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基于患者和实验模型中血液标志物搜索的帕金森病早期诊断方法的改进。

Upgraded Methodology for the Development of Early Diagnosis of Parkinson's Disease Based on Searching Blood Markers in Patients and Experimental Models.

机构信息

Koltzov Institute of Developmental Biology, Russian Academy of Sciences, Moscow, Russia.

Kazan State Medical University, Ministry of Health of the Russian Federation, Kazan, Russia.

出版信息

Mol Neurobiol. 2019 May;56(5):3437-3450. doi: 10.1007/s12035-018-1315-2. Epub 2018 Aug 20.

Abstract

Numerous attempts to develop an early diagnosis of Parkinson's disease (PD) by searching biomarkers in biological fluids were unsuccessful. The drawback of this methodology is searching markers in patients at the clinical stage without guarantee that they are also characteristic of either preclinical stage or prodromal stage (preclinical-prodromal stage). We attempted to upgrade this methodology by selecting only markers that are found both in patients and in PD animal models. HPLC and RT-PCR were used to estimate the concentration of amino acids, catecholamines/metabolites in plasma and gene expression in lymphocytes in 36 untreated early-stage PD patients and 52 controls, and in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-treated mice at modeling the clinical ("symptomatic") stage and preclinical-prodromal ("presymptomatic") stage of PD. It was shown that among 13 blood markers found in patients, 7 markers are characteristic of parkinsonian symptomatic mice and 3 markers of both symptomatic and presymptomatic mice. According to our suggestion, the detection of the same marker in patients and symptomatic animals indicates adequate reproduction of pathogenesis along the corresponding metabolic pathway, whereas the detection of the same marker in presymptomatic animals indicates its specificity for preclinical-prodromal stage. This means that the minority of markers found in patients-decreased concentration of L-3,4-dihydroxyphenylalanine (L-DOPA) and dihydroxyphenylacetic acid (DOPAC) and increased dopamine D3 receptor gene expression-are specific for preclinical-prodromal stage and are suitable for early diagnosis of PD. Thus, we upgraded a current methodology for development of early diagnosis of PD by searching blood markers not only in patients but also in parkinsonian animals.

摘要

尽管人们曾试图通过在生物体液中寻找生物标志物来开发出帕金森病(PD)的早期诊断方法,但均以失败告终。这种方法的缺陷在于,在临床阶段的患者中寻找标志物,并不能保证这些标志物也具有临床前或前驱期(临床前-前驱期)的特征。我们试图通过仅选择在患者和 PD 动物模型中都发现的标志物来改进这种方法。使用 HPLC 和 RT-PCR 来评估 36 名未经治疗的早期 PD 患者和 52 名对照者以及 1-甲基-4-苯基-1,2,3,6-四氢吡啶(MPTP)处理的 PD 动物模型的临床(“有症状”)期和临床前-前驱期(“无症状”)期的血浆中氨基酸、儿茶酚胺/代谢物浓度和淋巴细胞中的基因表达。结果表明,在 13 种在患者中发现的血液标志物中,有 7 种标志物是帕金森病有症状小鼠的特征,3 种标志物是有症状和无症状小鼠的共同标志物。根据我们的建议,如果在患者和有症状的动物中都检测到相同的标志物,则表明沿着相应的代谢途径复制了适当的发病机制;而如果在无症状的动物中也检测到相同的标志物,则表明该标志物对临床前-前驱期具有特异性。这意味着在患者中发现的少数标志物(L-3,4-二羟基苯丙氨酸(L-DOPA)和二羟基苯乙酸(DOPAC)浓度降低,多巴胺 D3 受体基因表达增加)对临床前-前驱期具有特异性,适合用于 PD 的早期诊断。因此,我们通过不仅在患者中,而且在帕金森病动物中寻找血液标志物来改进 PD 早期诊断的开发方法。

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