A K Minochkin, V Yu Lobzin, A Yu Emelin, Yu P Kopteva, O A Klitsenko, S V Apalko, S G Sherbak
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引用次数: 0
Abstract
Objective: To determine, evaluate, and analyze the diagnostic value of various laboratory biomarkers of Alzheimer's disease (AD) in blood and cerebrospinal fluid (CSF).
Material and methods: The concentrations of 93 potential biomarkers in plasma and CSF were studied in patients with AD at various stages (n=53) and independently in the group at the predementia stage (n=15).
Results: Statistically significant correlations of various directions (p≤0.05) were found between the coefficients characterizing the amyloidosis and neurodegeneration (Aβ-42/Aβ-40, phTau181/Aβ-42, phTau181/oTau, oTau/Aβ-42) with markers associated with neuroinflammation, vascular disorders, angiogenesis, neuroimaging changes, and neuropsychological indicators. Previous studies of markers associated with inflammation in CSF in AD patients have shown mixed results, and no markers have been introduced into clinical practice so far. Many biomarkers associated with two classical pathogenetic links and other pathophysiological processes have been identified.
Conclusion: Coefficients reflecting two main pathogenetic processes in CSF of AD patients (Aβ-42/Aβ-40, phTau181/Aβ-42, phTau181/oTau, oTau/Aβ-42) are the most informative for verifying two main links in the disease pathogenesis-amyloidogenesis and neurodegeneration. In the group of patients with amnestic mild cognitive impairment (aMCI), statistically significant relationships of cytokines associated with neuroinflammation, growth factors, and complement system protein with coefficients of amyloidosis and neurodegeneration in CSF, as well as PET, MRI, and neuropsychological tests were shown; therefore, these indicators can also be considered as potential diagnostic biomarkers of early stages and possible predictors of MCI conversion to dementia. Such markers as GFAP, apolipoprotein A1, GDF-15, IFN-γ, IL-5, IL-7, IL-8, IL-10, IL-12p70, IL-13, IL-17, VEGF, and complement C3 should be considered as objects for further research as biomarkers for early diagnosis.
目的：测定、评价和分析血液和脑脊液中各种实验室生物标志物对阿尔茨海默病（AD）的诊断价值。材料与方法：研究了不同阶段AD患者（n=53）血浆和脑脊液中93种潜在生物标志物的浓度，并独立研究了痴呆前期组（n=15）。结果：淀粉样变和神经变性特征系数（Aβ-42/Aβ-40、phTau181/Aβ-42、phTau181/oTau、oTau/Aβ-42）与神经炎症、血管病变、血管生成、神经影像学改变、神经心理指标等相关指标呈各方向显著相关（p≤0.05）。以往对阿尔茨海默病患者脑脊液炎症相关标志物的研究结果喜忧参半，迄今尚未有标志物被引入临床实践。许多生物标志物与两个经典的致病环节和其他病理生理过程相关。结论：反映AD患者脑脊液中两个主要发病过程的系数（a - β-42/ a - β-40、phTau181/ a - β-42、phTau181/oTau、oTau/ a - β-42）是验证AD发病机制中淀粉样变和神经变性两个主要环节信息最丰富的。在遗忘性轻度认知障碍（aMCI）患者组中，与神经炎症相关的细胞因子、生长因子和补体系统蛋白与脑脊液淀粉样变和神经变性系数以及PET、MRI和神经心理学测试均显示有统计学意义的关系；因此，这些指标也可以被认为是早期阶段的潜在诊断生物标志物和MCI转化为痴呆的可能预测因子。GFAP、载脂蛋白A1、GDF-15、IFN-γ、IL-5、IL-7、IL-8、IL-10、IL-12p70、IL-13、IL-17、VEGF、补体C3等标志物应作为早期诊断的生物标志物，作为进一步研究的对象。
期刊介绍：
Одно из старейших медицинских изданий России, основанное в 1901 году. Создание журнала связано с именами выдающихся деятелей отечественной медицины, вошедших в историю мировой психиатрии и неврологии, – С.С. Корсакова и А.Я. Кожевникова.
Широкий диапазон предлагаемых журналом материалов и разнообразие форм их представления привлекают внимание научных работников и врачей, опытных и начинающих медиков, причем не только неврологов и психиатров, но и специалистов смежных областей медицины.
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