Gong Katherine, Timsina Jigyasha, Ali Muhammad, Chen Yike, Liu Menghan, Wang Ciyang, Pottier Cyril, Feld Geoffrey K, Heo Gyujin, Benzinger Tammie L S, Raji Cyrus A, Ances Beau, Gordon Brian A, Wisch Julie K, Schindler Suzanne E, Morris John C, Holtzman David M, Ibanez Laura, Cruchaga Carlos
Res Sq. 2025 Jun 29:rs.3.rs-6440485. doi: 10.21203/rs.3.rs-6440485/v1.
Highly sensitive plasma assays enable accurate blood-based biomarkers for neurodegenerative disease and provide minimally invasive options for clinical use. Large-scale studies encompassing multiple neurodegenerative diseases and utilizing multiplex platforms are essential to uncover disease-specific biomarkers and pathways. We generated and analyzed plasma proteomics using the NULISASeq™ CNS Disease Panel 120 from 3,002 participants with Alzheimer disease (AD), Dementia with Lewy bodies (DLB), Frontotemporal dementia (FTD), Parkinson disease (PD) and cognitively unimpaired participants at the Charles F. and Joanne Knight Alzheimer Disease Research Center. We identified proteins associated with disease status and AD-related phenotypes (Clinical Dementia Rating® [CDR ], CSF Aβ42/Aβ40, amyloid-PET, and tau-PET tauopathy), which were used to identify disease-specific biomarkers and perform pathway analyses. Among the 123 measured protein, 78 were associated with AD, two with DLB, two with FTD, and one with PD after multiple test correction. Disease comparison showed that AD and DLB showed the highest similarity, followed by FTD and DLB. At the same time there were also disease-specific signatures. Some AD-specific proteins include p-tau217 being AD-specific, MME was specific for FTD, CHR for DLB and PARK7 for PD. We also identified 8 proteins associated with Amyloid PET, 7 with Tau PET, 14 with CSF Aβ42/40 ration and 73 with CDR, with Amyloid PET and CDR showing the highest overlap. As few extensive plasma p-tau217 studies have been performed with the NULISA platform, we used a data-driven approach to establish the cut-off for biomarker positivity, and analyze its predictivity performance for clinical status and amyloid-PET. Plasma p-tau217 achieved an AUC of 0.81 (95% CI: 0.79-0.83) for AD diagnosis and 0.95 (95% CI: 0.93-0.98) for amyloid positivity. Using a two-cutoff approach, plasma p-tau217 had an AUC of 0.95 and 93.59% agreement with amyloid-PET status. Proteins associated with AD were enriched on vascular endothelial growth factor receptor binding, mainly driven by VEGFD and VEGFA. Cell death and apoptosis pathways were unique to FTD and driven by CCL2 and TREM2, and PD was enriched on enzymatic activity and metal ion binding. This is the largest plasma proteomic investigation to date, incorporating p-tau217 and utilizing the NULISA platform to understand neurodegenerative diseases. It validates the high classification accuracy of plasma p-tau217 and its strong correlation with amyloid PET status. Additionally, we identify disease-specific proteins that could enhance differential diagnosis. These findings underscore the potential of the NULISA platform as a reliable quantitative tool for research and clinical applications in neurodegenerative diseases.
高灵敏度血浆检测能够为神经退行性疾病提供准确的血液生物标志物,并为临床应用提供微创选择。涵盖多种神经退行性疾病并利用多重检测平台的大规模研究对于发现疾病特异性生物标志物和通路至关重要。我们使用来自查尔斯·F·和乔安妮·奈特阿尔茨海默病研究中心的3002名患有阿尔茨海默病(AD)、路易体痴呆(DLB)、额颞叶痴呆(FTD)、帕金森病(PD)的参与者以及认知未受损的参与者,通过NULISASeq™中枢神经系统疾病检测板120生成并分析了血浆蛋白质组学。我们鉴定出与疾病状态和AD相关表型(临床痴呆评定量表[CDR]、脑脊液Aβ42/Aβ40、淀粉样蛋白PET和tau蛋白PET tau病变)相关的蛋白质,这些蛋白质被用于识别疾病特异性生物标志物并进行通路分析。在123种检测的蛋白质中,经过多重检验校正后,78种与AD相关,2种与DLB相关,2种与FTD相关,1种与PD相关。疾病比较显示,AD和DLB的相似性最高,其次是FTD和DLB。同时也存在疾病特异性特征。一些AD特异性蛋白质包括p-tau217是AD特异性的,MME是FTD特异性的,CHR是DLB特异性的,PARK7是PD特异性的。我们还鉴定出8种与淀粉样蛋白PET相关的蛋白质,7种与tau蛋白PET相关的蛋白质,14种与脑脊液Aβ42/40比值相关的蛋白质,以及73种与CDR相关的蛋白质,其中淀粉样蛋白PET和CDR的重叠度最高。由于使用NULISA平台进行的血浆p-tau217广泛研究较少,我们采用数据驱动的方法来确定生物标志物阳性的临界值,并分析其对临床状态和淀粉样蛋白PET的预测性能。血浆p-tau217在AD诊断中的AUC为0.81(95%CI:0.79-0.83),在淀粉样蛋白阳性方面的AUC为0.95(95%CI:0.93-0.98)。采用双临界值方法,血浆p-tau217的AUC为0.95,与淀粉样蛋白PET状态的一致性为93.59%。与AD相关的蛋白质在血管内皮生长因子受体结合方面富集,主要由VEGFD和VEGFA驱动。细胞死亡和凋亡通路是FTD特有的,由CCL2和TREM2驱动,而PD在酶活性和金属离子结合方面富集。这是迄今为止最大规模的血浆蛋白质组学研究,纳入了p-tau217并利用NULISA平台来了解神经退行性疾病。它验证了血浆p-tau217的高分类准确性及其与淀粉样蛋白PET状态的强相关性。此外,我们鉴定出了可增强鉴别诊断的疾病特异性蛋白质。这些发现强调了NULISA平台作为神经退行性疾病研究和临床应用可靠定量工具的潜力。
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