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Blood-based biomarkers for Alzheimer's disease: towards clinical implementation

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Summary: Plasma phosphorylated-tau181 (p-tau181) is a promising blood-based biomarker specific for Alzheimer's disease (AD), showing high diagnostic accuracy and increasing levels with disease progression.

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Summary: P-tau181 shows potential as an effective diagnostic and prognostic biomarker in AD, detecting the disease at MCI and dementia stages and being strongly associated with cognitive decline and gray matter loss.

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Summary: Measurement of tau phosphorylated at threonine 181 (p-tau181) in blood plasma is proposed as a specific biomarker for Alzheimer's disease. Longitudinal study reveals that plasma p-tau181 increases before amyloid-beta markers reach abnormal levels, correlating with amyloid-beta pathology. Plasma p-tau181 also shows associations with widespread cortical tau aggregation and may be a useful diagnostic and screening tool for Alzheimer's disease.
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Summary: This study investigated the diagnostic performance of plasma neurofilament light chain (Nf-L) and total-tau in distinguishing cognitive status among adults with Down syndrome (DS). The results indicated that Nf-L and total-tau could serve as useful biomarkers for both AD pathology and clinical status in DS, potentially becoming outcome measures in clinical trials for disease-modifying drugs in the future.

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Longitudinal Associations of Blood Phosphorylated Tau181 and Neurofilament Light Chain With Neurodegeneration in Alzheimer Disease

Alexis Moscoso et al.

Summary: This study found that plasma p-tau181 could serve as a marker for predicting and monitoring neurodegeneration and cognitive decline, with greater AD specificity compared to plasma NfL, holding important implications for monitoring AD progression in clinical practice and treatment trials.

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Plasma glial fibrillary acidic protein is elevated in cognitively normal older adults at risk of Alzheimer's disease

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Plasma p-tau181, p-tau217, and other blood-based Alzheimer's disease biomarkers in a multi-ethnic, community study

Adam M. Brickman et al.

Summary: Blood-based Alzheimer's disease biomarkers show associations with pathological and clinical diagnoses, and have predictive value for future development of clinical AD, indicating their potential for incorporation into multi-ethnic community studies.

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The validation status of blood biomarkers of amyloid and phospho-tau assessed with the 5-phase development framework for AD biomarkers

N. J. Ashton et al.

Summary: The development of blood biomarkers for Alzheimer's disease has shown promise for dementia diagnosis and early detection. Plasma p-tau has demonstrated analytical and clinical validity, while A beta's maturity level remains partially achieved. Despite progress in phases 1 through 3, more data is needed on covariate effects on biomarker measurement.

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Alzheimer's disease

Philip Scheltens et al.

Summary: Alzheimer's disease is projected to see a significant increase in prevalence in the future, with genetics playing a key role. Novel biomarkers and lifestyle-based prevention trials show promising therapeutic potential. Promising pharmacological treatments are advancing in clinical trials, targeting amyloid beta, tau, and inflammation.

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Associations of Plasma Phospho-Tau217 Levels With Tau Positron Emission Tomography in Early Alzheimer Disease

Shorena Janelidze et al.

Summary: This study highlights the potential of plasma P-tau217 as an early biomarker for Alzheimer's disease, showing elevated levels before tau-PET detected insoluble tau aggregates. Modeling suggests that changes in plasma and CSF P-tau217 precede tau-PET signals, indicating its usefulness in detecting early AD brain pathology.

JAMA NEUROLOGY (2021)

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The Alzheimer's Association international guidelines for handling of cerebrospinal fluid for routine clinical measurements of amyloid β and tau

Oskar Hansson et al.

Summary: To address variability in measurements across laboratories, a workgroup led by the Alzheimer's Association developed a simplified and standardized pre-analytical protocol for CSF collection and handling, aiming to improve AD diagnostic accuracy and reduce patient misclassification rates.

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A blood-based diagnostic test incorporating plasma Aβ42/40 ratio, ApoE proteotype, and age accurately identifies brain amyloid status: findings from a multi cohort validity analysis

Tim West et al.

Summary: The development of a high-resolution mass spectrometry-based plasma biomarker test shows strong diagnostic performance in distinguishing brain amyloid status for Alzheimer's disease and may enhance the efficiency of enrolling participants into AD drug trials.

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Highly specific and ultrasensitive plasma test detects Abeta(1-42) and Abeta(1-40) in Alzheimer's disease

Elisabeth H. Thijssen et al.

Summary: Plasma biomarkers reflecting specific Abeta proteoforms can provide valuable insights into the treatment effects of Alzheimer's disease therapies. The newly developed Amyblood assays showed similar technical and clinical performance as commercial assays, but exhibited better specificity and selectivity, making them promising for monitoring treatment response in clinical trials.

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Plasma glial fibrillary acidic protein detects Alzheimer pathology and predicts future conversion to Alzheimer dementia in patients with mild cognitive impairment

Claudiaf Cicognola et al.

Summary: Plasma GFAP can detect AD pathology in patients with MCI and predict conversion to AD dementia, showing potential clinical utility.

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Elisabeth H. Thijssen et al.

Summary: Plasma tau phosphorylated at threonine 217 (p-tau217) and plasma tau phosphorylated at threonine 181 (p-tau181) showed excellent diagnostic performance in distinguishing patients with Alzheimer's disease syndromes from other neurodegenerative disorders. P-tau217 outperformed p-tau181 in differentiating Alzheimer's disease syndromes from FTLD syndromes, indicating amyloid-PET positivity, and showing stronger correlations with tau-PET signal.

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