Neurology：新型阿尔兹海默氏症血液检测法

一种廉价便利的阿尔兹海默症检测法在未来几年内即将出现，刊登在8月份的国际杂志Neurology上的研究报告中，研究者开发出了一种新型的阿尔兹海默氏症血液检测法，新型方法可以在三组独立病人组中进行统计学分析。

研究者William表示，重复最初结果的安全性和失败是这项领域最大的挑战，在这里我们阐述了这种一致性发现的可能性。

来自宾夕法尼亚大学和华盛顿大学的研究者合作，测定了体系统600个研究对象血液中190种蛋白质的水平。研究对象包括健康志愿者和那些诊断出患有阿尔兹海默症或者弱的认知损伤（MCI）的患者。

在MCI和阿尔兹海默症患者中，其190种蛋白质的水平明显不同，当和另外一项研究中对566个患者的研究结果对比以后，只有四种标记物保留了下来，这四种蛋白质包括载脂蛋白E、B型利尿钠肽、C-反应蛋白和胰多肽。

血液中四种蛋白质水平的改变和相同病人脑脊髓液的测定水平相关，研究者表示他们正在寻找一种敏感的信号，MCI被假设为早期的AD患者（阿尔兹海默氏症患者），敏感标志物可以捕获MCI和AD患者的生理学改变。神经学家们诊断AD是基于当前的临床症状，附加的信息可以通过PET脑部成像来判断，但是这种成像非常昂贵。

尽管血液检测识别AD对于当下来说并没有完全做好准备，但是研究者发现了一种使得测试可靠的方法，这种临床检验和脑脊髓液分析互相结合的方法依然是诊断记忆力减退和认知障碍的最佳方法。

编译自：Blood test for Alzheimer's coming soon?

doi:10.1212/WNL.0b013e318266fa70
PMC:
PMID:

Plasma multianalyte profiling in mild cognitive impairment and Alzheimer disease

William T. Hu, MD, PhD, David M. Holtzman, MD, Anne M. Fagan, PhD, Leslie M. Shaw, PhD, Richard Perrin, MD, PhD, Steven E. Arnold, MD, PhD, Murray Grossman, MD, Chengjie Xiong, PhD, Rebecca Craig-Schapiro, PhD, Christopher M. Clark, MD†, Eve Pickering, PhD, Max Kuhn, PhD, Yu Chen, PhD, Vivianna M. Van Deerlin, MD, PhD, Leo McCluskey, MD, MBE, Lauren Elman, MD, Jason Karlawish, MD, Alice Chen-Plotkin, MD, Howard I. Hurtig, MD, Andrew Siderowf, MD, Frank Swenson, PhD, Virginia M.-Y. Lee, PhD, MBA, John C. Morris, MD, John Q. Trojanowski, MD, PhD and Holly Soares, PhD For the Alzheimer's Disease Neuroimaging Initiative

Objectives: While plasma biomarkers have been proposed to aid in the clinical diagnosis of Alzheimer disease (AD), few biomarkers have been validated in independent patient cohorts. Here we aim to determine plasma biomarkers associated with AD in 2 independent cohorts and validate the findings in the multicenter Alzheimer's Disease Neuroimaging Initiative (ADNI). Methods: Using a targeted proteomic approach, we measured levels of 190 plasma proteins and peptides in 600 participants from 2 independent centers (University of Pennsylvania, Philadelphia; Washington University, St. Louis, MO), and identified 17 analytes associated with the diagnosis of very mild dementia/mild cognitive impairment (MCI) or AD. Four analytes (apoE, B-type natriuretic peptide, C-reactive protein, pancreatic polypeptide) were also found to be altered in clinical MCI/AD in the ADNI cohort (n = 566). Regression analysis showed CSF Aβ42 levels and t-tau/Aβ42 ratios to correlate with the number of APOE4 alleles and plasma levels of B-type natriuretic peptide and pancreatic polypeptide. Conclusion: Four plasma analytes were consistently associated with the diagnosis of very mild dementia/MCI/AD in 3 independent clinical cohorts. These plasma biomarkers may predict underlying AD through their association with CSF AD biomarkers, and the association between plasma and CSF amyloid biomarkers needs to be confirmed in a prospective study.