Alzheimer&Dementia:新发现——临床前阿尔茨海默病的诊断性和预后性血浆生物标志物

2022-07-02 MedSci原创 MedSci原创

这些发现强调了GFAP和p-tau对临床前AD的诊断和纵向监测潜力。

当病人发现自己有阿尔茨海默病(AD)的时候,疾病程度通常已经进入了中晚期。在AD早期诊断疾病,有助于AD患者的治疗和康复。那么通过怎样的检测技术,检测哪些指标能在早期就诊断疾病呢?

美国国家衰老研究院和阿尔茨海默病协会(NIA-AA)共同发布的AD 最新诊断指南将AD 分成了三个阶段,即临床前AD 阶段、轻度认知损害(MCI)阶段和痴呆阶段。为了发现AD早期诊断及预后的血浆生物标志物,来自澳洲的学者开展了相关研究。

本研究涉及平行比较血浆胶质纤维酸性蛋白(GFAP)、总tau(t-tau)、磷酸化tau(p-tau181和p-tau231)和神经丝光(NFL)在临床前阿尔茨海默病(AD)的诊断和纵向监测潜力。使用Simoa检测法对认知能力无障碍的老年人(CU)的血浆蛋白进行检测,这些人没有(Aβ-)或存在(Aβ+)脑淀粉样变。

结果显示,与Aβ-CU相比,Aβ+CU的血浆GFAP、t-tau、p-tau181和p-tau231的横断面浓度更高。GFAP在区分Aβ+和Aβ-CU方面具有最高的效应大小和曲线下面积(AUC);然而,GFAP、p-tau181和p-tau231的AUC之间没有统计学上的明显差异,但都明显高于NFL的AUC,而且GFAP的AUC高于t-tau的AUC。

基础模型(BM)包括AD危险因素、年龄、性别和脂蛋白E基因(APOE)ε4状态与GFAP的组合被观察到,与BM与本研究中调查的任何其他蛋白的组合相比,AUC更高(>90%)。纵向分析显示,在12个月的时间里,Aβ+ CU的GFAP和p-tau181增加,Aβ- CU的NFL增加。GFAP、p-tau181、p-tau231和NFL与认知能力显示出明显的相关性,而与海马体积没有观察到明显的相关性。

综上,这些发现强调了GFAP和p-tau对临床前AD的诊断和纵向监测潜力。

参考文献:

Diagnostic and prognostic plasma biomarkers for preclinical Alzheimer's disease. https://doi.org/10.1002/alz.12447

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    2022-09-14 swallow
  3. 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  5. 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  6. 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  7. 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  8. 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  9. 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