血浆和脑脊液中磷酸化 tau181 和 tau231 水平与阿尔茨海默病认知功能的关联：系统评价和荟萃分析。

The Associations of Phosphorylated Tau 181 and Tau 231 Levels in Plasma and Cerebrospinal Fluid with Cognitive Function in Alzheimer's Disease: A Systematic Review and Meta-Analysis.

机构信息

Department of Disease Control and Prevention, Sichuan Provincial Center for Disease Control and Prevention, Sichuan Chengdu, China.

School of Health Policy and Management, Peking Union Medical College, Beijing, China.

出版信息

J Alzheimers Dis. 2024;98(1):13-32. doi: 10.3233/JAD-230799.

DOI:10.3233/JAD-230799

PMID:38339929

Abstract

BACKGROUND

Cerebrospinal fluid (CSF) or blood biomarkers like phosphorylated tau proteins (p-tau) are used to detect Alzheimer's disease (AD) early. Increasing studies on cognitive function and blood or CSF p-tau levels are controversial.

OBJECTIVE

Our study examined the potential of p-tau as a biomarker of cognitive status in normal control (NC), mild cognitive impairment (MCI), and AD patients.

METHODS

We searched PubMed, Cochrane, Embase, and Web of Science for relevant material through 12 January 2023. 5,017 participants from 20 studies-1,033 AD, 2,077 MCI, and 1,907 NC-were evaluated. Quantitative analysis provided continuous outcomes as SMDs with 95% CIs. Begg tested publication bias.

RESULTS

MCI patients had lower CSF p-tau181 levels than AD patients (SMD =-0.60, 95% CI (-0.85, -0.36)) but higher than healthy controls (SMD = 0.67). AD/MCI patients had greater plasma p-tau181 levels than healthy people (SMD =-0.73, 95% CI (-1.04, -0.43)). MCI patients had significantly lower p-tau231 levels than AD patients in plasma and CSF (SMD =-0.90, 95% CI (-0.82, -0.45)). MCI patients showed greater CSF and plasma p-tau231 than healthy controls (SMD = 1.34, 95% CI (0.89, 1.79) and 0.43, (0.23, 0.64)). Plasma p-tau181/231 levels also distinguished the three categories. MCI patients had higher levels than healthy people, while AD patients had higher levels than MCI patients.

CONCLUSIONS

CSF p-tau181 and p-tau231 biomarkers distinguished AD, MCI, and healthy populations. Plasma-based p-tau181 and p-tau231 biomarkers for AD and MCI need further study.

摘要

背景

脑脊液（CSF）或血液生物标志物，如磷酸化 tau 蛋白（p-tau），用于早期发现阿尔茨海默病（AD）。越来越多的关于认知功能以及血液或 CSF p-tau 水平的研究存在争议。

目的

我们的研究旨在检测 p-tau 是否可作为正常对照（NC）、轻度认知障碍（MCI）和 AD 患者认知状态的生物标志物。

方法

我们通过 2023 年 1 月 12 日在 PubMed、Cochrane、Embase 和 Web of Science 上搜索相关材料。共评估了来自 20 项研究的 5017 名参与者，包括 1033 名 AD 患者、2077 名 MCI 患者和 1907 名 NC 患者。定量分析提供了连续结果，SMD 及其 95%置信区间（CI）。Begg 检验评估了发表偏倚。

结果

与 AD 患者相比，MCI 患者的 CSF p-tau181 水平更低（SMD=-0.60，95%CI[-0.85，-0.36]），但高于健康对照组（SMD=0.67）。AD/MCI 患者的血浆 p-tau181 水平低于健康人（SMD=-0.73，95%CI[-1.04，-0.43]）。与 AD 患者相比，MCI 患者的血浆和 CSF 中 p-tau231 水平显著更低（SMD=-0.90，95%CI[-0.82，-0.45]）。与健康对照组相比，MCI 患者的 CSF 和血浆 p-tau231 水平更高（SMD=1.34，95%CI[0.89，1.79]和 0.43，95%CI[0.23，0.64]）。血浆 p-tau181/231 水平也可区分这三个类别。MCI 患者的水平高于健康人，而 AD 患者的水平高于 MCI 患者。