血浆pTau217在评估淀粉样蛋白和tau生物标志物特征方面的潜在效用。

Potential utility of plasma pTau217 for assessing amyloid and tau biomarker profiles.

作者信息

Shin Daeun, Jang Hyemin, Yoo Heejin, Kim Kyungmin, Zetterberg Henrik, Blennow Kaj, Gonzalez-Ortiz Fernando, Ashton Nicholas J, Lee Eun Hye, Yun Jihwan, Na Duk L, Kim Hee Jin, Kang Sung Hoon, Kim Ko Woon, Kim Si Eun, Kim Yeo Jin, Kim Yeshin, Chun Min Young, Jung Na Yeon, Cho Soo Hyun, Kim Jun Pyo, Seo Sang Won

机构信息

Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.

Department of Neurology, Asan Medical Center, Ulsan University School of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.

出版信息

Eur J Nucl Med Mol Imaging. 2025 Aug 6. doi: 10.1007/s00259-025-07457-y.

DOI:10.1007/s00259-025-07457-y

PMID:40768095

Abstract

PURPOSE

Plasma phosphorylated tau 217 (pTau217) is a promising biomarker for Alzheimer's disease, reflecting both amyloid β (Aβ) and tau positron emission tomography (PET) results. While its diagnostic role is actively being investigated, this study aims to expand its application to staging disease progression and predicting cognitive decline.

METHODS

A total of 2,919 participants, primarily diagnosed as Alzheimer's clinical syndrome, were recruited. Plasma pTau217 was measured using the ALZpath assay, and its diagnostic accuracy for binary Aβ/tau (A/T) biomarker profiles and Aβ and tau PET staging was assessed using area under the curve (AUC). Longitudinal Mini-Mental State Examination (MMSE) changes according to plasma pTau217-based staging were analyzed.

RESULTS

Plasma pTau217 accurately predicted binary Aβ (AUC 0.96) and tau (AUC 0.90) PET positivity. Both the Aβ-positive/tau-positive (A+/T+) and Aβ-positive/tau-negative (A+/T-) groups, defined using plasma pTau217 cutoffs, showed significantly worse MMSE trajectories compared to the Aβ-negative/tau-negative (A-/T-) group (for A+/T+ vs. A-/T-, β = -1.061 ± 0.055; for A+/T- vs. A-/T-, β = -0.322 ± 0.070, all adjusted P < 0.001). However, its performance was less effective for Aβ and tau PET staging, particularly for medial temporal tau PET stage (AUC 0.71). Nevertheless, plasma pTau217-based staging distinguished longitudinal MMSE deterioration (all adjusted P < 0.001).

CONCLUSION

Plasma pTau217 is effective for predicting A/T biomarker profile and cognitive decline, though further study is needed to better explain its association with Aβ and tau PET staging.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

目的

血浆磷酸化tau 217（pTau217）是阿尔茨海默病一种很有前景的生物标志物，能反映淀粉样蛋白β（Aβ）和tau正电子发射断层扫描（PET）结果。虽然其诊断作用正在积极研究中，但本研究旨在扩大其在疾病进展分期和预测认知衰退方面的应用。

方法

共招募了2919名主要诊断为阿尔茨海默病临床综合征的参与者。使用ALZpath检测法测量血浆pTau217，并使用曲线下面积（AUC）评估其对二元Aβ/tau（A/T）生物标志物谱以及Aβ和tau PET分期的诊断准确性。分析了基于血浆pTau217分期的纵向简易精神状态检查表（MMSE）变化。

结果

血浆pTau217准确预测了二元Aβ（AUC 0.96）和tau（AUC 0.90）PET阳性。使用血浆pTau217临界值定义的Aβ阳性/tau阳性（A+/T+）和Aβ阳性/tau阴性（A+/T-）组，与Aβ阴性/tau阴性（A-/T-）组相比，MMSE轨迹明显更差（A+/T+与A-/T-相比，β = -1.061±0.055；A+/T-与A-/T-相比，β = -0.322±0.070，所有校正P < 0.001）。然而，其在Aβ和tau PET分期方面的表现效果较差，尤其是在内侧颞叶tau PET分期方面（AUC 0.71）。尽管如此，基于血浆pTau217的分期区分了纵向MMSE恶化情况（所有校正P < 0.001）。