路易体痴呆中的 tau 蛋白。
Tau in dementia with Lewy bodies.
机构信息
Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia.
Department of Aged Care, The Royal Melbourne Hospital, Parkville, VIC, Australia.
出版信息
Aust N Z J Psychiatry. 2024 Feb;58(2):175-182. doi: 10.1177/00048674231177219. Epub 2023 Jun 1.
OBJECTIVE
Neurofibrillary tangles are present in a proportion of people with dementia with Lewy bodies and may be associated with worse cognition. Recent advances in biomarkers for Alzheimer's disease include second-generation tau positron emission tomography as well as the detection of phosphorylated tau at threonine 181 (p-tau181) in plasma. This study aimed to investigate tau in people with dementia with Lewy bodies using a second-generation tau positron emission tomography tracer as well as plasma p-tau181.
METHODS
Twenty-seven participants (mean age 74.7 ± 5.5) with clinically diagnosed probable dementia with Lewy bodies underwent comprehensive clinical assessment and positron emission tomography imaging (F-MK6240 and F-NAV4694). Plasma p-tau181 levels were measured using Simoa technology.
RESULTS
Five dementia with Lewy bodies participants (18.5%) had an abnormal tau positron emission tomography (increased tau uptake in the temporal meta-region-of-interest). Higher plasma p-tau181 concentrations correlated with higher tau deposition in the temporal region (ρ = 0.46, 95% confidence interval = [0.10, 0.72]) and classified abnormal tau positron emission tomography in dementia with Lewy bodies with an area under the curve of 0.95 (95% confidence interval = [0.86, 0.99]). Plasma p-tau181 also correlated positively with cortical amyloid-beta binding (ρ = 0.68, 95% confidence interval = [0.40, 0.84]) and classified abnormal amyloid-beta positron emission tomography in dementia with Lewy bodies with an area under the curve of 0.91 (95% confidence interval = [0.79, 0.99]). There was no association found between tau deposition and any of the clinical variables.
CONCLUSIONS
Tau is a common co-pathology in dementia with Lewy bodies. Plasma p-tau181 correlated with abnormal tau and amyloid-beta positron emission tomography and may potentially be used as a marker to identify co-morbid Alzheimer's disease-related pathology in dementia with Lewy bodies. The clinical implications of tau in dementia with Lewy bodies need to be further evaluated in larger longitudinal studies.
目的
神经原纤维缠结存在于一部分路易体痴呆患者中，可能与认知功能更差有关。阿尔茨海默病生物标志物的最新进展包括第二代 tau 正电子发射断层扫描，以及血浆中苏氨酸 181 位磷酸化 tau（p-tau181）的检测。本研究旨在使用第二代 tau 正电子发射断层扫描示踪剂和血浆 p-tau181 来研究路易体痴呆患者中的 tau。
方法
27 名（平均年龄 74.7±5.5）临床诊断为可能的路易体痴呆患者接受了全面的临床评估和正电子发射断层扫描成像（F-MK6240 和 F-NAV4694）。使用 Simoa 技术测量血浆 p-tau181 水平。
结果
5 名路易体痴呆患者（18.5%） tau 正电子发射断层扫描异常（颞叶感兴趣区 tau 摄取增加）。较高的血浆 p-tau181 浓度与颞叶区域更高的 tau 沉积相关（ρ=0.46，95%置信区间=[0.10，0.72]），并以 0.95（95%置信区间=[0.86，0.99]）的曲线下面积对路易体痴呆患者中的 tau 正电子发射断层扫描异常进行分类。血浆 p-tau181 还与皮质淀粉样蛋白-β结合呈正相关（ρ=0.68，95%置信区间=[0.40，0.84]），并以 0.91（95%置信区间=[0.79，0.99]）的曲线下面积对路易体痴呆患者中的淀粉样蛋白-β正电子发射断层扫描异常进行分类。tau 沉积与任何临床变量均无相关性。
结论
tau 是路易体痴呆的常见共病。血浆 p-tau181 与 tau 和淀粉样蛋白-β正电子发射断层扫描异常相关，可能作为识别路易体痴呆中合并的阿尔茨海默病相关病理的标志物。需要在更大的纵向研究中进一步评估 tau 在路易体痴呆中的临床意义。
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