Elevated Levels of Tau Protein in Cerebrospinal Fluid of Patients With Probable Creutzfeldt-Jakob Disease

Introduction: A definitive diagnosis of Creutzfeldt-Jakob disease (CJD) can only be made by neuropathologic examination and demonstration of typical pathologic changes and the pathologic prion protein in central nervous tissues. This study investigated the diagnostic sensitivity and specificity of the microtubule-association protein tau in cerebrospinal fluid (CSF) from Chinese patients with sporadic CJD. Methods: Two hundred two CSF samples from clinically suspected patients with sporadic CJD were analyzed for tau protein by enzyme-linked immunosorbent assay and for the signal transduction regulatory protein 14-3-3 protein by immunoblot. Results: Remarkably increased levels of tau protein and increased incidence of 14-3-3 positivity were observed in probable CJD, when compared with possible CJD and others. With a threshold of 1400 pg/mL, tau determination showed a sensitivity of 90% and a specificity of 94% for the diagnosis of probable CJD. The combination of raised tau and positive 14-3-3 increased the specificity but slightly reduced the sensitivity. Statistical analysis indicated that the raised level of tau positively correlated with the presence of 14-3-3 in CSF but not with other main clinical features, eg, age, gender, clinical manifestations and sampling time. Conclusions: These data suggest that Chinese patients with probable CJD have similar increased levels of tau in the CSF as in Caucasian patients. Measurement of CSF tau will be another potential technique for antemortem CJD diagnosis.