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Predictive Accuracy of Blood-Derived Biomarkers for Amyloid-β Brain Deposition Along with the Alzheimer’s Disease Continuum: A Systematic Review
Journal of Alzheimer’s Disease ( IF 4 ) Pub Date : 2021-09-17 , DOI: 10.3233/jad-210496
Alessandra Cianflone 1 , Luigi Coppola 1 , Peppino Mirabelli 1 , Marco Salvatore 1
Affiliation  

Background:An amyloid-β (Aβ) positron emission tomography (Aβ-PET) scan of the human brain could lead to an early diagnosis of Alzheimer’s disease (AD) and estimate disease progression. However, Aβ-PET imaging is expensive, invasive, and rarely applicable to cognitively normal subjects at risk fordementia. The identification of blood biomarkers predictive of Aβ brain deposition could help the identification of subjects at risk for dementia and could be helpful for the prognosis of AD progression. Objective:This study aimed to analyze the prognostic accuracy of blood biomarkers in predicting Aβ-PET status along with progression toward AD. Methods:In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched bibliographic databases from 2010 to 2020. The quality of the included studies was assessed by the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Results:A total of 8 studies were retrieved. The prognostic accuracy of Aβ-PET status was calculated by obtaining ROCs for the following biomarkers: free, total, and bound Aβ 42 and Aβ 40; Aβ 42/40 ratio; neurofilaments (NFL); total tau (T-tau); and phosphorylated-Tau181 (P-tau181). Higher and lower plasma baseline levels of P-tau181 and the Aβ 42/40 ratio, respectively, showed consistently good prognostication of Aβ-PET brain accumulation. Only P-tau181 was shown to predict AD progression. Conclusion:In conclusion, the Aβ 42/40 ratio and plasma P-tau181 were shown to predict Aβ-PET status. Plasma P-tau181 could also be a preclinical biomarker for AD progression.

中文翻译:

β淀粉样蛋白脑沉积的血液衍生生物标志物与阿尔茨海默病连续体的预测准确性:系统评价

背景:人脑的淀粉样蛋白 β (Aβ) 正电子发射断层扫描 (Aβ-PET) 扫描可导致阿尔茨海默病 (AD) 的早期诊断并估计疾病进展。然而,Aβ-PET 成像昂贵、侵入性强,并且很少适用于有痴呆风险的认知正常受试者。鉴定预测 Aβ 脑沉积的血液生物标志物有助于识别有痴呆风险的受试者,并有助于 AD 进展的预后。目的:本研究旨在分析血液生物标志物在预测 Aβ-PET 状态以及 AD 进展中的预后准确性。方法:根据系统评价和元分析首选报告项目(PRISMA)指南,我们检索了 2010 年至 2020 年的书目数据库。纳入研究的质量通过诊断准确性研究质量评估 2 (QUADAS-2) 工具进行评估。结果:共检索到8项研究。通过获得以下生物标志物的 ROC 来计算 Aβ-PET 状态的预后准确性:游离、总和结合的 Aβ 42 和 Aβ 40;Aβ 42/40 比例;神经丝(NFL);总 tau (T-tau); 和磷酸化的 Tau181 (P-tau181)。P-tau181 和 Aβ 42/40 比率的较高和较低血浆基线水平分别显示出对 Aβ-PET 脑积聚的良好预测。只有 P-tau181 被证明可以预测 AD 进展。结论:总之,Aβ 42/40 比值和血浆 P-tau181 可预测 Aβ-PET 状态。血浆 P-tau181 也可能是 AD 进展的临床前生物标志物。
更新日期:2021-09-17
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