Transitioning from cerebrospinal fluid to blood tests to facilitate diagnosis and disease monitoring in Alzheimer's disease
| Autor: | Nicholas J. Ashton, Joel Simrén, Kaj Blennow, Philip S.J. Weston, Antoinette O Connor, Amanda Heslegrave, Jonathan M. Schott, Deborah O T Alawode, Johan Gobom, Josef Pannee, Ashvini Keshavan, Henrik Zetterberg, Juan Lantero-Rodriguez, Ross W. Paterson, Nick C. Fox, Thomas K. Karikari, Laia Montoliu-Gaya, Anniina Snellman |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Amyloid beta Fluid biomarkers Population Reviews tau Proteins Review Disease 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid Neuroimaging Alzheimer Disease Diagnosis Epidemiology Internal Medicine medicine Humans Sampling (medicine) education Intensive care medicine Disease monitoring education.field_of_study Amyloid beta-Peptides Hematologic Tests biology business.industry Alzheimer's disease Peptide Fragments 3. Good health Blood 030104 developmental biology biology.protein Biomarker (medicine) business Biomarkers |
| Zdroj: | Journal of Internal Medicine |
| ISSN: | 1365-2796 0954-6820 |
| DOI: | 10.1111/joim.13332 |
| Popis: | Alzheimer’s disease (AD) is increasingly prevalent worldwide, and disease‐modifying treatments may soon be at hand; hence, now, more than ever, there is a need to develop techniques that allow earlier and more secure diagnosis. Current biomarker‐based guidelines for AD diagnosis, which have replaced the historical symptom‐based guidelines, rely heavily on neuroimaging and cerebrospinal fluid (CSF) sampling. While these have greatly improved the diagnostic accuracy of AD pathophysiology, they are less practical for application in primary care, population‐based and epidemiological settings, or where resources are limited. In contrast, blood is a more accessible and cost‐effective source of biomarkers in AD. In this review paper, using the recently proposed amyloid, tau and neurodegeneration [AT(N)] criteria as a framework towards a biological definition of AD, we discuss recent advances in biofluid‐based biomarkers, with a particular emphasis on those with potential to be translated into blood‐based biomarkers. We provide an overview of the research conducted both in CSF and in blood to draw conclusions on biomarkers that show promise. Given the evidence collated in this review, plasma neurofilament light chain (N) and phosphorylated tau (p‐tau; T) show particular potential for translation into clinical practice. However, p‐tau requires more comparisons to be conducted between its various epitopes before conclusions can be made as to which one most robustly differentiates AD from non‐AD dementias. Plasma amyloid beta (A) would prove invaluable as an early screening modality, but it requires very precise tests and robust pre‐analytical protocols. |
| Databáze: | OpenAIRE |
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