MRC Prion Unit at UCL, UCL Institute of Prion Diseases, London, UK.
NHS National Prion Clinic, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.
J Neurol Neurosurg Psychiatry. 2018 Sep;89(9):955-961. doi: 10.1136/jnnp-2017-317793. Epub 2018 Feb 27.
A blood-based biomarker of neuronal damage in sporadic Creutzfeldt-Jakob disease (sCJD) will be extremely valuable for both clinical practice and research aiming to develop effective therapies.
We used an ultrasensitive immunoassay to measure two candidate biomarkers, tau and neurofilament light (NfL), in serum from patients with sCJD and healthy controls. We tested longitudinal sample sets from six patients to investigate changes over time, and examined correlations with rate of disease progression and associations with known phenotype modifiers.
Serum concentrations of both tau and NfL were increased in patients with sCJD. NfL distinguished patients from controls with 100% sensitivity and 100% specificity. Tau did so with 91% sensitivity and 83% specificity. Both tau and NfL appeared to increase over time in individual patients, particularly in those with several samples tested late in their disease. Tau, but not NfL, was positively correlated with rate of disease progression, and was particularly increased in patients homozygous for methionine at codon 129 of .
These findings independently replicate other recent studies using similar methods and offer novel insights. They show clear promise for these blood-based biomarkers in prion disease. Future work should aim to fully establish their potential roles for monitoring disease progression and response to therapies.
在散发性克雅氏病(sCJD)中,神经元损伤的血液生物标志物将对临床实践和旨在开发有效疗法的研究极具价值。
我们使用超敏免疫测定法测量了 sCJD 患者和健康对照者血清中的两个候选生物标志物,即tau 和神经丝轻链(NfL)。我们检测了来自 6 名患者的纵向样本集,以研究随时间的变化,并考察了与疾病进展速度的相关性以及与已知表型修饰因子的关联。
sCJD 患者的血清 tau 和 NfL 浓度均升高。NfL 以 100%的灵敏度和 100%的特异性将患者与对照者区分开来。tau 的灵敏度为 91%,特异性为 83%。在个体患者中,tau 和 NfL 似乎都随时间增加,尤其是在疾病晚期接受了多次测试的患者中。tau 与疾病进展速度呈正相关,但 NfL 则不然,并且在. 第 129 位密码子为蛋氨酸纯合的患者中尤其增加。
这些发现与其他使用类似方法的最近研究独立重复,提供了新的见解。它们为这些基于血液的生物标志物在朊病毒病中的应用提供了明确的前景。未来的工作应旨在充分确立它们在监测疾病进展和对治疗的反应方面的潜在作用。