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JAMA Sub-Journal: Lumbar puncture is not required. Plasma GFAP may be more sensitive in diagnosing early Alzheimer's disease!

 Last Update: 2021-11-01
 Source: Internet
 Author: User

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In recent years, rapid progress has been made in the development of blood biomarkers for the accurate detection of Alzheimer's disease (AD), which indicates that these biomarkers will be rapidly applied in clinical routine and clinical trials
.
This application is especially true for preclinical AD patients, because scalable, less invasive biomarkers are needed to screen a large number of cognitively impaired (CU) populations to test innovative interventions

The pathology of AD is related to the morphological, molecular and functional remodeling of astrocytes
.
This process is called reactive astrogliosis .

Glial fibrillary acidic protein (GFAP) is a biomarker of reactive astrocyte hyperplasia, its blood level is higher in preclinical AD patients, and it is a promising candidate biomarker in the early stages of the disease

JAMA

This observational cross-sectional study collected data from three centers from July 29, 2014 to January 31, 2020
.
The Translational Biomarker for Aging and Dementia (TRIAD) cohort (Montreal, Canada) includes individuals with the entire AD continuum

A total of 300 TRIAD participants, 384 ALFA+ participants and 187 BioCogBank Paris Lariboisière participants were included
.
Compared with cognitive impairment (CU) Aβ-negative patients, preclinical AD patients have significantly higher plasma GFAP levels (TRIAD: Aβ-negative patients on average = 185.

1 pg/mL, Aβ positive on average = 285.

In the asymptomatic stage of the AD continuum, plasma GFAP levels are also higher (TRIAD: CU Aβ positive average=285.

0=pg/mL, mild cognitive impairment [MCI] Aβ positive average=332.

In the asymptomatic stage of the AD continuum, plasma GFAP levels are also higher (TRIAD: CU Aβ positive average=285.

The relationship between plasma and CSF GFAP levels and p-tau181

The amplitude change of plasma GFAP is always higher than that of CSF GFAP

Compared with CSF GFAP, plasma GFAP can more accurately distinguish Aβ-positive and Aβ-negative individuals (the area under the curve of plasma GFAP, 0.

This study shows that plasma GFAP is a sensitive biomarker for detecting and tracking reactive astrocytopathies and Aβ pathology, even in individuals in the early stages of AD

references:

Differences Between Plasma and Cerebrospinal Fluid Glial Fibrillary Acidic Protein Levels Across the Alzheimer Disease Continuum.
JAMA Neurol.
Published online October 18, 2021.
doi:10.
1001/jamaneurol.
2021.
3671

Differences Between Plasma and Cerebrospinal Fluid Glial Fibrillary Acidic Protein Levels Across the Alzheimer Disease Continuum.
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