Alz Res Therapy: 神经丝轻链和p-tau 181可预测痴呆进展

2021-11-14 Freeman MedSci原创

血浆NfL提示神经变性,而血浆p-tau181水平可作为脑部AD病理学和认知衰退的生物标志物

对阿尔茨海默病(AD)的脑部病理生理过程的体内检测是准确诊断和适当护理的关键。脑脊液(CSF)和正电子断层扫描的淀粉样蛋白和tau的生物标志物可以准确地检测出AD,但由于相关费用、侵入性或无法获得所需的工具,在临床实践中的用途有限。非侵入性的血液生物标志物可以提供一个有吸引力的替代方案,允许识别可能从进一步的、更具侵入性和/或昂贵的诊断中受益的患者,或用于招募和监测临床试验的参与者。


神经丝轻链(NfL)蛋白和在苏氨酸181处磷酸化的tau181(p-tau181)是有希望成为AD的血液生物标志物。NfL的血液水平被认为是轴突损伤和神经元损伤的生物标志物,并被发现在临床诊断的AD中与健康对照组相比有所增加。

它还与认知能力正常的参与者的认知能力下降,以及各种神经退行性疾病的神经变性有关。最近有报道称,血浆p-tau181在临床诊断和生物标志物确认的AD痴呆中都会增加,并与CSF tau水平和淀粉样PET测量相关。此外,它可以预测疾病的发展和认知能力的下降,在认知能力无障碍的参与者和MCI患者中。

藉此,苏黎世大学的Christopher Clark等人,探究血浆NfL和血浆p-tau181水平或其组合的能力,以作为诊断脑部AD病理学和预测临床疾病进展的血液生物标志物。

他们在认知正常(CN)和认知障碍(轻度认知障碍和痴呆,CI)的记忆门诊患者中测量血浆NfL和p-tau181,以及已建立的AD病理生物标志物。在纳入时和18和36个月的随访中进行了临床和神经心理学评估。多变量分析评估了血浆NfL和p-tau181水平与AD、单一CSF生物标志物、海马体积和疾病进展的临床措施的关联。

与CN非AD相比,具有AD CSF特征(定义为CSF p-tau181/Aβ1-42 > 0.0779)的CN参与者的血浆NfL水平较高,而p-tau181血浆水平在CI的AD患者中较高。

在CN患者中,血浆NfL水平与CSF tau和p-tau181相关,在CI患者中与CSF tau相关。血浆p-tau181与CN患者的CSF p-tau181相关,与CI患者的CSF tau、p-tau181、Aβ1-42和Aβ1-42/Aβ1-40相关。

与参考模型相比,加入血浆p-tau181可提高CI患者的AD预测率,而加入NfL则并不增加预测率。

在参考模型中加入p-tau181,而不是NfL水平,可改善对CI参与者认知能力下降的预测。

该研究的重要意义在于发现了:血浆NfL提示神经变性,而血浆p-tau181水平可作为脑部AD病理学和认知衰退的生物标志物。它们的预测性能取决于是否存在认知功能障碍。


原文出处:
Clark C, Lewczuk P, Kornhuber J, et al. Plasma neurofilament light and phosphorylated tau 181 as biomarkers of Alzheimer’s disease pathology and clinical disease progression. Alz Res Therapy. 2021;13(1):65. doi:10.1186/s13195-021-00805-8

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    特别牛

    0

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    2021-11-15 hb2008ye
  6. [GetPortalCommentsPageByObjectIdResponse(id=1739096, encodeId=8f4e1e39096cb, content=<a href='/topic/show?id=6e566913df' target=_blank style='color:#2F92EE;'>#ERA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6913, encryptionId=6e566913df, topicName=ERA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e36234488643, createdName=124988c7m106暂无昵称, createdTime=Sun Oct 16 06:16:48 CST 2022, time=2022-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1801694, encodeId=f9dc18016949d, content=<a href='/topic/show?id=91f1e4142bd' target=_blank style='color:#2F92EE;'>#神经丝#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74142, encryptionId=91f1e4142bd, topicName=神经丝)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1d01326, createdName=lizhou0204, createdTime=Sun May 01 23:16:48 CST 2022, time=2022-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1935026, encodeId=f454193502605, content=<a href='/topic/show?id=df6ee41476f' target=_blank style='color:#2F92EE;'>#神经丝轻链#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74147, encryptionId=df6ee41476f, topicName=神经丝轻链)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Sun Dec 19 18:16:48 CST 2021, time=2021-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1071631, encodeId=e4bf10e163170, content=特别牛, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dd305637358, createdName=ms9000000252861142, createdTime=Fri Nov 19 08:10:25 CST 2021, time=2021-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1509349, encodeId=a3ab150934965, content=<a href='/topic/show?id=19791e14471' target=_blank style='color:#2F92EE;'>#Tau#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17144, encryptionId=19791e14471, topicName=Tau)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Mon Nov 15 20:16:48 CST 2021, time=2021-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1070277, encodeId=05c710e027705, content=🐮牛, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6b3b5711295, createdName=ms7000000798320930, createdTime=Sun Nov 14 23:02:56 CST 2021, time=2021-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1070211, encodeId=48da10e021172, content=特别好, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=116a5651959, createdName=ms3000000802209056, createdTime=Sun Nov 14 18:54:23 CST 2021, time=2021-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1246356, encodeId=c34e124635607, content=老年性痴呆,未来还是希望借助神经电生理吧,也许更为有效!, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=neuro.Dr, createdTime=Sun Nov 14 08:16:48 CST 2021, time=2021-11-14, status=1, ipAttribution=)]
    2021-11-14 ms7000000798320930

    🐮牛

    0

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    2021-11-14 ms3000000802209056

    特别好

    0

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    2021-11-14 neuro.Dr

    老年性痴呆,未来还是希望借助神经电生理吧,也许更为有效!

    0

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