NatMed: marker for neurodegenerative diseases

With the increase of human lifespan, the prevalence of neurodegenerative diseases is also increasing

Researchers from Lund University and Malmöskane University in Sweden published a review in Nature Medicine describing recent advances in biomarkers for neurodegenerative diseases and discussing the future direction of biomarkers in clinical and trial settings

1 Demand for biomarkers for neurodegenerative diseases

In the clinical diagnosis and treatment of neurodegenerative diseases, accurate diagnosis is very important

2 Clinical trials and studies

There are many disease-modifying therapies for β-amyloid (Aβ), tau or α-synuclein in clinical trials

Figure 1| Biomarkers of neurodegenerative diseases

3 biomarkers for the latest ideas

1) Biomarkers of Aβ

PET-CT studies have shown that Aβ begins to be deposited in the brain 20 years before the onset

By detecting the different subtypes and levels of Aβ in cerebrospinal fluid (CSF), it is conducive to the diagnosis of AD and the evaluation of prognosis

2) Biomarkers of tau protein

The tau-PET ligand can bind to insoluble tau fibrils in AD brain tissue, but bind little or no to tau proteins in other neurodegenerative diseases

Although typical symptoms of AD are predominantly memory impairment, due to the deposition of tau protein in different areas of the cerebral cortex, it may lead to some atypical clinical manifestations of AD: such as the deposition of the temporopex-top region of tau protein symmetry, and the symptoms are mainly amnesia; Tau protein deposits left temporary, with language symptoms manifested predominantly; Parietal occipital cortical tau protein deposition, which is mainly visually impaired; The deposition of tau protein in the medial temporal lobe is mainly manifested

Compared to other tau protein subtypes, p-tau in the blood can accurately distinguish individuals with neuropathological changes in AD and even distinguish AD from

3) Biomarkers for α-synuclein pathology

Although α-synuclein can be accurately detected in CSF, due to its low specificity, it cannot distinguish well between various neurodegenerative diseases and is not used much in clinical practice and trials

Figure 2| Biomarker changes in AD

4) Biomarkers that reflect neurodegeneration

SV2A-PET can detect a local decrease in synaptic density in neurodegenerative diseases as well as the deposition of fluorodeoxyglucose (FDG), which is used to assess the metabolism of regional glucose, which may imply a specific neurodegenerative disease

5) Biomarkers of glial activation and blood-brain barrier function

As a specific marker of reactive astrocytes, plasma GFAP levels are increased in patients with Aβ and are associated

Figure 3| Potential uses of blood-based biomarkers in primary care and preclinical trials

4 Conclusions and Future Directions

Although biological markers of neurodegenerative diseases have made progress