Tau protein and 14-3-3 protein in the differential diagnosis of Creutzfeldt–Jakob disease
| Autor: | Hans A. Kretzschmar, Walter J. Schulz-Schaeffer, Jens Wiltfang, Barbara Ciesielczyk, Brit Mollenhauer, Lukas Cepek, Petra Steinacker, Manuela Neumann, Sigrid Poser, Markus Otto |
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| Rok vydání: | 2002 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Adolescent Tyrosine 3-Monooxygenase Immunoblotting Tau protein Enzyme-Linked Immunosorbent Assay tau Proteins Disease Sensitivity and Specificity Creutzfeldt-Jakob Syndrome Diagnosis Differential Central nervous system disease 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Degenerative disease Valine mental disorders medicine Humans Enzyme Inhibitors 14-3-3 protein Aged 030304 developmental biology Aged 80 and over 0303 health sciences Methionine biology business.industry Middle Aged medicine.disease 3. Good health 14-3-3 Proteins chemistry biology.protein Dementia Female Neurology (clinical) Differential diagnosis business 030217 neurology & neurosurgery |
| Zdroj: | Neurology. 58:192-197 |
| ISSN: | 1526-632X 0028-3878 |
| Popis: | Background: Diagnosis of Creutzfeldt–Jakob disease (CJD) is made according to the typical clinical picture and can be supported by a positive 14-3-3 CSF immunoblot. Promising results for the diagnostic sensitivity and specificity of tau-protein measurement in CSF already have been described in a smaller group of patients. Both tests in a larger group of patients with the differential diagnosis of CJD were evaluated.Methods: CSF of 297 patients under the differential diagnosis of CJD (109 definite, 55 probable, 39 possible; 85 others, 1 iatrogenic, 8 genetic), 23 nondemented control subjects, and 15 non-CJD patients with positive 14-3-3 immunoblots were analyzed. The 14-3-3 immunoblot bands were semiquantitatively rated as strong, medium, and weak. Tau-protein was analyzed using a commercially available ELISA. In addition, patients were neuropathologically classified according to prion protein type and polymorphism at codon 129.Results: A diagnostic sensitivity of 94%, a diagnostic specificity of 90%, and a positive predictive value of 92% were achieved for tau-protein at a cut-off of 1,300 pg/mL. These results are comparable with those of the 14-3-3 immunoblot. For patients with type II prion protein and methionine/valine or valine/valine polymorphism at codon 129, tau-protein has a higher diagnostic sensitivity than 14-3-3 protein. Tau-protein levels were significantly higher in patients with higher-rated 14-3-3 immunoblot bands.Conclusion: The differential diagnostic significance of the 14-3-3 immunoblot is similar to that of the tau-protein ELISA. The advantage of the tau-protein ELISA is that it is easy to use in routine laboratories. Patients with a negative 14-3-3 immunoblot already have measurable tau-protein levels. This increases information on 14-3-3—negative patients with CJD and especially on patients with other diseases. |
| Databáze: | OpenAIRE |
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