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Ma Y, Norton DL, Van Hulle CA, Chappell RJ, Lazar KK, Jonaitis EM, Koscik RL, Clark LR, Krause R, Andreasson U, Chin NA, Bendlin BB, Asthana S, Okonkwo OC, Gleason CE, Johnson SC, Zetterberg H, Blennow K, Carlsson CM. Measurement batch differences and between-batch conversion of Alzheimer's disease cerebrospinal fluid biomarker values. Alzheimers Dement (Amst) 2021; 13:e12194. [PMID: 34084888 PMCID: PMC8144935 DOI: 10.1002/dad2.12194] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 04/06/2021] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Batch differences in cerebrospinal fluid (CSF) biomarker measurement can introduce bias into analyses for Alzheimer's disease studies. We evaluated and adjusted for batch differences using statistical methods. METHODS A total of 792 CSF samples from 528 participants were assayed in three batches for 12 biomarkers and 3 biomarker ratios. Batch differences were assessed using Bland-Altman plot, paired t test, Pitman-Morgan test, and linear regression. Generalized linear models were applied to convert CSF values between batches. RESULTS We found statistically significant batch differences for all biomarkers and ratios, except that neurofilament light was comparable between batches 1 and 2. The conversion models generally had high R 2 except for converting P-tau between batches 1 and 3. DISCUSSION Between-batch conversion allows harmonized CSF values to be used in the same analysis. Such method may be applied to adjust for other sources of variability in measuring CSF or other types of biomarkers.
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Lifke V, Kollmorgen G, Manuilova E, Oelschlaegel T, Hillringhaus L, Widmann M, von Arnim CAF, Otto M, Christenson RH, Powers JL, Shaw LM, Hansson O, Doecke JD, Li QX, Teunissen C, Tumani H, Blennow K. Elecsys ® Total-Tau and Phospho-Tau (181P) CSF assays: Analytical performance of the novel, fully automated immunoassays for quantification of tau proteins in human cerebrospinal fluid. Clin Biochem 2019; 72:30-38. [PMID: 31129184 DOI: 10.1016/j.clinbiochem.2019.05.005] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [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: 05/10/2019] [Accepted: 05/19/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Total tau (tTau) and phosphorylated 181P tau (pTau) are supportive diagnostic cerebrospinal fluid (CSF) biomarkers for Alzheimer's disease. Manual CSF tau assays are limited by lot-to-lot and between-laboratory variability and long incubation/turnaround times. Elecsys® Total-Tau CSF and Phospho-Tau (181P) CSF immunoassays were developed for fully automated cobas e analyzers, allowing broader access in clinical practice and trials. METHODS Analytical performance, reproducibility, method comparisons with commercially available assays, and lot-to-lot and platform comparability (cobas e 601/411) of the Elecsys® CSF assays were assessed. Tau distributions and concentration ranges were evaluated in CSF samples from two clinical cohorts. RESULTS Both assays showed high sensitivity (limit of quantitation [LoQ]: 63 pg/mL [tTau]; 4 pg/mL [pTau]) and linearity over the measuring range (80-1300 pg/mL; 8-120 pg/mL), which covered the entire concentration range measured in clinical samples. Lot-to-lot and platform comparability demonstrated good consistency (Pearson's r: 0.998; 1.000). Multicenter evaluation coefficients of variation (CVs): repeatability, < 1.8%; intermediate precision, < 2.8%; between-laboratory variability, < 2.7% (both assays); and total reproducibility, < 6.7% (tTau) and < 4.7% (pTau). Elecsys® CSF assays demonstrated good correlation with commercially available tau assays. CONCLUSIONS Elecsys® Total-Tau CSF and Phospho-Tau (181P) CSF assays demonstrate good analytical performance with clinically relevant measuring ranges; data support their use in clinical trials and practice.
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Affiliation(s)
- Valeria Lifke
- Roche Diagnostics GmbH, Nonnenwald 2, 82377 Penzberg, Germany.
| | | | | | | | | | - Monika Widmann
- Amsterdam University Medical Center, Vrije Universiteit, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands.
| | | | - Markus Otto
- Clinic for Neurology, University Clinic Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany.
| | - Robert H Christenson
- Department of Pathology, University of Maryland School of Medicine, 655 W Baltimore S, Baltimore, MD 21201, USA.
| | - Jennifer L Powers
- Division of Endocrinology, Metabolism and Lipid Research, School of Medicine, Washington University in St Louis, 660 S Euclid Ave, St. Louis, MO 63110, USA.
| | - Leslie M Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA.
| | - Oskar Hansson
- Clinical Memory Research Unit, Lund University, VO Minnessjukdomar, Simrisbanv 14/4, 212 24 Malmö, Sweden; Memory Clinic, Skåne University Hospital, Inga Marie Nilssons gata 47, 214 21 Malmö, Sweden.
| | - James D Doecke
- The Commonwealth Scientific and Industrial Research Organisation/Australian E-Health Research Centre, Butterfield St & Bowen Bridge Rd, Herston, QLD 4029, Australia.
| | - Qiao-Xin Li
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, 30 Royal Parade, Parkville, VIC 3052, Australia.
| | - Charlotte Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Amsterdam University Medical Center, Vrije Universiteit, De Boelelaan 1117, 1081, HV Amsterdam, the Netherlands.
| | - Hayrettin Tumani
- Clinic for Neurology, University Clinic Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany.
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Göteborgsvägen 31, 431 80 Mölndal, Sweden; Institute of Neuroscience and Physiology, Dept. of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Wallinsgatan 6, 431 41 Mölndal, Sweden.
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Hansson O, Mikulskis A, Fagan AM, Teunissen C, Zetterberg H, Vanderstichele H, Molinuevo JL, Shaw LM, Vandijck M, Verbeek MM, Savage M, Mattsson N, Lewczuk P, Batrla R, Rutz S, Dean RA, Blennow K. The impact of preanalytical variables on measuring cerebrospinal fluid biomarkers for Alzheimer's disease diagnosis: A review. Alzheimers Dement 2018; 14:1313-1333. [DOI: 10.1016/j.jalz.2018.05.008] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 04/20/2018] [Accepted: 05/03/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Oskar Hansson
- Department of Neurology; Skåne University Hospital; Lund Sweden
- Memory Clinic; Skåne University Hospital; Malmö Sweden
| | | | - Anne M. Fagan
- Department of Neurology; Washington University School of Medicine; St Louis MO USA
| | | | - Henrik Zetterberg
- UK Dementia Research Institute; London UK
- Department of Molecular Neuroscience; UCL Institute of Neurology; London UK
- Clinical Neurochemistry Laboratory; Sahlgrenska University Hospital; Mölndal Sweden
- Department of Psychiatry and Neurochemistry; Sahlgrenska Academy at the University of Gothenburg; Mölndal Sweden
| | | | - Jose Luis Molinuevo
- BarcelonaBeta Brain Research Center; Pasqual Maragall Foundation; Barcelona Spain
| | - Leslie M. Shaw
- Department of Pathology and Laboratory Medicine; Perelman School of Medicine; University of Pennsylvania; Philadelphia PA USA
| | | | - Marcel M. Verbeek
- Radboud University Medical Center; Departments of Neurology and Laboratory Medicine; Donders Institute for Brain; Cognition and Behaviour; Nijmegen The Netherlands
| | | | - Niklas Mattsson
- Department of Neurology; Skåne University Hospital; Lund Sweden
| | - Piotr Lewczuk
- Department of Psychiatry and Psychotherapy; Universitätsklinikum Erlangen; Friedrich-Alexander Universität Erlangen-Nürnberg; Germany
- Department of Neurodegeneration Diagnostics; Medical University of Bialystok; Poland
| | | | | | - Robert A. Dean
- Department of Pathology and Laboratory Medicine; Indiana University School of Medicine; Indianapolis IN USA
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory; Sahlgrenska University Hospital; Mölndal Sweden
- Department of Psychiatry and Neurochemistry; Sahlgrenska Academy at the University of Gothenburg; Mölndal Sweden
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Abstract
The Alzheimer center of the VU University Medical Center opened in 2000 and was initiated to combine both patient care and research. Together, to date, all patients forming the Amsterdam Dementia Cohort number almost 6,000 individuals. In this cohort profile, we provide an overview of the results produced based on the Amsterdam Dementia Cohort. We describe the main results over the years in each of these research lines: 1) early diagnosis, 2) heterogeneity, and 3) vascular factors. Among the most important research efforts that have also impacted patients' lives and/or the research field, we count the development of novel, easy to use diagnostic measures such as visual rating scales for MRI and the Amsterdam IADL Questionnaire, insight in different subgroups of AD, and findings on incidence and clinical sequelae of microbleeds. Finally, we describe in the outlook how our research endeavors have improved the lives of our patients.
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Affiliation(s)
- Wiesje M. van der Flier
- Department of Neurology, Alzheimer Center, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Philip Scheltens
- Department of Neurology, Alzheimer Center, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands
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Ritchie C, Smailagic N, Noel‐Storr AH, Ukoumunne O, Ladds EC, Martin S. CSF tau and the CSF tau/ABeta ratio for the diagnosis of Alzheimer's disease dementia and other dementias in people with mild cognitive impairment (MCI). Cochrane Database Syst Rev 2017; 3:CD010803. [PMID: 28328043 PMCID: PMC6464349 DOI: 10.1002/14651858.cd010803.pub2] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Research suggests that measurable change in cerebrospinal fluid (CSF) biomarkers occurs years in advance of the onset of clinical symptoms (Beckett 2010). In this review, we aimed to assess the ability of CSF tau biomarkers (t-tau and p-tau) and the CSF tau (t-tau or p-tau)/ABeta ratio to enable the detection of Alzheimer's disease pathology in patients with mild cognitive impairment (MCI). These biomarkers have been proposed as important in new criteria for Alzheimer's disease dementia that incorporate biomarker abnormalities. OBJECTIVES To determine the diagnostic accuracy of 1) CSF t-tau, 2) CSF p-tau, 3) the CSF t-tau/ABeta ratio and 4) the CSF p-tau/ABeta ratio index tests for detecting people with MCI at baseline who would clinically convert to Alzheimer's disease dementia or other forms of dementia at follow-up. SEARCH METHODS The most recent search for this review was performed in January 2013. We searched MEDLINE (OvidSP), Embase (OvidSP), BIOSIS Previews (Thomson Reuters Web of Science), Web of Science Core Collection, including Conference Proceedings Citation Index (Thomson Reuters Web of Science), PsycINFO (OvidSP), and LILACS (BIREME). We searched specialized sources of diagnostic test accuracy studies and reviews. We checked reference lists of relevant studies and reviews for additional studies. We contacted researchers for possible relevant but unpublished data. We did not apply any language or data restriction to the electronic searches. We did not use any methodological filters as a method to restrict the search overall. SELECTION CRITERIA We selected those studies that had prospectively well-defined cohorts with any accepted definition of MCI and with CSF t-tau or p-tau and CSF tau (t-tau or p-tau)/ABeta ratio values, documented at or around the time the MCI diagnosis was made. We also included studies which looked at data from those cohorts retrospectively, and which contained sufficient data to construct two by two tables expressing those biomarker results by disease status. Moreover, studies were only selected if they applied a reference standard for Alzheimer's disease dementia diagnosis, for example, the NINCDS-ADRDA or Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. DATA COLLECTION AND ANALYSIS We screened all titles generated by the electronic database searches. Two review authors independently assessed the abstracts of all potentially relevant studies, and the full papers for eligibility. Two independent assessors performed data extraction and quality assessment. Where data allowed, we derived estimates of sensitivity at fixed values of specificity from the model we fitted to produce the summary receiver operating characteristic (ROC) curve. MAIN RESULTS In total, 1282 participants with MCI at baseline were identified in the 15 included studies of which 1172 had analysable data; 430 participants converted to Alzheimer's disease dementia and 130 participants to other forms of dementia. Follow-up ranged from less than one year to over four years for some participants, but in the majority of studies was in the range one to three years. Conversion to Alzheimer's disease dementia The accuracy of the CSF t-tau was evaluated in seven studies (291 cases and 418 non-cases).The sensitivity values ranged from 51% to 90% while the specificity values ranged from 48% to 88%. At the median specificity of 72%, the estimated sensitivity was 75% (95% CI 67 to 85), the positive likelihood ratio was 2.72 (95% CI 2.43 to 3.04), and the negative likelihood ratio was 0.32 (95% CI 0.22 to 0.47).Six studies (164 cases and 328 non-cases) evaluated the accuracy of the CSF p-tau. The sensitivities were between 40% and 100% while the specificities were between 22% and 86%. At the median specificity of 47.5%, the estimated sensitivity was 81% (95% CI: 64 to 91), the positive likelihood ratio was 1.55 (CI 1.31 to 1.84), and the negative likelihood ratio was 0.39 (CI: 0.19 to 0.82).Five studies (140 cases and 293 non-cases) evaluated the accuracy of the CSF p-tau/ABeta ratio. The sensitivities were between 80% and 96% while the specificities were between 33% and 95%. We did not conduct a meta-analysis because the studies were few and small. Only one study reported the accuracy of CSF t-tau/ABeta ratio.Our findings are based on studies with poor reporting. A significant number of studies had unclear risk of bias for the reference standard, participant selection and flow and timing domains. According to the assessment of index test domain, eight of 15 studies were of poor methodological quality.The accuracy of these CSF biomarkers for 'other dementias' had not been investigated in the included primary studies. Investigation of heterogeneity The main sources of heterogeneity were thought likely to be reference standards used for the target disorders, sources of recruitment, participant sampling, index test methodology and aspects of study quality (particularly, inadequate blinding).We were not able to formally assess the effect of each potential source of heterogeneity as planned, due to the small number of studies available to be included. AUTHORS' CONCLUSIONS The insufficiency and heterogeneity of research to date primarily leads to a state of uncertainty regarding the value of CSF testing of t-tau, p-tau or p-tau/ABeta ratio for the diagnosis of Alzheimer's disease in current clinical practice. Particular attention should be paid to the risk of misdiagnosis and overdiagnosis of dementia (and therefore over-treatment) in clinical practice. These tests, like other biomarker tests which have been subject to Cochrane DTA reviews, appear to have better sensitivity than specificity and therefore might have greater utility in ruling out Alzheimer's disease as the aetiology to the individual's evident cognitive impairment, as opposed to ruling it in. The heterogeneity observed in the few studies awaiting classification suggests our initial summary will remain valid. However, these tests may have limited clinical value until uncertainties have been addressed. Future studies with more uniformed approaches to thresholds, analysis and study conduct may provide a more homogenous estimate than the one that has been available from the included studies we have identified.
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Affiliation(s)
- Craig Ritchie
- University of EdinburghCentre for Clinical Brain SciencesEdinburghUK
| | - Nadja Smailagic
- University of CambridgeInstitute of Public HealthForvie SiteRobinson WayCambridgeUKCB2 0SR
| | - Anna H Noel‐Storr
- University of OxfordRadcliffe Department of MedicineRoom 4401c (4th Floor)John Radcliffe Hospital, HeadingtonOxfordUKOX3 9DU
| | - Obioha Ukoumunne
- University of Exeter Medical School, University of ExeterNIHR CLAHRC South West Peninsula (PenCLAHRC)Veysey BuildingSalmon Pool LaneExeterDevonUKEX2 4SG
| | - Emma C Ladds
- North Bristol NHS TrustSouthmead hospitalBristolUK
| | - Steven Martin
- University of CambridgeInstitute of Public HealthForvie SiteRobinson WayCambridgeUKCB2 0SR
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Kester MI, Teunissen CE, Crimmins DL, Herries EM, Ladenson JH, Scheltens P, van der Flier WM, Morris JC, Holtzman DM, Fagan AM. Neurogranin as a Cerebrospinal Fluid Biomarker for Synaptic Loss in Symptomatic Alzheimer Disease. JAMA Neurol 2016; 72:1275-80. [PMID: 26366630 DOI: 10.1001/jamaneurol.2015.1867] [Citation(s) in RCA: 172] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
IMPORTANCE Neurogranin (NGRN) seems to be a promising novel cerebrospinal fluid (CSF) biomarker for synaptic loss; however, clinical, and especially longitudinal, data are sparse. OBJECTIVE To examine the utility of NGRN, with repeated CSF sampling, for diagnosis, prognosis, and monitoring of Alzheimer disease (AD). DESIGN, SETTING, AND PARTICIPANTS Longitudinal study of consecutive patients who underwent 2 lumbar punctures between the beginning of 1995 and the end of 2010 within the memory clinic-based Amsterdam Dementia Cohort. The study included 163 patients: 37 cognitively normal participants (mean [SE] age, 64 [2] years; 38% female; and mean [SE] Mini-Mental State Examination [MMSE] score, 28 [0.3]), 61 patients with mild cognitive impairment (MCI) (mean [SE] age, 68 [1] years; 38% female; and mean [SE] MMSE score, 27 [0.3]), and 65 patients with AD (mean [SE] age, 65 [1] years; 45% female; and mean [SE] MMSE score, 22 [0.7]). The mean (SE) interval between lumbar punctures was 2.0 (0.1) years, and the mean (SE) duration of cognitive follow-up was 3.8 (0.2) years. Measurements of CSF NGRN levels were obtained in January and February 2014. MAIN OUTCOME AND MEASURE Levels of NGRN in CSF samples. RESULTS Baseline CSF levels of NGRN in patients with AD (median level, 2381 pg/mL [interquartile range, 1651-3416 pg/mL]) were higher than in cognitively normal participants (median level, 1712 pg/mL [interquartile range, 1206-2724 pg/mL]) (P = .04). Baseline NGRN levels were highly correlated with total tau and tau phosphorylated at threonine 181 in all patient groups (all P < .001), but not with Aβ42. Baseline CSF levels of NGRN were also higher in patients with MCI who progressed to AD (median level, 2842 pg/mL [interquartile range, 1882-3950 pg/mL]) compared with those with stable MCI (median level, 1752 pg/mL [interquartile range, 1024-2438 pg/mL]) (P = .004), and they were predictive of progression from MCI to AD (hazard ratio, 1.8 [95% CI, 1.1-2.9]; stratified by tertiles). Linear mixed-model analyses demonstrated that within-person levels of NGRN increased over time in cognitively normal participants (mean [SE] level, 90 [45] pg/mL per year; P < .05) but not in patients with MCI or AD. CONCLUSIONS AND RELEVANCE Neurogranin is a promising biomarker for AD because levels were elevated in patients with AD compared with cognitively normal participants and predicted progression from MCI to AD. Within-person levels of NGRN increased in cognitively normal participants but not in patients with later stage MCI or AD, which suggests that NGRN may reflect presymptomatic synaptic dysfunction or loss.
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Affiliation(s)
- Maartje I Kester
- Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands
| | - Charlotte E Teunissen
- Department of Clinical Chemistry, VU University Medical Center, Amsterdam, the Netherlands
| | - Daniel L Crimmins
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, Missouri
| | - Elizabeth M Herries
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, Missouri
| | - Jack H Ladenson
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, Missouri
| | - Philip Scheltens
- Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands4Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
| | - John C Morris
- The Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St Louis, Missouri6Department of Neurology, Washington University School of Medicine, St Louis, Missouri7Hope Center for Neurological Disorders, Washington Universit
| | - David M Holtzman
- The Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St Louis, Missouri6Department of Neurology, Washington University School of Medicine, St Louis, Missouri7Hope Center for Neurological Disorders, Washington Universit
| | - Anne M Fagan
- The Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St Louis, Missouri6Department of Neurology, Washington University School of Medicine, St Louis, Missouri7Hope Center for Neurological Disorders, Washington Universit
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Kester MI, Teunissen CE, Sutphen C, Herries EM, Ladenson JH, Xiong C, Scheltens P, van der Flier WM, Morris JC, Holtzman DM, Fagan AM. Cerebrospinal fluid VILIP-1 and YKL-40, candidate biomarkers to diagnose, predict and monitor Alzheimer's disease in a memory clinic cohort. Alzheimers Res Ther 2015; 7:59. [PMID: 26383836 PMCID: PMC4574487 DOI: 10.1186/s13195-015-0142-1] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 08/14/2015] [Indexed: 01/11/2023]
Abstract
Introduction We examined the utility of cerebrospinal fluid (CSF) proteins, Chitinase-3-like protein 1 (CHI3L1 or YKL-40), a putative marker of inflammation, and Visinin-like protein-1 (VILIP-1), a marker for neuronal injury, for diagnostic classification and monitoring of disease progression in a memory clinic cohort. Methods CSF levels of YKL-40 and VILIP-1 were measured in 37 cognitively normal, 61 Mild Cognitive Impairment (MCI) and 65 Alzheimer’s disease (AD) patients from the memory clinic-based Amsterdam Dementia Cohort who underwent two lumbar punctures, with minimum interval of 6 months and a mean(SE) interval of 2.0(0.1) years. Mean(SE) cognitive follow-up was 3.8 (0.2) years. ANOVA was used to compare baseline differences of log-transformed CSF measures. Cox proportional hazard models were used to evaluate disease progression as a function of CSF tertiles. Linear mixed models were used to evaluate longitudinal change over time. All analyses were sex and age adjusted. Results Baseline levels of YKL-40, but not VILIP-1, were higher in MCI and AD patients compared to cognitively normal individuals (mean (SE) pg/mL, 304 (16) and 288 (12) vs. 231 (16), p = 0.03 and p = 0.006). Baseline levels of both YKL-40 and VILIP-1 in MCI predicted progression to AD (HR 95 % CI = 3.0 (1.1–7.9) and 4.4 (1.5–13.0), respectively, for highest vs. lowest tertile). YKL-40 increased longitudinally in patients with MCI and AD (mean (SE) pg/mL per year, 8.9 (3.0) and 7.1 (3.1), respectively), but not in cognitively normal individuals, whereas levels of VILIP-1 increased only in MCI (mean (SE), 10.7 (2.6) pg/mL per year). Conclusions CSF levels of YKL-40 may have utility for discriminating between cognitively normal individuals and patients with MCI or AD. Increased levels of both YKL-40 and VILIP-1 may be associated with disease progression. These CSF biomarkers should be considered for future evaluation in the characterization of the natural history of AD.
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Affiliation(s)
- Maartje I Kester
- Alzheimer Center and Department of Neurology, VU University Medical Center, PO box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - Charlotte E Teunissen
- Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands.
| | - Courtney Sutphen
- The Knight Alzheimer's Disease Research Center, Washington University School of Medicine, 660 South Euclid, Campus Box 8111, St Louis, 63110, MO, USA. .,Department of Neurology, Washington University School of Medicine, 660 South Euclid, Campus Box 8111, St Louis, 63110, MO, USA. .,Hope Center for Neurological Disorders, Washington University School of Medicine, 660 South Euclid, Campus Box 8111, St Louis, 63110, MO, USA.
| | - Elizabeth M Herries
- Department of Pathology and Immunology, Washington University School of Medicine, 660 South Euclid, Campus Box 8111, St Louis, 63110, MO, USA.
| | - Jack H Ladenson
- Department of Pathology and Immunology, Washington University School of Medicine, 660 South Euclid, Campus Box 8111, St Louis, 63110, MO, USA.
| | - Chengjie Xiong
- The Knight Alzheimer's Disease Research Center, Washington University School of Medicine, 660 South Euclid, Campus Box 8111, St Louis, 63110, MO, USA. .,Division of Biostatistics, Washington University School of Medicine, 660 South Euclid, Campus Box 8111, St Louis, 63110, MO, USA.
| | - Philip Scheltens
- Alzheimer Center and Department of Neurology, VU University Medical Center, PO box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - Wiesje M van der Flier
- Alzheimer Center and Department of Neurology, VU University Medical Center, PO box 7057, 1007 MB, Amsterdam, The Netherlands. .,Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
| | - John C Morris
- The Knight Alzheimer's Disease Research Center, Washington University School of Medicine, 660 South Euclid, Campus Box 8111, St Louis, 63110, MO, USA. .,Department of Neurology, Washington University School of Medicine, 660 South Euclid, Campus Box 8111, St Louis, 63110, MO, USA. .,Hope Center for Neurological Disorders, Washington University School of Medicine, 660 South Euclid, Campus Box 8111, St Louis, 63110, MO, USA.
| | - David M Holtzman
- The Knight Alzheimer's Disease Research Center, Washington University School of Medicine, 660 South Euclid, Campus Box 8111, St Louis, 63110, MO, USA. .,Department of Neurology, Washington University School of Medicine, 660 South Euclid, Campus Box 8111, St Louis, 63110, MO, USA. .,Hope Center for Neurological Disorders, Washington University School of Medicine, 660 South Euclid, Campus Box 8111, St Louis, 63110, MO, USA.
| | - Anne M Fagan
- The Knight Alzheimer's Disease Research Center, Washington University School of Medicine, 660 South Euclid, Campus Box 8111, St Louis, 63110, MO, USA. .,Department of Neurology, Washington University School of Medicine, 660 South Euclid, Campus Box 8111, St Louis, 63110, MO, USA. .,Hope Center for Neurological Disorders, Washington University School of Medicine, 660 South Euclid, Campus Box 8111, St Louis, 63110, MO, USA.
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Babić M, Vogrinc Z, Diana A, Klepac N, Borovečki F, Hof PR, Simić G. Comparison of two commercial enzyme-linked immunosorbent assays for cerebrospinal fluid measurement of amyloid β 1-42 and total tau. Transl Neurosci 2013; 4. [PMID: 24376914 DOI: 10.2478/s13380-013-0123-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Amyloid β1-42 (Aβ1-42), total tau (t-tau), and phosphorylated tau (p-tau) are the main cerebrospinal fluid (CSF) biomarkers for early diagnosis of Alzheimer's disease (AD). Detection of AD is critically important in view of the growing number of potential new drugs that may influence the course of the disease in its early phases. However, cut-off levels for these CSF biomarkers have not yet been established. Variability in absolute concentrations of AD biomarkers is high among studies and significant differences were noticed even within the same datasets. Variability in biomarkers levels in these assays may be due to many aspects of operating procedures. Standardization of pre-analytical and analytical procedures in collection, treatment, and storage of CSF samples is crucial because differences in sample handling can drastically influence results. Multicenter studies showed that usage of ELISA kits from different manufacturers also affects outcome. So far only very few studies tested the efficiency of ELISA kits produced by different vendors. In this study, the performance of Innogenetics (Gent, Belgium) and Invitrogen (Camarillo, CA, USA) ELISA kits for t-tau and Aβ1-42 was tested. Passing-Bablok analysis showed significant differences between Invitrogen and Innogenetics ELISA methods, making it impossible to use them interchangeably.
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Kester MI, Scheffer PG, Koel-simmelink MJ, Twaalfhoven H, Verwey NA, Veerhuis R, Twisk JW, Bouwman FH, Blankenstein MA, Scheltens P, Teunissen C, van der Flier WM. Serial CSF sampling in Alzheimer's disease: specific versus non-specific markers. Neurobiol Aging 2012; 33:1591-8. [DOI: 10.1016/j.neurobiolaging.2011.05.013] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2010] [Revised: 05/06/2011] [Accepted: 05/25/2011] [Indexed: 11/19/2022]
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Verwey NA, van der Flier WM, Blennow K, Clark C, Sokolow S, De Deyn PP, Galasko D, Hampel H, Hartmann T, Kapaki E, Lannfelt L, Mehta PD, Parnetti L, Petzold A, Pirttila T, Saleh L, Skinningsrud A, Swieten JCV, Verbeek MM, Wiltfang J, Younkin S, Scheltens P, Blankenstein MA. A worldwide multicentre comparison of assays for cerebrospinal fluid biomarkers in Alzheimer's disease. Ann Clin Biochem 2009; 46:235-40. [PMID: 19342441 DOI: 10.1258/acb.2009.008232] [Citation(s) in RCA: 136] [Impact Index Per Article: 9.1] [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: 11/18/2022]
Abstract
BACKGROUND Different cerebrospinal fluid (CSF) amyloid-beta 1-42 (Abeta(1-42)), total Tau (Tau) and Tau phosphorylated at threonine 181 (P-Tau) levels are reported, but currently there is a lack of quality control programmes. The aim of this study was to compare the measurements of these CSF biomarkers, between and within centres. METHODS Three CSF-pool samples were distributed to 13 laboratories in 2004 and the same samples were again distributed to 18 laboratories in 2008. In 2004 six laboratories measured Abeta(1-42), Tau and P-Tau and seven laboratories measured one or two of these marker(s) by enzyme-linked immunosorbent assays (ELISAs). In 2008, 12 laboratories measured all three markers, three laboratories measured one or two marker(s) by ELISAs and three laboratories measured the markers by Luminex. RESULTS In 2004, the ELISA intercentre coefficients of variance (interCV) were 31%, 21% and 13% for Abeta(1-42), Tau and P-Tau, respectively. These were 37%, 16% and 15%, respectively, in 2008. When we restricted the analysis to the Innotest (N = 13) for Abeta(1-42), lower interCV were calculated (22%). The centres that participated in both years (N = 9) showed interCVs of 21%, 15% and 9% and intra-centre coefficients (intraCV) of variance of 25%,18% and 7% in 2008. CONCLUSIONS The highest variability was found for Abeta(1-42). The variabilities for Tau and P-Tau were lower in both years. The centres that participated in both years showed a high intraCV comparable to their interCV, indicating that there is not only a high variation between but also within centres. Besides a uniform standardization of (pre)analytical procedures, the same assay should be used to decrease the inter/intracentre variation.
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Affiliation(s)
- N A Verwey
- Department of Clinical Chemistry, VU University Medical Center, , HV, The Netherlands.
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