瑞典隆德大学Oskar Hansson、Sebastian Palmqvist等研究人员合作发现，血浆磷酸化tau与其他方法的结合可预测阿尔茨海默氏症的痴呆产生。相关论文于2021年5月24日在线发表在《自然—医学》杂志上。

研究人员通过BioFINDER（n=340）和阿尔茨海默氏病神经成像计划（ADNI）（n=543）研究对具有主观认知下降和轻度认知障碍的参与者进行了检查。研究人员检查了血浆磷酸化tau蛋白（P-tau）、血浆Aβ42/Aβ40、血浆神经丝轻链、APOE基因型、简短的认知测验和阿尔茨海默氏病（AD）特异性磁共振成像测量结果，并以AD进展为结果。在4年内，血浆P-tau217在BioFINDER中准确预测了AD（曲线下面积（AUC）= 0.83）。结合血浆P-tau217、记忆力、执行功能和APOE可产生更高的准确度（AUC = 0.91，P<0.001）。

在ADNI中，使用血浆P-tau181代替P-tau217，该模型具有相似的AUC（0.90）。该模型是在线实施的，用于预测进展为AD的个体可能性。在2年和6年内，两个队列的相似模型的AUC均在0.90-0.91之间。使用脑脊液P-tau、Aβ42/Aβ40和神经丝轻链代替血浆生物标志物并不能显著提高准确性。总之，血浆P-tau与简短的认知测试和APOE基因分型相结合，可能会大大改善AD的诊断预测并促进AD试验的招募。

据介绍，血浆P-tau与其他可利用的生物标记物的组合可能会提供有关患AD痴呆症风险的准确预测。

附：英文原文

Title: Prediction of future Alzheimer’s disease dementia using plasma phospho-tau combined with other accessible measures

Author: Sebastian Palmqvist, Pontus Tideman, Nicholas Cullen, Henrik Zetterberg, Kaj Blennow, Jeffery L. Dage, Erik Stomrud, Shorena Janelidze, Niklas Mattsson-Carlgren, Oskar Hansson

Issue&Volume: 2021-05-24

Abstract: A combination of plasma phospho-tau (P-tau) and other accessible biomarkers might provide accurate prediction about the risk of developing Alzheimer’s disease (AD) dementia. We examined this in participants with subjective cognitive decline and mild cognitive impairment from the BioFINDER (n=340) and Alzheimer’s Disease Neuroimaging Initiative (ADNI) (n=543) studies. Plasma P-tau, plasma Aβ42/Aβ40, plasma neurofilament light, APOE genotype, brief cognitive tests and an AD-specific magnetic resonance imaging measure were examined using progression to AD as outcome. Within 4 years, plasma P-tau217 predicted AD accurately (area under the curve (AUC) = 0.83) in BioFINDER. Combining plasma P-tau217, memory, executive function and APOE produced higher accuracy (AUC = 0.91, P<0.001). In ADNI, this model had similar AUC (0.90) using plasma P-tau181 instead of P-tau217. The model was implemented online for prediction of the individual probability of progressing to AD. Within 2 and 6 years, similar models had AUCs of 0.90–0.91 in both cohorts. Using cerebrospinal fluid P-tau, Aβ42/Aβ40 and neurofilament light instead of plasma biomarkers did not improve the accuracy significantly. The clinical predictions by memory clinic physicians had significantly lower accuracy (4-year AUC = 0.71). In summary, plasma P-tau, in combination with brief cognitive tests and APOE genotyping, might greatly improve the diagnostic prediction of AD and facilitate recruitment for AD trials.

DOI: 10.1038/s41591-021-01348-z

Source: https://www.nature.com/articles/s41591-021-01348-z