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额颞叶痴呆和阿尔茨海默病患者的脑脊液β淀粉样蛋白40同样减少。

Cerebrospinal fluid Aβ40 is similarly reduced in patients with Frontotemporal Lobar Degeneration and Alzheimer's Disease.

作者信息

Baldeiras Inês, Santana Isabel, Leitão Maria João, Ribeiro Maria Helena, Pascoal Rui, Duro Diana, Lemos Raquel, Santiago Beatriz, Almeida Maria Rosário, Oliveira Catarina Resende

机构信息

Laboratory of Neurochemistry, Coimbra University Hospital, Portugal; Center for Neuroscience and Cell Biology, University of Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Portugal.

Center for Neuroscience and Cell Biology, University of Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Portugal; Neurology Department, Coimbra University Hospital, Portugal.

出版信息

J Neurol Sci. 2015 Nov 15;358(1-2):308-16. doi: 10.1016/j.jns.2015.09.022. Epub 2015 Sep 10.

Abstract

Cerebrospinal fluid (CSF) biomarkers have been increasingly studied for dementia diagnosis, however the accuracy to distinguish between different forms of dementia is still unsatisfactory. In this study, the added value of another CSF Aβ-peptide (Aβ40), along with the core CSF markers t-Tau, p-Tau, and Aβ42, in the discrimination between two large dementia groups of Frontotemporal Lobar Degeneration (FTLD; n=107), Alzheimer's Disease (AD; n=107) and non-demented subjects (n=33) was evaluated. In FTLD, t-Tau and p-Tau were significantly increased in relation to controls, but lower than in AD, while Aβ42 was similar in FTLD and controls, but higher than in AD. Equally reduced Aβ40 levels were seen in both dementia groups, and therefore the combination of Aβ40 with core CSF biomarkers optimally discriminated FTLD and AD patients from controls. Aβ42 and t-Tau were selected as the best biomarker subset to differentiate FTLD from AD, with no added value of Aβ40 to the model. Diagnostic accuracy between FTLD and AD was still sub-optimal, with a significant percentage (23%) of FTLD patients, in particularly women, carrying an ApoE-ε4 allele, showing a CSF-AD biomarkers profile. Although CSF Aβ40 does not appear to have an additional value in the distinction between FTLD and AD, it increases the discrimination between subjects with dementia from controls. A CSF-AD biomarker profile can be seen in patients with a clinical phenotype of FTLD, reinforcing the need for autopsy confirmation.

摘要

脑脊液(CSF)生物标志物在痴呆症诊断方面的研究越来越多,然而区分不同形式痴呆症的准确性仍不尽人意。在本研究中,评估了另一种脑脊液β淀粉样肽(Aβ40)与脑脊液核心标志物总tau蛋白(t-Tau)、磷酸化tau蛋白(p-Tau)和Aβ42一起,在区分两个大型痴呆症组,即额颞叶痴呆(FTLD;n = 107)、阿尔茨海默病(AD;n = 107)和非痴呆受试者(n = 33)中的附加价值。在FTLD中,与对照组相比,t-Tau和p-Tau显著升高,但低于AD组,而Aβ42在FTLD组和对照组中相似,但高于AD组。在两个痴呆症组中均观察到Aβ40水平同样降低,因此Aβ40与脑脊液核心生物标志物的组合能最佳地区分FTLD和AD患者与对照组。选择Aβ42和t-Tau作为区分FTLD和AD的最佳生物标志物子集,Aβ40对该模型无附加价值。FTLD和AD之间的诊断准确性仍然欠佳,相当比例(23%)的FTLD患者,尤其是女性,携带载脂蛋白E-ε4等位基因,表现出脑脊液AD生物标志物特征。尽管脑脊液Aβ40在区分FTLD和AD方面似乎没有额外价值,但它增加了痴呆患者与对照组之间的区分度。在具有FTLD临床表型的患者中可以看到脑脊液AD生物标志物特征,这进一步凸显了尸检确认的必要性。

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