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对阿尔茨海默病的高性能粉样β生物标志物

Akinori Nakamura¹, Naoki Kaneko², Victor L Villemagne^3,4

¹Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan.

|February 9, 2018

概括

新的血液检测可以准确地检测阿尔茨海默氏症早期的大脑变化. 这些血生物标志物为PET扫描和CSF测试提供了具有成本效益,可扩展的替代方案,用于识别粉样β沉积.

科学领域:

神经学与神经科学
生物标志物发现
医疗诊断

背景情况:

阿尔茨海默病 (AD) 治疗在早期最有效,需要早期检测生物标志物.
目前验证的检测大脑粉样β沉积的方法包括粉样β正子发射断层扫描 (PET) 和脑脊液 (CSF) 分析.
对于临床试验和诊断来说,一种低侵袭性,高成本的血基生物标志物是非常理想的.

研究的目的:

开发和验证用于检测大脑粉样β沉积的高性能血生物标志物.
评估血粉样蛋白-β (Aβ) 比率在预测个体粉样蛋白-β阳性或负性的临床效用.
评估这些血基生物标志物的性能与已知的方法,如粉样β-PET成像.

主要方法:

使用免疫沉与质谱相结合测量粉样β前体蛋白 (APP) _669-711/粉样β (Aβ) _1-42和Aβ_1-40/Aβ_1-42的比率.
在发现数据集 (日本,n=121) 和验证数据集 (澳大利亚,n=252) 中测试生物标志物的性能,包括各种认知状态.
血生物标志物结果与粉样β-PET成像 (包括C标记的匹兹堡化合物-B (PIB) -PET) 和脑液Aβ-1-42水平的比较.

主要成果:

在两个数据集中,血Aβ比率在预测大脑粉样蛋白-β负担方面表现出很高的表现.
与PIB-PET相比,一个复合生物标志物在受体操作特征曲线 (AUC) 下获得了高面积 (发现率:96.7%,验证率:94.1%),准确度约为90%.
测试生物标志物与粉样β-PET负担和脑脊液Aβ_1-42水平有显著的相关性.

结论:

基于等离子体的粉样β生物标志物显示出在个体水平上预测大脑粉样β负担的显著潜力.
与目前的PET和CSF方法相比,这些生物标志物在成本效益和可扩展性方面具有优势.
开发的血生物标志物可以使更广泛的临床准入,并促进有效的阿尔茨海默病人口查.

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