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  • 1
    In: Alzheimer's & Dementia, Wiley
    Abstract: Blood biomarkers accurately identify Alzheimer's disease (AD) pathophysiology and axonal injury. We investigated the influence of food intake on AD‐related biomarkers in cognitively healthy, obese adults at high metabolic risk. METHODS One‐hundred eleven participants underwent repeated blood sampling during 3 h after a standardized meal (postprandial group, PG). For comparison, blood was sampled from a fasting subgroup over 3 h (fasting group, FG). Plasma neurofilament light (NfL), glial fibrillary acidic protein (GFAP), amyloid‐beta (Aβ) 42/40, phosphorylated tau (p‐tau) 181 and 231, and total‐tau were measured via single molecule array assays. RESULTS Significant differences were found for NfL, GFAP, Aβ42/40, p‐tau181, and p‐tau231 between FG and PG. The greatest change to baseline occurred for GFAP and p‐tau181 (120 min postprandially, p   〈  0.0001). CONCLUSION Our data suggest that AD‐related biomarkers are altered by food intake. Further studies are needed to verify whether blood biomarker sampling should be performed in the fasting state. Highlights Acute food intake alters plasma biomarkers of Alzheimer's disease in obese, otherwise healthy adults. We also found dynamic fluctuations in plasma biomarkers concentration in the fasting state suggesting physiological diurnal variations. Further investigations are highly needed to verify if biomarker measurements should be performed in the fasting state and at a standardized time of day to improve the diagnostic accuracy.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2201940-6
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  • 2
    In: Molecular Psychiatry, Springer Science and Business Media LLC, Vol. 27, No. 11 ( 2022-11), p. 4781-4789
    Abstract: Astrocytes can adopt multiple molecular phenotypes in the brain of Alzheimer’s disease (AD) patients. Here, we studied the associations of cerebrospinal fluid (CSF) glial fibrillary acidic protein (GFAP) and chitinase-3-like protein 1 (YKL-40) levels with brain amyloid-β (Aβ) and tau pathologies. We assessed 121 individuals across the aging and AD clinical spectrum with positron emission tomography (PET) brain imaging for Aβ ([ 18 F]AZD4694) and tau ([ 18 F]MK-6240), as well as CSF GFAP and YKL-40 measures. We observed that higher CSF GFAP levels were associated with elevated Aβ-PET but not tau-PET load. By contrast, higher CSF YKL-40 levels were associated with elevated tau-PET but not Aβ-PET burden. Structural equation modeling revealed that CSF GFAP and YKL-40 mediate the effects of Aβ and tau, respectively, on hippocampal atrophy, which was further associated with cognitive impairment. Our results suggest the existence of distinct astrocyte biomarker signatures in response to brain Aβ and tau accumulation, which may contribute to our understanding of the complex link between reactive astrogliosis heterogeneity and AD progression.
    Type of Medium: Online Resource
    ISSN: 1359-4184 , 1476-5578
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1502531-7
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  • 3
    In: Alzheimer's & Dementia, Wiley, Vol. 19, No. 3 ( 2023-03), p. 797-806
    Abstract: The effect of random error on the performance of blood‐based biomarkers for Alzheimer's disease (AD) must be determined before clinical implementation. Methods We measured test‐retest variability of plasma amyloid beta (Aβ)42/Aβ40, neurofilament light (NfL), glial fibrillary acidic protein (GFAP), and phosphorylated tau (p‐tau)217 and simulated effects of this variability on biomarker performance when predicting either cerebrospinal fluid (CSF) Aβ status or conversion to AD dementia in 399 non‐demented participants with cognitive symptoms. Results Clinical performance was highest when combining all biomarkers. Among single‐biomarkers, p‐tau217 performed best. Test‐retest variability ranged from 4.1% (Aβ42/Aβ40) to 25% (GFAP). This variability reduced the performance of the biomarkers (≈ΔAUC [area under the curve] −1% to −4%) with the least effects on models with p‐tau217. The percent of individuals with unstable predicted outcomes was lowest for the multi‐biomarker combination (14%). Discussion Clinical prediction models combining plasma biomarkers—particularly p‐tau217—exhibit high performance and are less effected by random error. Individuals with unstable predicted outcomes (“gray zone”) should be recommended for further tests.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2201940-6
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  • 4
    In: Alzheimer's & Dementia, Wiley, Vol. 19, No. 5 ( 2023-05), p. 1913-1924
    Abstract: Direct comparisons of the main blood phosphorylated tau immunoassays in memory clinic populations are needed to understand possible differences. Methods In the BIODEGMAR study, 197 participants presenting with cognitive complaints were classified into an Alzheimer's disease (AD) or a non‐AD cerebrospinal fluid (CSF) profile group, according to their amyloid beta 42/ phosphorylated tau (Aβ42/p‐tau) ratio. We performed a head‐to‐head comparison of nine plasma and nine CSF tau immunoassays and determined their accuracy to discriminate abnormal CSF Aβ42/p‐tau ratio. Results All studied plasma tau biomarkers were significantly higher in the AD CSF profile group compared to the non‐AD CSF profile group and significantly discriminated abnormal CSF Aβ42/p‐tau ratio. For plasma p‐tau biomarkers, the higher discrimination accuracy was shown by Janssen p‐tau217 ( r  = 0.76; area under the curve [AUC] = 0.96), ADx p‐tau181 ( r  = 0.73; AUC = 0.94), and Lilly p‐tau217 ( r  = 0.73; AUC = 0.94). Discussion Several plasma p‐tau biomarkers can be used in a specialized memory clinic as a stand‐alone biomarker to detect biologically‐defined AD. Highlights Patients with an Alzheimer's disease cerebrospinal fluid (AD CSF) profile have higher plasma phosphorylated tau (p‐tau) levels than the non‐AD CSF profile group. All plasma p‐tau biomarkers significantly discriminate patients with an AD CSF profile from the non‐AD CSF profile group. Janssen p‐tau217, ADx p‐tau181, and Lilly p‐tau217 in plasma show the highest accuracy to detect biologically defined AD. Janssen p‐tau217, ADx p‐tau181, Lilly p‐tau217, Lilly p‐tau181, and UGot p‐tau231 in plasma show performances that are comparable to their CSF counterparts.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2201940-6
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  • 5
    In: Alzheimer's & Dementia, Wiley, Vol. 18, No. S5 ( 2022-12)
    Abstract: It has already been shown that longitudinal changes in plasma phosphorylated tau 181 (p‐tau181) correlate with longitudinal Alzheimer’s disease (AD) progression. However, it is unclear whether longitudinal plasma p‐tau181 is a suitable measure to be used as a surrogate variable in clinical trials. This study aims to evaluate the utility of using longitudinal changes in plasma p‐tau181 to monitor drug effects in AD clinical trials. Method We evaluated 715 individuals (227 cognitively unimpaired (CU) amyloid‐beta (Aβ ) negative, 103 CU Aβ positive, 265 mild cognitive impairment (MCI) Aβ positive, and 120 Alzheimer’s disease (AD) dementia Aβ positive) from the Alzheimer’s Disease Neuroimaging Initiative. Individuals diagnosed with AD or MCI were classified as cognitive impaired (CI). The subjects had [ 18 F]florbetapir Aβ PET at baseline and longitudinal plasma p‐tau181 (up to 4‐year follow‐up duration). We determined the longitudinal rates of change in plasma p‐tau181 concentrations and its effect sizes, calculated as mean change divided by the standard deviation. Logistic regression tested whether the longitudinal change in p‐tau181 status was associated with individuals’ clinical deterioration. Result Plasma p‐tau181 slope of change was positively associated with baseline plasma p‐tau concentrations (Fig 1) . Longitudinal increase in plasma p‐tau181 was correlated with longitudinal worsening in cognition. Long‐term increase in plasma p‐tau181 values was more consistent in CU Aβ negative (48‐month effects size=0.4) and CU Aβ positive (48‐month effects size=0.6) than in CI Aβ positive (48‐month effects size=0.2) individuals ( Fig 2 ). Conclusion Monitoring change in plasma p‐tau181 status from negative to positive can be helpful to identify individuals on the verge of cognitive deterioration in clinical practice. Longitudinal changes in plasma p‐tau181 values can open a new frontier in AD research offering a cost‐effective and scalable alternative to be used as a surrogate variable in large‐scale trials designed to test the effects of population interventions on the natural history of tau pathology in elderly populations.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2201940-6
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  • 6
    In: Alzheimer's & Dementia, Wiley, Vol. 18, No. S6 ( 2022-12)
    Abstract: Although it has been alredy demonstrated that plasma amyloid‐β (Aβ), phosphorylated tau (p‐tau), and glial fibrillar protein (GFAP) can predict with high accuracy Alzheimer's disease (AD) pathophysiology, no previous study has compared their performance in the same set of individuals. Here, we compare the performance of plasma Aβ42/40, p‐tau, GFAP, and NfL against Aβ and tau PET across the AD spectrum. Method We used the ROC curve to test the predictive performance of Simoa plasma Aβ42/40, p‐tau (at threonine 181 and 231), NfL, and GFAP to identify Aβ and Pau PET positivity in 138 cognitive unimpaired (CU) and 87 cognitive impaired (CI) from the McGill TRIAD cohort. Pearson correlation and linear regression tested the association between markers. Result We showed that plasma p‐tau231, p‐tau181, GFAP, and NfL correlated with each other (Figure 1), while Aβ42/40 did not. In CU, voxel‐wise linear regressions (Figure 2A) showed that p‐tau231, p‐tau181, and GFAP concentrations were significantly associated with Aβ‐PET (Figure 2A). While for Tau‐PET (Figure 2B), there was a significant association only with p‐tau231 and p‐tau181 (Figure 2B). P‐tau231 outperformed the other plasma biomarkers to identify both Aβ‐ and Tau‐PET positivity (AUC 0.877 and 0.796, respectively) in CU individuals. In CI, Aβ‐ and Tau‐PET were significantly associated with p‐tau231, p‐tau181, and GFAP, whereas NfL was only associated with Tau‐PET. The discriminative accuracy of GFAP in identifying both Aβ‐PET and Tau positivity (AUC 0.936 and 0.944, respectively) outperformed the other plasma biomarkers in CI individuals (Figure 3, Table 1). Conclusion We showed that plasma p‐tau231, a novel biomarker of early AD, best depicted AD pathophysiology in CU individuals. Interestingly, GFAP, an astrocyte reactivity marker, was better associated with brain Aβ and tau pathologies than plasma p‐tau and Aβ markers in CI individuals. Our results highlight that the performance of the novel plasma biomarkers of amyloid, tau and neuroinflammation to detect brain AD pathophysiology is disease stage specific.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2201940-6
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  • 7
    In: Alzheimer's & Dementia, Wiley
    Abstract: Fluid biomarkers capable of specifically tracking tau tangle pathology in vivo are greatly needed. METHODS We measured cerebrospinal fluid (CSF) and plasma concentrations of N‐terminal tau fragments (NTA‐tau), using a novel immunoassay (NTA) in the TRIAD cohort, consisting of 272 individuals assessed with amyloid beta (Aβ) positron emission tomography (PET), tau PET, magnetic resonance imaging (MRI) and cognitive assessments. RESULTS CSF and plasma NTA‐tau concentrations were specifically increased in cognitively impaired Aβ‐positive groups. CSF and plasma NTA‐tau concentrations displayed stronger correlations with tau PET than with Aβ PET and MRI, both in global uptake and at the voxel level. Regression models demonstrated that both CSF and plasma NTA‐tau are preferentially associated with tau pathology. Moreover, plasma NTA‐tau was associated with longitudinal tau PET accumulation across the aging and Alzheimer's disease (AD) spectrum. DISCUSSION NTA‐tau is a biomarker closely associated with in vivo tau deposition in the AD continuum and has potential as a tau tangle biomarker in clinical settings and trials. HIGHLIGHTS An assay for detecting N‐terminal tau fragments (NTA‐tau) in plasma and CSF was evaluated. NTA‐tau is more closely associated with tau PET than amyloid PET or neurodegeneration. NTA‐tau can successfully track in vivo tau deposition across the AD continuum . Plasma NTA‐tau increased over time only in cognitively impaired amyloid‐β positive individuals.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    Language: English
    Publisher: Wiley
    Publication Date: 2023
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  • 8
    In: Alzheimer's & Dementia, Wiley, Vol. 18, No. 10 ( 2022-10), p. 1988-1992
    Abstract: Recent evidence has shown that the marker of reactive astrogliosis, glial fibrillary acidic protein (GFAP), has a stronger relationship with cerebral amyloid beta (Aβ) pathology in blood than in cerebrospinal fluid (CSF). This study investigates if pre‐analytical treatment of blood and CSF contribute to these unexpected findings. Methods Paired CSF and serum samples from 49 individuals (Aβ‐negative = 28; Aβ‐positive = 21) underwent a series of seven freeze‐thaw cycles (FTCs). All samples were analyzed for GFAP and neurofilament light (NfL) using single molecule array technology including a fresh unfrozen sample from each patient. Results FTC significantly affected CSF GFAP concentration (−188.12 pg/ml per FTC) but not serum GFAP. In the same samples, NfL remained stable. Serum GFAP had a higher discrimination of Aβ burden than CSF GFAP, irrespective of FTC, which also included unfrozen samples. Discussion This study demonstrates large stability differences of GFAP in CSF and serum. However, this disparity does not seem to fully explain the stronger association of serum GFAP with Aβ pathology. Further work should investigate mechanisms of GFAP release into the bloodstream under pathological conditions.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2201940-6
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  • 9
    In: JAMA Neurology, American Medical Association (AMA), Vol. 80, No. 9 ( 2023-09-01), p. 969-
    Abstract: Knowledge is lacking on the prevalence and prognosis of individuals with a β-amyloid–negative, tau-positive (A−T+) cerebrospinal fluid (CSF) biomarker profile. Objective To estimate the prevalence of a CSF A−T+ biomarker profile and investigate its clinical implications. Design, Setting, and Participants This was a retrospective cohort study of the cross-sectional multicenter University of Gothenburg (UGOT) cohort (November 2019-January 2021), the longitudinal multicenter Alzheimer Disease Neuroimaging Initiative (ADNI) cohort (individuals with mild cognitive impairment [MCI] and no cognitive impairment; September 2005-May 2022), and 2 Wisconsin cohorts, Wisconsin Alzheimer Disease Research Center and Wisconsin Registry for Alzheimer Prevention (WISC; individuals without cognitive impairment; February 2007-November 2020). This was a multicenter study, with data collected from referral centers in clinical routine (UGOT) and research settings (ADNI and WISC). Eligible individuals had 1 lumbar puncture (all cohorts), 2 or more cognitive assessments (ADNI and WISC), and imaging (ADNI only) performed on 2 separate occasions. Data were analyzed on August 2022 to April 2023. Exposures Baseline CSF Aβ42/40 and phosphorylated tau (p-tau)181; cognitive tests (ADNI: modified preclinical Alzheimer cognitive composite [mPACC]; WISC: modified 3-test PACC [PACC-3] ). Exposures in the ADNI cohort included [ 18 F]-florbetapir amyloid positron emission tomography (PET), magnetic resonance imaging (MRI), [ 18 F]-fluorodeoxyglucose PET (FDG-PET), and cross-sectional tau-PET (ADNI: [ 18 F]-flortaucipir, WISC: [ 18 F]-MK6240). Main Outcomes and Measures Primary outcomes were the prevalence of CSF AT biomarker profiles and continuous longitudinal global cognitive outcome and imaging biomarker trajectories in A−T+ vs A−T− groups. Secondary outcomes included cross-sectional tau-PET. Results A total of 7679 individuals (mean [SD] age, 71.0 [8.4] years; 4101 male [53%]) were included in the UGOT cohort, 970 individuals (mean [SD] age, 73 [7.0] years; 526 male [54%] ) were included in the ADNI cohort, and 519 individuals (mean [SD] age, 60 [7.3] years; 346 female [67%]) were included in the WISC cohort. The prevalence of an A−T+ profile in the UGOT cohort was 4.1% (95% CI, 3.7%-4.6%), being less common than the other patterns. Longitudinally, no significant differences in rates of worsening were observed between A−T+ and A−T− profiles for cognition or imaging biomarkers. Cross-sectionally, A−T+ had similar tau-PET uptake to individuals with an A−T− biomarker profile. Conclusion and Relevance Results suggest that the CSF A−T+ biomarker profile was found in approximately 5% of lumbar punctures and was not associated with a higher rate of cognitive decline or biomarker signs of disease progression compared with biomarker-negative individuals.
    Type of Medium: Online Resource
    ISSN: 2168-6149
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2023
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  • 10
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    Springer Science and Business Media LLC ; 2023
    In:  Molecular Neurodegeneration Vol. 18, No. 1 ( 2023-03-16)
    In: Molecular Neurodegeneration, Springer Science and Business Media LLC, Vol. 18, No. 1 ( 2023-03-16)
    Abstract: As the leading cause of dementia, Alzheimer's disease (AD) is a major burden on affected individuals, their families and caregivers, and healthcare systems. Although AD can be identified and diagnosed by cerebrospinal fluid or neuroimaging biomarkers that concord with neuropathological evidence and clinical symptoms, challenges regarding practicality and accessibility hinder their widespread availability and implementation. Consequently, many people with suspected cognitive impairment due to AD do not receive a biomarker-supported diagnosis. Blood biomarkers have the capacity to help expand access to AD diagnostics worldwide. One such promising biomarker is plasma phosphorylated tau (p-tau), which has demonstrated specificity to AD versus non-AD neurodegenerative diseases, and will be extremely important to inform on clinical diagnosis and eligibility for therapies that have recently been approved. This review provides an update on the diagnostic and prognostic performances of plasma p-tau181, p-tau217 and p-tau231, and their associations with in vivo and autopsy-verified diagnosis and pathological hallmarks. Additionally, we discuss potential applications and unanswered questions of plasma p-tau for therapeutic trials, given their recent addition to the biomarker toolbox for participant screening, recruitment and during-trial monitoring. Outstanding questions include assay standardization, threshold generation and biomarker verification in diverse cohorts reflective of the wider community attending memory clinics and included in clinical trials.
    Type of Medium: Online Resource
    ISSN: 1750-1326
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2244557-2
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