Faculty of Medicine and Health and the Brain and Mind Centre, School of Medical Sciences, University of Sydney, Camperdown, NSW, 2050, Australia.
Garvan Institute of Medical Research, Darlinghurst, NSW, 2010, Australia.
Sci Rep. 2023 Mar 30;13(1):5217. doi: 10.1038/s41598-023-32480-0.
Objective biomarkers for Parkinson's Disease (PD) could aid early and specific diagnosis, effective monitoring of disease progression, and improved design and interpretation of clinical trials. Although alpha-synuclein remains a biomarker candidate of interest, the multifactorial and heterogenous nature of PD highlights the need for a PD biomarker panel. Ideal biomarker candidates include markers that are detectable in easily accessible samples, (ideally blood) and that reflect the underlying pathological process of PD. In the present study, we explored the diagnostic and prognostic PD biomarker potential of the SIMOA neurology 4-plex-A biomarker panel, which included neurofilament light (NFL), glial fibrillary acid protein (GFAP), tau and ubiquitin C-terminal hydrolase L1 (UCHL-1). We initially performed a serum vs plasma comparative study to determine the most suitable blood-based matrix for the measurement of these proteins in a multiplexed assay. The levels of NFL and GFAP in plasma and serum were highly correlated (Spearman rho-0.923, p < 0.0001 and rho = 0.825, p < 0.001 respectively). In contrast, the levels of tau were significantly higher in plasma compared to serum samples (p < 0.0001) with no correlation between sample type (Spearman p > 0.05). The neurology 4-plex-A panel, along with plasma alpha-synuclein was then assessed in a cross-sectional cohort of 29 PD patients and 30 controls. Plasma NFL levels positively correlated with both GFAP and alpha-synuclein levels (rho = 0.721, p < 0.0001 and rho = 0.390, p < 0.05 respectively). As diagnostic biomarkers, the control and PD groups did not differ in their mean NFL, GFAP, tau or UCHL-1 plasma levels (t test p > 0.05). As disease state biomarkers, motor severity (MDS-UPDRS III) correlated with increased NFL (rho = 0.646, p < 0.0001), GFAP (rho = 0.450, p < 0.05) and alpha-synuclein levels (rho = 0.406, p < 0.05), while motor stage (Hoehn and Yahr) correlated with increased NFL (rho = 0.455, p < 0.05) and GFAP (rho = 0.549, p < 0.01) but not alpha-synuclein levels (p > 0.05). In conclusion, plasma was determined to be most suitable blood-based matrix for multiplexing the neurology 4-plex-A panel. Given their correlation with motor features of PD, NFL and GFAP appear to be promising disease state biomarker candidates and further longitudinal validation of these two proteins as blood-based biomarkers for PD progression is warranted.
目的 帕金森病 (PD) 的客观生物标志物可辅助早期和特异性诊断、有效监测疾病进展,并改善临床试验的设计和解读。虽然 α-突触核蛋白仍然是一个备受关注的生物标志物候选物,但 PD 的多因素和异质性特点突出表明需要一个 PD 生物标志物组合。理想的生物标志物候选物包括在易于获取的样本(理想情况下是血液)中可检测到的、反映 PD 潜在病理过程的标志物。在本研究中,我们探讨了 SIMOA 神经病学 4 重检测-A 生物标志物组合(包括神经丝轻链 (NFL)、神经胶质纤维酸性蛋白 (GFAP)、tau 和泛素 C 端水解酶 L1 (UCHL-1))的 PD 诊断和预后生物标志物潜力。我们首先进行了血清与血浆的对比研究,以确定最适合在多重检测中测量这些蛋白质的基于血液的基质。NFL 和 GFAP 在血浆和血清中的水平高度相关(Spearman rho-0.923,p < 0.0001 和 rho = 0.825,p < 0.001)。相比之下,tau 在血浆中的水平明显高于血清样本(p < 0.0001),且样本类型之间无相关性(Spearman p > 0.05)。随后,我们在 29 名 PD 患者和 30 名对照的横断面队列中评估了神经病学 4 重检测-A 组合以及血浆 α-突触核蛋白。血浆 NFL 水平与 GFAP 和 α-突触核蛋白水平均呈正相关(rho = 0.721,p < 0.0001 和 rho = 0.390,p < 0.05)。作为诊断生物标志物,对照组和 PD 组的 NFL、GFAP、tau 或 UCHL-1 血浆水平无差异(t 检验 p > 0.05)。作为疾病状态生物标志物,运动严重程度(MDS-UPDRS III)与 NFL(rho = 0.646,p < 0.0001)、GFAP(rho = 0.450,p < 0.05)和 α-突触核蛋白水平(rho = 0.406,p < 0.05)的增加相关,而运动阶段(Hoehn 和 Yahr)与 NFL(rho = 0.455,p < 0.05)和 GFAP(rho = 0.549,p < 0.01)的增加相关,但与 α-突触核蛋白水平无关(p > 0.05)。总之,确定了血浆是最适合对神经病学 4 重检测-A 组合进行多重检测的基于血液的基质。鉴于它们与 PD 的运动特征相关,NFL 和 GFAP 似乎是很有前途的疾病状态生物标志物候选物,需要进一步对这两种蛋白作为 PD 进展的基于血液的生物标志物进行纵向验证。