生物标志物 生物标志物
Julie K Wisch1, Ziqiao Jiao2, Patrick J Lao3
1Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 25, 2025
概括
血pTau217可以预测唐氏综合征 (DS) 中的粉样蛋白阳性,并估计当粉样蛋白水平高时,对抗粉样蛋白治疗试验的资格时间. 然而,这项测试对于在DS患者中检测早期粉样蛋白阳性反应的敏感性有限.
科学领域:
- 神经学 神经学
- 生物标志物研究 生物标志物研究
- 唐氏综合征研究 唐氏综合征研究
背景情况:
- 唐氏综合征 (DS) 抗粉样蛋白治疗试验需要PET确认的粉样蛋白阳性才能将参与者纳入.
- 疾病进展建模用于预测早期粉样蛋白水平的个体何时会满足试验标准.
- 血pTau217是粉样质斑块存在的潜在生物标志物,但其在预测试验资格方面的实用性,特别是低粉样质水平,正在研究中.
研究的目的:
- 评估血pTau217在检测DS的个体中粉样蛋白阳性的准确性.
- 用血pTau217与粉胺PET进行疾病进展建模估计的时间到粉胺阳性的比较.
- 评估血pTau217的灵敏度,以检测DS的早期粉样蛋白病理.
主要方法:
- 包括来自ABC-DS研究的329名DS患者.
- 使用了纵向粉样蛋白PET (PiB或AV45) 和血pTau217 (Lilly测定) 数据.
- 采用ROC分析来确定粉样蛋白阳性的最佳pTau217值,并使用通用添加模型比较时间估计.
主要成果:
- 对于粉样蛋白阳性 (15-30个百分位素) 确定了0.4778微克/毫升的最佳血pTau217截止值.
- 血pTau217在较低的粉样蛋白水平 (<30CL) 上显示出高的可变性和较低的准确性 (MAE=5.2年, ρ=0.226).
- 在30CL以上,血pTau217和PET估计的时间对阳性度的相关性很好 (MAE=3.5年, ρ=0.629).
结论:
- 血pTau217有效地预测了粉样蛋白-PET阳性,并估计了DS患者的阳性时间,粉样蛋白负担>30CL.
- 该试验在较低的粉样蛋白病理水平 (10-30 CL) 估计时间到阳性的有用性有限.
- 特定的血pTau217测定可能缺乏早期检测粉样蛋白阳性的必要灵敏度.
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