Lai Roy, Li Brenden, Bishnoi Ram
Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA.
Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL 33613, USA.
Biomedicines. 2024 Aug 13;12(8):1836. doi: 10.3390/biomedicines12081836.
Amyloid plaques and tau tangles are the hallmark pathologic features of Alzheimer's disease (AD). Traditionally, these changes are identified in vivo via cerebrospinal fluid (CSF) analysis or positron emission tomography (PET) scans. However, these methods are invasive, expensive, and resource-intensive. To address these limitations, there has been ongoing research over the past decade to identify blood-based markers for AD. Despite the challenges posed by their extremely low concentrations, recent advances in mass spectrometry and immunoassay techniques have made it feasible to detect these blood markers of amyloid and tau deposition. Phosphorylated tau (p-tau) has shown greater promise in reflecting amyloid pathology as evidenced by CSF and PET positivity. Various isoforms of p-tau, distinguished by their differential phosphorylation sites, have been recognized for their ability to identify amyloid-positive individuals. Notable examples include p-tau181, p-tau217, and p-tau235. Among these, p-tau217 has emerged as a superior and reliable marker of amyloid positivity and, thus, AD in terms of accuracy of diagnosis and ability for early prognosis. In this narrative review, we aim to elucidate the utility of p-tau217 as an AD marker, exploring its underlying basis, clinical diagnostic potential, and relevance in clinical care and trials.
淀粉样斑块和tau缠结是阿尔茨海默病（AD）的标志性病理特征。传统上，这些变化是通过脑脊液（CSF）分析或正电子发射断层扫描（PET）在体内识别的。然而，这些方法具有侵入性、成本高且资源密集。为了解决这些局限性，在过去十年中一直在进行研究以确定AD的血液标志物。尽管它们的浓度极低带来了挑战，但质谱和免疫测定技术的最新进展使得检测这些淀粉样蛋白和tau沉积的血液标志物成为可能。磷酸化tau（p-tau）在反映淀粉样蛋白病理方面显示出更大的前景，脑脊液和PET阳性证明了这一点。p-tau的各种亚型，因其不同的磷酸化位点而有所区别，因其识别淀粉样蛋白阳性个体的能力而受到认可。值得注意的例子包括p-tau181、p-tau217和p-tau235。其中，p-tau217在诊断准确性和早期预后能力方面已成为淀粉样蛋白阳性以及AD的一种优越且可靠的标志物。在这篇叙述性综述中，我们旨在阐明p-tau217作为AD标志物的效用，探讨其潜在基础、临床诊断潜力以及在临床护理和试验中的相关性。
