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Influence of cognitive impairment and race on plasma p-Tau217 in two diverse cohorts
Ashima Nayyar1,2, Mei-Ling Li1,2, Victor Sotelo1,2
1Department of Neurology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Introduction:
Factors influencing plasma Alzheimer's disease (AD) biomarkers remain incompletely understood. Here we evaluated Fujirebio plasma p-Tau217 in two diverse cohorts among whom 91% underwent cerebrospinal fluid (CSF) analysis.
Methods:
Non-Hispanic White (NHW, n = 113), Black/African American (B/AA, n = 66), and Chinese American (ChA, n = 38) participants recruited from two universities were included. We examined if plasma p-Tau217 correlated with CSF and clinical factors, differed between racial groups, and associated with novel CSF proteins.
Results:
CSF p-Tau181 strongly correlated with CSF p-Tau217 (R2 = 0.912) which moderately correlated with plasma p-Tau217 (R2 = 0.694). Plasma p-Tau217 levels were higher with greater cognitive impairment but lower in B/AA than NHW participants even after adjusting for CSF p-Tau181. This resulted in greater positive predictive value for NHW than B/AA participants, and could be mediated by complement or lysosomal pathways.
Discussion:
Severity of cognitive impairment and race both influence plasma p-Tau217 levels beyond race-associated differences in CSF p-Tau181.
Highlights:
Cognitive impairment associates with plasma p-Tau217 independent of CSF biomarkers. Black/African Americans had lower plasma p-Tau217 than non-Hispanic White Americans. CSF p-Tau181 could not explain lower plasma p-Tau217 in Black/African Americans. Plasma p-Tau217 difference results in more false positive cases according to race. Novel CSF processes were associated with race-related plasma p-Tau217 difference.
