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预测阿尔茨海默病的神经病理变化的等离子体生物标志物
Camilo Bermudez1, Jonathan Graff-Radford2, Jeremy A Syrjanen3
1Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55902, USA. bermudeznoguera.camilo@mayo.edu.
Acta neuropathologica
|June 3, 2023
概括
像GFAP和p-tau181这样的等离子体生物标志物,结合认知得分,有效地预测阿尔茨海默氏症的神经病理学,包括布拉克分期和神经质斑块得分,有助于早期检测.
科学领域:
- 神经学 神经学
- 生物标志物研究 生物标志物研究
- 老年学是一门学科.
背景情况:
- 阿尔茨海默病 (AD) 诊断依赖于临床评估,但血生物标志物正在出现用于预后.
- 基于人群的尸检研究对于验证血生物标志物对神经病理变化的验证至关重要.
- 使用可访问的血标志物预测AD神经病理仍然是研究的一个活跃领域.
研究的目的:
- 评估临床上可用的血生物标志物在预测阿尔茨海默氏症关键神经病理特征方面的有用性.
- 评估血Aβ42 / 40比率,p-tau181,GFAP和NfL的预测能力,用于布拉克分期,神经质斑块得分,塔尔阶段和整体AD神经病理变化 (ADNC).
主要方法:
- 一项基于人口的前性研究,涉及350名参与者,尸检和死前血生物标志物数据.
- 使用了Quanterix抗体测定Aβ42/40比率,p-tau181,GFAP和NfL.
- 采用经过交叉验证的物流回归与变量选择,结合人口和认知数据 (Mayo-PACC).
主要成果:
- 通过GFAP,NfL,p-tau181,APOE ε4状态和Mayo-PACC (CV AUC=0.798) 最好预测ADNC的情况.
- 布拉克分期使用GFAP,p-tau181和认知得分 (CV AUC=0.774);神经性斑块得分使用Aβ42/40,p-tau181,GFAP和NfL (CV AUC=0.770).
- GFAP和p-tau提供了斑块和Braak分数的不同信息,而Aβ42/40和NfL预测了斑块分数;认知状态改善了预测.
结论:
- 血生物标志物,特别是GFAP和p-tau181,结合认知和人口统计数据,显著改善了AD神经病理变化的预测.
- 这些生物标志物对ADNC,布拉克分期和神经质斑块得分进行了差异化信息,支持它们在早期AD检测中的实用性.
- 血生物标志物与临床数据的整合为早期和更准确的阿尔茨海默病评估提供了一个有希望的途径.
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