de Souza Leonardo Cruz, Sarazin Marie, Teixeira-Júnior Antônio Lúcio, Caramelli Paulo, Santos Antônio Emanuel dos, Dubois Bruno
Institut de la Memoire et de la Maladie dAlzheimer, departement de Neurologie, Hopital de la Pitie-Salpetriere, Paris, France.
Grupo de Neuroimunologia, Laboratorio Interdisciplinar de Investigacao Medica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Arq Neuropsiquiatr. 2014 Mar;72(3):227-31. doi: 10.1590/0004-282x20130233.
The challenges for establishing an early diagnosis of Alzheimer's disease (AD) have created a need for biomarkers that reflect the core pathology of the disease. The cerebrospinal fluid (CSF) levels of total Tau (T-tau), phosphorylated Tau (P-Tau) and beta-amyloid peptide (Aβ₄₂) reflect, respectively, neurofibrillary tangle and amyloid pathologies and are considered as surrogate markers of AD pathophysiology. The combination of low Aβ₄₂ and high levels of T-tau and P-Tau can accurately identify patients with AD at early stages, even before the development of dementia. The combined analysis of the CSF biomarkers is also helpful for the differential diagnosis between AD and other degenerative dementias. The development of these CSF biomarkers has evolved to a novel diagnostic definition of the disease. The identification of a specific clinical phenotype combined with the in vivo evidence of pathophysiological markers offers the possibility to make a diagnosis of AD before the dementia stage with high specificity.
建立阿尔茨海默病（AD）早期诊断面临的挑战催生了对反映该疾病核心病理的生物标志物的需求。总 Tau（T-tau）、磷酸化 Tau（P-Tau）和β-淀粉样肽（Aβ₄₂）的脑脊液（CSF）水平分别反映神经原纤维缠结和淀粉样病理，被视为 AD 病理生理学的替代标志物。低 Aβ₄₂与高 T-tau 和 P-Tau 水平相结合，即使在痴呆症出现之前，也能在早期准确识别 AD 患者。CSF 生物标志物的联合分析也有助于 AD 与其他退行性痴呆的鉴别诊断。这些 CSF 生物标志物的发展已演变成该疾病的一种新的诊断定义。识别特定的临床表型并结合病理生理标志物的体内证据，为在痴呆症阶段之前以高特异性诊断 AD 提供了可能性。
