Neurology-Automatic biochemical analysis of cerebrospinal fluid to help diagnose Alzheimer's

The recent NIA-AA research framework guidelines now define Alzheimer’s disease (AD) as a biological entity.
The in vivo diagnosis of AD is no longer based on clinical diagnostic criteria, but requires positron emission tomography (PET) or Supporting evidence for humoral biomarkers of AD typical amyloid β (Aβ) and tau pathology
.

Compared with PET, body fluid-based measurements can provide different molecular biomarkers through one assessment, are more cost-effective, widely available, and are not restricted by radiation

Diagnostic immunity

The recently developed detection method for measuring phosphorylated tau in the blood provides another opportunity to assess AD pathology in a cost-effective, highly accessible and scalable way
.

The concentration of threonine 181 phosphorylated tau181 (p-tau181) in plasma is highly correlated with p-tau181 measured by CSF and Aβ and tau pathology measured by PET, and it has been proven to distinguish AD from other neurodegenerative diseases, and its diagnosis The accuracy is comparable to CSF ​​and PET-based tau pathology measurements

It has been proven to be able to distinguish AD from other neurodegenerative diseases, and its diagnostic accuracy is comparable to CSF ​​and PET-based tau pathological measurements

In this way, Michel J.
Grothe et al.
of Universidad de Sevilla, Spain, compared the cerebrospinal fluid (CSF) biomarker of Alzheimer’s disease (AD) analyzed by the fully automated Elecsys immunoassay method with the gold standard for neuropathology, and compared Its accuracy is compared with plasma phosphorylated tau181 measured by a new Simoa method
.

And compare its accuracy with plasma phosphorylated tau181 measured with a new Simoa method and compare its accuracy with plasma phosphorylated tau181 measured with a new Simoa method

They studied Elecsys-derived CSF biomarkers in 45 people who underwent a standardized postmortem assessment of AD and non-AD neuropathological changes at autopsy
.

In a subset of 26 participants, ante-mortem plasma p-tau181 and neurofilament (NfL) levels were also analyzed

They found that all CSF biomarkers can clearly distinguish pathologically proven AD dementia (N=27) and HC (AUCs=0.
86-1.
00)
.

CSF total tau (t-tau), p-tau181 and the ratio of Aβ1-42 can also accurately distinguish pathologically proven AD from non-AD dementia (N=8; AUCs=0.
94-0.
97)
.

In the pathological specific analysis, CSF Aβ1-42 has the best detection effect on medium and high Thal amyloid stages (AUC[95% CI]=0.

The best Elecsys biomarker cut-off values ​​for Aβ1-42, t-tau and p-tau181 are 1097/229/19 pg/ml
.

In the plasma subsample, plasma p-tau181 (AUC=0.

The important significance of this study lies in the discovery of the CSF biomarker derived from Elecsys to detect AD neuropathological changes, which has a very high identification accuracy in vivo
.

Preliminary research results support the use of plasma p-tau181 as an easily available and scalable biomarker for AD pathology

Original Source:
Grothe MJ, Moscoso A, Ashton NJ, Karikari TK, Lantero-Rodriguez J, Snellman A, Zetterberg H, Blennow K, Schöll M; Alzheimer's Disease Neuroimaging Initiative.

Associations of Fully Automated CSF and Novel Plasma Biomarkers With Alzheimer Disease Neuropathology at Autopsy.
Neurology.

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