Imbimbo Bruno P, Watling Mark, Imbimbo Camillo, Nisticò Robert
Department of Research & Development, Chiesi Farmaceutici, Parma, Italy.
Independent Scholar (formerly at TranScrip Ltd, Reading, UK), Ruthin, UK.
Alzheimers Dement. 2023 Oct;19(10):4729-4734. doi: 10.1002/alz.13084. Epub 2023 Apr 20.
Evaluating potential therapies for Alzheimer's disease (AD) depends on use of biomarkers for appropriate subject selection and monitoring disease progression. Biomarkers that predict onset of clinical symptoms are particularly important for AD because they enable intervention before irreversible neurodegeneration occurs. The amyloid-β-tau-neurodegeneration (ATN) classification system is currently used as a biological staging model for AD and is based on three classes of biomarkers evaluating amyloid-β (Aβ), tau pathology and neurodegeneration or neuronal injury. Promising blood-based biomarkers for each of these categories have been identified (Aβ42/Aβ40 ratio, phosphorylated tau, neurofilament light chain), and this matrix is now being expanded toward an ATN(I) system, where "I" represents a neuroinflammatory biomarker. The plasma ATN(I) system, together with APOE genotyping, offers a basis for individualized evaluation and a move away from the classic "one size fits all" approach toward a biomarker-driven individualisation of therapy for patients with AD.
评估阿尔茨海默病（AD）的潜在疗法依赖于使用生物标志物来进行合适的受试者选择和监测疾病进展。对于AD而言，预测临床症状发作的生物标志物尤为重要，因为它们能够在不可逆的神经退行性变发生之前进行干预。淀粉样蛋白-β- tau-神经退行性变（ATN）分类系统目前被用作AD的生物学分期模型，它基于三类评估淀粉样蛋白-β（Aβ）、tau病理学以及神经退行性变或神经元损伤的生物标志物。已确定了针对这些类别中每一类的有前景的血液生物标志物（Aβ42/Aβ40比值、磷酸化tau、神经丝轻链），并且这个矩阵现在正朝着ATN（I）系统扩展，其中“I”代表一种神经炎症生物标志物。血浆ATN（I）系统，连同APOE基因分型，为个体化评估提供了基础，并使我们从经典的“一刀切”方法转向基于生物标志物的AD患者治疗个体化。
