Zetterberg Henrik
Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden;
Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.
Am J Physiol Cell Physiol. 2017 Jul 1;313(1):C3-C10. doi: 10.1152/ajpcell.00007.2017. Epub 2017 Apr 19.
Alzheimer's disease (AD) is a common neurodegenerative disease that starts with a clinically silent phase of a decade or more during which brain pathologies accumulate predominantly in the medial temporal lobe but also elsewhere in the brain. Network dysfunction and clinical symptoms typically appear when senile plaque (amyloid-β) and neurofibrillary tangle (tau) pathologies meet in the brain parenchyma, producing synapse and neuronal loss. For plaque and tangle pathologies, reliable fluid biomarkers have been developed. These require sampling of cerebrospinal fluid. Reliable blood tests for plaque and tangle pathologies are currently lacking, but blood tests for general neurodegeneration have recently been developed. In AD, plaques and tangles often coexist with other pathologies, including Lewy bodies, and to what extent these contribute to symptoms is currently unknown. There are also important differential diagnoses that may be possible to distinguish from AD with the aid of biomarkers. The scope of this review is fluid biomarkers for AD and related pathologies. The purpose is to provide the reader with an updated account of currently available fluid biomarkers for AD and clinically relevant differential diagnoses.
阿尔茨海默病（AD）是一种常见的神经退行性疾病，始于长达十年或更长时间的临床无症状期，在此期间，脑病变主要在颞叶内侧积累，但也在大脑其他部位出现。当脑实质中出现老年斑（淀粉样β蛋白）和神经原纤维缠结（tau蛋白）病变并导致突触和神经元丢失时，通常会出现网络功能障碍和临床症状。对于斑块和缠结病变，已经开发出了可靠的体液生物标志物。这些需要采集脑脊液样本。目前缺乏针对斑块和缠结病变的可靠血液检测方法，但最近已经开发出了针对一般神经退行性变的血液检测方法。在AD中，斑块和缠结通常与其他病变共存，包括路易小体，目前尚不清楚这些病变在多大程度上导致了症状。借助生物标志物也有可能进行重要的鉴别诊断，以区分AD。本综述的范围是AD及相关病变的体液生物标志物。目的是为读者提供关于目前可用的AD体液生物标志物及临床相关鉴别诊断的最新信息。
