Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, he Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.
Clinical Neurochemistry Laboratory, Sahlgrenska, University Hospital, Mölndal, Sweden.
Mol Brain. 2019 Mar 28;12(1):26. doi: 10.1186/s13041-019-0448-1.
A major barrier to the effective conduct of clinical trials of new drug candidates against Alzheimer's disease (AD) and to identifying patients for receiving future disease-modifying treatments is the limited capacity of the current health system to find and diagnose patients with early AD pathology. This may be related in part to the limited capacity of the current health systems to select those people likely to have AD pathology in order to confirm the diagnosis with available cerebrospinal fluid and imaging biomarkers at memory clinics. In the current narrative review, we summarize the literature on candidate blood tests for AD that could be implemented in primary care settings and used for the effective identification of individuals at increased risk of AD pathology, who could be referred for potential inclusion in clinical trials or future approved treatments following additional testing. We give an updated account of blood-based candidate biomarkers and biomarker panels for AD-related brain changes. Our analysis centres on biomarker candidates that have been replicated in more than one study and discusses the need of further studies to achieve the goal of a primary care-based screening algorithm for AD.
有效开展针对阿尔茨海默病(AD)新候选药物的临床试验并确定未来接受疾病修正治疗的患者的主要障碍是,当前卫生系统发现和诊断早期 AD 病理患者的能力有限。这可能部分与当前卫生系统选择那些可能患有 AD 病理的人的能力有限有关,以便在记忆诊所中使用现有的脑脊液和成像生物标志物来确认诊断。在目前的叙述性综述中,我们总结了有关 AD 候选血液检测的文献,这些检测可在初级保健环境中实施,并用于有效识别 AD 病理风险增加的个体,这些个体可被转介参加临床试验或在进一步检测后接受未来批准的治疗。我们提供了与 AD 相关脑变化相关的基于血液的候选生物标志物和生物标志物组合的最新情况。我们的分析集中在已在多项研究中复制的生物标志物候选物上,并讨论了进一步研究的必要性,以实现基于初级保健的 AD 筛查算法的目标。