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Digital seed amplification assay for TDP-43 aggregate quantification in CSF.

Ella Borberg1,2,3, Zoe Swank1,2,3, Tal Gilboa1,2,3

  • 1Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|May 5, 2026
PubMed
Summary
This summary is machine-generated.

A new digital seed amplification assay (dSAA) precisely quantifies transactive response deoxyribonucleic acid binding protein 43 (TDP-43) seeds in cerebrospinal fluid. This sensitive diagnostic tool shows potential for identifying frontotemporal lobar dementia with TDP (FTLD-TDP).

Keywords:
cerebrospinal fluidfrontotemporal lobar dementiaseed amplification assaytransactive response deoxyribonucleic acid binding protein 43

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Area of Science:

  • Neuroscience
  • Biochemistry
  • Biotechnology

Background:

  • Dementia is often caused by misfolded protein aggregates, with subtypes presenting overlapping symptoms that complicate diagnosis.
  • Accurate diagnosis of dementia subtypes is challenging without reliable biomarkers, hindering effective drug development.
  • Transactive response deoxyribonucleic acid binding protein 43 (TDP-43) pathology is implicated in several neurodegenerative diseases.

Purpose of the Study:

  • To develop a precise and sensitive method for quantifying TDP-43 seeds in cerebrospinal fluid (CSF).
  • To establish a diagnostic tool for frontotemporal lobar dementia with TDP (FTLD-TDP) and related conditions.

Main Methods:

  • Development of a digital seed amplification assay (dSAA) utilizing nanoliter compartments.
  • Isolation and precise quantification of individual TDP-43 protein aggregates in CSF samples.
  • Testing of 40 CSF samples from FTLD-TDP patients and healthy controls.

Main Results:

  • The dSAA demonstrated high sensitivity in detecting TDP-43 seeds.
  • Elevated TDP-43 seed concentrations were found in FTLD-TDP patients compared to controls.
  • Seed concentrations correlated with disease severity in FTLD-TDP patients.

Conclusions:

  • The dSAA is a novel, quantitative, and high-sensitivity assay for TDP-43 seeds in CSF.
  • The assay offers single-aggregate resolution with low limits of detection and quantification.
  • This technology provides a foundation for diagnostic and monitoring tools for TDP-43-related diseases like FTLD-TDP.