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Maranzano A, Verde F, Dubini A, Torre S, Colombo E, Doretti A, Gentile F, Manini A, Milone I, Brusati A, Peverelli S, Santangelo S, Spinelli EG, Torresani E, Gentilini D, Messina S, Morelli C, Poletti B, Agosta F, Ratti A, Filippi M, Silani V, Ticozzi N. Association of APOE genotype and cerebrospinal fluid Aβ and tau biomarkers with cognitive and motor phenotype in amyotrophic lateral sclerosis. Eur J Neurol 2024; 31:e16374. [PMID: 38853763 PMCID: PMC11295165 DOI: 10.1111/ene.16374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 04/13/2024] [Accepted: 05/17/2024] [Indexed: 06/11/2024]
Abstract
OBJECTIVE Little is known about amyotrophic lateral sclerosis (ALS)-nonspecific cognitive deficits - most notably memory disturbance - and their biological underpinnings. We investigated the associations of the Alzheimer's disease (AD) genetic risk factor APOE and cerebrospinal fluid (CSF) biomarkers Aβ and tau proteins with cognitive and motor phenotype in ALS. METHODS APOE haplotype was determined in 281 ALS patients; for 105 of these, CSF levels of Aβ42, Aβ40, total tau (T-tau), and phosphorylated tau (P-tau181) were quantified by chemiluminescence enzyme immunoassay (CLEIA). The Edinburgh Cognitive and Behavioural ALS Screen (ECAS) was employed to evaluate the neuropsychological phenotype. RESULTS APOE-E4 allele was associated with worse ECAS memory score (median, 14.0 in carriers vs. 16.0 in non-carriers) and lower CSF Aβ42 (-0.8 vs. 0.1, log-transformed values) and Aβ42/40 ratio (-0.1 vs. 0.3). Some 37.1% of ALS patients showed low Aβ42 levels, possibly reflecting cerebral Aβ deposition. While lower Aβ42/40 correlated with lower memory score (β = 0.20), Aβ42 positively correlated with both ALS-specific (β = 0.24) and ALS-nonspecific (β = 0.24) scores. Although Aβ42/40 negatively correlated with T-tau (β = -0.29) and P-tau181 (β = -0.33), we found an unexpected positive association of Aβ42 and Aβ40 with both tau proteins. Regarding motor phenotype, lower levels of Aβ species were associated with lower motor neuron (LMN) signs (Aβ40: β = 0.34; Aβ42: β = 0.22). CONCLUSIONS APOE haplotype and CSF Aβ biomarkers are associated with cognitive deficits in ALS and particularly with memory impairment. This might partly reflect AD-like pathophysiological processes, but additional ALS-specific mechanisms could be involved.
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Affiliation(s)
- Alessio Maranzano
- Department of Neurology and Laboratory of NeuroscienceIRCCS Istituto Auxologico ItalianoMilanItaly
| | - Federico Verde
- Department of Neurology and Laboratory of NeuroscienceIRCCS Istituto Auxologico ItalianoMilanItaly
- Department of Pathophysiology and Transplantation, ‘Dino Ferrari’ CenterUniversità degli Studi di MilanoMilanItaly
| | - Antonella Dubini
- Department of Laboratory Medicine, Laboratory of Clinical Chemistry and MicrobiologyIRCCS Istituto Auxologico ItalianoMilanItaly
| | - Silvia Torre
- Department of Neurology and Laboratory of NeuroscienceIRCCS Istituto Auxologico ItalianoMilanItaly
| | - Eleonora Colombo
- Department of Neurology and Laboratory of NeuroscienceIRCCS Istituto Auxologico ItalianoMilanItaly
| | - Alberto Doretti
- Department of Neurology and Laboratory of NeuroscienceIRCCS Istituto Auxologico ItalianoMilanItaly
| | - Francesco Gentile
- Division of Genetics and Cell BiologyIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Arianna Manini
- Department of Pathophysiology and Transplantation, ‘Dino Ferrari’ CenterUniversità degli Studi di MilanoMilanItaly
| | - Ilaria Milone
- Department of Neurology and Laboratory of NeuroscienceIRCCS Istituto Auxologico ItalianoMilanItaly
| | - Alberto Brusati
- Department of Brain and Behavioural SciencesUniversità degli Studi di PaviaPaviaItaly
| | - Silvia Peverelli
- Department of Neurology and Laboratory of NeuroscienceIRCCS Istituto Auxologico ItalianoMilanItaly
| | - Serena Santangelo
- Department of Medical Biotechnology and Molecular MedicineUniversità degli Studi di MilanoMilanItaly
| | - Edoardo Gioele Spinelli
- Neurology Unit, Division of NeuroscienceIRCCS San Raffaele Scientific InstituteMilanItaly
- Neuroimaging Research Unit, Division of NeuroscienceIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Erminio Torresani
- Department of Laboratory Medicine, Laboratory of Clinical Chemistry and MicrobiologyIRCCS Istituto Auxologico ItalianoMilanItaly
| | - Davide Gentilini
- Department of Brain and Behavioural SciencesUniversità degli Studi di PaviaPaviaItaly
- Bioinformatics and Statistical Genomics UnitIRCCS Istituto Auxologico ItalianoMilanItaly
| | - Stefano Messina
- Department of Neurology and Laboratory of NeuroscienceIRCCS Istituto Auxologico ItalianoMilanItaly
| | - Claudia Morelli
- Department of Neurology and Laboratory of NeuroscienceIRCCS Istituto Auxologico ItalianoMilanItaly
| | - Barbara Poletti
- Department of Neurology and Laboratory of NeuroscienceIRCCS Istituto Auxologico ItalianoMilanItaly
- Department of Oncology and Hemato‐OncologyUniversità degli Studi di MilanoMilanItaly
| | - Federica Agosta
- Neurology Unit, Division of NeuroscienceIRCCS San Raffaele Scientific InstituteMilanItaly
- Neuroimaging Research Unit, Division of NeuroscienceIRCCS San Raffaele Scientific InstituteMilanItaly
- Vita‐Salute San Raffaele UniversityMilanItaly
- Neurorehabilitation Unit, Division of NeuroscienceIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Antonia Ratti
- Department of Neurology and Laboratory of NeuroscienceIRCCS Istituto Auxologico ItalianoMilanItaly
- Department of Medical Biotechnology and Molecular MedicineUniversità degli Studi di MilanoMilanItaly
| | - Massimo Filippi
- Neurology Unit, Division of NeuroscienceIRCCS San Raffaele Scientific InstituteMilanItaly
- Neuroimaging Research Unit, Division of NeuroscienceIRCCS San Raffaele Scientific InstituteMilanItaly
- Vita‐Salute San Raffaele UniversityMilanItaly
- Neurorehabilitation Unit, Division of NeuroscienceIRCCS San Raffaele Scientific InstituteMilanItaly
- Neurophysiology Service, Division of NeuroscienceIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Vincenzo Silani
- Department of Neurology and Laboratory of NeuroscienceIRCCS Istituto Auxologico ItalianoMilanItaly
- Department of Pathophysiology and Transplantation, ‘Dino Ferrari’ CenterUniversità degli Studi di MilanoMilanItaly
| | - Nicola Ticozzi
- Department of Neurology and Laboratory of NeuroscienceIRCCS Istituto Auxologico ItalianoMilanItaly
- Department of Pathophysiology and Transplantation, ‘Dino Ferrari’ CenterUniversità degli Studi di MilanoMilanItaly
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Alanazi N, Fitzgerald M, Hume P, Hellewell S, Horncastle A, Anyaegbu C, Papini MG, Hargreaves N, Halicki M, Entwistle I, Hind K, Chazot P. Concussion-Related Biomarker Variations in Retired Rugby Players and Implications for Neurodegenerative Disease Risk: The UK Rugby Health Study. Int J Mol Sci 2024; 25:7811. [PMID: 39063053 PMCID: PMC11276902 DOI: 10.3390/ijms25147811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 07/02/2024] [Accepted: 07/04/2024] [Indexed: 07/28/2024] Open
Abstract
The health and well-being of retired rugby union and league players, particularly regarding the long-term effects of concussions, are of major concern. Concussion has been identified as a major risk factor for neurodegenerative diseases, such as Alzheimer's and Amyotrophic Lateral Sclerosis (ALS), in athletes engaged in contact sports. This study aimed to assess differences in specific biomarkers between UK-based retired rugby players with a history of concussion and a non-contact sports group, focusing on biomarkers associated with Alzheimer's, ALS, and CTE. We randomly selected a sample of male retired rugby or non-contact sport athletes (n = 56). The mean age was 41.84 ± 6.44, and the mean years since retirement from the sport was 7.76 ± 6.69 for participants with a history of substantial concussions (>5 concussions in their career) (n = 30). The mean age was 45.75 ± 11.52, and the mean years since retirement was 6.75 ± 4.64 for the healthy controls (n = 26). Serum biomarkers (t-tau, RBP-4, SAA, Nf-L, and retinol), plasma cytokines, and biomarkers associated with serum-derived exosomes (Aβ42, p-tau181, p-tau217, and p-tau231) were analyzed using validated commercial ELISA assays. The results of the selected biomarkers were compared between the two groups. Biomarkers including t-tau and p-tau181 were significantly elevated in the history of the substantial concussion group compared to the non-contact sports group (t-tau: p < 0.01; p-tau181: p < 0.05). Although between-group differences in p-tau217, p-tau231, SAA, Nf-L, retinol, and Aβ42 were not significantly different, there was a trend for higher levels of Aβ42, p-tau217, and p-tau231 in the concussed group. Interestingly, the serum-derived exosome sizes were significantly larger (p < 0.01), and serum RBP-4 levels were significantly reduced (p < 0.05) in the highly concussed group. These findings indicate that retired athletes with a history of multiple concussions during their careers have altered serum measurements of exosome size, t-tau, p-tau181, and RBP-4. These biomarkers should be explored further for the prediction of future neurodegenerative outcomes, including ALS, in those with a history of concussion.
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Affiliation(s)
- Norah Alanazi
- Department of Biosciences, Wolfson Research Institute for Health and Wellbeing, Durham University, Durham DH1 3LE, UK; (N.A.); (A.H.); (N.H.); (M.H.); (I.E.)
| | - Melinda Fitzgerald
- Curtin Health Innovation Research Institute, Curtin University, Bentley, WA 6102, Australia; (M.F.); (S.H.); (M.G.P.)
- Perron Institute for Neurological and Translational Sciences, Nedlands, WA 6009, Australia
| | - Patria Hume
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, AUT Millennium, 17 Antares Place, Mairangi Bay, Private Bag 92006, Auckland 1142, New Zealand;
- Traumatic Brain Injury Network (TBIN), Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand
- Auckland Bioengineering Institute, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
- Technology and Policy Laboratory, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia
| | - Sarah Hellewell
- Curtin Health Innovation Research Institute, Curtin University, Bentley, WA 6102, Australia; (M.F.); (S.H.); (M.G.P.)
- Perron Institute for Neurological and Translational Sciences, Nedlands, WA 6009, Australia
- Centre for Neuromuscular & Neurological Disorders, University of Western Australia, Crawley, WA 6009, Australia
| | - Alex Horncastle
- Department of Biosciences, Wolfson Research Institute for Health and Wellbeing, Durham University, Durham DH1 3LE, UK; (N.A.); (A.H.); (N.H.); (M.H.); (I.E.)
| | - Chidozie Anyaegbu
- Curtin Health Innovation Research Institute, Curtin University, Bentley, WA 6102, Australia; (M.F.); (S.H.); (M.G.P.)
- Perron Institute for Neurological and Translational Sciences, Nedlands, WA 6009, Australia
- Centre for Neuromuscular & Neurological Disorders, University of Western Australia, Crawley, WA 6009, Australia
| | - Melissa G. Papini
- Curtin Health Innovation Research Institute, Curtin University, Bentley, WA 6102, Australia; (M.F.); (S.H.); (M.G.P.)
- Perron Institute for Neurological and Translational Sciences, Nedlands, WA 6009, Australia
- Centre for Neuromuscular & Neurological Disorders, University of Western Australia, Crawley, WA 6009, Australia
| | - Natasha Hargreaves
- Department of Biosciences, Wolfson Research Institute for Health and Wellbeing, Durham University, Durham DH1 3LE, UK; (N.A.); (A.H.); (N.H.); (M.H.); (I.E.)
| | - Michal Halicki
- Department of Biosciences, Wolfson Research Institute for Health and Wellbeing, Durham University, Durham DH1 3LE, UK; (N.A.); (A.H.); (N.H.); (M.H.); (I.E.)
| | - Ian Entwistle
- Department of Biosciences, Wolfson Research Institute for Health and Wellbeing, Durham University, Durham DH1 3LE, UK; (N.A.); (A.H.); (N.H.); (M.H.); (I.E.)
- Wolfson Research Institute for Health and Wellbeing, Durham University, Durham TS17 6BH, UK
| | - Karen Hind
- Wolfson Research Institute for Health and Wellbeing, Durham University, Durham TS17 6BH, UK
| | - Paul Chazot
- Department of Biosciences, Wolfson Research Institute for Health and Wellbeing, Durham University, Durham DH1 3LE, UK; (N.A.); (A.H.); (N.H.); (M.H.); (I.E.)
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Rajendrakumar AL, Arbeev KG, Bagley O, Yashin AI, Ukraintseva S. The association between rs6859 in NECTIN2 gene and Alzheimer's disease is partly mediated by pTau. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.21.24309310. [PMID: 38947013 PMCID: PMC11213054 DOI: 10.1101/2024.06.21.24309310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Introduction Emerging evidence suggests a connection between vulnerability to infections and Alzheimer's disease (AD). The nectin cell adhesion molecule 2 (NECTIN2) gene coding for a membrane component of adherens junctions is involved in response to infection, and its single nucleotide polymorphism (SNP) rs6859 was significantly associated with AD risk in several human cohorts. It is unclear, however, how exactly rs6859 influences the development of AD pathology. The aggregation of hyperphosphorylated tau protein (pTau) is a key pathological feature of neurodegeneration in AD, which may be induced by infections, among other factors, and potentially influenced by genes involved in both AD and vulnerability to infections, such as NECTIN2. Materials and methods We conducted a causal mediation analysis (CMA) on a sample of 708 participants in the Alzheimer's Disease Neuroimaging Initiative (ADNI). The relationship between rs6859 and Alzheimer's disease (AD), with AD (yes/no) as the outcome and pTau-181 levels in the cerebrospinal fluid (CSF) acting as a mediator in this association, was assessed. Adjusted estimates from the probit and linear regression models were used in the CMA model, where an additive model considered an increase in dosage of the rs6859 A allele (AD risk factor). Results The increase in dose of allele A of the SNP rs6859 resulted in about 0.144 increase per standard deviation (SD) of pTau-181 (95% CI: 0.041, 0.248, p<0.01). When included together in the probit model, the change in A allele dose and each standard deviation change in pTau-181 predicted 6.84% and 9.79% higher probabilities for AD, respectively. In the CMA, the proportion of the average mediated effect was 17.05% and was higher for the risk allele homozygotes (AA), at 19.40% (95% CI: 6.20%, 43.00%, p<0.01). The sensitivity analysis confirmed the evidence of a robust mediation effect. Conclusion This study reported a new causal relationship between pTau-181 and AD. We found that the association between rs6859 in the NECTIN2 gene and AD is partly mediated by pTau-181 levels in CSF. The rest of this association may be mediated by other factors. Further research, using other biomarkers, is needed to uncover the remaining mechanisms of the association between the NECTIN2 gene and AD.
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Affiliation(s)
| | - Konstantin G. Arbeev
- Biodemography of Aging Research Unit, Duke University, Social Science Research Institute, Durham, NC, USA
| | - Olivia Bagley
- Biodemography of Aging Research Unit, Duke University, Social Science Research Institute, Durham, NC, USA
| | - Anatoliy I. Yashin
- Biodemography of Aging Research Unit, Duke University, Social Science Research Institute, Durham, NC, USA
| | - Svetlana Ukraintseva
- Biodemography of Aging Research Unit, Duke University, Social Science Research Institute, Durham, NC, USA
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Antonioni A, Raho EM, Di Lorenzo F. Is blood pTau a reliable indicator of the CSF status? A narrative review. Neurol Sci 2024; 45:2471-2487. [PMID: 38129590 DOI: 10.1007/s10072-023-07258-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/03/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The identification of biomarkers for the early diagnosis of Alzheimer's disease (AD) is a crucial goal of the current research. Blood biomarkers are less invasive, easier to obtain and achievable by a cheaper means than those on cerebrospinal fluid (CSF) and significantly more economic than functional neuroimaging investigations; thus, a great interest is focused on blood isoforms of the phosphorylated Tau protein (pTau), indicators of ongoing tau pathology (i.e. neurofibrillary tangles, NFTs, an AD neuropathological hallmark) in the central nervous system (CNS). However, current data often highlight discordant results about the ability of blood pTau to predict CSF status. OBJECTIVE We aim to synthesise the studies that compared pTau levels on CSF and blood to assess their correlation in AD continuum. METHODS We performed a narrative literature review using, first, MEDLINE (via PubMed) by means of MeSH terms, and then, we expanded the reults by means of Scopus and Web of Sciences to be as inclusive as possible. Finally, we added work following an expert opinion. Only papers presenting original data on pTau values on both blood and CSF were included. RESULTS The 33 included studies show an extreme heterogeneity in terms of pTau isoform (pTau181, 217 and 231), laboratory methods, diagnostic criteria and choice of comparison groups. Most studies evaluated plasma pTau181, while data on other isoforms and serum are scarcer. DISCUSSION Most papers identify a correlation between CSF and blood measurements. Furthermore, even when not specified, it is often possible to show an increase in blood pTau values as AD-related damage progresses in the AD continuum and higher values in AD than in other neurodegenerative diseases. Notably, plasma pTau231 seems the first biomarker to look for in the earliest and pre-clinical stages, quickly followed by pTau217 and, finally, by pTau181. CONCLUSIONS Our results encourage the use of blood pTau for the early identification of patients with AD continuum.
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Affiliation(s)
- Annibale Antonioni
- Unit of Clinical Neurology, Neurosciences and Rehabilitation Department, University of Ferrara, 44121, Ferrara, Italy
- Doctoral Program in Translational Neurosciences and Neurotechnologies, University of Ferrara, 44121, Ferrara, Italy
| | - Emanuela Maria Raho
- Unit of Clinical Neurology, Neurosciences and Rehabilitation Department, University of Ferrara, 44121, Ferrara, Italy
| | - Francesco Di Lorenzo
- Non Invasive Brain Stimulation Unit, Istituto Di Ricovero E Cura a Carattere Scientifico Santa Lucia, 00179, Rome, Italy.
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Donini L, Tanel R, Zuccarino R, Basso M. Protein biomarkers for the diagnosis and prognosis of Amyotrophic Lateral Sclerosis. Neurosci Res 2023; 197:31-41. [PMID: 37689321 DOI: 10.1016/j.neures.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 09/11/2023]
Abstract
Amyotrophic Lateral Sclerosis (ALS) is the most common motor neuron disease, still incurable. The disease is highly heterogenous both genetically and phenotypically. Therefore, developing efficacious treatments is challenging in many aspects because it is difficult to predict the rate of disease progression and stratify the patients to minimize statistical variability in clinical studies. Moreover, there is a lack of sensitive measures of therapeutic effect to assess whether a pharmacological intervention ameliorates the disease. There is also urgency of markers that reflect a molecular mechanism dysregulated by ALS pathology and can be rescued when a treatment relieves the condition. Here, we summarize and discuss biomarkers tested in multicentered studies and across different laboratories like neurofilaments, the most used marker in ALS clinical studies, neuroinflammatory-related proteins, p75ECD, p-Tau/t-Tau, and UCHL1. We also explore the applicability of muscle proteins and extracellular vesicles as potential biomarkers.
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Affiliation(s)
- Luisa Donini
- Department of Cellular, Computational and Integrative Biology - CIBIO, University of Trento, Italy.
| | - Raffaella Tanel
- Clinical Center NeMO, APSS Ospedale Riabilitativo Villa Rosa, Pergine 38057, TN, Italy.
| | - Riccardo Zuccarino
- Clinical Center NeMO, APSS Ospedale Riabilitativo Villa Rosa, Pergine 38057, TN, Italy
| | - Manuela Basso
- Department of Cellular, Computational and Integrative Biology - CIBIO, University of Trento, Italy.
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Verde F, Milone I, Colombo E, Maranzano A, Dubini A, Colombrita C, Gentile F, Doretti A, Torre S, Messina S, Morelli C, Torresani E, Poletti B, Priori A, Maderna L, Ratti A, Silani V, Ticozzi N. Phosphorylated tau in plasma could be a biomarker of lower motor neuron impairment in amyotrophic lateral sclerosis. Neurol Sci 2023; 44:3697-3702. [PMID: 37369876 DOI: 10.1007/s10072-023-06916-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023]
Abstract
INTRODUCTION Plasma levels of phosphorylated tau (P-tau181) have been recently reported to be increased in amyotrophic lateral sclerosis (ALS) and associated with lower motor neuron (LMN) impairment. PATIENTS AND METHODS We quantified plasma P-tau181 (pP-tau181) in a cohort of 29 deeply phenotyped ALS patients using the new fully automated Lumipulse assay and analysed phenotype-biomarker correlations. RESULTS pP-tau181 levels correlated positively with a clinical LMN score (r = 0.3803) and negatively, albeit not significantly, with a composite index of muscle strength (r = - 0.3416; p = 0.0811), but not with Penn Upper Motor Neuron (UMN) Score. Accordingly, pP-tau181 correlated with electromyographic indices of spinal active and chronic denervation (r = 0.4507 and r = 0.3864, respectively) but not with transcranial magnetic stimulation parameters of UMN dysfunction. pP-tau181 levels did not correlate with those in the cerebrospinal fluid (CSF), serum NFL, serum GFAP, CSF/serum albumin ratio, or estimated glomerular filtration rate, but correlated with plasma creatine kinase levels (r = 0.4661). Finally, while not being associated with neuropsychological phenotype, pP-tau181 correlated negatively with pH (r = - 0.5632) and positively with partial pressure of carbon dioxide (PaCO2; r = 0.7092), bicarbonate (sHCO3-; r = 0.6667) and base excess (r = 0.6611) on arterial blood gas analysis. DISCUSSION pP-tau181 has potential as ALS biomarker and could be associated with LMN impairment. Its raised levels might reflect pathophysiological processes (tau hyperphosphorylation and/or release) occurring in the axons of LMNs distantly from the CNS and the CSF. pP-tau181 could also be associated with respiratory dysfunction.
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Affiliation(s)
- Federico Verde
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia, 20 - 20149, Milan, Italy.
- Department of Pathophysiology and Transplantation, Dino Ferrari Center, Università Degli Studi Di Milano, Milan, Italy.
| | - Ilaria Milone
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia, 20 - 20149, Milan, Italy
| | - Eleonora Colombo
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia, 20 - 20149, Milan, Italy
| | - Alessio Maranzano
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia, 20 - 20149, Milan, Italy
| | - Antonella Dubini
- Laboratory of Clinical Chemistry and Microbiology, Department of Laboratory Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Claudia Colombrita
- Laboratory of Clinical Chemistry and Microbiology, Department of Laboratory Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Francesco Gentile
- Neurology Residency Program, Università Degli Studi Di Milano, Milan, Italy
| | - Alberto Doretti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia, 20 - 20149, Milan, Italy
| | - Silvia Torre
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia, 20 - 20149, Milan, Italy
| | - Stefano Messina
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia, 20 - 20149, Milan, Italy
| | - Claudia Morelli
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia, 20 - 20149, Milan, Italy
| | - Erminio Torresani
- Laboratory of Clinical Chemistry and Microbiology, Department of Laboratory Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia, 20 - 20149, Milan, Italy
- Department of Oncology and Hemato-Oncology, Università Degli Studi Di Milano, Milan, Italy
| | - Alberto Priori
- Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, Università Degli Studi Di Milano, Milan, Italy
- III Neurology Clinic, ASST Santi Paolo E Carlo University Hospital, Milan, Italy
| | - Luca Maderna
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia, 20 - 20149, Milan, Italy
| | - Antonia Ratti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia, 20 - 20149, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, Università Degli Studi Di Milano, Milan, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia, 20 - 20149, Milan, Italy
- Department of Pathophysiology and Transplantation, Dino Ferrari Center, Università Degli Studi Di Milano, Milan, Italy
| | - Nicola Ticozzi
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia, 20 - 20149, Milan, Italy
- Department of Pathophysiology and Transplantation, Dino Ferrari Center, Università Degli Studi Di Milano, Milan, Italy
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Mastrangelo A, Vacchiano V, Zenesini C, Ruggeri E, Baiardi S, Cherici A, Avoni P, Polischi B, Santoro F, Capellari S, Liguori R, Parchi P. Amyloid-Beta Co-Pathology Is a Major Determinant of the Elevated Plasma GFAP Values in Amyotrophic Lateral Sclerosis. Int J Mol Sci 2023; 24:13976. [PMID: 37762278 PMCID: PMC10531493 DOI: 10.3390/ijms241813976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/29/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
Recent studies reported increased plasma glial acidic fibrillary protein (GFAP) levels in amyotrophic lateral sclerosis (ALS) patients compared to controls. We expanded these findings in a larger cohort, including 156 ALS patients and 48 controls, and investigated the associations of plasma GFAP with clinical variables and other biofluid biomarkers. Plasma GFAP and Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers were assessed by the single molecule array and the Lumipulse platforms, respectively. In ALS patients, plasma GFAP was higher than in controls (p < 0.001) and associated with measures of cognitive decline. Twenty ALS patients (12.8%) showed a positive amyloid status (A+), of which nine also exhibited tau pathology (A+T+, namely ALS-AD). ALS-AD patients showed higher plasma GFAP than A- ALS participants (p < 0.001) and controls (p < 0.001), whereas the comparison between A- ALS and controls missed statistical significance (p = 0.07). Plasma GFAP distinguished ALS-AD subjects more accurately (area under the curve (AUC) 0.932 ± 0.027) than plasma p-tau181 (AUC 0.692 ± 0.058, p < 0.0001) and plasma neurofilament light chain protein (AUC, 0.548 ± 0.088, p < 0.0001). Cognitive measures differed between ALS-AD and other ALS patients. AD co-pathology deeply affects plasma GFAP values in ALS patients. Plasma GFAP is an accurate biomarker for identifying AD co-pathology in ALS, which can influence the cognitive phenotype.
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Affiliation(s)
- Andrea Mastrangelo
- Dipartimento di Scienze Biomediche e Neuromotorie, Alma Mater Studiorum Università di Bologna, 40139 Bologna, Italy; (A.M.); (S.B.); (P.A.); (S.C.); (R.L.)
| | - Veria Vacchiano
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (V.V.); (C.Z.); (E.R.); (A.C.); (B.P.); (F.S.)
| | - Corrado Zenesini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (V.V.); (C.Z.); (E.R.); (A.C.); (B.P.); (F.S.)
| | - Edoardo Ruggeri
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (V.V.); (C.Z.); (E.R.); (A.C.); (B.P.); (F.S.)
| | - Simone Baiardi
- Dipartimento di Scienze Biomediche e Neuromotorie, Alma Mater Studiorum Università di Bologna, 40139 Bologna, Italy; (A.M.); (S.B.); (P.A.); (S.C.); (R.L.)
| | - Arianna Cherici
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (V.V.); (C.Z.); (E.R.); (A.C.); (B.P.); (F.S.)
| | - Patrizia Avoni
- Dipartimento di Scienze Biomediche e Neuromotorie, Alma Mater Studiorum Università di Bologna, 40139 Bologna, Italy; (A.M.); (S.B.); (P.A.); (S.C.); (R.L.)
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (V.V.); (C.Z.); (E.R.); (A.C.); (B.P.); (F.S.)
| | - Barbara Polischi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (V.V.); (C.Z.); (E.R.); (A.C.); (B.P.); (F.S.)
| | - Francesca Santoro
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (V.V.); (C.Z.); (E.R.); (A.C.); (B.P.); (F.S.)
| | - Sabina Capellari
- Dipartimento di Scienze Biomediche e Neuromotorie, Alma Mater Studiorum Università di Bologna, 40139 Bologna, Italy; (A.M.); (S.B.); (P.A.); (S.C.); (R.L.)
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (V.V.); (C.Z.); (E.R.); (A.C.); (B.P.); (F.S.)
| | - Rocco Liguori
- Dipartimento di Scienze Biomediche e Neuromotorie, Alma Mater Studiorum Università di Bologna, 40139 Bologna, Italy; (A.M.); (S.B.); (P.A.); (S.C.); (R.L.)
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (V.V.); (C.Z.); (E.R.); (A.C.); (B.P.); (F.S.)
| | - Piero Parchi
- Dipartimento di Scienze Biomediche e Neuromotorie, Alma Mater Studiorum Università di Bologna, 40139 Bologna, Italy; (A.M.); (S.B.); (P.A.); (S.C.); (R.L.)
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (V.V.); (C.Z.); (E.R.); (A.C.); (B.P.); (F.S.)
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8
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Verde F, Aiello EN, Adobbati L, Poletti B, Solca F, Tiloca C, Sangalli D, Maranzano A, Muscio C, Ratti A, Zago S, Ticozzi N, Frisoni GB, Silani V. Coexistence of Amyotrophic Lateral Sclerosis and Alzheimer's Disease: Case Report and Review of the Literature. J Alzheimers Dis 2023; 95:1383-1399. [PMID: 37694369 DOI: 10.3233/jad-230562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
We describe a case of amyotrophic lateral sclerosis (ALS) associated with Alzheimer's disease (AD) and review the literature about the coexistence of the two entities, highlighting the following: mean age at onset is 63.8 years, with slight female predominance; ALS tends to manifest after cognitive impairment and often begins in the bulbar region; average disease duration is 3 years; cognitive phenotype is mostly amnestic; the pattern of brain involvement is, in most cases, consistent with AD. Our case and the reviewed ones suggest that patients with ALS and dementia lacking unequivocal features of FTD should undergo additional examinations in order to recognize AD.
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Affiliation(s)
- Federico Verde
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli Studi di Milano, Milan, Italy
| | - Edoardo Nicolò Aiello
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Laura Adobbati
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - Federica Solca
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Cinzia Tiloca
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Davide Sangalli
- Department of Neurology and Stroke Unit, Azienda Socio Sanitaria Territoriale Lecco, Lecco, Italy
| | - Alessio Maranzano
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Cristina Muscio
- Neurology-5 (Neuropathology) Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Antonia Ratti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
| | - Stefano Zago
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Nicola Ticozzi
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Battista Frisoni
- Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli Studi di Milano, Milan, Italy
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9
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Barba L, Otto M, Abu-Rumeileh S. The Underestimated Relevance of Alzheimer's Disease Copathology in Amyotrophic Lateral Sclerosis. J Alzheimers Dis 2023; 95:1401-1404. [PMID: 37807784 DOI: 10.3233/jad-230900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Concomitant Alzheimer's disease (AD) pathology can be observed in approximately 10-15% of cases with amyotrophic lateral sclerosis (ALS). ALS-AD patients have a higher prevalence of amnestic cognitive disturbances, which may often precede motor symptoms. Cerebrospinal fluid (CSF) AD core biomarkers usually show no or slightly significant changes in ALS, whereas blood phosphorylated tau protein might be increased independently from AD copathology. Neurofilament proteins are consistently elevated in CSF and blood of ALS, but have been poorly investigated in ALS-AD. All these issues should be taken into account when using fluid biomarkers as inclusion criteria or secondary endpoints in clinical trials.
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Affiliation(s)
- Lorenzo Barba
- Department of Neurology, Martin-Luther-University of Halle-Wittenberg, Halle (Saale), Germany
| | - Markus Otto
- Department of Neurology, Martin-Luther-University of Halle-Wittenberg, Halle (Saale), Germany
| | - Samir Abu-Rumeileh
- Department of Neurology, Martin-Luther-University of Halle-Wittenberg, Halle (Saale), Germany
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