1
|
Hermann P, Zerr I. Unmet needs of biochemical biomarkers for human prion diseases. Prion 2024; 18:89-93. [PMID: 38734978 DOI: 10.1080/19336896.2024.2349017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
Although the development of aggregation assays has noticeably improved the accuracy of the clinical diagnosis of prion diseases, research on biomarkers remains vital. The major challenges to overcome are non-invasive sampling and the exploration of new biomarkers that may predict the onset or reflect disease progression. This will become extremely important in the near future, when new therapeutics are clinically evaluated and eventually become available for treatment. This article aims to provide an overview of the achievements of biomarker research in human prion diseases, addresses unmet needs in the field, and points out future perspectives.
Collapse
Affiliation(s)
- Peter Hermann
- Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Inga Zerr
- Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
- German Center for Neurodegenerative Diseases, Göttingen, Germany
| |
Collapse
|
2
|
Vallabh SM, Mortberg MA, Allen SW, Kupferschmid AC, Kivisäkk P, Hammerschlag BL, Bolling A, Trombetta BA, Devitte-McKee K, Ford AM, Sather L, Duffy G, Rivera A, Gerber J, McManus AJ, Minikel EV, Arnold SE. Biomarker changes preceding symptom onset in genetic prion disease. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.18.23300042. [PMID: 38196583 PMCID: PMC10775317 DOI: 10.1101/2023.12.18.23300042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Importance Genetic prion disease is a universally fatal and rapidly progressive neurodegenerative disease for which genetically targeted therapies are currently under development. Preclinical proofs of concept indicate that treatment before symptoms will offer outsize benefit. Though early treatment paradigms will be informed by the longitudinal biomarker trajectory of mutation carriers, to date limited cases have been molecularly tracked from the presymptomatic phase through symptomatic onset. Objective To longitudinally characterize disease-relevant cerebrospinal fluid (CSF) and plasma biomarkers in individuals at risk for genetic prion disease up to disease conversion, alongside non-converters and healthy controls. Design setting and participants This single-center longitudinal cohort study has followed 41 PRNP mutation carriers and 21 controls for up to 6 years. Participants spanned a range of known pathogenic PRNP variants; all subjects were asymptomatic at first visit and returned roughly annually. Four at-risk individuals experienced prion disease onset during the study. Main outcomes and measures RT-QuIC prion seeding activity, prion protein (PrP), neurofilament light chain (NfL) total tau (t-tau), and beta synuclein were measured in CSF. Glial fibrillary acidic protein (GFAP) and NfL were measured in plasma. Results We observed RT-QuIC seeding activity in the CSF of three E200K carriers prior to symptom onset and death, while the CSF of one P102L carrier remained RT-QuIC negative through symptom conversion. The prodromal window of RT-QuIC positivity was one year long in an E200K individual homozygous (V/V) at PRNP codon 129 and was longer than two years in two codon 129 heterozygotes (M/V). Other neurodegenerative and neuroinflammatory markers gave less consistent signal prior to symptom onset, whether analyzed relative to age or individual baseline. CSF PrP was longitudinally stable (mean CV 10%) across all individuals over up to 6 years, including at RT-QuIC positive timepoints. Conclusion and relevance In this study, we demonstrate that at least for the E200K mutation, CSF prion seeding activity may represent the earliest detectable prodromal sign, and that its prognostic value may be modified by codon 129 genotype. Neuronal damage and neuroinflammation markers show limited sensitivity in the prodromal phase. CSF PrP levels remain stable even in the presence of RT-QuIC seeding activity.
Collapse
Affiliation(s)
- Sonia M Vallabh
- McCance Center for Brain Health and Department of Neurology, Massachusetts General Hospital, Boston, MA 02114
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142
- Department of Neurology, Harvard Medical School, Boston, MA 02115
| | - Meredith A Mortberg
- McCance Center for Brain Health and Department of Neurology, Massachusetts General Hospital, Boston, MA 02114
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142
| | - Shona W. Allen
- McCance Center for Brain Health and Department of Neurology, Massachusetts General Hospital, Boston, MA 02114
| | - Ashley C Kupferschmid
- McCance Center for Brain Health and Department of Neurology, Massachusetts General Hospital, Boston, MA 02114
| | - Pia Kivisäkk
- McCance Center for Brain Health and Department of Neurology, Massachusetts General Hospital, Boston, MA 02114
- Department of Neurology, Harvard Medical School, Boston, MA 02115
| | - Bruno L Hammerschlag
- McCance Center for Brain Health and Department of Neurology, Massachusetts General Hospital, Boston, MA 02114
| | - Anna Bolling
- McCance Center for Brain Health and Department of Neurology, Massachusetts General Hospital, Boston, MA 02114
| | - Bianca A. Trombetta
- McCance Center for Brain Health and Department of Neurology, Massachusetts General Hospital, Boston, MA 02114
| | - Kelli Devitte-McKee
- McCance Center for Brain Health and Department of Neurology, Massachusetts General Hospital, Boston, MA 02114
| | - Abaigeal M. Ford
- McCance Center for Brain Health and Department of Neurology, Massachusetts General Hospital, Boston, MA 02114
| | - Lauren Sather
- McCance Center for Brain Health and Department of Neurology, Massachusetts General Hospital, Boston, MA 02114
| | - Griffin Duffy
- McCance Center for Brain Health and Department of Neurology, Massachusetts General Hospital, Boston, MA 02114
| | - Ashley Rivera
- McCance Center for Brain Health and Department of Neurology, Massachusetts General Hospital, Boston, MA 02114
| | - Jessica Gerber
- McCance Center for Brain Health and Department of Neurology, Massachusetts General Hospital, Boston, MA 02114
| | - Alison J McManus
- McCance Center for Brain Health and Department of Neurology, Massachusetts General Hospital, Boston, MA 02114
| | - Eric Vallabh Minikel
- McCance Center for Brain Health and Department of Neurology, Massachusetts General Hospital, Boston, MA 02114
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142
- Department of Neurology, Harvard Medical School, Boston, MA 02115
| | - Steven E Arnold
- McCance Center for Brain Health and Department of Neurology, Massachusetts General Hospital, Boston, MA 02114
- Department of Neurology, Harvard Medical School, Boston, MA 02115
| |
Collapse
|
3
|
Amin R, Darwin R, Chakraborty S, Chandran D, Chopra H, Dhama K. Bovine Spongiform Encephalopathy, "Mad Cow's Disease" and Variant Creutzfeldt-Jakob Disease in Humans: A Critical Update. Arch Med Res 2023:102854. [PMID: 37453805 DOI: 10.1016/j.arcmed.2023.102854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Ruhul Amin
- Faculty of Pharmaceutical Science, Assam down town University, Panikhaiti, Gandhinagar, Guwahati, Assam, India.
| | - Ronald Darwin
- School of Pharmaceutical Sciences, Vels Institute of Science Technology and Advanced Studies, Chennai, India
| | - Sandip Chakraborty
- Department of Veterinary Microbiology, College of Veterinary Sciences and Animal Husbandry, R.K. Nagar, West Tripura, Tripura, India
| | | | - Hitesh Chopra
- Department of Biosciences, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, Izatnagar, Uttar Pradesh, India
| |
Collapse
|
4
|
Bregman N, Shiner T, Kavé G, Alcalay R, Gana-Weisz M, Goldstein O, Glinka T, Aizenstein O, Ben Bashat D, Alcalay Y, Mirelman A, Thaler A, Giladi N, Omer N. Correction: The natural history study of preclinical genetic Creutzfeldt-Jakob Disease (CJD): a prospective longitudinal study protocol. BMC Neurol 2023; 23:229. [PMID: 37312066 DOI: 10.1186/s12883-023-03272-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Affiliation(s)
- Noa Bregman
- Cognitive Neurology Unit, Neurological Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel.
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel.
| | - Tamara Shiner
- Cognitive Neurology Unit, Neurological Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Gitit Kavé
- Cognitive Neurology Unit, Neurological Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel
- Department of Education and Psychology, The Open University, Ra'anana, Israel
| | - Roy Alcalay
- Laboratory of biomarkers and genomic of neurodegeneration, Tel-Aviv Medical Center, Tel-Aviv, Israel
| | - Mali Gana-Weisz
- Laboratory of biomarkers and genomic of neurodegeneration, Tel-Aviv Medical Center, Tel-Aviv, Israel
| | - Orly Goldstein
- Laboratory of biomarkers and genomic of neurodegeneration, Tel-Aviv Medical Center, Tel-Aviv, Israel
| | - Tal Glinka
- Laboratory of biomarkers and genomic of neurodegeneration, Tel-Aviv Medical Center, Tel-Aviv, Israel
| | - Orna Aizenstein
- Sagol Brain Institute, Wohl Institute for Advanced Imaging, Sourasky Medical Center, Tel Aviv, Israel
- Department of Diagnostic Imaging, Sourasky Medical Center, Tel Aviv, Israel
| | - Dafna Ben Bashat
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
- Sagol Brain Institute, Wohl Institute for Advanced Imaging, Sourasky Medical Center, Tel Aviv, Israel
| | - Yifat Alcalay
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Division of Clinical Laboratories, Tel Aviv Sourasky Medical Center, Tel- Aviv, Israel
| | - Anat Mirelman
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
- Laboratory of early markers of neurodegeneration, Neurological Institute, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Avner Thaler
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
- Laboratory of early markers of neurodegeneration, Neurological Institute, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Nir Giladi
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
- Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Nurit Omer
- Cognitive Neurology Unit, Neurological Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Laboratory of early markers of neurodegeneration, Neurological Institute, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| |
Collapse
|