背景:尽管脑脊液(CSF)淀粉样β42肽(Aβ42)和磷酸化tau(p-tau)和血液p-tau对阿尔茨海默病(AD)与认知正常(CN)的鉴别诊断很有价值,但缺乏对轻度认知障碍(MCI)的有效生物标志物。
目的:本研究旨在确定血浆和CSF蛋白标志物在MCI和AD状态表征中的比较。
方法:这项队列研究包括阿尔茨海默病神经影像学计划(ADNI)参与者,他们的基线水平通常在血浆和CSF中测量75种蛋白质(共257种,46CN,143MCI,和68AD)。Logistic回归,使用最小绝对收缩和选择算子(LASSO)和随机森林(RF)方法来鉴定用于疾病分类的候选蛋白。
结果:我们观察到六个血浆蛋白组(APOE,AMBP,C3,IL16,IGFBP2,APOD)优于七个CSF蛋白组(VEGFA,HGF,PRL,FABP3,FGF4,CD40,RETN)以及AD标记(CSFp-tau和Aβ42),以区分MCI与AD[曲线下面积(AUC)=0.75(血浆蛋白),AUC=0.60(CSF蛋白)和AUC=0.56(CSFp-tau和Aβ42)]。此外,这6种血浆蛋白在区分CN和MCI受试者时表现优于CSF蛋白,与CSFp-tau和Aβ42一致[AUC=0.89(血浆蛋白),AUC=0.85(CSF蛋白)和AUC=0.89(CSFp-tau和Aβ42)]。这些结果根据年龄进行了调整,性别,教育,和APOE4基因型。
结论:这项研究表明,6种血浆蛋白的组合可以作为区分MCI与AD和CN的有效标志物。
BACKGROUND: Although cerebrospinal fluid (CSF) amyloid-β42 peptide (Aβ42) and phosphorylated tau (p-tau) and blood p-tau are valuable for differential diagnosis of Alzheimer\'s disease (AD) from cognitively normal (CN) there is a lack of validated biomarkers for mild cognitive impairment (MCI).
OBJECTIVE: This study sought to determine how plasma and CSF protein markers compared in the characterization of MCI and AD status.
METHODS: This cohort study included Alzheimer\'s Disease Neuroimaging Initiative (ADNI) participants who had baseline levels of 75 proteins measured commonly in plasma and CSF (257 total, 46 CN, 143 MCI, and 68 AD). Logistic regression, least absolute shrinkage and selection operator (LASSO) and Random Forest (RF) methods were used to identify the protein candidates for the disease classification.
RESULTS: We observed that six plasma proteins panel (APOE, AMBP, C3, IL16, IGFBP2, APOD) outperformed the seven CSF proteins panel (VEGFA, HGF, PRL, FABP3, FGF4, CD40, RETN) as well as AD markers (CSF p-tau and Aβ42) to distinguish the MCI from AD [area under the curve (AUC) = 0.75 (plasma proteins), AUC = 0.60 (CSF proteins) and AUC = 0.56 (CSF p-tau and Aβ42)]. Also, these six plasma proteins performed better than the CSF proteins and were in line with CSF p-tau and Aβ42 in differentiating CN versus MCI subjects [AUC = 0.89 (plasma proteins), AUC = 0.85 (CSF proteins) and AUC = 0.89 (CSF p-tau and Aβ42)]. These results were adjusted for age, sex, education, and APOEϵ4 genotype.
CONCLUSIONS: This study suggests that the combination of 6 plasma proteins can serve as an effective marker for differentiating MCI from AD and CN.