血清生物标志物作为阿尔茨海默病的临床预后标志物

IF 4 Q1 CLINICAL NEUROLOGY
Steffi De Meyer, Elena R Blujdea, Jolien M Schaeverbeke, Katarzyna Adamczuk, Rik Vandenberghe, Koen Poesen, Charlotte E Teunissen
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引用次数: 0

摘要

血液基胶质纤维酸性蛋白(GFAP)、神经丝轻链(NfL)和磷酸化tau (pTau)在阿尔茨海默病(AD)中显示出有希望的预后潜力,但它们在合共病普遍存在的临床环境中的适用性仍不确定。方法:Simoa测定了102例AD患者和21例非AD对照组回顾性提取的诊断前血清样本中的GFAP、NfL和pTau181。结果:较高的血清GFAP水平预示着AD患者更早的临床表现和随后更快的迷你精神状态检查下降。血清NfL水平在有动脉高血压(AHT)、肾功能不全和卒中史的患者中升高,并且只有在调整这些合并症后才显示出对临床AD出现时间的预测价值。血清pTau181在-20°C长期储存期间的不稳定性阻碍了回顾性提取血清样本的预后评估。讨论:血清GFAP是AD进展的可靠预后标志物,而NfL受各种合并症的影响,这使其预后价值的解释复杂化。重点:血清GFAP水平预测临床AD表现的时间。血清NfL水平因高血压、肾病和中风病史而升高。血清NfL对AD的预后价值只有在合并症纠正后才有意义。血清GFAP水平,而非NfL,在AD诊断前阶段随时间增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Serum biomarkers as prognostic markers for Alzheimer's disease in a clinical setting.

Introduction: Blood-based glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL), and phosphorylated tau (pTau) have shown promising prognostic potential in Alzheimer's disease (AD), but their applicability in clinical settings where comorbidities are prevalent remains uncertain.

Methods: Simoa assays quantified GFAP, NfL, and pTau181 in retrospectively retrieved prediagnostic serum samples from 102 AD patients and 21 non-AD controls.

Results: Higher serum GFAP levels predicted earlier clinical presentation and faster subsequent Mini-Mental State Examination decline in AD patients. Serum NfL levels were increased in patients with arterial hypertension (AHT), kidney dysfunction, and a history of stroke and only demonstrated predictive value for time to clinical AD presentation after adjustment for these comorbidities. Serum pTau181 instability during long-term storage at -20°C prevented its prognostic evaluation in retrospectively retrieved serum samples.

Discussion: Serum GFAP is a robust prognostic marker for AD progression, whereas NfL is impacted by various comorbidities, which complicates the interpretation of its prognostic value.

Highlights: Serum GFAP levels predict time to clinical AD presentation.Serum NfL levels are increased by hypertension, kidney disease, and stroke history.Prognostic value of serum NfL in AD is only evident after comorbidity correction.Serum levels of GFAP, but not NfL, increase over time within prediagnostic AD stages.

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来源期刊
CiteScore
7.80
自引率
7.50%
发文量
101
审稿时长
8 weeks
期刊介绍: Alzheimer''s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM) is an open access, peer-reviewed, journal from the Alzheimer''s Association® that will publish new research that reports the discovery, development and validation of instruments, technologies, algorithms, and innovative processes. Papers will cover a range of topics interested in the early and accurate detection of individuals with memory complaints and/or among asymptomatic individuals at elevated risk for various forms of memory disorders. The expectation for published papers will be to translate fundamental knowledge about the neurobiology of the disease into practical reports that describe both the conceptual and methodological aspects of the submitted scientific inquiry. Published topics will explore the development of biomarkers, surrogate markers, and conceptual/methodological challenges. Publication priority will be given to papers that 1) describe putative surrogate markers that accurately track disease progression, 2) biomarkers that fulfill international regulatory requirements, 3) reports from large, well-characterized population-based cohorts that comprise the heterogeneity and diversity of asymptomatic individuals and 4) algorithmic development that considers multi-marker arrays (e.g., integrated-omics, genetics, biofluids, imaging, etc.) and advanced computational analytics and technologies.
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