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Dark HE, Duggan MR, Walker KA. Plasma biomarkers for Alzheimer's and related dementias: A review and outlook for clinical neuropsychology. Arch Clin Neuropsychol 2024; 39:313-324. [PMID: 38520383 DOI: 10.1093/arclin/acae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 03/25/2024] Open
Abstract
Recent technological advances have improved the sensitivity and specificity of blood-based biomarkers for Alzheimer's disease and related dementias. Accurate quantification of amyloid-ß peptide, phosphorylated tau (pTau) isoforms, as well as markers of neurodegeneration (neurofilament light chain [NfL]) and neuro-immune activation (glial fibrillary acidic protein [GFAP] and chitinase-3-like protein 1 [YKL-40]) in blood has allowed researchers to characterize neurobiological processes at scale in a cost-effective and minimally invasive manner. Although currently used primarily for research purposes, these blood-based biomarkers have the potential to be highly impactful in the clinical setting - aiding in diagnosis, predicting disease risk, and monitoring disease progression. Whereas plasma NfL has shown promise as a non-specific marker of neuronal injury, plasma pTau181, pTau217, pTau231, and GFAP have demonstrated desirable levels of sensitivity and specificity for identification of individuals with Alzheimer's disease pathology and Alzheimer's dementia. In this forward looking review, we (i) provide an overview of the most commonly used blood-based biomarkers for Alzheimer's disease and related dementias, (ii) discuss how comorbid medical conditions, demographic, and genetic factors can inform the interpretation of these biomarkers, (iii) describe ongoing efforts to move blood-based biomarkers into the clinic, and (iv) highlight the central role that clinical neuropsychologists may play in contextualizing and communicating blood-based biomarker results for patients.
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Affiliation(s)
- Heather E Dark
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD, USA
| | - Michael R Duggan
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD, USA
| | - Keenan A Walker
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD, USA
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Abbatecola AM, Giuliani A, Biscetti L, Scisciola L, Battista P, Barbieri M, Sabbatinelli J, Olivieri F. Circulating biomarkers of inflammaging and Alzheimer's disease to track age-related trajectories of dementia: Can we develop a clinically relevant composite combination? Ageing Res Rev 2024; 96:102257. [PMID: 38437884 DOI: 10.1016/j.arr.2024.102257] [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: 11/08/2023] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 03/06/2024]
Abstract
Alzheimer's disease (AD) is a rapidly growing global concern due to a consistent rise of the prevalence of dementia which is mainly caused by the aging population worldwide. An early diagnosis of AD remains important as interventions are plausibly more effective when started at the earliest stages. Recent developments in clinical research have focused on the use of blood-based biomarkers for improve diagnosis/prognosis of neurodegenerative diseases, particularly AD. Unlike invasive cerebrospinal fluid tests, circulating biomarkers are less invasive and will become increasingly cheaper and simple to use in larger number of patients with mild symptoms or at risk of dementia. In addition to AD-specific markers, there is growing interest in biomarkers of inflammaging/neuro-inflammaging, an age-related chronic low-grade inflammatory condition increasingly recognized as one of the main risk factor for almost all age-related diseases, including AD. Several inflammatory markers have been associated with cognitive performance and AD development and progression. The presence of senescent cells, a key driver of inflammaging, has also been linked to AD pathogenesis, and senolytic therapy is emerging as a potential treatment strategy. Here, we describe blood-based biomarkers clinically relevant for AD diagnosis/prognosis and biomarkers of inflammaging associated with AD. Through a systematic review approach, we propose that a combination of circulating neurodegeneration and inflammatory biomarkers may contribute to improving early diagnosis and prognosis, as well as providing valuable insights into the trajectory of cognitive decline and dementia in the aging population.
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Affiliation(s)
- Angela Marie Abbatecola
- Alzheimer's Disease Day Clinic, Azienda Sanitaria Locale, Frosinone, Italy; Univesità degli Studi di Cassino e del Lazio Meridionale, Dipartimento di Scienze Umane, Sociali e della Salute, Cassino, Italy
| | - Angelica Giuliani
- Istituti Clinici Scientifici Maugeri IRCCS, Cardiac Rehabilitation Unit of Bari Institute, Italy.
| | | | - Lucia Scisciola
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Petronilla Battista
- Istituti Clinici Scientifici Maugeri IRCCS, Laboratory of Neuropsychology, Bari Institute, Italy
| | - Michelangela Barbieri
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Jacopo Sabbatinelli
- Department of Clinical and Molecular Sciences, DISCLIMO, Università Politecnica delle Marche, Ancona, Italy; Clinic of Laboratory and Precision Medicine, IRCCS INRCA, Ancona, Italy
| | - Fabiola Olivieri
- Department of Clinical and Molecular Sciences, DISCLIMO, Università Politecnica delle Marche, Ancona, Italy; Clinic of Laboratory and Precision Medicine, IRCCS INRCA, Ancona, Italy
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Noda K, Lim Y, Goto R, Sengoku S, Kodama K. Cost-effectiveness comparison between blood biomarkers and conventional tests in Alzheimer's disease diagnosis. Drug Discov Today 2024; 29:103911. [PMID: 38311028 DOI: 10.1016/j.drudis.2024.103911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/26/2024] [Accepted: 01/30/2024] [Indexed: 02/06/2024]
Abstract
Dementia management has evolved with drugs such as lecanemab, shifting management from palliative care to early diagnosis and intervention. However, the administration of these drugs presents challenges owing to the invasiveness, high cost and limited availability of amyloid-PET and cerebrospinal fluid tests for guiding drug administration. Our manuscript explores the potential of less invasive blood biomarkers as a diagnostic method, with a cost-effectiveness analysis and a comparison with traditional tests. Our findings suggest that blood biomarkers are a cost-effective alternative, but with lower accuracy, indicating the need for multiple specific biomarkers for precision. This underscores the importance of future research on new blood biomarkers and their clinical efficacy.
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Affiliation(s)
- Kenta Noda
- Graduate School of Design and Architecture, Nagoya City University, Nagoya 464-0083, Japan
| | | | - Rei Goto
- Graduate School of Health Management, Keio University, Fujisawa 252-0883, Kanagawa, Japan; Graduate School of Business Administration, Keio University, Yokohama 223-8526, Japan
| | - Shintaro Sengoku
- School of Environment and Society, Tokyo Institute of Technology, Tokyo 108-0023, Japan
| | - Kota Kodama
- Graduate School of Design and Architecture, Nagoya City University, Nagoya 464-0083, Japan; Ritsumeikan University, Osaka 567-8570, Japan; Faculty of Data Science, Nagoya City University, Nagoya 467-8501, Japan; Center for Research and Education on Drug Discovery, The Graduate School of Pharmaceutical Sciences, Hokkaido University, Sapporo 060-0812, Japan.
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Liu H, Yuan X, Liu T, Zhang W, Dong H, Chu Z. Freestanding Nanofiber-Assembled Aptasensor for Precisely and Ultrafast Electrochemical Detection of Alzheimer's Disease Biomarkers. Adv Healthc Mater 2024:e2304355. [PMID: 38387159 DOI: 10.1002/adhm.202304355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/07/2024] [Indexed: 02/24/2024]
Abstract
Amyloid beta-protein (AβAβ) is a main hallmark of Alzheimer's disease (AD), and a low amount of Aβ protein accumulation appears to be a potential marker for AD. Here, an electrochemical DNA biosensor based on polyamide/polyaniline carbon nanotubes (PA/PANI-CNTs) is developed with the aim of diagnosing AD early using a simple, low-cost, and accessible method to rapidly detect Aβ42 in human blood. Electrospun PA nanofibers served as the skeleton for the successive in situ deposition of PANI and CNTs, which contribute both high conductivity and abundant binding sites for the Aβ42 aptamers. After the aptamers are immobilized, this aptasensor exhibits precise and specific detection of Aβ42 in human blood within only 4 min with an extremely fast response rate, lower detection limit, and excellent linear detection range. These findings make a significant contribution to advancing the development of serum-based detection techniques for Aβ42, thereby paving the way for improved diagnostic capabilities in the field of AD.
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Affiliation(s)
- Hui Liu
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, 30 Zhongyang Road, Nanjing, Jiangsu, 210008, China
| | - Xueli Yuan
- State Key Laboratory of Materials-Oriented Chemical Engineering, College of Chemical Engineering, Nanjing Tech University, Nanjing, 211816, China
| | - Tao Liu
- State Key Laboratory of Materials-Oriented Chemical Engineering, College of Chemical Engineering, Nanjing Tech University, Nanjing, 211816, China
| | - Wei Zhang
- Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China
| | - Heng Dong
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, 30 Zhongyang Road, Nanjing, Jiangsu, 210008, China
| | - Zhenyu Chu
- State Key Laboratory of Materials-Oriented Chemical Engineering, College of Chemical Engineering, Nanjing Tech University, Nanjing, 211816, China
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Varma VR, An Y, Kac PR, Bilgel M, Moghekar A, Loeffler T, Amschl D, Troncoso J, Blennow K, Zetterberg H, Ashton NJ, Resnick SM, Thambisetty M. Longitudinal progression of blood biomarkers reveals a key role of astrocyte reactivity in preclinical Alzheimer's disease. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.25.24301779. [PMID: 38343809 PMCID: PMC10854357 DOI: 10.1101/2024.01.25.24301779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/26/2024]
Abstract
Defining the progression of blood biomarkers of Alzheimer's disease (AD) is essential for targeting treatments in patients most likely to benefit from early intervention. We delineated the temporal ordering of blood biomarkers a decade prior to the onset of AD symptoms in participants in the Baltimore Longitudinal Study of Aging. We show that increased astrocyte reactivity, assessed by elevated glial fibrillary acidic protein (GFAP) levels is an early event in the progression of blood biomarker changes in preclinical AD. In AD-converters who are initially cognitively unimpaired (N=158, 377 serial plasma samples), higher plasma GFAP levels are observed as early as 10-years prior to the onset of cognitive impairment due to incident AD compared to individuals who remain cognitively unimpaired (CU, N=160, 379 serial plasma samples). Plasma GFAP levels in AD-converters remain elevated 5-years prior to and coincident with the onset of cognitive impairment due to AD. In participants with neuropathologically confirmed AD, plasma GFAP levels are elevated relative to cognitively normal individuals and intermediate in those who remain cognitively unimpaired despite significant AD pathology (asymptomatic AD). Higher plasma GFAP levels at death are associated with greater severity of both neuritic plaques and neurofibrillary tangles. In the 5XFAD transgenic model of AD, we observed greater GFAP levels in the cortex and hippocampus of transgenic mice relative to wild-type prior to the development of cognitive impairment. Reactive astrocytosis, an established biological response to neuronal injury, may be an early initiator of AD pathogenesis and a promising therapeutic target.
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Affiliation(s)
- V R Varma
- Clinical and Translational Neuroscience Section, Laboratory of Behavioral Neuroscience, National Institute on Aging (NIA), National Institutes of Health (NIH), Baltimore, Maryland, United States of America
| | - Y An
- Brain Aging and Behavior Section, Laboratory of Behavioral Neuroscience, National Institute on Aging (NIA), National Institutes of Health (NIH), Baltimore, MD, USA
| | - P R Kac
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - M Bilgel
- Brain Aging and Behavior Section, Laboratory of Behavioral Neuroscience, National Institute on Aging (NIA), National Institutes of Health (NIH), Baltimore, MD, USA
| | - A Moghekar
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA
| | - T Loeffler
- Scantox Neuro GmbH, Parkring 12, 8074, Grambach, Austria
| | - D Amschl
- Scantox Neuro GmbH, Parkring 12, 8074, Grambach, Austria
| | - J Troncoso
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - K Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - H Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - N J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- King's College London, Institute of Psychiatry, Psychology and Neuroscience Maurice Wohl Institute Clinical Neuroscience Institute London UK
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation London UK
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - S M Resnick
- Brain Aging and Behavior Section, Laboratory of Behavioral Neuroscience, National Institute on Aging (NIA), National Institutes of Health (NIH), Baltimore, MD, USA
| | - M Thambisetty
- Clinical and Translational Neuroscience Section, Laboratory of Behavioral Neuroscience, National Institute on Aging (NIA), National Institutes of Health (NIH), Baltimore, Maryland, United States of America
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Garcia-Escobar G, Manero RM, Fernández-Lebrero A, Ois A, Navalpotro-Gómez I, Puente-Periz V, Contador-Muñana J, Estragués-Gazquez I, Puig-Pijoan A, Jiménez-Balado J. Blood Biomarkers of Alzheimer's Disease and Cognition: A Literature Review. Biomolecules 2024; 14:93. [PMID: 38254693 PMCID: PMC10813472 DOI: 10.3390/biom14010093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/02/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Recent advances in blood-based biomarkers of Alzheimer's Disease (AD) show great promise for clinical applications, offering a less invasive alternative to current cerebrospinal fluid (CSF) measures. However, the relationships between these biomarkers and specific cognitive functions, as well as their utility in predicting longitudinal cognitive decline, are not yet fully understood. This descriptive review surveys the literature from 2018 to 2023, focusing on the associations of amyloid-β (Aβ), Total Tau (t-Tau), Phosphorylated Tau (p-Tau), Neurofilament Light (NfL), and Glial Fibrillary Acidic Protein (GFAP) with cognitive measures. The reviewed studies are heterogeneous, varying in design and population (cognitively unimpaired, cognitively impaired, or mixed populations), and show results that are sometimes conflicting. Generally, cognition positively correlates with Aβ levels, especially when evaluated through the Aβ42/Aβ40 ratio. In contrast, t-Tau, p-Tau, Nfl, and GFAP levels typically show a negative correlation with cognitive performance. While p-Tau measures generally exhibit stronger associations with cognitive functions compared to other biomarkers, no single blood marker has emerged as being predominantly linked to a specific cognitive domain. These findings contribute to our understanding of the complex relationship between blood biomarkers and cognitive performance and underscore their potential utility in clinical assessments of cognition.
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Affiliation(s)
- Greta Garcia-Escobar
- Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (G.G.-E.); (R.M.M.); (A.F.-L.); (I.N.-G.); (V.P.-P.); (J.C.-M.); (I.E.-G.); (A.P.-P.); (J.J.-B.)
| | - Rosa Maria Manero
- Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (G.G.-E.); (R.M.M.); (A.F.-L.); (I.N.-G.); (V.P.-P.); (J.C.-M.); (I.E.-G.); (A.P.-P.); (J.J.-B.)
- Neurology Department, Hospital del Mar, 08003 Barcelona, Spain
| | - Aida Fernández-Lebrero
- Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (G.G.-E.); (R.M.M.); (A.F.-L.); (I.N.-G.); (V.P.-P.); (J.C.-M.); (I.E.-G.); (A.P.-P.); (J.J.-B.)
- Neurology Department, Hospital del Mar, 08003 Barcelona, Spain
- Department of Health and Experimental Sciences, Universitat Pompeu Fabra, 08003 Barcelona, Spain
| | - Angel Ois
- Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (G.G.-E.); (R.M.M.); (A.F.-L.); (I.N.-G.); (V.P.-P.); (J.C.-M.); (I.E.-G.); (A.P.-P.); (J.J.-B.)
- Neurology Department, Hospital del Mar, 08003 Barcelona, Spain
- Department of Health and Experimental Sciences, Universitat Pompeu Fabra, 08003 Barcelona, Spain
| | - Irene Navalpotro-Gómez
- Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (G.G.-E.); (R.M.M.); (A.F.-L.); (I.N.-G.); (V.P.-P.); (J.C.-M.); (I.E.-G.); (A.P.-P.); (J.J.-B.)
- Neurology Department, Hospital del Mar, 08003 Barcelona, Spain
- Department of Health and Experimental Sciences, Universitat Pompeu Fabra, 08003 Barcelona, Spain
| | - Victor Puente-Periz
- Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (G.G.-E.); (R.M.M.); (A.F.-L.); (I.N.-G.); (V.P.-P.); (J.C.-M.); (I.E.-G.); (A.P.-P.); (J.J.-B.)
- Neurology Department, Hospital del Mar, 08003 Barcelona, Spain
| | - José Contador-Muñana
- Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (G.G.-E.); (R.M.M.); (A.F.-L.); (I.N.-G.); (V.P.-P.); (J.C.-M.); (I.E.-G.); (A.P.-P.); (J.J.-B.)
- Neurology Department, Hospital del Mar, 08003 Barcelona, Spain
| | - Isabel Estragués-Gazquez
- Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (G.G.-E.); (R.M.M.); (A.F.-L.); (I.N.-G.); (V.P.-P.); (J.C.-M.); (I.E.-G.); (A.P.-P.); (J.J.-B.)
- Neurology Department, Hospital del Mar, 08003 Barcelona, Spain
| | - Albert Puig-Pijoan
- Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (G.G.-E.); (R.M.M.); (A.F.-L.); (I.N.-G.); (V.P.-P.); (J.C.-M.); (I.E.-G.); (A.P.-P.); (J.J.-B.)
- Neurology Department, Hospital del Mar, 08003 Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Joan Jiménez-Balado
- Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; (G.G.-E.); (R.M.M.); (A.F.-L.); (I.N.-G.); (V.P.-P.); (J.C.-M.); (I.E.-G.); (A.P.-P.); (J.J.-B.)
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Arranz J, Zhu N, Rubio-Guerra S, Rodríguez-Baz Í, Ferrer R, Carmona-Iragui M, Barroeta I, Illán-Gala I, Santos-Santos M, Fortea J, Lleó A, Tondo M, Alcolea D. Diagnostic performance of plasma pTau 217, pTau 181, Aβ 1-42 and Aβ 1-40 in the LUMIPULSE automated platform for the detection of Alzheimer disease. RESEARCH SQUARE 2023:rs.3.rs-3725688. [PMID: 38168408 PMCID: PMC10760237 DOI: 10.21203/rs.3.rs-3725688/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
BACKGROUND Recently developed blood markers for Alzheimer's disease (AD) detection have high accuracy but usually require ultra-sensitive analytic tools not commonly available in clinical laboratories, and their performance in clinical practice is unknown. METHODS We analyzed plasma samples from 290 consecutive participants that underwent lumbar puncture in routine clinical practice in a specialized memory clinic (66 cognitively unimpaired, 130 participants with mild cognitive impairment, and 94 with dementia). Participants were classified as amyloid positive (A+) or negative (A-) according to CSF Aβ1-42/Aβ1-40 ratio. Plasma pTau217, pTau181, Aβ1-42 and Aβ1-40 were measured in the fully-automated LUMIPULSE platform. We used linear regression to compare plasma biomarkers concentrations between A + and A- groups, evaluated Spearman's correlation between plasma and CSF and performed ROC analyses to assess their diagnostic accuracy to detect brain amyloidosis as determined by CSF Aβ1-42/Aβ1-40 ratio. We analyzed the potential of pTau217 to predict amyloidosis in CSF. RESULTS Plasma pTau217 and pTau181 concentration were higher in A + than A- while the plasma Aβ1-42/Aβ1-40 ratio was lower in A + compared to A-. pTau181 and the Aβ1-42/Aβ1-40 ratio showed moderate correlation between plasma and CSF (Rho = 0.66 and 0.69, respectively). The areas under the ROC curve to discriminate A + from A- participants were 0.94 (95% CI 0.92-0.97) for pTau217, and 0.88 (95% CI 0.84-0.92) for both pTau181 and Aβ1-42/Aβ1-40. Chronic kidney disease (CKD) was related to increased plasma biomarker concentrations, but ratios were less affected. Plasma pTau217 had the highest fold change (x4.2) and showed high predictive capability in discriminating A + from A-, having 4-7% misclassification rate. The global accuracy of plasma pTau217 using a two-threshold approach was robust in symptomatic groups, exceeding 90%. CONCLUSION The evaluation of blood biomarkers on an automated platform exhibited high diagnostic accuracy for AD pathophysiology, and pTau217 showed excellent diagnostic accuracy to identify participants with AD in a consecutive sample representing the routine clinical practice in a specialized memory unit.
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Affiliation(s)
| | - Nuole Zhu
- IR SANT PAU, Hospital de la Santa Creu i Sant Pau
| | | | | | - Rosa Ferrer
- IR SANT PAU, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona
| | | | | | | | | | - Juan Fortea
- IR SANT PAU, Hospital de la Santa Creu i Sant Pau
| | - Alberto Lleó
- IR SANT PAU, Hospital de la Santa Creu i Sant Pau
| | - Mireia Tondo
- IR SANT PAU, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona
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