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在老年人群中,血浆 p-tau181 和 p-tau217 可用于区分 PART、AD 及其他关键神经病理学特征。

Plasma p-tau181 and p-tau217 in discriminating PART, AD and other key neuropathologies in older adults.

机构信息

Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison Street, Suite 1000, Chicago, IL, 60612, USA.

Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.

出版信息

Acta Neuropathol. 2023 Jul;146(1):1-11. doi: 10.1007/s00401-023-02570-4. Epub 2023 Apr 9.

Abstract

We examined whether plasma p-tau181 and p-tau217 are specific biomarkers of pathologically confirmed Alzheimer's disease (AD). In particular, we investigated the utility of plasma p-tau for differentiating AD from primary age-related tauopathy (PART), as well as AD with mixed pathologies. Data came from 269 older adults who participated in the Religious Orders Study or the Rush Memory and Aging Project. Blood samples were collected during annual clinical evaluations. Participants died and underwent brain autopsy. P-tau181 and p-tau217 were quantified in the plasma samples proximate to death (average interval before death: 1.4 years) using Lilly-developed MSD immunoassays. Uniform neuropathologic evaluations assessed AD, PART, and other common degenerative and cerebrovascular conditions. Plasma p-tau217 was more strongly correlated with brain β-amyloid and paired helical filament tau (PHFtau) tangles than p-tau181. Both p-tau markers were associated with greater odds of AD, but p-tau217 had higher accuracy (area under the ROC curve (AUC): 0.83) than p-tau181 (AUC: 0.76). Plasma p-tau markers were almost exclusively associated with AD pathologic indices with the exception of cerebral amyloid angiopathy. Compared to p-tau181, p-tau217 showed a higher AUC (0.82 versus 0.74) in differentiating AD from PART. For either p-tau, we did not observe a level difference between individuals with AD alone and those with mixed AD pathologies. In summary, plasma p-tau181and p-tau217 were specifically associated with AD pathological changes. Further, our data provide initial evidence that p-tau217 may be able to differentiate between AD and PART in individuals with comparable burdens of tau tangle pathology. These results demonstrate the specificity of p-tau217 for AD, supporting its use to identify patients suitable for anti-AD therapies including β-amyloid immunotherapies.

摘要

我们研究了血浆 p-tau181 和 p-tau217 是否是经过病理证实的阿尔茨海默病(AD)的特异性生物标志物。特别是,我们研究了血浆 p-tau 用于区分 AD 与原发性年龄相关性 tau 病(PART),以及具有混合病理的 AD 的能力。数据来自参加宗教秩序研究或拉什记忆与衰老项目的 269 名老年人。血液样本在每年的临床评估期间采集。参与者死亡并接受了脑部尸检。在接近死亡时(死亡前的平均间隔:1.4 年),使用礼来公司开发的 MSD 免疫分析法在血浆样本中定量测定 p-tau181 和 p-tau217。统一的神经病理学评估评估了 AD、PART 以及其他常见的退行性和脑血管疾病。与 p-tau181 相比,p-tau217 与脑 β-淀粉样蛋白和配对螺旋丝 tau(PHFtau)缠结的相关性更强。这两种 p-tau 标志物都与 AD 的可能性更大相关,但 p-tau217 的准确性更高(ROC 曲线下面积(AUC):0.83)比 p-tau181(AUC:0.76)。除了脑淀粉样血管病外,血浆 p-tau 标志物几乎只与 AD 病理指标相关。与 p-tau181 相比,p-tau217 在区分 AD 与 PART 方面具有更高的 AUC(0.82 对 0.74)。对于任一 p-tau,我们在仅患有 AD 的个体和具有混合 AD 病理学的个体之间没有观察到水平差异。总之,血浆 p-tau181 和 p-tau217 与 AD 病理变化特异性相关。此外,我们的数据提供了初步证据,表明 p-tau217 可能能够区分具有相似 tau 缠结病理负担的 AD 与 PART。这些结果表明 p-tau217 对 AD 的特异性,支持其用于识别适合抗 AD 治疗的患者,包括β-淀粉样蛋白免疫疗法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ca2/10261204/fbd12d928360/401_2023_2570_Fig1_HTML.jpg

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