Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, USA.
Neurology. 2012 Aug 28;79(9):897-905. doi: 10.1212/WNL.0b013e318266fa70. Epub 2012 Aug 1.
While plasma biomarkers have been proposed to aid in the clinical diagnosis of Alzheimer disease (AD), few biomarkers have been validated in independent patient cohorts. Here we aim to determine plasma biomarkers associated with AD in 2 independent cohorts and validate the findings in the multicenter Alzheimer's Disease Neuroimaging Initiative (ADNI).
Using a targeted proteomic approach, we measured levels of 190 plasma proteins and peptides in 600 participants from 2 independent centers (University of Pennsylvania, Philadelphia; Washington University, St. Louis, MO), and identified 17 analytes associated with the diagnosis of very mild dementia/mild cognitive impairment (MCI) or AD. Four analytes (apoE, B-type natriuretic peptide, C-reactive protein, pancreatic polypeptide) were also found to be altered in clinical MCI/AD in the ADNI cohort (n = 566). Regression analysis showed CSF Aβ42 levels and t-tau/Aβ42 ratios to correlate with the number of APOE4 alleles and plasma levels of B-type natriuretic peptide and pancreatic polypeptide.
Four plasma analytes were consistently associated with the diagnosis of very mild dementia/MCI/AD in 3 independent clinical cohorts. These plasma biomarkers may predict underlying AD through their association with CSF AD biomarkers, and the association between plasma and CSF amyloid biomarkers needs to be confirmed in a prospective study.
虽然已有研究提出血浆生物标志物可辅助阿尔茨海默病(AD)的临床诊断,但在独立的患者队列中得到验证的生物标志物较少。本研究旨在通过 2 个独立队列确定与 AD 相关的血浆生物标志物,并在多中心阿尔茨海默病神经影像学倡议(ADNI)中验证这些发现。
我们使用靶向蛋白质组学方法,测量了来自 2 个独立中心(费城宾夕法尼亚大学;密苏里州圣路易斯华盛顿大学)的 600 名参与者的 190 种血浆蛋白和肽的水平,并鉴定出与非常轻度痴呆/轻度认知障碍(MCI)或 AD 诊断相关的 17 种分析物。在 ADNI 队列(n=566)中,还发现 4 种分析物(载脂蛋白 E、B 型利钠肽、C 反应蛋白、胰多肽)在临床 MCI/AD 中发生改变。回归分析显示,CSF Aβ42 水平和 t-tau/Aβ42 比值与 APOE4 等位基因的数量以及 B 型利钠肽和胰多肽的血浆水平相关。
4 种血浆分析物在 3 个独立的临床队列中与非常轻度痴呆/MCI/AD 的诊断一致相关。这些血浆生物标志物可能通过与 CSF AD 生物标志物的关联来预测潜在的 AD,需要在前瞻性研究中进一步证实血浆和 CSF 淀粉样蛋白生物标志物之间的关联。