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Jiang Y, Uhm H, Ip FC, Ouyang L, Lo RMN, Cheng EYL, Cao X, Tan CMC, Law BCH, Ortiz‐Romero P, Puig‐Pijoan A, Fernández‐Lebrero A, Contador J, Mok KY, Hardy J, Kwok TCY, Mok VCT, Suárez‐Calvet M, Zetterberg H, Fu AKY, Ip NY. A blood-based multi-pathway biomarker assay for early detection and staging of Alzheimer's disease across ethnic groups. Alzheimers Dement 2024; 20:2000-2015. [PMID: 38183344 PMCID: PMC10984431 DOI: 10.1002/alz.13676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 01/08/2024]
Abstract
INTRODUCTION Existing blood-based biomarkers for Alzheimer's disease (AD) mainly focus on its pathological features. However, studies on blood-based biomarkers associated with other biological processes for a comprehensive evaluation of AD status are limited. METHODS We developed a blood-based, multiplex biomarker assay for AD that measures the levels of 21 proteins involved in multiple biological pathways. We evaluated the assay's performance for classifying AD and indicating AD-related endophenotypes in three independent cohorts from Chinese or European-descent populations. RESULTS The 21-protein assay accurately classified AD (area under the receiver operating characteristic curve [AUC] = 0.9407 to 0.9867) and mild cognitive impairment (MCI; AUC = 0.8434 to 0.8945) while also indicating brain amyloid pathology. Moreover, the assay simultaneously evaluated the changes of five biological processes in individuals and revealed the ethnic-specific dysregulations of biological processes upon AD progression. DISCUSSION This study demonstrated the utility of a blood-based, multi-pathway biomarker assay for early screening and staging of AD, providing insights for patient stratification and precision medicine. HIGHLIGHTS The authors developed a blood-based biomarker assay for Alzheimer's disease. The 21-protein assay classifies AD/MCI and indicates brain amyloid pathology. The 21-protein assay can simultaneously assess activities of five biological processes. Ethnic-specific dysregulations of biological processes in AD were revealed.
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Affiliation(s)
- Yuanbing Jiang
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience, Molecular Neuroscience CenterThe Hong Kong University of Science and Technology, Clear Water Bay, KowloonHKSARChina
| | - Hyebin Uhm
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience, Molecular Neuroscience CenterThe Hong Kong University of Science and Technology, Clear Water Bay, KowloonHKSARChina
| | - Fanny C. Ip
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
- Guangdong Provincial Key Laboratory of Brain ScienceDisease and Drug DevelopmentHKUST Shenzhen Research InstituteShenzhenGuangdongChina
| | - Li Ouyang
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
| | - Ronnie M. N. Lo
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience, Molecular Neuroscience CenterThe Hong Kong University of Science and Technology, Clear Water Bay, KowloonHKSARChina
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
| | - Elaine Y. L. Cheng
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience, Molecular Neuroscience CenterThe Hong Kong University of Science and Technology, Clear Water Bay, KowloonHKSARChina
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
| | - Xiaoyun Cao
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
| | - Clara M. C. Tan
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
| | - Brian C. H. Law
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
| | - Paula Ortiz‐Romero
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Hospital del Mar Research InstituteBarcelonaSpain
| | - Albert Puig‐Pijoan
- Hospital del Mar Research InstituteBarcelonaSpain
- Cognitive Decline Unit, Department of NeurologyHospital Del MarBarcelonaSpain
- Medicine DepartmentUniversitat Autònoma de BarcelonaBarcelonaSpain
- ERA‐Net on Cardiovascular Diseases (ERA‐CVD) ConsortiumBarcelonaSpain
| | - Aida Fernández‐Lebrero
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Hospital del Mar Research InstituteBarcelonaSpain
- Cognitive Decline Unit, Department of NeurologyHospital Del MarBarcelonaSpain
- ERA‐Net on Cardiovascular Diseases (ERA‐CVD) ConsortiumBarcelonaSpain
- Department of Medicine and Life SciencesUniversitat Pompeu FabraBarcelonaSpain
| | - José Contador
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Hospital del Mar Research InstituteBarcelonaSpain
- Cognitive Decline Unit, Department of NeurologyHospital Del MarBarcelonaSpain
| | - Kin Y. Mok
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience, Molecular Neuroscience CenterThe Hong Kong University of Science and Technology, Clear Water Bay, KowloonHKSARChina
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
- Department of Neurodegenerative DiseaseQueen Square Institute of NeurologyUniversity College LondonLondonUK
| | - John Hardy
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
- Department of Neurodegenerative DiseaseQueen Square Institute of NeurologyUniversity College LondonLondonUK
- UK Dementia Research InstituteUniversity College LondonLondonUK
| | - Timothy C. Y. Kwok
- Therese Pei Fong Chow Research Centre for Prevention of DementiaDivision of GeriatricsDepartment of Medicine and TherapeuticsThe Chinese University of Hong Kong, ShatinHKSARChina
| | - Vincent C. T. Mok
- Lau Tat‐chuen Research Centre of Brain Degenerative Diseases in ChineseGerald Choa Neuroscience InstituteLui Che Woo Institute of Innovative MedicineLi Ka Shing Institute of Health SciencesDivision of NeurologyDepartment of Medicine and TherapeuticsThe Chinese University of Hong Kong, ShatinHKSARChina
| | - Marc Suárez‐Calvet
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Hospital del Mar Research InstituteBarcelonaSpain
- Cognitive Decline Unit, Department of NeurologyHospital Del MarBarcelonaSpain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES)MadridSpain
| | - Henrik Zetterberg
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
- Department of Neurodegenerative DiseaseQueen Square Institute of NeurologyUniversity College LondonLondonUK
- UK Dementia Research InstituteUniversity College LondonLondonUK
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and Physiologythe Sahlgrenska Academy at the University of GothenburgGothenburgSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Amy K. Y. Fu
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience, Molecular Neuroscience CenterThe Hong Kong University of Science and Technology, Clear Water Bay, KowloonHKSARChina
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
- Guangdong Provincial Key Laboratory of Brain ScienceDisease and Drug DevelopmentHKUST Shenzhen Research InstituteShenzhenGuangdongChina
| | - Nancy Y. Ip
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience, Molecular Neuroscience CenterThe Hong Kong University of Science and Technology, Clear Water Bay, KowloonHKSARChina
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
- Guangdong Provincial Key Laboratory of Brain ScienceDisease and Drug DevelopmentHKUST Shenzhen Research InstituteShenzhenGuangdongChina
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Puig‐Pijoan A, Jimenez‐Balado J, Fernández‐Lebrero A, García‐Escobar G, Navalpotro‐Gómez I, Contador J, Manero‐Borràs R, Puente‐Periz V, Suárez A, Muñoz FJ, Grau‐Rivera O, Suárez‐Calvet M, de la Torre R, Roquer J, Ois A. Risk of cognitive decline progression is associated to increased blood-brain-barrier permeability: A longitudinal study in a memory unit clinical cohort. Alzheimers Dement 2024; 20:538-548. [PMID: 37727082 PMCID: PMC10916969 DOI: 10.1002/alz.13433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/19/2023] [Accepted: 07/27/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION This study examined the relationship between blood-brain-barrier permeability (BBBp), measured by cerebrospinal fluid/serum albumin ratio (QAlb), and cognitive decline progression in a clinical cohort. METHODS This prospective observational study included 334 participants from the BIODEGMAR cohort. Cognitive decline progression was defined as an increase in Global Deterioration Scale and/or Clinical Dementia Rating scores. Associations between BBBp, demographics, and clinical factors were explored. RESULTS Male sex, diabetes mellitus, and cerebrovascular burden were associated with increased log-QAlb. Vascular cognitive impairment patients had the highest log-QAlb levels. Among the 273 participants with valid follow-up data, 154 (56.4%) showed cognitive decline progression. An 8% increase in the hazard of clinical worsening was observed for each 10% increase in log-QAlb. DISCUSSION These results suggest that increased BBBp in individuals with cognitive decline may contribute to clinical worsening, pointing to potential targeted therapies. QAlb could be a useful biomarker for identifying patients with a worse prognosis.
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Suárez‐Calvet M, Ashton NJ, Puig‐Pijoan A, Milà‐Alomà M, Fernández‐Lebrero A, García‐Escobar G, González‐Ortiz F, Kac PR, Brum WS, Benedet AL, Rodriguez JL, Day TA, Dage JL, Vanbrabant J, Stoops E, Vanmechelen E, Triana‐Baltzer G, Moughadam S, Kolb HC, Ortiz‐Romero P, Karikari TK, Minguillón C, Sánchez JJH, Navalpotro‐Gómez I, Grau‐Rivera O, Manero RM, Puente‐Periz V, de la Torre R, Roquer J, Zetterberg H, Blennow K. A head‐to‐head comparison of plasma phosphorylated tau assays in the real‐world memory clinic. Alzheimers Dement 2022. [DOI: 10.1002/alz.065391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Marc Suárez‐Calvet
- Hospital del Mar Medical Research Institute (IMIM) Barcelona Spain
- Servei de Neurologia, Hospital del Mar Barcelona Spain
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation Barcelona Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES) Madrid Spain
| | - Nicholas J. Ashton
- NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS Foundation London United Kingdom
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg Mölndal Sweden
- Wallenberg Centre for Molecular and Translational Medicine; University of Gothenburg Gothenburg Sweden
- King’s College London, Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute London United Kingdom
| | - Albert Puig‐Pijoan
- Hospital del Mar Medical Research Institute (IMIM) Barcelona Spain
- Servei de Neurologia, Hospital del Mar Barcelona Spain
- Department of Medicine, Universitat Autònoma de Barcelona Barcelona Spain
| | - Marta Milà‐Alomà
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation Barcelona Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES) Madrid Spain
- Universitat Pompeu Fabra Barcelona Spain
| | | | - Greta García‐Escobar
- Hospital del Mar Medical Research Institute (IMIM) Barcelona Spain
- Servei de Neurologia, Hospital del Mar Barcelona Spain
| | - Fernándo González‐Ortiz
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation Barcelona Spain
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg Mölndal Sweden
| | - Przemyslaw Radoslaw Kac
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg Mölndal Sweden
| | - Wagner Scheeren Brum
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg Mölndal Sweden
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre Brazil
| | - Andréa Lessa Benedet
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg Mölndal Sweden
| | - Juan Lantero Rodriguez
- Institute of Neuroscience & Physiology, Department of Psychiatry & Neurochemistry, The Sahlgrenska Academy, University of Gothenburg Mölndal Sweden
| | - Theresa A. Day
- Lilly Research Laboratories, Eli Lilly and Company Indianapolis IN USA
| | - Jeffrey L. Dage
- Stark Neurosciences Research Institute, Indiana University School of Medicine Indianapolis IN USA
- Eli Lilly and Company Indianapolis IN USA
| | | | - Erik Stoops
- ADx NeuroSciences NV, Technologiepark 94 Ghent 9052 Belgium
| | | | | | | | | | - Paula Ortiz‐Romero
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation Barcelona Spain
- IMIM (Hospital del Mar Medical Research Institute) Barcelona Spain
| | - Thomas K Karikari
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg Mölndal Sweden
| | - Carolina Minguillón
- Hospital del Mar Medical Research Institute (IMIM) Barcelona Spain
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation Barcelona Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES) Madrid Spain
| | | | - Irene Navalpotro‐Gómez
- Hospital del Mar Medical Research Institute (IMIM) Barcelona Spain
- Servei de Neurologia, Hospital del Mar Barcelona Spain
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation Barcelona Spain
| | - Oriol Grau‐Rivera
- Hospital del Mar Medical Research Institute (IMIM) Barcelona Spain
- Servei de Neurologia, Hospital del Mar Barcelona Spain
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation Barcelona Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES) Madrid Spain
| | - Rosa María Manero
- Hospital del Mar Medical Research Institute (IMIM) Barcelona Spain
- Servei de Neurologia, Hospital del Mar Barcelona Spain
| | - Víctor Puente‐Periz
- Hospital del Mar Medical Research Institute (IMIM) Barcelona Spain
- Servei de Neurologia, Hospital del Mar Barcelona Spain
| | - Rafael de la Torre
- Hospital del Mar Medical Research Institute (IMIM) Barcelona Spain
- Universitat Pompeu Fabra Barcelona Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN) Madrid Spain
| | - Jaume Roquer
- Hospital del Mar Medical Research Institute (IMIM) Barcelona Spain
- Servei de Neurologia, Hospital del Mar Barcelona Spain
- Department of Medicine, Universitat Autònoma de Barcelona Barcelona Spain
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg Mölndal Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital Mölndal Sweden
- Hong Kong Center for Neurodegenerative Diseases Clear Water Bay Hong Kong
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square London United Kingdom
- UK Dementia Research Institute at UCL London United Kingdom
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg Mölndal Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital Mölndal Sweden
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