一个基于血液的生物标志物工作流程,用于在记忆诊所设置中的最佳tau-PET转诊
Wagner S Brum1,2, Nicholas C Cullen3,4, Joseph Therriault5,6
1Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.
Nature communications
|March 15, 2024
概括
对阿尔茨海默病生物标志物的血液检测,如血pTau217,可以帮助选择患者进行昂贵的定子发射断层扫描 (PET) 扫描,提高预后准确性和节省资源.
科学领域:
- 神经学 神经学
- 生物标志物发现发现
- 阿尔茨海默氏症疾病的诊断方法
背景情况:
- 阿尔茨海默病 (AD) 的诊断和预后依赖于准确检测tau病理.
- 定子发射断层扫描 (PET) 是一种敏感但昂贵的工具,用于可视化聚合物.
- 识别最能从tau-PET扫描中获益的患者对于优化临床工作流程至关重要.
研究的目的:
- 评估基于血液的生物标志物的实用性,以指导对认知衰退患者的tau-PET成像的转诊.
- 确定等离子体生物标志物的最佳切割值,以最大限度地提高tau-PET转介的效率和预测值.
- 评估血生物标志物是否可以识别tau-PET提供预后相关信息的个体.
主要方法:
- 在两个独立的队列 (BioFINDER-2和TRIAD) 中测量了Aβ42/Aβ40,pTau181,pTau217,pTau231,NfL和GFAP的血水平.
- 在患有主观认知衰退,轻度认知障碍或痴呆症的患者中评估了tau-PET阳性.
- 血生物标志物的切割值被确定为达到90%,95%或97.5%的灵敏度来检测tau-PET阳性.
主要成果:
- 血pTau217在识别tau-PET阳性个体方面表现最好.
- 使用血pTau217的95%敏感度截止值,可以避免大约一半的tau-PET扫描,对tau-PET阳性的积极预测值约为70%.
- 在BioFINDER-2队列中,tau-PET仅在血pTau217推切线以上的个体中预测认知衰退,这表明预后不信息的扫描减少了.
结论:
- 血pTau217是一种有前途的基于血液的生物标志物,用于指导阿尔茨海默病患者选择TAU-PET扫描.
- 这种以生物标志物为指导的方法有可能减少不必要的tau-PET扫描的数量,从而优化资源配置.
- 使用血pTau217进行tau-PET转诊选择可能会提高AD预后评估的临床效用.
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