Vogelgsang Jonathan, Wiltfang Jens
Universitätsmedizin Göttingen (UMG), Klinik für Psychiatrie und Psychotherapie, Georg-August-Universität, Von-Siebold-Str. 5, 37075, Göttingen, Deutschland.
Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Von-Siebold-Str. 3a, 37075, Göttingen, Deutschland.
Nervenarzt. 2019 Sep;90(9):907-913. doi: 10.1007/s00115-019-0772-9.
In accordance with the current German dementia guidelines, the dementia biomarkers amyloid beta 42, the tau peptides total tau and phosphorylated tau 181 are recommended for cerebrospinal fluid (CSF)-based diagnostics of dementia. Several studies have clearly shown that determination of the amyloid beta 42 to amyloid beta 40 peptide ratio is superior to the interpretation of amyloid beta 42 alone and should be implemented in the clinical work-up; however, in recent years different studies have presented many other innovative CSF and blood-based biomarkers. Besides CSF-based neurochemical diagnostics of dementia promising novel protocols for the detection of amyloid beta peptides in blood have meanwhile been published, which can currently be used in clinical studies for blood-based early diagnostics of Alzheimer's dementia. Following further validation and assay optimization these blood assays should be available for routine diagnostics in the near future.
根据当前德国痴呆症指南,痴呆生物标志物β淀粉样蛋白42、总tau蛋白和磷酸化tau蛋白181被推荐用于基于脑脊液(CSF)的痴呆症诊断。多项研究已明确表明,测定β淀粉样蛋白42与β淀粉样蛋白40的肽比率优于单独解读β淀粉样蛋白42,应在临床检查中采用;然而,近年来不同研究提出了许多其他基于脑脊液和血液的创新生物标志物。除了基于脑脊液的痴呆症神经化学诊断外,同时已发表了用于检测血液中β淀粉样肽的有前景的新方案,目前可用于阿尔茨海默病痴呆症基于血液的早期诊断的临床研究。经过进一步验证和检测优化后,这些血液检测方法在不久的将来应可用于常规诊断。