Randall J. Bateman, Washington University School of Medicine, St. Louis, MO, USA,
J Prev Alzheimers Dis. 2019;6(3):169-173. doi: 10.14283/jpad.2019.21.
There is an urgent need to develop reliable and sensitive blood-based biomarkers of Alzheimer's disease (AD) that can be used for screening and to increase the efficiency of clinical trials. The European Union-North American Clinical Trials in Alzheimer's Disease Task Force (EU/US CTAD Task Force) discussed the current status of blood-based AD biomarker development at its 2018 annual meeting in Barcelona, Spain. Recent improvements in technologies to assess plasma levels of amyloid beta indicate that a single sample of blood could provide an accurate estimate of brain amyloid positivity. Plasma neurofilament light protein appears to provide a good marker of neurodegeneration, although not specific for AD. Plasma tau shows some promising results but weak or no correlation with CSF tau levels, which may reflect rapid clearance of tau in the bloodstream. Blood samples analyzed using -omics and other approaches are also in development and may provide important insight into disease mechanisms as well as biomarker profiles for disease prediction. To advance these technologies, international multidisciplinary, multi-stakeholder collaboration is essential.
目前迫切需要开发可靠且敏感的阿尔茨海默病(AD)血液生物标志物,用于筛查并提高临床试验的效率。欧盟-北美治疗阿尔茨海默病临床试验联合会(EU/US CTAD Task Force)在西班牙巴塞罗那举行的 2018 年年度会议上讨论了当前血液 AD 生物标志物开发的现状。最近在评估血浆β淀粉样蛋白水平的技术方面取得了进展,这表明一份血样可以准确估计脑内淀粉样蛋白阳性。血浆神经丝轻蛋白似乎是神经退行性变的一个很好的标志物,但特异性不强,不能用于 AD 的诊断。血浆 tau 显示出一些有希望的结果,但与 CSF tau 水平相关性较弱或没有,这可能反映了 tau 在血液中的快速清除。使用组学和其他方法分析的血液样本也在开发中,可能为疾病机制以及疾病预测的生物标志物特征提供重要的见解。为了推进这些技术,国际多学科、多方利益相关者的合作至关重要。