for AD CSF biomarkers are: a wide dynamic range of ready-to-use calibrators, time savings for the simultaneous analyses of three biomarkers in one analytical run, reduction of human error, potential of reduced cost of reagents, and a modest reduction of sample volume as compared to conventional enzyme-linked immunosorbant assay (ELISA) methodology. Recent clinical studies support the use of CSF Aβ(1-42), t-tau and p-tau(181) measurement using the xMAP-Luminex platform for the early detection of AD pathology in cognitively normal individuals, and for prediction of progression to AD dementia in subjects with mild cognitive impairment (MCI). Studies that have shown the prediction of risk for progression to AD dementia by MCI patients provide the basis for the use of CSF Aβ(1-42), t-tau and p-tau(181) testing to assign risk for progression in patients enrolled in therapeutic trials. Furthermore emerging study data suggest that these pathologic changes occur in cognitively normal subjects 20 or more years before the onset of clinically detectable memory changes thus providing an objective measurement for use in the assessment of treatment effects in primary treatment trials. However, numerous previous ELISA and Luminex-based multiplex studies reported a wide range of absolute values of CSF Aβ(1-42), t-tau and p-tau(181) indicative of substantial inter-laboratory variability as well as varying degrees of intra-laboratory imprecision. In order to address these issues a recent inter-laboratory investigation that included a common set of CSF pool aliquots from controls as well as AD patients over a range of normal and pathological Aβ(1-42), t-tau and p-tau(181) values as well as agreed-on standard operating procedures (SOPs) assessed the reproducibility of the multiplex methodology and Innogenetics AlzBio3 immunoassay reagents. This study showed within-center precision values of 5% to a little more than 10% and good inter-laboratory %CV values (10-20%). There are several likely factors influencing the variability of CSF Aβ(1-42), t-tau and p-tau(181) measurements. In this review, we describe the pre-analytical, analytical and post-analytical sources of variability including sources inherent to kits, and describe procedures to decrease the variability. A CSF AD biomarker Quality Control program has been established and funded by the Alzheimer Association, and global efforts are underway to further define optimal pre-analytical SOPs and best practices for the methodologies available or in development including plans for production of a standard reference material that could provide for a common standard against which manufacturers of immunoassay kits would assign calibration standard values.
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Regeniter A, Kuhle J, Baumann T, Sollberger M, Herdener M, Kunze U, Camuso MC, Monsch AU. Biomarkers of dementia: comparison of electrochemiluminescence results and reference ranges with conventional ELISA. Methods 2012; 56:494-9. [PMID: 22503775 DOI: 10.1016/j.ymeth.2012.03.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Revised: 03/04/2012] [Accepted: 03/09/2012] [Indexed: 10/28/2022] Open
Abstract
We compared the performance of the Meso Scale Diagnostics electrochemiluminescence (MSD) multiplex assay for t-tau and p-tau(231), originally developed for measurement of brain cell extract and tissue cultures, with the established standard method, the Innogenetics ELISA for total and p-tau(181). The methods were also clinically evaluated with 120 samples from our mono center population. The established Innogenetics ELISA procedures have been well optimized to measure patient samples in the normal and pathological range. Compared to the MSD they were superior in the limit of detection for total as well as p-tau. The obtained reference values for our normal controls were in the upper third of the published studies. Innogenetics tau, Innogenetics p-tau(181) and MSD t-tau differentiated the Alzheimer's (n=44) and minimal impairment group (MCI, n=39) from normal controls (n=37), but the MCI group was not statistically different from the normal controls. The MSD multiplex assay measured t-tau adequately but p-tau(231) could not differentiate normal from pathological results in CSF due to the high limit of detection. Both procedures however, have to be further standardized and complemented by adequate internal and external quality control schemes to qualify for routine analysis in a medical laboratory.
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Affiliation(s)
- Axel Regeniter
- Basel University Hospital, Dept. of Laboratory Medicine, Petersgraben 4, CH 4031 Basel, Switzerland.
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[The future of biomarkers in dementia diagnostics]. DER NERVENARZT 2012; 82:1385-6, 1388, 1390, passim. [PMID: 21922304 DOI: 10.1007/s00115-011-3348-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Neurochemical dementia diagnostics (NDD) is a routine laboratory tool in the diagnostic process of patients with neurodegenerative disorders, such as Alzheimer's disease (AD). Currently, two groups of biomarkers analyzed in the cerebrospinal fluid (CSF) are being considered, namely amyloid β (Aβ) peptides and tau proteins, along with the hyperphosphorylated forms of the latter (p-tau). Current directions in the development of NDD include the following: 1. search for novel biomarkers with improved analytical or diagnostic performance; 2. search for biomarkers in the blood; 3. applications of novel technologies enabling better management of patient samples; 4. optimization of the analysis of the biomarkers already available (for example, by improved quality control and inter-laboratory comparison of results). This review presents the state of the art in the field of CSF-based NDD and also summarizes some of the hypotheses of how the future development of NDD tools might look.
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Kułakowska A, Mroczko B, Mantur M, Lelental N, Tarasiuk J, Kapica-Topczewska K, Schulz U, Lange P, Zimmermann R, Kornhuber J, Lewczuk P. Multiplexing analysis of the polyspecific intrathecal immune response in multiple sclerosis. Methods 2012; 56:528-31. [PMID: 22445706 DOI: 10.1016/j.ymeth.2012.03.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Accepted: 03/02/2012] [Indexed: 10/28/2022] Open
Abstract
Intrathecal synthesis of the antibodies specific to neurotrofic viruses: measles (M), rubella (R), Varicella-Zoster (Z), and/or H. simplex (H), known as "MRZH-reaction" plays important diagnostic role in multiple sclerosis (MS). Whereas the analysis of the oligoclonal IgG bands provides high sensitivity, the MRZH-reaction shows high specificity, and hence these methods complement each other. For the first time we applied multiplexing bead-based technology to simultaneously analyze cerebrospinal fluid (CSF) and serum concentrations of antibodies against these viruses, and to calculate the antibody specific indices (ASI's). The method shows reasonable precision: intra-assay, 2.9-6.7%, and inter-assay, 2.0-3.2%. The results are comparable with these obtained with other methods (ELISAs), including two runs of the certified external quality control schemes. Eighty-one percent of the MS cases (n=27) and none of the sex- and age-matched controls (n=14), except one subject with "borderline" anti-measles ASI of 1.5, showed intrathecal synthesis of IgG against at least one of the viruses discussed. The ratios of the MRZH-positive cases in the MS group were: 12/22 for M, 12/19 for R, 13/26 for Z, and 7/26 for H. We conclude that the multiplexing technology can be applied as a tool to study the intrathecal immune response in the diagnosis of MS.
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Affiliation(s)
- Alina Kułakowska
- Department of Neurology, Medical University of Białystok, Poland
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Patients with mild cognitive impairment and a reduced CSF Aβ1-42 protein progress rapidly to Alzheimer's disease. NEUROLOGÍA (ENGLISH EDITION) 2012. [DOI: 10.1016/j.nrleng.2011.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Bjornstal O, Rogers K, Zhang W, Delhaye R, Malone M, Unger S, Nowatzke W. The impact of decreased bead count to determine concentrations of amyloid beta1-42, total-tau, and phosphorylated-tau181 in human cerebrospinal fluid using xMAP technology. J Pharm Sci 2011; 100:4655-63. [PMID: 21780117 DOI: 10.1002/jps.22700] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 06/16/2011] [Accepted: 06/20/2011] [Indexed: 01/29/2023]
Abstract
Alzheimer's disease is the leading cause of human dementia. The lack of diagnostic tests and limited therapeutic options has driven the search for endogenous biomarkers. The INNO-BIA AlzBio3 assay is a multiplex flow-based immunoassay measuring Aβ42, tau, and p-tau in cerebrospinal fluid (CSF). This study assesses assays performance under varying bead count (BC) parameters. Original method validation parameters at 100 BC were acceptable. Reanalyses performed at 3, 10, 25, and 50 BCs were compared to 100 BC data by ANOVA, Bland-Altman analysis, evaluation of concordance correlation coefficients, and frequency distribution of coefficient of variation (CV) ranges. Method validation characteristics were acceptable with 100 BCs. Equivalency for 25 and 50 versus 100 BCs was demonstrated, but not for 3 and 10 BCs. A general trend of decreasing agreement between decreasing BCs and the 100 BC reference resulted in decreases in concordance coefficients ρ(c) . The frequency of CV values greater than 20% increased with decreasing BCs, and CV values of 5% or less decreased with decreased BCs. Statistical analyses demonstrate that BCs of 3 and 10 are not equivalent with the reference and should not be used as a basis for determination of Aβ42, tau, and p-tau concentration in human CSF.
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Affiliation(s)
- Olaf Bjornstal
- Worldwide Clinical Trials Drug Development Solutions-Bioanalytical Sciences, Austin, Texas 78754, USA
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Monge-Argilés JA, Sánchez-Payá J, Muñoz-Ruiz C, Pampliega-Pérez A, Gómez-López MJ, Rodríguez Borja E, Montoya-Gutiérrez J, Leiva-Santana C. [Patients with mild cognitive impairment and a reduced CSF Aβ₁₋₄₂ protein progress rapidly to Alzheimer's disease]. Neurologia 2011; 27:28-33. [PMID: 21621878 DOI: 10.1016/j.nrl.2011.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2010] [Revised: 03/21/2011] [Accepted: 03/27/2011] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Some studies have shown that CSF amyloid-beta 1-42 (Aβ₁₋₄₂), total tau (T-tau) and tau phosphorylated at threonine 181 (P-tau(181p)) proteins are useful diagnostic markers for distinguishing between clinically stable mild cognitive impairment (MCI) patients and those who will develop Alzheimeŕs disease (AD). Our objective was to test the ability of this technique to discriminate in our cohort of MCI patients, according to the clinical outcome, one year after the lumbar puncture. MATERIAL AND METHODS A total of 36 MCI patients were included from the local hospital memory clinic. Using INNO-BIA Alzbio-3 reagents from Innogenetics, we measured CSF Aβ₁₋₄₂, T-tau and P-tau(181p) proteins, and calculated the T-tau/Aβ₁₋₄₂ y P-tau(181p)/Aβ₁₋₄₂ ratios. This project was approved by the local ethics committee. RESULTS One year after the lumbar puncture, 14 MCI patients (38%) developed AD. These patients had lower Aβ₁₋₄₂ protein levels (285.3 vs 377 ng/ml, P<.02) and higher P-tau(181p)/Aβ₁₋₄₂ ratio (0,25 vs 0,16, p<.02) than the clinically stable patients. CONCLUSIONS Our MCI patients with lower Aβ₁₋₄₂ protein levels and an increased P-tau(181p) /Aβ₁₋₄₂ ratio progressed quickly to AD. These results may help to identify those MCI patients with a poorer prognosis.
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Affiliation(s)
- J A Monge-Argilés
- Servicio de Neurología, Hospital General Universitario de Alicante, Alicante, España. monge
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Fagan AM, Shaw LM, Xiong C, Vanderstichele H, Mintun MA, Trojanowski JQ, Coart E, Morris JC, Holtzman DM. Comparison of analytical platforms for cerebrospinal fluid measures of β-amyloid 1-42, total tau, and p-tau181 for identifying Alzheimer disease amyloid plaque pathology. ACTA ACUST UNITED AC 2011; 68:1137-44. [PMID: 21555603 DOI: 10.1001/archneurol.2011.105] [Citation(s) in RCA: 134] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Cerebrospinal fluid (CSF) biomarkers of Alzheimer disease (AD) are currently being considered for inclusion in revised diagnostic criteria for research and/or clinical purposes to increase the certainty of antemortem diagnosis. OBJECTIVE To test whether CSF biomarker assays differ in their ability to identify true markers of underlying AD pathology (eg, amyloid plaques and/or neurofibrillary tangles) in living individuals. DESIGN We compared the performances of the 2 most commonly used platforms, INNOTEST enzyme-linked immunosorbent assay and INNO-BIA AlzBio3, for measurement of CSF β-amyloid (Aβ) and tau proteins to identify the presence of amyloid plaques in a research cohort (n=103). Values obtained for CSF Aβ1-42, total tau, and phosphorylated tau 181 (p-tau(181)) using the 2 assay platforms were compared with brain amyloid load as assessed by positron emission tomography using the amyloid imaging agent Pittsburgh compound B. SETTING The Knight Alzheimer's Disease Research Center at Washington University in St Louis, Missouri. SUBJECTS Research volunteers who were cognitively normal or had mild to moderate AD dementia. RESULTS The 2 assay platforms yielded different (approximately 2- to 6-fold) absolute values for the various analytes, but relative values were highly correlated. The CSF Aβ1-42 correlated inversely and tau and p-tau(181) correlated positively with the amount of cortical Pittsburgh compound B binding, albeit to differing degrees. Both assays yielded similar patterns of CSF biomarker correlations with amyloid load. The ratios of total tau to Aβ1-42 and p-tau(181) to Aβ1-42 outperformed any single analyte, including Aβ1-42, in discriminating individuals with vs without cortical amyloid. CONCLUSIONS The INNOTEST and INNO-BIA CSF platforms perform equally well in identifying individuals with underlying amyloid plaque pathology. Differences in absolute values, however, point to the need for assay-specific diagnostic cutoff values.
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Affiliation(s)
- Anne M Fagan
- Knight Alzheimer’s Disease Research Center, St Louis, Missouri, USA.
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Biomarkers of Alzheimer′s Disease in the Cerebrospinal Fluid of Spanish Patients With Mild Cognitive Impairment. Neurochem Res 2011; 36:986-93. [DOI: 10.1007/s11064-011-0438-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2011] [Indexed: 11/30/2022]
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Influence of brain-derived neurotrophic-factor and apolipoprotein E genetic variants on hippocampal volume and memory performance in healthy young adults. J Neural Transm (Vienna) 2010; 118:249-57. [DOI: 10.1007/s00702-010-0539-8] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2010] [Accepted: 11/14/2010] [Indexed: 12/12/2022]
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Humpel C. Identifying and validating biomarkers for Alzheimer's disease. Trends Biotechnol 2010; 29:26-32. [PMID: 20971518 PMCID: PMC3016495 DOI: 10.1016/j.tibtech.2010.09.007] [Citation(s) in RCA: 287] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Revised: 09/28/2010] [Accepted: 09/28/2010] [Indexed: 12/13/2022]
Abstract
The identification and validation of biomarkers for diagnosing Alzheimer's disease (AD) and other forms of dementia are increasingly important. To date, ELISA measurement of β-amyloid(1–42), total tau and phospho-tau-181 in cerebrospinal fluid (CSF) is the most advanced and accepted method to diagnose probable AD with high specificity and sensitivity. However, it is a great challenge to search for novel biomarkers in CSF and blood by using modern potent methods, such as microarrays and mass spectrometry, and to optimize the handling of samples (e.g. collection, transport, processing, and storage), as well as the interpretation using bioinformatics. It seems likely that only a combined analysis of several biomarkers will define a patient-specific signature to diagnose AD in the future.
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Affiliation(s)
- Christian Humpel
- Laboratory of Psychiatry and Experimental Alzheimer's Research, Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Anichstr. 35, A-6020 Innsbruck, Austria.
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Maetzler W, Berg D. Biomarkers of Alzheimer's and Parkinson's Disease. Biomarkers 2010. [DOI: 10.1002/9780470918562.ch6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Sonnen JA, Montine KS, Quinn JF, Breitner JCS, Montine TJ. Cerebrospinal fluid biomarkers in mild cognitive impairment and dementia. J Alzheimers Dis 2010; 19:301-9. [PMID: 20061646 DOI: 10.3233/jad-2010-1236] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Given the magnitude of the public health problem of dementia in the elderly, there is a pressing need for research, development, and timely application of biomarkers that will identify latent and prodromal illness as well as dementia. Although identification of risk factors and neuroimaging measures will remain key to these efforts, this review focuses on recent progress in the discovery, validation, and standardization of cerebrospinal fluid (CSF) biomarkers, small molecules and macromolecules whose CSF concentration can aid in diagnosis at different stages of disease as well as in assessment of disease progression and response to therapeutics. A multimodal approach that brings independent information from risk factor assessment, neuroimaging, and biomarkers may soon guide physicians in the early diagnosis and management of cognitive impairment in the elderly.
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Affiliation(s)
- Joshua A Sonnen
- Department of Pathology, Division of Neuropathology, University of Washington, Seattle, WA 98104-2420, USA.
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Confirmation rate of blinded (99m)Tc-SPECT compared to neurochemical dementia biomarkers in CSF in patients with Alzheimer disease. J Neural Transm (Vienna) 2010; 117:1111-4. [PMID: 20694486 DOI: 10.1007/s00702-010-0459-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Accepted: 07/27/2010] [Indexed: 10/19/2022]
Abstract
In Alzheimer disease, CSF biomarkers and nuclear imaging are of particular interest. Many studies investigated only one technique, limiting comparison. Here, in 76 patients blinded 99mTc-SPECT was compared to CSF. Sensitivity of CSF was 92%; and 51% for SPECT. Specificity favored SPECT (90 vs. 80%). Both techniques showed no coherence (p = 0.17-0.47). Our results confirm that CSF biomarkers show higher sensitivity. SPECT has higher specificity and can also be used for other dementias without established CSF biomarkers.
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Chow VW, Mattson MP, Wong PC, Gleichmann M. An overview of APP processing enzymes and products. Neuromolecular Med 2010; 12:1-12. [PMID: 20232515 DOI: 10.1007/s12017-009-8104-z] [Citation(s) in RCA: 446] [Impact Index Per Article: 31.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The generation of amyloid beta-peptide (A beta) by enzymatic cleavages of the beta-amyloid precursor protein (APP) has been at the center of Alzheimer's disease (AD) research. While the basic process of beta- and gamma-secretase-mediated generation of A beta is text book knowledge, new aspects of A beta and other cleavage products have emerged in recent years. Also our understanding of the enzymes involved in APP proteolysis has increased dramatically. All of these discoveries contribute to a more complete understanding of APP processing and the physiologic and pathologic roles of its secreted and intracellular protein products. Understanding APP processing is important for any therapeutic strategy aimed at reducing A beta levels in AD. In this review, we provide a concise description of the current state of understanding the enzymes involved in APP processing, the cleavage products generated by different processing patterns, and the potential functions of those cleavage products.
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Affiliation(s)
- Vivian W Chow
- Department of Pathology, Division of Neuropathology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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