IEEE J Biomed Health Inform. 2021 Jan;25(1):218-226. doi: 10.1109/JBHI.2020.2984355. Epub 2021 Jan 5.
The successful development of amyloid-based biomarkers and tests for Alzheimer's disease (AD) represents an important milestone in AD diagnosis. However, two major limitations remain. Amyloid-based diagnostic biomarkers and tests provide limited information about the disease process and they are unable to identify individuals with the disease before significant amyloid-beta accumulation in the brain develops. The objective in this study is to develop a method to identify potential blood-based non-amyloid biomarkers for early AD detection. The use of blood is attractive because it is accessible and relatively inexpensive. Our method is mainly based on machine learning (ML) techniques (support vector machines in particular) because of their ability to create multivariable models by learning patterns from complex data. Using novel feature selection and evaluation modalities, we identified 5 novel panels of non-amyloid proteins with the potential to serve as biomarkers of early AD. In particular, we found that the combination of A2M, ApoE, BNP, Eot3, RAGE and SGOT may be a key biomarker profile of early disease. Disease detection models based on the identified panels achieved sensitivity (SN) > 80%, specificity (SP) > 70%, and area under receiver operating curve (AUC) of at least 0.80 at prodromal stage (with higher performance at later stages) of the disease. Existing ML models performed poorly in comparison at this stage of the disease, suggesting that the underlying protein panels may not be suitable for early disease detection. Our results demonstrate the feasibility of early detection of AD using non-amyloid based biomarkers.
基于淀粉样蛋白的生物标志物和阿尔茨海默病 (AD) 检测方法的成功开发是 AD 诊断的重要里程碑。然而,目前仍存在两个主要局限性。基于淀粉样蛋白的诊断生物标志物和检测方法提供的关于疾病过程的信息有限,并且无法在大脑中出现明显的淀粉样蛋白-β积累之前识别出患有该疾病的个体。本研究的目的是开发一种识别潜在的血液非淀粉样蛋白 AD 早期检测生物标志物的方法。使用血液是有吸引力的,因为它是可及的,相对便宜。我们的方法主要基于机器学习 (ML) 技术(特别是支持向量机),因为它们能够通过从复杂数据中学习模式来创建多变量模型。使用新颖的特征选择和评估模式,我们确定了 5 种新的非淀粉样蛋白蛋白组,它们具有作为 AD 早期标志物的潜力。特别是,我们发现 A2M、ApoE、BNP、Eot3、RAGE 和 SGOT 的组合可能是早期疾病的关键生物标志物特征。基于鉴定出的蛋白组的疾病检测模型在疾病的前驱期(在疾病的后期阶段性能更高)达到了>80%的敏感性 (SN)、>70%的特异性 (SP) 和至少 0.80 的接收者操作特征曲线 (AUC)。与现阶段相比,现有的 ML 模型性能较差,这表明潜在的蛋白组可能不适合早期疾病检测。我们的结果表明,使用非淀粉样蛋白生物标志物进行 AD 的早期检测是可行的。