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Abyadeh M, Gupta V, Paulo JA, Mahmoudabad AG, Shadfar S, Mirshahvaladi S, Gupta V, Nguyen CTO, Finkelstein DI, You Y, Haynes PA, Salekdeh GH, Graham SL, Mirzaei M. Amyloid-beta and tau protein beyond Alzheimer's disease. Neural Regen Res 2024; 19:1262-1276. [PMID: 37905874 DOI: 10.4103/1673-5374.386406] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 09/07/2023] [Indexed: 11/02/2023] Open
Abstract
ABSTRACT The aggregation of amyloid-beta peptide and tau protein dysregulation are implicated to play key roles in Alzheimer's disease pathogenesis and are considered the main pathological hallmarks of this devastating disease. Physiologically, these two proteins are produced and expressed within the normal human body. However, under pathological conditions, abnormal expression, post-translational modifications, conformational changes, and truncation can make these proteins prone to aggregation, triggering specific disease-related cascades. Recent studies have indicated associations between aberrant behavior of amyloid-beta and tau proteins and various neurological diseases, such as Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis, as well as retinal neurodegenerative diseases like Glaucoma and age-related macular degeneration. Additionally, these proteins have been linked to cardiovascular disease, cancer, traumatic brain injury, and diabetes, which are all leading causes of morbidity and mortality. In this comprehensive review, we provide an overview of the connections between amyloid-beta and tau proteins and a spectrum of disorders.
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Affiliation(s)
| | - Vivek Gupta
- Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie Medical School, Macquarie University, Macquarie Park, North Ryde, Sydney, NSW, Australia
| | - Joao A Paulo
- Department of Cell Biology, Harvard Medical School, Boston, MA, USA
| | | | - Sina Shadfar
- Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie Medical School, Macquarie University, Macquarie Park, North Ryde, Sydney, NSW, Australia
| | - Shahab Mirshahvaladi
- Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie Medical School, Macquarie University, Macquarie Park, North Ryde, Sydney, NSW, Australia
| | - Veer Gupta
- School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Christine T O Nguyen
- Department of Optometry and Vision Sciences, School of Health Sciences, Faculty of Medicine Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - David I Finkelstein
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Yuyi You
- Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie Medical School, Macquarie University, Macquarie Park, North Ryde, Sydney, NSW, Australia
| | - Paul A Haynes
- School of Natural Sciences, Macquarie University, Macquarie Park, NSW, Australia
| | - Ghasem H Salekdeh
- School of Natural Sciences, Macquarie University, Macquarie Park, NSW, Australia
| | - Stuart L Graham
- Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie Medical School, Macquarie University, Macquarie Park, North Ryde, Sydney, NSW, Australia
| | - Mehdi Mirzaei
- Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie Medical School, Macquarie University, Macquarie Park, North Ryde, Sydney, NSW, Australia
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Arroyo Pereiro P, Muñoz-Vendrell A, León Moreno I, Bau L, Matas E, Romero-Pinel L, Martínez Yélamos A, Martínez Yélamos S, Andrés-Benito P. Baseline serum neurofilament light chain levels differentiate aggressive from benign forms of relapsing-remitting multiple sclerosis: a 20-year follow-up cohort. J Neurol 2024; 271:1599-1609. [PMID: 38085343 DOI: 10.1007/s00415-023-12135-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 03/28/2024]
Abstract
BACKGROUND AND OBJECTIVES Serum biomarkers are emerging as useful prognostic tools for multiple sclerosis (MS); however, long-term studies are lacking. We aimed to evaluate the long-term prognostic value of the serum levels of neurofilament light chain (NfL), total tau, glial fibrillary acidic protein (GFAP), and chitinase 3-like-1 (CHI3L1) measured close to the time of MS onset. METHODS In this retrospective, exploratory, observational, case and controls study, patients with relapsing-remitting MS (RRMS) with available baseline serum samples and prospectively follow-up in our MS unit for a long time were selected based on their clinical evolution to form two groups: (1) a benign RRMS (bRRMS) group, defined as patients with an Expanded Disability Status Scale (EDSS) score of ≤ 3 at ≥ 10 years of follow-up; (2) an aggressive RRMS (aRRMS) group, defined as patients with an EDSS score of ≥ 6 at ≤ 15 years of follow-up. An age-matched healthy control (HC) group was selected. NfL, total tau, and GFAP serum levels were quantified using a single-molecule array (SIMOA), and CHI3L1 was quantified using ELISA. RESULTS Thirty-one patients with bRRMS, 19 with aRRMS, and 10 HC were included. The median follow-up time from sample collection was 17.74 years (interquartile range, 14.60-20.37). Bivariate and multivariate analyses revealed significantly higher NfL and GFAP levels in the aRRMS group than in the bRRMS group. A receiver operating characteristic curve analysis identified serum NfL level as the most efficient marker for distinguishing aRRMS from bRRMS. DISCUSSION This proof-of-concept study comparing benign and aggressive RRMS groups reinforces the potential role of baseline NfL serum levels as a promising long-term disability prognostic marker. In contrast, serum GFAP, total tau, and CHI3L1 levels demonstrated a lower or no ability to differentiate between the long-term outcomes of RRMS.
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Affiliation(s)
- Pablo Arroyo Pereiro
- Neurologic Diseases and Neurogenetics Group, Institute of Biomedical Research (IDIBELL), Avinguda de la Gran Via de L'Hospitalet, 199, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
- Multiple Sclerosis Unit, Department of Neurology, Bellvitge University Hospital, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
| | - Albert Muñoz-Vendrell
- Neurologic Diseases and Neurogenetics Group, Institute of Biomedical Research (IDIBELL), Avinguda de la Gran Via de L'Hospitalet, 199, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
- Multiple Sclerosis Unit, Department of Neurology, Bellvitge University Hospital, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
| | - Isabel León Moreno
- Neurologic Diseases and Neurogenetics Group, Institute of Biomedical Research (IDIBELL), Avinguda de la Gran Via de L'Hospitalet, 199, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
- Multiple Sclerosis Unit, Department of Neurology, Bellvitge University Hospital, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
| | - Laura Bau
- Neurologic Diseases and Neurogenetics Group, Institute of Biomedical Research (IDIBELL), Avinguda de la Gran Via de L'Hospitalet, 199, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
- Multiple Sclerosis Unit, Department of Neurology, Bellvitge University Hospital, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
| | - Elisabet Matas
- Neurologic Diseases and Neurogenetics Group, Institute of Biomedical Research (IDIBELL), Avinguda de la Gran Via de L'Hospitalet, 199, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
- Multiple Sclerosis Unit, Department of Neurology, Bellvitge University Hospital, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
| | - Lucía Romero-Pinel
- Neurologic Diseases and Neurogenetics Group, Institute of Biomedical Research (IDIBELL), Avinguda de la Gran Via de L'Hospitalet, 199, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
- Multiple Sclerosis Unit, Department of Neurology, Bellvitge University Hospital, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
| | - Antonio Martínez Yélamos
- Neurologic Diseases and Neurogenetics Group, Institute of Biomedical Research (IDIBELL), Avinguda de la Gran Via de L'Hospitalet, 199, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
- Multiple Sclerosis Unit, Department of Neurology, Bellvitge University Hospital, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
- Departament de Ciències Clíniques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Sergio Martínez Yélamos
- Neurologic Diseases and Neurogenetics Group, Institute of Biomedical Research (IDIBELL), Avinguda de la Gran Via de L'Hospitalet, 199, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
- Multiple Sclerosis Unit, Department of Neurology, Bellvitge University Hospital, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
- Departament de Ciències Clíniques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Pol Andrés-Benito
- Neurologic Diseases and Neurogenetics Group, Institute of Biomedical Research (IDIBELL), Avinguda de la Gran Via de L'Hospitalet, 199, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.
- Multiple Sclerosis Unit, Department of Neurology, Bellvitge University Hospital, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.
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Huang Z, Jordan JD, Zhang Q. Myelin Pathology in Alzheimer's Disease: Potential Therapeutic Opportunities. Aging Dis 2024; 15:698-713. [PMID: 37548935 PMCID: PMC10917545 DOI: 10.14336/ad.2023.0628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/28/2023] [Indexed: 08/08/2023] Open
Abstract
Alzheimer's disease (AD) is an age-related neurodegenerative disease characterized by memory loss and cognitive decline. Despite significant efforts over several decades, our understanding of the pathophysiology of this disease is still incomplete. Myelin is a multi-layered membrane structure ensheathing neuronal axons, which is essential for the fast and effective propagation of action potentials along the axons. Recent studies highlight the critical involvement of myelin in memory consolidation and reveal its vulnerability in various pathological conditions. Notably, apart from the classic amyloid hypothesis, myelin degeneration has been proposed as another critical pathophysiological feature of AD, which could occur prior to the development of amyloid pathology. Here, we review recent works supporting the critical role of myelin in cognition and myelin pathology during AD progression, with a focus on the mechanisms underlying myelin degeneration in AD. We also discuss the complex intersections between myelin pathology and typical AD pathophysiology, as well as the therapeutic potential of pro-myelinating approaches for this disease. Overall, these findings implicate myelin degeneration as a critical contributor to AD-related cognitive deficits and support targeting myelin repair as a promising therapeutic strategy for AD.
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Affiliation(s)
- Zhihai Huang
- Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, LA 71103 USA
| | - J. Dedrick Jordan
- Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, LA 71103 USA
| | - Quanguang Zhang
- Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, LA 71103 USA
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Barizzone N, Leone M, Pizzino A, Kockum I, Martinelli-boneschi F, D’alfonso S. A Scoping Review on Body Fluid Biomarkers for Prognosis and Disease Activity in Patients with Multiple Sclerosis. J Pers Med 2022; 12:1430. [PMID: 36143216 PMCID: PMC9501898 DOI: 10.3390/jpm12091430] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/22/2022] [Accepted: 08/27/2022] [Indexed: 11/30/2022] Open
Abstract
Multiple sclerosis (MS) is a complex demyelinating disease of the central nervous system, presenting with different clinical forms, including clinically isolated syndrome (CIS), which is a first clinical episode suggestive of demyelination. Several molecules have been proposed as prognostic biomarkers in MS. We aimed to perform a scoping review of the potential use of prognostic biomarkers in MS clinical practice. We searched MEDLINE up to 25 November 2021 for review articles assessing body fluid biomarkers for prognostic purposes, including any type of biomarkers, cell types and tissues. Original articles were obtained to confirm and detail the data reported by the review authors. We evaluated the reliability of the biomarkers based on the sample size used by various studies. Fifty-two review articles were included. We identified 110 molecules proposed as prognostic biomarkers. Only six studies had an adequate sample size to explore the risk of conversion from CIS to MS. These confirm the role of oligoclonal bands, immunoglobulin free light chain and chitinase CHI3L1 in CSF and of serum vitamin D in the prediction of conversion from CIS to clinically definite MS. Other prognostic markers are not yet explored in adequately powered samples. Serum and CSF levels of neurofilaments represent a promising biomarker.
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5
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Mathur D, Mishra BK, Rout S, Lopez-Iranzo FJ, Lopez-Rodas G, Vallamkondu J, Kandimalla R, Casanova B. Potential Biomarkers Associated with Multiple Sclerosis Pathology. Int J Mol Sci 2021; 22:10323. [PMID: 34638664 DOI: 10.3390/ijms221910323] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 12/15/2022] Open
Abstract
Multiple sclerosis (MS) is a complex disease of the central nervous system (CNS) that involves an intricate and aberrant interaction of immune cells leading to inflammation, demyelination, and neurodegeneration. Due to the heterogeneity of clinical subtypes, their diagnosis becomes challenging and the best treatment cannot be easily provided to patients. Biomarkers have been used to simplify the diagnosis and prognosis of MS, as well as to evaluate the results of clinical treatments. In recent years, research on biomarkers has advanced rapidly due to their ability to be easily and promptly measured, their specificity, and their reproducibility. Biomarkers are classified into several categories depending on whether they address personal or predictive susceptibility, diagnosis, prognosis, disease activity, or response to treatment in different clinical courses of MS. The identified members indicate a variety of pathological processes of MS, such as neuroaxonal damage, gliosis, demyelination, progression of disability, and remyelination, among others. The present review analyzes biomarkers in cerebrospinal fluid (CSF) and blood serum, the most promising imaging biomarkers used in clinical practice. Furthermore, it aims to shed light on the criteria and challenges that a biomarker must face to be considered as a standard in daily clinical practice.
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Momtazmanesh S, Shobeiri P, Saghazadeh A, Teunissen CE, Burman J, Szalardy L, Klivenyi P, Bartos A, Fernandes A, Rezaei N. Neuronal and glial CSF biomarkers in multiple sclerosis: a systematic review and meta-analysis. Rev Neurosci 2021; 32:573-595. [PMID: 33594840 DOI: 10.1515/revneuro-2020-0145] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/15/2021] [Indexed: 12/29/2022]
Abstract
Multiple sclerosis (MS) is a neurodegenerative disease associated with inflammatory demyelination and astroglial activation, with neuronal and axonal damage as the leading factors of disability. We aimed to perform a meta-analysis to determine changes in CSF levels of neuronal and glial biomarkers, including neurofilament light chain (NFL), total tau (t-tau), chitinase-3-like protein 1 (CHI3L1), glial fibrillary acidic protein (GFAP), and S100B in various groups of MS (MS versus controls, clinically isolated syndrome (CIS) versus controls, CIS versus MS, relapsing-remitting MS (RRMS) versus progressive MS (PMS), and MS in relapse versus remission. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we included 64 articles in the meta-analysis, including 4071 subjects. For investigation of sources of heterogeneity, subgroup analysis, meta-regression, and sensitivity analysis were conducted. Meta-analyses were performed for comparisons including at least three individual datasets. NFL, GFAP, t-tau, CHI3L1, and S100B were higher in MS and NFL, t-tau, and CHI3L1 were also elevated in CIS patients than controls. CHI3L1 was the only marker with higher levels in MS than CIS. GFAP levels were higher in PMS versus RRMS, and NFL, t-tau, and CHI3L1 did not differ between different subtypes. Only levels of NFL were higher in patients in relapse than remission. Meta-regression showed influence of sex and disease severity on NFL and t-tau levels, respectively and disease duration on both. Added to the role of these biomarkers in determining prognosis and treatment response, to conclude, they may serve in diagnosis of MS and distinguishing different subtypes.
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Affiliation(s)
- Sara Momtazmanesh
- School of Medicine, Tehran University of Medical Sciences (TUMS), Children's Medical Center Hospital, Dr. Qarib St., Keshavarz Blvd, Tehran14194, Iran.,Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.,Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Parnian Shobeiri
- School of Medicine, Tehran University of Medical Sciences (TUMS), Children's Medical Center Hospital, Dr. Qarib St., Keshavarz Blvd, Tehran14194, Iran.,Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Amene Saghazadeh
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.,Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Location VUmc, PK 2 BR 141, Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Joachim Burman
- Department of Neuroscience, Uppsala University Hospital, 75185Uppsala, Sweden
| | - Levente Szalardy
- Department of Neurology, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Semmelweis u. 6, 6725Szeged, Hungary
| | - Peter Klivenyi
- Department of Neurology, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Semmelweis u. 6, 6725Szeged, Hungary
| | - Ales Bartos
- Department of Neurology, Third Faculty of Medicine, Charles University, Ruska 87, 100 00Prague 10, Czech Republic
| | - Adelaide Fernandes
- Department of Pharmacological Sciences and Medicines, Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003Lisbon, Portugal
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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7
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Tang Y, Liu HL, Min LX, Yuan HS, Guo L, Han PB, Lu YX, Zhong JF, Wang DL. Serum and cerebrospinal fluid tau protein level as biomarkers for evaluating acute spinal cord injury severity and motor function outcome. Neural Regen Res 2019; 14:896-902. [PMID: 30688276 PMCID: PMC6375043 DOI: 10.4103/1673-5374.249238] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Tau protein, a microtubule-associated protein, has a high specific expression in neurons and axons. Because traumatic spinal cord injury mainly affects neurons and axons, we speculated that tau protein may be a promising biomarker to reflect the degree of spinal cord injury and prognosis of motor function. In this study, 160 female Sprague-Dawley rats were randomly divided into a sham group, and mild, moderate, and severe spinal cord injury groups. A laminectomy was performed at the T8 level to expose the spinal cord in all groups. A contusion lesion was made with the NYU-MASCIS impactor by dropping a 10 g rod from heights of 12.5 mm (mild), 25 mm (moderate) and 50 mm (severe) upon the exposed dorsal surface of the spinal cord. Tau protein levels were measured in serum and cerebrospinal fluid samples at 1, 6, 12, 24 hours, 3, 7, 14 and 28 days after operation. Locomotor function of all rats was assessed using the Basso, Beattie and Bresnahan locomotor rating scale. Tau protein concentration in the three spinal cord injury groups (both in serum and cerebrospinal fluid) rapidly increased and peaked at 12 hours after spinal cord injury. Statistically significant positive linear correlations were found between tau protein level and spinal cord injury severity in the three spinal cord injury groups, and between the tau protein level and Basso, Beattie, and Bresnahan locomotor rating scale scores. The tau protein level at 12 hours in the three spinal cord injury groups was negatively correlated with Basso, Beattie, and Bresnahan locomotor rating scale scores at 28 days (serum: r = −0.94; cerebrospinal fluid: r = −0.95). Our data suggest that tau protein levels in serum and cerebrospinal fluid might be a promising biomarker for predicting the severity and functional outcome of traumatic spinal cord injury.
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Affiliation(s)
- Ying Tang
- Key Laboratory of Biorheological Science and Technology, Ministry of Education (Chongqing University), Chongqing University Cancer Hospital, Chongqing, China
| | - Hong-Liang Liu
- Department of Rehabilitation, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Ling-Xia Min
- Department of Rehabilitation, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Hao-Shi Yuan
- Department of Spine Surgery, Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shanxi Province, China
| | - Lei Guo
- Department of Orthopedics, Chinese PLA Beijing Army General Hospital, Beijing, China
| | - Peng-Bo Han
- Department of Spine Surgery, Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shanxi Province, China
| | - Yu-Xin Lu
- Department of Spine Surgery, Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shanxi Province, China
| | - Jian-Feng Zhong
- Department of Spine Surgery, Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shanxi Province, China
| | - Dong-Lin Wang
- Key Laboratory of Biorheological Science and Technology, Ministry of Education (Chongqing University), Chongqing University Cancer Hospital, Chongqing, China
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Matute-Blanch C, Montalban X, Comabella M. Multiple sclerosis, and other demyelinating and autoimmune inflammatory diseases of the central nervous system. Cerebrospinal Fluid in Neurologic Disorders 2018; 146:67-84. [DOI: 10.1016/b978-0-12-804279-3.00005-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Abstract
Neurodegeneration plays a key role in multiple sclerosis (MS) contributing to long-term disability in patients. The prognosis is, however, unpredictable coloured by complex disease mechanisms which can only be clearly appreciated using biomarkers specific to pathobiology of the underlying process. Here, we describe six promising neurodegenerative biomarkers in MS (neurofilament proteins, neurofilament antibodies, tau, N-acetylaspartate, chitinase and chitinase-like proteins and osteopontin), critically evaluating the evidence using a modified Bradford Hill criteria.
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Affiliation(s)
- Nicolas Dubuisson
- Department of Neuroscience and Trauma, Blizard Institute, Queen Mary University of London, London, UK
| | - Fabiola Puentes
- Department of Neuroscience and Trauma, Blizard Institute, Queen Mary University of London, London, UK
| | - Gavin Giovannoni
- Department of Neuroscience and Trauma, Blizard Institute, Queen Mary University of London, London, UK
| | - Sharmilee Gnanapavan
- Department of Neuroscience and Trauma, Blizard Institute, Queen Mary University of London, London, UK
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Popova EV, Bryukhov VV, Boyko AN, Krotenkova MV. [Primary-progressive multiple sclerosis as an atypical demyelinating process]. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 116:42-46. [PMID: 28139610 DOI: 10.17116/jnevro201611610242-46] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article presents an overview of current data on primary-progressive multiple sclerosis (MS). In this aspect, the authors consider its characteristics in comparison to other MS forms as well as possible markers of the disease, criteria of diagnosis and therapeutic options in the present and the future times.
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Affiliation(s)
- E V Popova
- Interregional Department of Multiple Sclerosis at Moscow Clinical Hospital #24, Moscow, Russia; Pirogov Russian National Research Medical University, Moscow, Russia
| | | | - A N Boyko
- Interregional Department of Multiple Sclerosis at Moscow Clinical Hospital #24, Moscow, Russia; Pirogov Russian National Research Medical University, Moscow, Russia
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Abstract
Multiple sclerosis (MS) is an autoimmune demyelinating disorder of the central nervous system. Only a few biomarkers are available in MS clinical practice, such as cerebrospinal fluid oligoclonal bands and immunoglobulin index, serum anti-aquaporin 4 antibodies, and serum anti-John Cunningham virus antibodies. Thus, there is a significant unmet need for biomarkers to assess prognosis, response to therapy, or potential treatment complications. Here we describe emerging biomarkers that are in development, focusing on those from peripheral blood. There are several limitations in the process of discovery and validation of a good biomarker, such as the pathophysiological complexity of MS and the technical difficulties in globally standardizing methods for sampling, processing, and conserving biological specimens. In spite of these limitations, ongoing international collaborations allow the exploration of many interesting molecules and markers to validate diagnostic, prognostic, and therapeutic-response biomarkers.
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Affiliation(s)
- Nabil K El Ayoubi
- American University of Beirut and Medical Center, Nehme and Therese Tohme Multiple Sclerosis Center, Riad El Solh, Beirut, 1107 2020, Lebanon
| | - Samia J Khoury
- American University of Beirut and Medical Center, Nehme and Therese Tohme Multiple Sclerosis Center, Riad El Solh, Beirut, 1107 2020, Lebanon.
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12
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Derkus B, Acar Bozkurt P, Tulu M, Emregul KC, Yucesan C, Emregul E. Simultaneous quantification of Myelin Basic Protein and Tau proteins in cerebrospinal fluid and serum of Multiple Sclerosis patients using nanoimmunosensor. Biosens Bioelectron 2016; 89:781-788. [PMID: 27816592 DOI: 10.1016/j.bios.2016.10.019] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 10/04/2016] [Accepted: 10/06/2016] [Indexed: 02/02/2023]
Abstract
This study was aimed at the development of an immunosensor for the simultaneous quantification of Myelin Basic Protein (MBP) and Tau proteins in cerebrospinal fluid (CSF) and serum, obtained from Multiple Sclerosis (MS) patients. The newly developed GO/pPG/anti-MBP/anti-Tau nanoimmunosensor has been established by immobilization of MBP and Tau antibodies. The newly developed nanoimmunosensor was tested, optimized and characterized using differential pulse voltammetry (DPV) and electrochemical impedance spectroscopy (EIS). The developed nanoimmunosensor was seen to have detection limits of 0.30nM for MBP and 0.15nM for Tau proteins which were sufficient for the levels to be analysed in neuro-clinic. The clinical study performed using CSF and serum of MS patients showed that the designed nanoimmunosensor was capable of detecting the proteins properly, that were essentially proven by ELISA.
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Affiliation(s)
- Burak Derkus
- Department of Chemistry, Ankara University, Tandogan, Ankara 06100, Turkey
| | - Pinar Acar Bozkurt
- Department of Chemistry, Ankara University, Tandogan, Ankara 06100, Turkey
| | - Metin Tulu
- Department of Chemistry, Yildiz Technical University, Esenler, Istanbul 34220, Turkey
| | - Kaan C Emregul
- Department of Chemistry, Ankara University, Tandogan, Ankara 06100, Turkey
| | - Canan Yucesan
- Department of Neurology, Medical School, Ankara University, Ibni Sina Hospital, Sihhiye, Ankara 06100, Turkey
| | - Emel Emregul
- Department of Chemistry, Ankara University, Tandogan, Ankara 06100, Turkey.
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Mellergård J, Tisell A, Blystad I, Grönqvist A, Blennow K, Olsson B, Dahle C, Vrethem M, Lundberg P, Ernerudh J. Cerebrospinal fluid levels of neurofilament and tau correlate with brain atrophy in natalizumab-treated multiple sclerosis. Eur J Neurol 2016; 24:112-121. [PMID: 27699930 DOI: 10.1111/ene.13162] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 08/09/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND PURPOSE Brain atrophy is related to clinical deterioration in multiple sclerosis (MS) but its association with intrathecal markers of inflammation or neurodegeneration is unclear. Our aim was to investigate whether cerebrospinal fluid (CSF) markers of inflammation or neurodegeneration are associated with brain volume change in natalizumab-treated MS and whether this change is reflected in non-lesional white matter metabolites. METHODS About 25 patients with natalizumab-treated MS were followed for 3 years with assessment of percentage brain volume change (PBVC) and absolute quantification of metabolites with proton magnetic resonance spectroscopy (1 H MRS). Analyses of inflammatory [interleukin 1β (IL-1β), IL-6, C-X-C motif chemokine 8 (CXCL8), CXCL10, CXCL11, C-C motif chemokine 22] and neurodegenerative [neurofilament light protein (NFL), glial fibrillary acidic protein, myelin basic protein, tau proteins] markers were done at baseline and 1-year follow-up. RESULTS The mean decline in PBVC was 3% at the 3-year follow-up, although mean 1 H MRS metabolite levels in non-lesional white matter were unchanged. CSF levels of NFL and tau at baseline correlated negatively with PBVC over 3 years (r = -0.564, P = 0.012, and r = -0.592, P = 0.010, respectively). CONCLUSIONS A significant 3-year whole-brain atrophy was not reflected in mean metabolite change of non-lesional white matter. In addition, our results suggest that CSF levels of NFL and tau correlate with brain atrophy development and may be used for evaluating treatment response in inflammatory active MS.
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Affiliation(s)
- J Mellergård
- Department of Neurology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - A Tisell
- Department of Radiation Physics and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - I Blystad
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,Department of Radiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - A Grönqvist
- Department of Radiation Physics and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - K Blennow
- Clinical Neurochemistry Laboratory, Institution of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
| | - B Olsson
- Clinical Neurochemistry Laboratory, Institution of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
| | - C Dahle
- Department of Clinical Immunology and Transfusion Medicine and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - M Vrethem
- Department of Neurology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.,Department of Clinical Neurophysiology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - P Lundberg
- Department of Radiation Physics and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,Department of Radiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - J Ernerudh
- Department of Clinical Immunology and Transfusion Medicine and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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Brettschneider J, Petzold A, Junker A, Tumani H. Axonal damage markers in the cerebrospinal fluid of patients with clinically isolated syndrome improve predicting conversion to definite multiple sclerosis. Mult Scler 2016; 12:143-8. [PMID: 16629417 DOI: 10.1191/135248506ms1263oa] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Clinically isolated syndrome (CIS) represents the earliest phase of multiple sclerosis (MS). This study tested whether biomarkers for axonal degeneration can improve upon sensitivity and specificity of magnetic resonance imaging (MRI) parameters in predicting conversion from CIS to MS. Patients with CIS ( n=52), relapsing-remitting MS (RRMS, n=38) and age-matched controls ( n=25) were included. Cerebrospinal fluid (CSF) levels of tau and neurofilaments (NfHSMI35) were measured using ELISA. The MRI T2-lesion load and the Expanded Disability Status Scale (EDSS) were recorded. CSF tau and NfHSMI35 were elevated in CIS compared to controls (p<0.05). RRMS patients with acute relapse had higher NfHSMI35 levels than stable patients. Tau and NfHSMI35 levels correlated with EDSS in CIS and RRMS. In RRMS, the number of T2-lesions correlated with tau levels ( R=0.53, P=0.01). The sensitivity predicting the conversion from CIS to MS was higher for the combination of CSF markers (either tau or NfHSMI35 elevated) than for MRI (40 versus 34%), but could be further increased to 60% if CSF and MRI criteria were combined. Similarly, the combination of tau and NfHSMI35 showed higher specificity (94%) than MRI (82%). Tau and NfHSMI35 are valuable biomarkers for axonal damage in the CIS patients. Predicting conversion from CIS to MS can be improved if CSF markers are combined with MRI.
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Abdelhak A, Junker A, Brettschneider J, Kassubek J, Ludolph AC, Otto M, Tumani H. Brain-Specific Cytoskeletal Damage Markers in Cerebrospinal Fluid: Is There a Common Pattern between Amyotrophic Lateral Sclerosis and Primary Progressive Multiple Sclerosis? Int J Mol Sci 2015; 16:17565-88. [PMID: 26263977 PMCID: PMC4581209 DOI: 10.3390/ijms160817565] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 07/20/2015] [Accepted: 07/23/2015] [Indexed: 11/25/2022] Open
Abstract
Many neurodegenerative disorders share a common pathophysiological pathway involving axonal degeneration despite different etiological triggers. Analysis of cytoskeletal markers such as neurofilaments, protein tau and tubulin in cerebrospinal fluid (CSF) may be a useful approach to detect the process of axonal damage and its severity during disease course. In this article, we review the published literature regarding brain-specific CSF markers for cytoskeletal damage in primary progressive multiple sclerosis and amyotrophic lateral sclerosis in order to evaluate their utility as a biomarker for disease progression in conjunction with imaging and histological markers which might also be useful in other neurodegenerative diseases associated with affection of the upper motor neurons. A long-term benefit of such an approach could be facilitating early diagnostic and prognostic tools and assessment of treatment efficacy of disease modifying drugs.
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Affiliation(s)
- Ahmed Abdelhak
- Department of Neurology, Ulm University, Oberer Eselsberg 45, 89081 Ulm, Germany.
| | - Andreas Junker
- Institute of Neuropathology, University Hospital Göttingen, Robert-Koch-Str 40, 37075 Göttingen, Germany.
| | | | - Jan Kassubek
- Department of Neurology, Ulm University, Oberer Eselsberg 45, 89081 Ulm, Germany.
| | - Albert C Ludolph
- Department of Neurology, Ulm University, Oberer Eselsberg 45, 89081 Ulm, Germany.
| | - Markus Otto
- Department of Neurology, Ulm University, Oberer Eselsberg 45, 89081 Ulm, Germany.
| | - Hayrettin Tumani
- Department of Neurology, Ulm University, Oberer Eselsberg 45, 89081 Ulm, Germany.
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Rommer PS, Kamin F, Petzold A, Tumani H, Abu-Mugheisib M, Koehler W, Hoffmann F, Winkelmann A, Benecke R, Zettl UK. Effects of repeated intrathecal triamcinolone-acetonide application on cerebrospinal fluid biomarkers of axonal damage and glial activity in multiple sclerosis patients. Mol Diagn Ther 2014; 18:631-7. [PMID: 24986188 DOI: 10.1007/s40291-014-0114-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background and Objectives Multiple sclerosis (MS) is the most common inflammatory disease of the central nervous system in young adults. Over time, the disease progresses and, with accumulating disability, symptoms such as spasticity may occur. Although several treatment options are available, some patients may not respond to first-line therapeutics. However, some of these patients may benefit from intrathecally administered triamcinolone-acetonide (TCA), a derivative of glucocorticosteroids (GCS). GCS may have neurotoxic effects, and cell apoptosis may occur. The aim of this study was to investigate the effects of TCA on biomarkers in the cerebrospinal fluid (CSF) suggestive of neurodegeneration. Methods In order to assess neurotoxic effects of TCA, neurofilament heavy-chain (NfH)SMI35, tau protein, and S-100B protein levels were determined before and during treatment with TCA in 54 patients with primary progressive MS, as well as relapsing MS (relapsing–remitting and secondary progressive MS). Results NfHSMI35 levels in the CSF of patients treated with TCA intrathecally did not increase significantly during the treatment cycle (p = 0.068). After application of TCA, tau protein levels were increased significantly at day 4 (p = 0.03) and at day 8 (p ≤ 0.001). S-100B protein levels decreased significantly (p ≤ 0.05) during treatment with TCA. Conclusion NfHSMI35 levels did not change significantly; however, tau protein levels did increase significantly within the reference range. Taking these findings together, the long-term effects of TCA on NfHSMI35 and tau protein levels need to be investigated further to understand whether levels of both biomarkers will change over repeated TCA applications. Interestingly, S-100B protein levels decreased significantly during the first applications, which may have represented reduced astrocytic activity during TCA treatment.
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Kosehasanogullari G, Ozakbas S, Idiman E. Tau protein levels in the cerebrospinal fluid of the patients with multiple sclerosis in an attack period: Low levels of tau protein may have significance, too. Clin Neurol Neurosurg 2015; 136:107-9. [PMID: 26093227 DOI: 10.1016/j.clineuro.2015.05.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 05/17/2015] [Accepted: 05/25/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Axonal loss is the cause of permanent neurologic disability in patients with MS. There are a lot of candidates to be a surrogate biological marker of the axonal loss in MS including tau protein. In the present study, we aimed to assess the levels of the tau protein in patients with MS, and in neurologically healthy controls. PATIENTS AND METHODS We included 41 patients with MS (32 RRMS, 9 SPMS) in this study. All the patients with MS were in an attack period. Control group was consist of 18 neurologically healty patients who underwent spinal anesthesia for orthopedic operations. The CSF tau protein level was measured by double antibody sandwich ELİSA. RESULTS The patients with RRMS had a higher tau protein level than the patients with SPMS and the control group. The patients with SPMS had a lower tau protein level than the control group. CONCLUSION High levels of tau protein in the CSF of RRMS patients in an attack period may indicate ongoing axonal transection owing to inflammation. Due to the brain atrophy, the patients with SPMS have less neurons to produce tau protein. The low levels of tau protein in the CSF of SPMS patients may denote axonal degeneration.
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Affiliation(s)
| | | | - Egemen Idiman
- Dokuz Eylul University, Department of Neurology, Turkey
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Abstract
Multiple sclerosis is an autoimmune disease that commonly affects young adults. If initially characterized by acute relapses, it is later followed by only incomplete remission. Over years, progressive disability and irreversible deficit lead to chronic neurological deficits in the majority of patients. The clinical course is protracted and unpredictable, and no biological marker is useful in predicting the evolution of autoaggression and disability. It is difficult to diagnose and to monitor disease progression after the initial symptoms or even during the major clinical manifestations, and it is difficult to treat. In this review, the authors report recent advances in the field, focusing on the search of new antigens as a marker of the disease, in their relevance to the pathophysiology and diagnosis of the disease.
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Affiliation(s)
- Francesco Lolli
- Laboratorio Interdipartimentale di Chimica & Biologia dei Peptidi & Proteine, Polo Scientifico e Tecnologico, Università degli Studi di Firenze, via Ugo Schiff 6, I-50019 Sesto Fiorentino, Italy.
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Gajofatto A, Calabrese M, Benedetti MD, Monaco S. Clinical, MRI, and CSF markers of disability progression in multiple sclerosis. Dis Markers 2013; 35:687-99. [PMID: 24324285 DOI: 10.1155/2013/484959] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Revised: 09/12/2013] [Accepted: 10/09/2013] [Indexed: 11/17/2022]
Abstract
Multiple sclerosis (MS) is a chronic disorder of the central nervous system (CNS) in which the complex interplay between inflammation and neurodegeneration determines varying degrees of neurological disability. For this reason, it is very difficult to express an accurate prognosis based on purely clinical information in the individual patient at an early disease stage. Magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) biomarkers are promising sources of prognostic information with a good potential of quantitative measure, sensitivity, and reliability. However, a comprehensive MS outcome prediction model combining multiple parameters is still lacking. Current relevant literature addressing the topic of clinical, MRI, and CSF markers as predictors of MS disability progression is reviewed here.
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Borroni B, Benussi A, Cosseddu M, Archetti S, Padovani A. Cerebrospinal fluid tau levels predict prognosis in non-inherited frontotemporal dementia. NEURODEGENER DIS 2013; 13:224-9. [PMID: 24029600 DOI: 10.1159/000353280] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 05/23/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The course of frontotemporal dementia (FTD) is heterogeneous and no predictors of survival are currently available. Cerebrospinal fluid (CSF) tau dosage has been demonstrated to be useful in predicting outcome over time in a number of neurological disorders. OBJECTIVE To assess CSF tau levels in FTD and to evaluate their prognostic value. METHODS Seventy-seven FTD patients with no mutations in known causative genes were consecutively enrolled, and CSF tau and phospho-tau levels analysed. Each patient was reassessed over time, and survival (i.e. death/bedridden and otherwise) was evaluated. The survival analysis was carried out by Cox proportional hazards regression models. RESULTS Patients with high CSF tau levels (≥400 pg/ml) had shorter survival than those with low CSF tau levels [hazard ratio (HR) = 3.406; 95% CI: 1.151-10.077; Wald χ(2) = 4.902; d.f. = 1; p = 0.027]. The association between tau levels and survival probability was confirmed after adjusting for age, gender, clinical phenotype and FTD clinical dementia rating at enrolment (HR = 3.769; 95% CI: 1.143-12.433; Wald χ(2) = 4.748; d.f. = 1; p = 0.029). Neither demographic or clinical characteristics nor CSF phospho-tau levels or apolipoprotein E genotype were significantly associated with prognosis. CONCLUSIONS This study argues that CSF tau levels may be considered in FTD to predict patients' outcome. Establishing in vivo prognostic biomarkers is mandatory to define homogeneous groups for inclusion in future clinical trials and to monitor the effectiveness of future therapeutic approaches.
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Affiliation(s)
- Barbara Borroni
- Centre for Neurodegenerative Disorders, University of Brescia, Brescia, Italy
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22
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Szalardy L, Zadori D, Simu M, Bencsik K, Vecsei L, Klivenyi P. Evaluating biomarkers of neuronal degeneration and neuroinflammation in CSF of patients with multiple sclerosis–osteopontin as a potential marker of clinical severity. J Neurol Sci 2013; 331:38-42. [DOI: 10.1016/j.jns.2013.04.024] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 03/31/2013] [Accepted: 04/22/2013] [Indexed: 01/26/2023]
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Agúndez JAG, García-Martín E, Martínez C, Benito-León J, Millán-Pascual J, Calleja P, Díaz-Sánchez M, Pisa D, Turpín-Fenoll L, Alonso-Navarro H, Ayuso-Peralta L, Torrecillas D, Plaza-Nieto JF, Jiménez-Jiménez FJ. MAPT gene rs1052553 variant is not associated with the risk for multiple sclerosis. Hum Immunol 2013; 74:1705-8. [PMID: 23911736 DOI: 10.1016/j.humimm.2013.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 07/08/2013] [Accepted: 07/19/2013] [Indexed: 02/08/2023]
Abstract
BACKGROUND/OBJECTIVES Some experimental data suggest a possible role of tau protein in the pathogenesis of multiple sclerosis (MS) and in experimental autoimmune encephalomyelitis. The aim of this study was to investigate a possible influence of the SNP rs1052553 in the MAPT gene in the risk for relapsing bout onset (relapsing-remitting and secondary progressive) MS. METHODS We analyzed the allelic and genotype frequency of MAPT rs1052553, which has been associated with some neurodegenerative diseases, in 259 patients with relapsing bout onset MS and 291 healthy controls, using TaqMan Assays. RESULTS MAPT rs1052553 allelic and genotype frequencies did not differ significantly between relapsing bout onset MS patients and controls, and were unrelated with the age of onset of MS or gender. CONCLUSIONS These results suggest that MAPT rs1052553 polymorphism is not related with the risk for relapsing bout onset MS.
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Affiliation(s)
- José A G Agúndez
- Department of Pharmacology, University of Extremadura, Cáceres, Spain
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Stangel M, Fredrikson S, Meinl E, Petzold A, Stüve O, Tumani H. The utility of cerebrospinal fluid analysis in patients with multiple sclerosis. Nat Rev Neurol 2013; 9:267-76. [DOI: 10.1038/nrneurol.2013.41] [Citation(s) in RCA: 150] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Jaworski J, Psujek M, Janczarek M, Szczerbo-Trojanowska M, Bartosik-Psujek H. Total-tau in cerebrospinal fluid of patients with multiple sclerosis decreases in secondary progressive stage of disease and reflects degree of brain atrophy. Ups J Med Sci 2012; 117:284-92. [PMID: 22554142 PMCID: PMC3410288 DOI: 10.3109/03009734.2012.669423] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Tau protein is a potential marker of neuronal damage. The aim of the study is to investigate its potential role as a marker of brain atrophy in multiple sclerosis (MS). MATERIALS AND METHODS Cerebrospinal fluid (CSF) and blood samples were collected from 48 patients with multiple sclerosis. Total-tau (t-tau) and phospho(181Thr)-tau (p-tau) concentrations were assayed with commercially available INNOTEST® hTAU Ag and INNOTEST® phospho181Thr-tau((181P)) and correlated with indices of brain atrophy in magnetic resonance imaging (MRI) and clinical characteristics of the study population. RESULTS T-tau concentration in CSF was significantly higher in relapsing-remitting (RR) compared to secondary progressive (SP) MS patients (P = 0.01). Brain parenchymal fraction (BPF) was significantly decreased in SP patients (P = 0.002). BPF in the whole study population correlated inversely with Expanded Disability Status Scale (EDSS) (r = -0.51, P = 0.0002) and Multiple Sclerosis Severity Score (MSSS) (r = -0.42, P = 0.002). T-tau in CSF in the whole patient group correlated inversely with EDSS (r = -0.58, P = 0.0006). CONCLUSIONS The results of our study suggest that total-tau concentration in CSF in a MS population decreases in the course of disease and reflects degree of parenchymal brain loss.
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Affiliation(s)
- Jacek Jaworski
- Department of Neurology, Medical University of Lublin, Poland.
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Clarke NA, Hartmann T, Jones EL, Ballard CG, Francis PT. Antipsychotic medication is associated with selective alterations in ventricular cerebrospinal fluid Aβ 40 and tau in patients with intractable unipolar depression. Int J Geriatr Psychiatry 2011; 26:1283-91. [PMID: 21308788 DOI: 10.1002/gps.2678] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Accepted: 11/29/2010] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Alterations in plasma and in lumbar cerebrospinal fluid amyloid-B peptide (Aβ) levels have been reported in Alzheimer's disease. Studies have also suggested similar changes in depressed patients. No information is available on the impact of psychotropic drugs on this in patients with depression. We therefore quantified Aβ in ventricular cerebrospinal fluid (CSF) in a population of patients with treatment-resistant depression, with and without antipsychotic medication. METHOD A cross-sectional study of 32 patients undergoing subcaudate tractotomy for major (unipolar) depressive disorder. Ventricular CSF concentrations of Aβ peptide 1-40 and 1-42, also p-tau and total tau were determined by Western blotting or enzyme-linked immunosorbent assay. RESULTS Patients taking antipsychotic medication in the 2 weeks prior to surgery demonstrated significantly higher levels of Aβ 1-40 (mean ± SD: 727.3 ± 382.3 vs. 440.9 ± 337.2 pg/ml; p = 0.032, Student's t-test) but unaltered Aβ 1-42 (mean 72.1 ± 67.5 vs. 60.0 ± 56.7 pg/ml; p = 0.587) compared to a matched sample not treated with antipsychotic drugs. The same group demonstrated elevated total tau (mean 945.0 ± 422.2 vs. 534.3 ± 388.3 pg/ml; p = 0.010) but not p-tau (mean 98.6 ± 71.5 vs. 88.1 ± 70.5 pg/ml; p = 0.694). No similar effect was found with lithium, antidepressants, carbamazepine or benzodiazepines. CONCLUSIONS This preliminary study suggests antipsychotic drugs, widely used in patients with severe depression across all age ranges, may be associated with alteration of Aβ 1-40 and total tau, indices strongly linked with progressive organic brain disease. Further confirmatory work is needed.
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Affiliation(s)
- Nicholas A Clarke
- King's College London, Wolfson Centre for Age-Related Diseases, London, UK
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Fialová L, Bartos A, Svarcová J, Malbohan I. Increased intrathecal high-avidity anti-tau antibodies in patients with multiple sclerosis. PLoS One 2011; 6:e27476. [PMID: 22140442 DOI: 10.1371/journal.pone.0027476] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Accepted: 10/17/2011] [Indexed: 11/30/2022] Open
Abstract
Background Antibodies against tau protein indicate an interaction between the immune system and the neurocytoskeleton and therefore may reflect axonal injury in multiple sclerosis (MS). Methodology/Principal Findings The levels and avidities of anti-tau IgG antibodies were measured using ELISA in paired cerebrospinal fluid (CSF) and serum samples obtained from 49 MS patients and 47 controls. Anti-tau antibodies were significantly elevated intrathecally (p<0.0001) in the MS group. The CSF anti-tau antibody levels were lower in MS patients receiving therapy than those without treatment (p<0.05). The avidities of anti-tau antibodies were higher in the CSF than in the serum (MS group p<0.0001; controls p<0.005). Anti-tau avidities in the CSF were elevated in MS patients in comparison with controls (p<0.05), but not in serum. Conclusions MS patients have higher levels of intrathecal anti-tau antibodies. Anti-tau antibodies have different avidities in different compartments with the highest values in the CSF of MS patients.
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Abstract
Background: Tau protein has been proposed as biomarker of axonal damage leading to irreversible neurological impairment in MS. CSF concentrations may be useful when determining risk of progression from ON to MS. Objective: To investigate the association between tau protein concentration and 14-3-3 protein in the cerebrospinal fluid (CSF) of patients with monosymptomatic optic neuritis (ON) versus patients with monosymptomatic onset who progressed to multiple sclerosis (MS). To evaluate results against data found in a complete literature review. Methods: A total of 66 patients with MS and/or ON from the Department of Neurology of Glostrup Hospital, University of Copenhagen, Denmark, were included. CSF samples were analysed for tau protein and 14-3-3 protein, and clinical and paraclinical information was obtained from medical records. Results: The study shows a significantly increased concentration of tau protein in CSF from patients with relapsing–remitting MS and patients monosymptomatic at onset who progressed to MS, but interestingly no increased tau protein concentration in monosymptomatic ON. The concentration of tau protein was significantly correlated to Expanded Disability Status Scale score. No 14-3-3 protein was detected in any CSF sample. Conclusions: The results of this study invite further exploration of the possible role of tau protein as a prognostic factor to predict progression from ON to MS in future studies.
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Affiliation(s)
- J Frederiksen
- Department of Neurology, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark
| | - K Kristensen
- Department of Neurology, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark
| | - JMC Bahl
- Department of Autoimmunity and Clinical Biochemistry, Statens Serum Institute, Copenhagen, Denmark
| | - M Christiansen
- Department of Autoimmunity and Clinical Biochemistry, Statens Serum Institute, Copenhagen, Denmark
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Graber JJ, Dhib-Jalbut S. Biomarkers of disease activity in multiple sclerosis. J Neurol Sci 2011; 305:1-10. [DOI: 10.1016/j.jns.2011.03.026] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Revised: 02/25/2011] [Accepted: 03/01/2011] [Indexed: 12/15/2022]
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Dujmovic I. Cerebrospinal fluid and blood biomarkers of neuroaxonal damage in multiple sclerosis. Mult Scler Int 2011; 2011:767083. [PMID: 22096642 DOI: 10.1155/2011/767083] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Accepted: 02/08/2011] [Indexed: 12/20/2022] Open
Abstract
Following emerging evidence that neurodegenerative processes in multiple sclerosis (MS) are present from its early stages, an intensive scientific interest has been directed to biomarkers of neuro-axonal damage in body fluids of MS patients. Recent research has introduced new candidate biomarkers but also elucidated pathogenetic and clinical relevance of the well-known ones. This paper reviews the existing data on blood and cerebrospinal fluid biomarkers of neuroaxonal damage in MS and highlights their relation to clinical parameters, as well as their potential predictive value to estimate future disease course, disability, and treatment response. Strategies for future research in this field are suggested.
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Bartosik-Psujek H, Psujek M, Jaworski J, Stelmasiak Z. Total tau and S100b proteins in different types of multiple sclerosis and during immunosuppressive treatment with mitoxantrone. Acta Neurol Scand 2011; 123:252-6. [PMID: 20597867 DOI: 10.1111/j.1600-0404.2010.01393.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Brain-specific proteins are biochemical markers of neurodegeneration. The aim of this study was to estimate the role of biomarkers in neuronal and glial damage as a potent marker of efficiency of immunosuppressive treatment. MATERIAL AND METHODS The levels of total Tau protein (tTau) and S100b protein were measured using the ELISA method in serum and cerebrospinal fluid (CSF) of 30 patients with RRMS, 24 patients with SPMS and 30 healthy subjects. Additionally, serum levels of tTau and S100b were assayed every 6 months during the 24-month mitoxantrone therapy. RESULTS In CSF and serum of patients with MS, both tTau and S100b were increased compared to control group; however, no significant difference was found between respective MS types. In serum of mitoxantrone-treated patients, both proteins showed to decrease after 24 months, yet the difference was statistically significant only for S100b. CONCLUSIONS CSF levels of tTau and S100b are elevated in patients with MS and can reflect an axonal and glial pathology. Measurement of serum concentrations of S100b may be useful for monitoring immunosuppressive therapy and may support clinical assessment. In contrast, tTau concentration did not prove to be a useful marker of mitoxantrone therapy.
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Affiliation(s)
- H Bartosik-Psujek
- Department of Neurology, Medical University of Lublin, Jaczewskiego 8, Lublin, Poland.
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Jaworski J, Psujek M, Bartosik-psujek H. CSF and serum total-tau and phospho-tau(181P) in MS patients. Open Med (Wars) 2011; 6:193-200. [DOI: 10.2478/s11536-011-0003-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AbstractIn search of biological marker in multiple sclerosis (MS), total-tau and phospho-tau (Thr181) concentrations were established in CSF and serum of 78 patients with MS, using commercially available kits. Serum and CSF concentrations of IgG, IgM, and albumin were assayed simultaneously to calculate quotients and indices of intrathecal synthesis. Serum t-tau detection was strikingly low (23.1%); therefore, this factor was excluded from further analysis. Serum p-tau levels did not correlate with any of indices or quotients. Unexpectedly, CSF t-tau and p-tau showed an inverse relation with MSSS and EDSS, which has not been published elsewhere. Our results do not support utility of serum t-tau and p-tau as surrogate markers for MS.
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Abstract
Multiple sclerosis is the major neurological disease among young adults. Biomarkers predicting disease prognosis in multiple sclerosis are needed. Axonal damage is related to disease progression and occurs early in the multiple sclerosis disease course. Therefore, biomarkers for axonal damage are potential candidate predictors of disease progression. Furthermore, biomarkers for early axonal damage could help in developing and evaluating early treatment. The state of the art and new developments of biomarkers for axonal damage in multiple sclerosis is discussed in this review. Lastly, a new European network is introduced that aims at optimizing cerebrospinal fluid biomarker research in multiple sclerosis. Such networks enhance the opportunities to obtain sufficient samples for in-depth studies on biomarkers in precious material, such as cerebrospinal fluid.
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Affiliation(s)
- Charlotte E Teunissen
- VU University Medical Center, Department of Molecular Cell Biology and Immunology, MS Center Amsterdam, NeuroUnit Biomarkers for Inflammation and Neurodegneration Amsterdam, FdG, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
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Schraen-Maschke S, Sergeant N, Dhaenens CM, Bombois S, Deramecourt V, Caillet-Boudin ML, Pasquier F, Maurage CA, Sablonnière B, Vanmechelen E, Buée L. Tau as a biomarker of neurodegenerative diseases. Biomark Med 2010; 2:363-84. [PMID: 20477391 DOI: 10.2217/17520363.2.4.363] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The microtubule-associated protein Tau is mainly expressed in neurons of the CNS and is crucial in axonal maintenance and axonal transport. The rationale for Tau as a biomarker of neurodegenerative diseases is that it is a major component of abnormal intraneuronal aggregates observed in numerous tauopathies, including Alzheimer's disease. The molecular diversity of Tau is very useful when analyzing it in the brain or in the peripheral fluids. Immunohistochemical and biochemical characterization of Tau aggregates in the brain allows the postmortem classification and differential diagnosis of tauopathies. As peripheral biomarkers of Alzheimer's disease in the cerebrospinal fluid, Tau proteins are now validated for diagnosis and predictive purposes. For the future, the detailed characterization of Tau in the brain and in peripheral fluids will lead to novel promising biomarkers for differential diagnosis of dementia and monitoring of therapeutics.
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Abstract
Multiple sclerosis (MS) is an autoimmune disorder of the brain and spinal cord that predominantly affects white matter. MS has a variable clinical presentation and has no 'diagnostic' laboratory test; this often results in delays to definite diagnosis. In confronting the disease, early diagnosis and appropriate, timely therapeutic intervention are critical factors in ensuring favorable long-term outcomes. The availability of reliable biomarkers could radically alter our management of MS at critical phases of the disease spectrum. Identification of markers that could predict the development of MS in high-risk populations would allow for intervention strategies that may prevent evolution to definite disease. Work with anti-myelin antibodies and the ongoing analysis of microarray gene expression have thus far not yielded biomarkers that predict future disease development. Similarly, extensive studies with serum and cerebrospinal fluid (CSF) have not yielded a disease-specific and sensitive diagnostic biomarker for MS. Establishment of disease diagnosis always leads to questions about long-term prognosis because in an individual patient the natural history of the disease is clinically unpredictable. Biomarkers that correlate with myelin loss, spinal cord disease, grey matter and subcortical demyelination need to be developed in order to accurately predict the disease course. The bulk of effort in biomarker development in MS has been concentrated in the area of monitoring disease activity. At present, a disease 'activation' panel of CSF biomarkers would include the following: interleukin-6 or its soluble receptor, nitric oxide and nitric oxide synthase, osteopontin, and fetuin-A. Although disease activity in MS is predominantly inflammatory, disease progression is likely to be the result of neurodegeneration. Therefore, the roles of proteins indicative of neuronal, axonal, and glial loss such as neurofilaments, tau, 14-3-3 proteins, and N-acetylaspartate are all under investigation, as are proteins affecting remyelination and regeneration, such as Nogo-A. With the increasing awareness of cognition dysfunction in MS, molecules such as apolipoprotein and proteins in the amyloid precursor protein pathway implicated in dementia are also being examined. Serum biomarkers that help monitor therapeutic efficacy such as the titer of antibody to beta-interferon, a first-line medication in MS, are established in clinical practice. Ongoing work with biomarkers that reflect drug bioavailability and factors that distinguish between medication responders and nonresponders are also under investigation. The discovery of new biomarkers relies on applying advances in proteomics along with microarray gene and antigen analysis and will hopefully result in the establishment of specific biomarkers for MS.
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Affiliation(s)
- Violaine K Harris
- Multiple Sclerosis Research Center of New York, New York, New York 10019, USA
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Tumani H, Hartung HP, Hemmer B, Teunissen C, Deisenhammer F, Giovannoni G, Zettl UK. Cerebrospinal fluid biomarkers in multiple sclerosis. Neurobiol Dis 2009; 35:117-27. [PMID: 19426803 DOI: 10.1016/j.nbd.2009.04.010] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2009] [Revised: 04/10/2009] [Accepted: 04/27/2009] [Indexed: 12/25/2022] Open
Abstract
In patients with multiple sclerosis (MS) intensive efforts are directed at identifying biomarkers in bodily fluids related to underlying disease mechanisms, disease activity and progression, and therapeutic response. Besides MR imaging parameters cerebrospinal fluid (CSF) biomarkers provide important and specific information since changes in the CSF composition may reflect disease mechanisms inherent to MS. The different cellular and protein-analytical methods of the CSF and the recommended standard of the diagnostic CSF profile in MS are described. A brief update on possible CSF biomarkers that might reflect key pathological processes of MS such as inflammation, demyelination, neuroaxonal loss, gliosis and regeneration is provided.
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Affiliation(s)
- Hayrettin Tumani
- Department of Neurology, University of Ulm, Oberer Eselsberg 45, Ulm D-89081, Germany.
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Tumani H, Teunissen C, Süssmuth S, Otto M, Ludolph AC, Brettschneider J. Cerebrospinal fluid biomarkers of neurodegeneration in chronic neurological diseases. Expert Rev Mol Diagn 2008; 8:479-94. [PMID: 18598229 DOI: 10.1586/14737159.8.4.479] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Chronic neurological diseases (CND) like amyotrophic lateral sclerosis (ALS), dementia or multiple sclerosis (MS) share a chronic progressive course of disease that frequently leads to the common pathological pathway of neurodegeneration, including neuroaxonal damage, apoptosis and gliosis. There is an ongoing search for biomarkers that could support early diagnosis of CND and help to identify responders to interventions in therapeutic treatment trials. Cerebrospinal fluid (CSF) is a promising source of biomarkers in CND, since the CSF compartment is in close anatomical contact with the brain interstitial fluid, where biochemical changes related to CND are reflected. We review recent advances in CSF biomarkers research in CND and thereby focus on markers associated with neurodegeneration.
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Affiliation(s)
- Hayrettin Tumani
- Department of Neurology, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany.
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de Bont JM, Vanderstichele H, Reddingius RE, Pieters R, van Gool SW. Increased total-Tau levels in cerebrospinal fluid of pediatric hydrocephalus and brain tumor patients. Eur J Paediatr Neurol 2008; 12:334-41. [PMID: 17951083 DOI: 10.1016/j.ejpn.2007.09.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2007] [Revised: 09/12/2007] [Accepted: 09/18/2007] [Indexed: 12/01/2022]
Abstract
Total Tau (t-Tau), hyperphosphorylated Tau (p-Tau(181P)) and beta-amyloid(1-42) in cerebrospinal fluid (CSF) have shown to be markers of neuronal and axonal degeneration in various neurological and neurodegenerative diseases. The aim of this study was to evaluate the influence of the presence of a brain tumor and hydrocephalus on t-Tau, p-Tau(181P) and beta-amyloid(1-42) levels in CSF of pediatric patients. t-Tau, p-Tau(181P) and beta-amyloid(1-42) levels were simultaneously quantified by xMAP technology in 22 lumbar and 15 ventricular CSF samples from newly diagnosed pediatric brain tumor patients and 39 lumbar and 12 ventricular CSF samples from pediatric patients without a brain tumor. t-Tau, p-Tau(181P) and beta-amyloid(1-42) levels in both lumbar and ventricular CSF were not significantly correlated with age. t-Tau levels in lumbar CSF were elevated in brain tumor patients, being especially high in medulloblastoma patients. Lumbar CSF p-Tau(181P) levels were lower in brain tumor patients compared to normal controls. Ventricular levels of t-Tau, p-Tau(181P) and beta-amyloid(1-42) were not significantly different between the brain tumor patients and non-tumor patients, but t-Tau levels were significantly increased in patients with radiological signs of hydrocephalus. Two patients with an infected ventriculo-peritoneal drain also had high CSF t-Tau levels. In conclusion, high t-Tau levels in CSF are found in pediatric patients with a brain tumor, patients with hydrocephalus and patients with a serious CNS infection, reflecting neuronal and axonal damage. Ongoing studies should determine whether these neurodegenerative markers in CSF can be used to monitor neuronal and axonal degeneration in these patients during therapy and long-term follow up.
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Affiliation(s)
- Judith M de Bont
- Erasmus MC, University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands.
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Hein (née Maier) K, Köhler A, Diem R, Sättler MB, Demmer I, Lange P, Bähr M, Otto M. Biological markers for axonal degeneration in CSF and blood of patients with the first event indicative for multiple sclerosis. Neurosci Lett 2008; 436:72-6. [DOI: 10.1016/j.neulet.2008.02.064] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2007] [Revised: 02/18/2008] [Accepted: 02/29/2008] [Indexed: 12/13/2022]
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Mehling M, Kuhle J, Regeniter A. 10 most commonly asked questions about cerebrospinal fluid characteristics in demyelinating disorders of the central nervous system. Neurologist 2008; 14:60-5. [PMID: 18195662 DOI: 10.1097/NRL.0b013e31815ac523] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
About 10-15% of patients with multiple sclerosis (MS) present with gradually increasing neurological disability, a disorder known as primary-progressive multiple sclerosis (PPMS). Compared with relapse-onset multiple sclerosis, people with PPMS are older at onset and a higher proportion are men. Inflammatory white-matter lesions are less evident but diffuse axonal loss and microglial activation are seen in healthy-looking white matter, in addition to cortical demyelination, and quantitative MRI shows atrophy and intrinsic abnormalities in the grey matter and the white matter. Spinal cord atrophy corresponds to the usual clinical presentation of progressive spastic paraplegia. Although neuroaxonal degeneration seems to underlie PPMS, the pathogenesis and the extent to which immune-mediated mechanisms operate is unclear. MRI of the brain and spinal cord, and examination of the CSF, are important investigations for diagnosis; conventional immunomodulatory therapies, such as interferon beta and glatiramer acetate, are ineffective. Future research should focus on the clarification of the mechanisms of axonal loss, improvements to the design of clinical trials, and the development of effective neuroprotective treatments.
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Affiliation(s)
- David H Miller
- Department of Neuroinflammation, Institute of Neurology, University College London, London, UK.
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42
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Abstract
BACKGROUND Tau protein is present in the microtubules of axons. Markers of various types have been used to demonstrate multiple sclerosis (MS) activity and axonal damage. This study aimed to demonstrate the association between cerebrospinal fluid (CSF) tau protein concentrations and clinical prognosis in MS patients. METHODS We included 45 patients that were diagnosed according to the McDonald's criteria. The control group was made up of 38 patients that had no signs or symptoms related to the primary central nervous system lesion correlated with the patient group. CSF total tau protein was measured using the ELISA method based on the sandwich method with Innogenetics Innotest hTau antigen kit in pg/ml type. RESULTS In the patient group, the mean CSF total tau protein level was 238.66 +/- 237.44, whereas it was 93.65 +/- 82.14 in the control group. The mean total tau protein was higher in the three clinical forms when compared with the control group and it was statistically significant (P<0.05). CONCLUSIONS High tau protein level may be an early marker of axonal damage and this marker may be used for monitoring axon preventing therapies in the follow-up.
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Affiliation(s)
- M Terzi
- Department of Neurology, Ondokuz Mayis University Medical School, Kurupelt-Samsun, Turkey.
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43
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Abstract
Although the diagnosis of multiple sclerosis (MS) may be clinically suspect and the magnetic resonance imaging findings compatible, cerebrospinal fluid (CSF) analysis remains mandatory in order to support the diagnosis. This is especially important since our understanding of the defining disease pathogenesis remains incomplete. However, there is no specifically diagnostic CSF test. And until recently, laboratory techniques for CSF analysis had not been rigorously standardized. Unconcentrated CSF without fixative should be used for the determinations of cell count and differential, protein and glucose, lactate, myelin basic protein, and the CSF/serum albumin ratio which is an indicator of blood-CSF barrier disruption. Additionally, CSF immunoglobulin-gamma (IgG) determinations are of major importance and are now included in the MS diagnostic criteria. Testing for oligoclonal IgG bands utilizing isoelectric focusing with IgG immunoblotting, the IgG synthesis rate, and the IgG index should be included. CSF analysis for kappa light chains and IGM may be diagnostically helpful. The search for biomarkers including those possibly present in the CSF which could predict and assess the course as well as response to treatment in a particular MS patient has not yet been successful. CSF immunoglobulin and T-cell/B-cell patterns, soluble HLA class I and II antigens, nitrous oxide metabolites, neurofilament and microtubule components and antibodies, tau protein, 14-3-3-protein, neuronal cell and intercellular adhesion molecules, and chemokines are actively being investigated as MS biomarkers.
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Affiliation(s)
- Francisco A Luque
- Neurology Service, Overton Brooks VA Medical Center Shreveport, Louisiana 71101, USA
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