载脂蛋白E基因型与阿尔茨海默病相关的血浆生物标志物

Holly D Soares, William Z Potter, Eve Pickering, Max Kuhn, Frederick W Immermann, David M Shera, Mats Ferm, Robert A Dean, Adam J Simon, Frank Swenson, Judith A Siuciak, June Kaplow, Madhav Thambisetty, Panayiotis Zagouras, Walter J Koroshetz, Hong I Wan, John Q Trojanowski, Leslie M Shaw
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引用次数: 192

摘要

背景:一种基于血液的测试可用于阿尔茨海默病(AD)的筛查,可能有助于早期干预和更好地获得治疗。目的:利用来自阿尔茨海默病神经影像学倡议队列的血浆样本,应用多重免疫测定面板来识别AD的血浆生物标志物。设计:队列研究。环境:生物标志物联盟阿尔茨海默病血浆蛋白质组学项目。参与者:对396例(345例)轻度认知障碍患者、112例(97例)AD患者和58例(54例)健康对照者在基线和1年时的血浆样本进行了分析。主要结果测量:使用多变量和单变量统计分析来检查诊断组之间以及载脂蛋白E (ApoE)基因型的差异。结果:患者中观察到eotaxin 3、胰腺多肽和n端蛋白b型脑利钠肽水平升高,证实了AD和MCI患者脑脊液样本中类似的变化。还观察到腱素C水平升高,IgM和ApoE水平降低。所有携带载脂蛋白ε3/ε4或ε4/ε4等位基因的参与者均表现出明显的生化特征:低c反应蛋白和ApoE水平,高皮质醇、白细胞介素13、载脂蛋白B和γ干扰素水平。血浆生物标志物的使用提高了区分AD患者和对照组的特异性,并且在轻度认知障碍进展为痴呆的患者中,ApoE血浆水平最低。结论:血浆生物标志物结果证实了脑脊液研究报告的AD和轻度认知障碍患者胰腺多肽和n端蛋白b型脑利钠肽水平升高。血浆生物标志物的结合产生了高灵敏度和改进的特异性,支持其作为筛选工具的有效性。与诊断无关,ApoE基因型与独特的生化谱相关,突出了基因型对血液蛋白谱的重要性。
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Plasma biomarkers associated with the apolipoprotein E genotype and Alzheimer disease.

Background: A blood-based test that could be used as a screen for Alzheimer disease (AD) may enable early intervention and better access to treatment.

Objective: To apply a multiplex immunoassay panel to identify plasma biomarkers of AD using plasma samples from the Alzheimer's Disease Neuroimaging Initiative cohort.

Design: Cohort study.

Setting: The Biomarkers Consortium Alzheimer's Disease Plasma Proteomics Project.

Participants: Plasma samples at baseline and at 1 year were analyzed from 396 (345 at 1 year) patients with mild cognitive impairment, 112 (97 at 1 year) patients with AD, and 58 (54 at 1 year) healthy control subjects.

Main outcome measures: Multivariate and univariate statistical analyses were used to examine differences across diagnostic groups and relative to the apolipoprotein E (ApoE) genotype.

Results: Increased levels of eotaxin 3, pancreatic polypeptide, and N-terminal protein B-type brain natriuretic peptide were observed in patients, confirming similar changes reported in cerebrospinal fluid samples of patients with AD and MCI. Increases in tenascin C levels and decreases in IgM and ApoE levels were also observed. All participants with Apo ε3/ε4 or ε4/ε4 alleles showed a distinct biochemical profile characterized by low C-reactive protein and ApoE levels and by high cortisol, interleukin 13, apolipoprotein B, and gamma interferon levels. The use of plasma biomarkers improved specificity in differentiating patients with AD from controls, and ApoE plasma levels were lowest in patients whose mild cognitive impairment had progressed to dementia.

Conclusions: Plasma biomarker results confirm cerebrospinal fluid studies reporting increased levels of pancreatic polypeptide and N-terminal protein B-type brain natriuretic peptide in patients with AD and mild cognitive impairment. Incorporation of plasma biomarkers yielded high sensitivity with improved specificity, supporting their usefulness as a screening tool. The ApoE genotype was associated with a unique biochemical profile irrespective of diagnosis, highlighting the importance of genotype on blood protein profiles.

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Archives of neurology
Archives of neurology 医学-临床神经学
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