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Sánchez-Juan P, Valeriano-Lorenzo E, Ruiz-González A, Pastor AB, Rodrigo Lara H, López-González F, Zea-Sevilla MA, Valentí M, Frades B, Ruiz P, Saiz L, Burgueño-García I, Calero M, Del Ser T, Rábano A. Serum GFAP levels correlate with astrocyte reactivity, post-mortem brain atrophy and neurofibrillary tangles. Brain 2024:awae035. [PMID: 38634687 DOI: 10.1093/brain/awae035] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 12/28/2023] [Accepted: 01/21/2024] [Indexed: 04/19/2024] Open
Abstract
Glial fibrillary acidic protein (GFAP), a proxy of astrocyte reactivity, has been proposed as biomarker of Alzheimer's disease. However, there is limited information about the correlation between blood biomarkers and post-mortem neuropathology. In a single-centre prospective clinicopathological cohort of 139 dementia patients, for which the time-frame between GFAP level determination and neuropathological assessment was exceptionally short (on average 139 days), we analysed this biomarker, measured at three time points, in relation to proxies of disease progression such as cognitive decline and brain weight. Most importantly, we investigated the use of blood GFAP to detect the neuropathological hallmarks of Alzheimer's disease, while accounting for potential influences of the most frequent brain co-pathologies. The main findings demonstrated an association between serum GFAP level and post-mortem tau pathology (β = 12.85; P < 0.001) that was independent of amyloid deposits (β = 13.23; P = 0.02). A mediation analysis provided additional support for the role of astrocytic activation as a link between amyloid and tau pathology in Alzheimer's disease. Furthermore, a negative correlation was observed between pre-mortem serum GFAP and brain weight at post-mortem (r = -0.35; P < 0.001). This finding, together with evidence of a negative correlation with cognitive assessments (r = -0.27; P = 0.005), supports the role of GFAP as a biomarker for disease monitoring, even in the late phases of Alzheimer's disease. Moreover, the diagnostic performance of GFAP in advanced dementia patients was explored, and its discriminative power (area under the receiver operator characteristic curve at baseline = 0.91) in differentiating neuropathologically-confirmed Alzheimer's disease dementias from non-Alzheimer's disease dementias was determined, despite the challenging scenario of advanced age and frequent co-pathologies in these patients. Independently of Alzheimer's disease, serum GFAP levels were shown to be associated with two other pathologies targeting the temporal lobes-hippocampal sclerosis (β = 3.64; P = 0.03) and argyrophilic grain disease (β = -6.11; P = 0.02). Finally, serum GFAP levels were revealed to be correlated with astrocyte reactivity, using the brain GFAP-immunostained area as a proxy (ρ = 0.21; P = 0.02). Our results contribute to increasing evidence suggesting a role for blood GFAP as an Alzheimer's disease biomarker, and the findings offer mechanistic insights into the relationship between blood GFAP and Alzheimer's disease neuropathology, highlighting its ties with tau burden. Moreover, the data highlighting an independent association between serum GFAP levels and other neuropathological lesions provide information for clinicians to consider when interpreting test results. The longitudinal design and correlation with post-mortem data reinforce the robustness of our findings. However, studies correlating blood biomarkers and neuropathological assessments are still scant, and further research is needed to replicate and validate these results in diverse populations.
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Affiliation(s)
- Pascual Sánchez-Juan
- Alzheimer's Centre Reina Sofia-CIEN Foundation-ISCIII, Research Platforms, 28031 Madrid, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, 28029 Madrid, Spain
| | | | - Alicia Ruiz-González
- Alzheimer's Centre Reina Sofia-CIEN Foundation-ISCIII, Research Platforms, 28031 Madrid, Spain
| | - Ana Belén Pastor
- Alzheimer's Centre Reina Sofia-CIEN Foundation-ISCIII, Research Platforms, 28031 Madrid, Spain
| | - Hector Rodrigo Lara
- Banco de Cerebros de la Región de Murcia, Neuropathology Department, 30120 Murcia, Spain
| | | | | | - Meritxell Valentí
- Alzheimer's Centre Reina Sofia-CIEN Foundation-ISCIII, Research Platforms, 28031 Madrid, Spain
| | - Belen Frades
- Alzheimer's Centre Reina Sofia-CIEN Foundation-ISCIII, Research Platforms, 28031 Madrid, Spain
| | - Paloma Ruiz
- Alzheimer's Centre Reina Sofia-CIEN Foundation-ISCIII, Research Platforms, 28031 Madrid, Spain
| | - Laura Saiz
- Alzheimer's Centre Reina Sofia-CIEN Foundation-ISCIII, Research Platforms, 28031 Madrid, Spain
| | - Iván Burgueño-García
- Alzheimer's Centre Reina Sofia-CIEN Foundation-ISCIII, Research Platforms, 28031 Madrid, Spain
| | - Miguel Calero
- Alzheimer's Centre Reina Sofia-CIEN Foundation-ISCIII, Research Platforms, 28031 Madrid, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, 28029 Madrid, Spain
- Chronic Disease Programme, Instituto de Salud Carlos III, Madrid, Spain
| | - Teodoro Del Ser
- Alzheimer's Centre Reina Sofia-CIEN Foundation-ISCIII, Research Platforms, 28031 Madrid, Spain
| | - Alberto Rábano
- Alzheimer's Centre Reina Sofia-CIEN Foundation-ISCIII, Research Platforms, 28031 Madrid, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, 28029 Madrid, Spain
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Cobelo-Gómez S, Sánchez-Iglesias S, Rábano A, Senra A, Aguiar P, Gómez-Lado N, García-Varela L, Burgueño-García I, Lampón-Fernández L, Fernández-Pombo A, Díaz-López EJ, Prado-Moraña T, San Millán B, Araújo-Vilar D. A murine model of BSCL2-associated Celia's encephalopathy. Neurobiol Dis 2023; 187:106300. [PMID: 37717662 DOI: 10.1016/j.nbd.2023.106300] [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: 06/03/2023] [Revised: 09/06/2023] [Accepted: 09/14/2023] [Indexed: 09/19/2023] Open
Abstract
Celia's encephalopathy or progressive encephalopathy with/without lipodystrophy is a neurodegenerative disease with a fatal prognosis in childhood. It is generally caused by the c.985C > T variant in the BSCL2 gene, leading to the skipping of exon 7 and resulting in an aberrant seipin protein (Celia-seipin). To precisely define the temporal evolution and the mechanisms involved in neurodegeneration, lipodystrophy and fatty liver in Celia's encephalopathy, our group has generated the first global knock-in murine model for the aberrant human transcript of BSCL2 (Bscl2Celia/Celia) using a strategy based on the Cre/loxP recombination system. In order to carry out a characterization at the neurological, adipose tissue and hepatic level, behavioral studies, brain PET, metabolic, histological and molecular studies were performed. Around 12% of homozygous and 5.4% of heterozygous knock-in mice showed severe neurological symptoms early in life, and their life expectancy was dramatically reduced. Severe generalized lipodystrophy and mild hepatic steatosis were present in these affected animals, while serum triglycerides and glucose metabolism were normal, with no insulin resistance. Furthermore, the study revealed a reduction in brain glucose uptake, along with patchy loss of Purkinje cells and the presence of intranuclear inclusions in cerebellar cortex cells. Homozygous, non-severely-affected knock-in mice showed a decrease in locomotor activity and greater anxiety compared with their wild type littermates. Bscl2Celia/Celia is the first murine model of Celia's encephalopathy which partially recapitulates the phenotype and severe neurodegenerative picture suffered by these patients. This model will provide a helpful tool to investigate both the progressive encephalopathy with/without lipodystrophy and congenital generalized lipodystrophy.
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Affiliation(s)
- Silvia Cobelo-Gómez
- UETeM-Molecular Pathology Group. Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, IDIS-CIMUS, University of Santiago de Compostela, Spain
| | - Sofía Sánchez-Iglesias
- UETeM-Molecular Pathology Group. Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, IDIS-CIMUS, University of Santiago de Compostela, Spain
| | - Alberto Rábano
- Alzheimer's Disease Research Unit, CIEN Foundation, Queen Sofia Foundation Alzheimer Center, Madrid, Spain
| | - Ana Senra
- Department of Physiology, CIMUS, University of Santiago de Compostela, Spain
| | - Pablo Aguiar
- Molecular Imaging and Medical Physics, University of Santiago de Compostela-IDIS, Spain; Nuclear Medicine and Molecular Imaging Group, IDIS, University Clinical Hospital of Santiago de Compostela, Spain
| | - Noemí Gómez-Lado
- Molecular Imaging and Medical Physics, University of Santiago de Compostela-IDIS, Spain; Nuclear Medicine and Molecular Imaging Group, IDIS, University Clinical Hospital of Santiago de Compostela, Spain
| | - Lara García-Varela
- Molecular Imaging and Medical Physics, University of Santiago de Compostela-IDIS, Spain; Nuclear Medicine and Molecular Imaging Group, IDIS, University Clinical Hospital of Santiago de Compostela, Spain
| | - Iván Burgueño-García
- Alzheimer's Disease Research Unit, CIEN Foundation, Queen Sofia Foundation Alzheimer Center, Madrid, Spain
| | - Laura Lampón-Fernández
- UETeM-Molecular Pathology Group. Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, IDIS-CIMUS, University of Santiago de Compostela, Spain
| | - Antía Fernández-Pombo
- UETeM-Molecular Pathology Group. Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, IDIS-CIMUS, University of Santiago de Compostela, Spain; Division of Endocrinology and Nutrition, University Clinical Hospital of Santiago de Compostela, Spain
| | - Everardo Josué Díaz-López
- UETeM-Molecular Pathology Group. Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, IDIS-CIMUS, University of Santiago de Compostela, Spain; Division of Endocrinology and Nutrition, University Clinical Hospital of Santiago de Compostela, Spain
| | - Teresa Prado-Moraña
- UETeM-Molecular Pathology Group. Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, IDIS-CIMUS, University of Santiago de Compostela, Spain; Division of Endocrinology and Nutrition, University Clinical Hospital of Santiago de Compostela, Spain
| | - Beatriz San Millán
- Grupo de Enfermedades Raras y Medicina Pediátrica, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo, Spain; Pathology Department, Alvaro Cunqueiro Hospital, Vigo, Spain
| | - David Araújo-Vilar
- UETeM-Molecular Pathology Group. Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, IDIS-CIMUS, University of Santiago de Compostela, Spain; Division of Endocrinology and Nutrition, University Clinical Hospital of Santiago de Compostela, Spain.
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Pérez-García F, Vázquez-Morón S, Burgueño-García I, José Muñoz-Gómez M, Zea-Sevilla MA, Calero M, Martínez I, Rábano A, Resino S. Hepatitis E virus seroprevalence is associated with neurodegenerative disorders in older people with dementia: a case-control study. J Infect Dis 2022; 227:873-877. [PMID: 35759220 DOI: 10.1093/infdis/jiac268] [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: 03/03/2022] [Revised: 05/16/2022] [Accepted: 06/24/2022] [Indexed: 11/12/2022] Open
Abstract
In this case-control study, we evaluated the association between serum antibodies against hepatitis E virus (HEV) and central nervous system (CNS) neurodegenerative disorders (NDs) in older people with dementia. The presence of anti-HEV antibodies was related to a higher adjusted odds ratio (aOR) of having CNS-NDs by neuropathological diagnosis (aOR = 2.13; p = 0.007) and clinical/neuropathological diagnosis (aOR = 1.84; p = 0.017). Besides, serum anti-HEV antibodies were directly related to neuropathological injury (higher vascular pathology, aOR = 1.97; p = 0.006) and higher probability of having Alzheimer-type pathology (aOR = 1.84; p = 0.022). In conclusion, the presence of anti-HEV antibodies was related to higher odds of CNS-NDs and neuropathological injury in older people.
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Affiliation(s)
- Felipe Pérez-García
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain.,Servicio de Microbiología Clínica, Hospital Universitario Príncipe de Asturias, Madrid, Spain.,Universidad de Alcalá, Facultad de Medicina, Departamento de Biomedicina y Biotecnología, Madrid, Spain
| | - Sonia Vázquez-Morón
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain
| | - Iván Burgueño-García
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - María José Muñoz-Gómez
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain
| | - María Ascensión Zea-Sevilla
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Miguel Calero
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain.,Unidad Funcional Investigación de Enfermedades Crónicas, Instituto de Salud Carlos III, Majadahonda, Spain.,Banco de Tejidos, Departamento de Neuropatología, Fundación Centro de Investigación en Enfermedades Neurológicas, Instituto de Salud Carlos III (FCIEN-ISCIII), Madrid, Spain
| | - Isidoro Martínez
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Alberto Rábano
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain.,Banco de Tejidos, Departamento de Neuropatología, Fundación Centro de Investigación en Enfermedades Neurológicas, Instituto de Salud Carlos III (FCIEN-ISCIII), Madrid, Spain
| | - Salvador Resino
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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