Park Sun Ah, Kang Ju Hee, Kang Eun Suk, Ki Chang Seok, Roh Jee Hoon, Youn Young Chul, Kim Seong Yoon, Kim Sang Yun
Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
Department of Pharmacology & Clinical Pharmacology, Inha University School of Medicine, Incheon, Korea.; Department of Pathology & Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
J Clin Neurol. 2015 Apr;11(2):132-41. doi: 10.3988/jcn.2015.11.2.132.
Cerebrospinal fluid (CSF) can provide vital informative about pathological processes occurring in the brain. In particular, the CSF concentrations of Aβ42, tTau, and pTau181 are useful for the early diagnosis of Alzheimer's disease (AD). However, many studies have demonstrated that confounding factors related to the preanalytical processing of CSF can seriously influence measurements of these AD biomarkers. It is therefore important to develop a standardized protocol for the acquisition and handling of CSF, particularly with regard to the types of tube used for collection and storage, the proper aliquot volume, blood contamination, and the number of tube transfers and freeze-thaw cycles, because these aspects of the procedure have been shown to affect AD biomarker measurements. A survey of the impact of several individual preanalytical procedures on the measurement of AD biomarkers in CSF was conducted for this review article, and the implications of the differences among them are discussed. Furthermore, following a review of the procedures used in Korean and international biomarker laboratories, a consensus was reached among a cooperative Korean multicenter research group regarding a standardized protocol for the analysis of AD biomarkers in CSF. All efforts were made to be stringent regarding the controversial issues associated with this protocol, thus minimizing the confounding influence of various factors on current investigations using established AD biomarkers and on future studies using novel biomarkers of AD and other neurodegenerative disorders.
脑脊液（CSF）能够提供有关大脑中发生的病理过程的重要信息。特别是，Aβ42、总tau蛋白（tTau）和磷酸化tau蛋白181（pTau181）的脑脊液浓度对阿尔茨海默病（AD）的早期诊断很有用。然而，许多研究表明，与脑脊液分析前处理相关的混杂因素会严重影响这些AD生物标志物的测量。因此，制定一套标准化的脑脊液采集和处理方案很重要，特别是在用于采集和储存的试管类型、合适的分装体积、血液污染以及试管转移次数和冻融循环次数方面，因为已证明该操作的这些方面会影响AD生物标志物的测量。本文综述对几种单独的分析前程序对脑脊液中AD生物标志物测量的影响进行了调查，并讨论了它们之间差异的意义。此外，在对韩国和国际生物标志物实验室所采用的程序进行综述之后，韩国一个合作多中心研究小组就脑脊液中AD生物标志物分析的标准化方案达成了共识。对于与该方案相关的有争议问题，我们都尽力做到严格，从而将各种因素对目前使用既定AD生物标志物的研究以及未来使用AD和其他神经退行性疾病新型生物标志物的研究的混杂影响降至最低。
