Inflammatory plasma biomarkers in subjects with preclinical Alzheimer’s disease

Abstract Background This study investigated plasma biomarkers for neuroinflammation associated with Alzheimer’s disease (AD) in subjects with preclinical AD compared to healthy elderly. How these biomarkers behave in patients with AD, compared to healthy elderly is well known, but determining these...

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Main Authors: Samantha Prins, Marieke L. de Kam, Charlotte E. Teunissen, Geert Jan Groeneveld
Format: Article
Language:English
Published: BMC 2022-08-01
Series:Alzheimer’s Research & Therapy
Subjects:
Online Access:https://doi.org/10.1186/s13195-022-01051-2
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author Samantha Prins
Marieke L. de Kam
Charlotte E. Teunissen
Geert Jan Groeneveld
author_facet Samantha Prins
Marieke L. de Kam
Charlotte E. Teunissen
Geert Jan Groeneveld
author_sort Samantha Prins
collection DOAJ
description Abstract Background This study investigated plasma biomarkers for neuroinflammation associated with Alzheimer’s disease (AD) in subjects with preclinical AD compared to healthy elderly. How these biomarkers behave in patients with AD, compared to healthy elderly is well known, but determining these in subjects with preclinical AD is not and will add information related to the onset of AD. When found to be different in preclinical AD, these inflammatory biomarkers may be used to select preclinical AD subjects who are most likely to develop AD, to participate in clinical trials with new disease-modifying drugs. Methods Healthy elderly (n= 50; age 71.9; MMSE >24) and subjects with preclinical AD (n=50; age 73.4; MMSE >24) defined by CSF Aβ1-42 levels < 1000 pg/mL were included. Four neuroinflammatory biomarkers were determined in plasma, GFAP, YKL-40, MCP-1, and eotaxin-1. Differences in biomarker outcomes were compared using ANCOVA. Subject characteristics age, gender, and APOE ε4 status were reported per group and were covariates in the ANCOVA. Least square means were calculated for all 4 inflammatory biomarkers using both the Aβ+/Aβ− cutoff and Ptau/Aβ1-42 ratio. Results The mean (standard deviation, SD) age of the subjects (n=100) was 72.6 (4.6) years old with 62 male and 38 female subjects. Mean (SD) overall MMSE score was 28.7 (0.49) and 32 subjects were APOE ε4 carriers. The number of subjects in the different APOE ε4 status categories differed significantly between the Aβ+ and Aβ− groups. Plasma GFAP concentration was significantly higher in the Aβ+ group compared to the Aβ− group with significant covariates age and sex, variables that also correlated significantly with GFAP. Conclusion GFAP was significantly higher in subjects with preclinical AD compared to healthy elderly which agrees with previous studies. When defining preclinical AD based on the Ptau181/Aβ1-42 ratio, YKL-40 was also significantly different between groups. This could indicate that GFAP and YKL-40 are more sensitive markers of the inflammatory process in response to the Aβ misfolding and aggregation that is ongoing as indicated by the lowered Aβ1-42 levels in the CSF. Characterizing subjects with preclinical AD using neuroinflammatory biomarkers is important for subject selection in new disease-modifying clinical trials. Trial registration ISRCTN.org identifier: ISRCTN79036545 (retrospectively registered).
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spelling doaj.art-8910cd9054ca41a2a22f12c4033ad9db2022-12-22T04:01:50ZengBMCAlzheimer’s Research & Therapy1758-91932022-08-011411910.1186/s13195-022-01051-2Inflammatory plasma biomarkers in subjects with preclinical Alzheimer’s diseaseSamantha Prins0Marieke L. de Kam1Charlotte E. Teunissen2Geert Jan Groeneveld3Centre for Human Drug ResearchCentre for Human Drug ResearchNeurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit AmsterdamCentre for Human Drug ResearchAbstract Background This study investigated plasma biomarkers for neuroinflammation associated with Alzheimer’s disease (AD) in subjects with preclinical AD compared to healthy elderly. How these biomarkers behave in patients with AD, compared to healthy elderly is well known, but determining these in subjects with preclinical AD is not and will add information related to the onset of AD. When found to be different in preclinical AD, these inflammatory biomarkers may be used to select preclinical AD subjects who are most likely to develop AD, to participate in clinical trials with new disease-modifying drugs. Methods Healthy elderly (n= 50; age 71.9; MMSE >24) and subjects with preclinical AD (n=50; age 73.4; MMSE >24) defined by CSF Aβ1-42 levels < 1000 pg/mL were included. Four neuroinflammatory biomarkers were determined in plasma, GFAP, YKL-40, MCP-1, and eotaxin-1. Differences in biomarker outcomes were compared using ANCOVA. Subject characteristics age, gender, and APOE ε4 status were reported per group and were covariates in the ANCOVA. Least square means were calculated for all 4 inflammatory biomarkers using both the Aβ+/Aβ− cutoff and Ptau/Aβ1-42 ratio. Results The mean (standard deviation, SD) age of the subjects (n=100) was 72.6 (4.6) years old with 62 male and 38 female subjects. Mean (SD) overall MMSE score was 28.7 (0.49) and 32 subjects were APOE ε4 carriers. The number of subjects in the different APOE ε4 status categories differed significantly between the Aβ+ and Aβ− groups. Plasma GFAP concentration was significantly higher in the Aβ+ group compared to the Aβ− group with significant covariates age and sex, variables that also correlated significantly with GFAP. Conclusion GFAP was significantly higher in subjects with preclinical AD compared to healthy elderly which agrees with previous studies. When defining preclinical AD based on the Ptau181/Aβ1-42 ratio, YKL-40 was also significantly different between groups. This could indicate that GFAP and YKL-40 are more sensitive markers of the inflammatory process in response to the Aβ misfolding and aggregation that is ongoing as indicated by the lowered Aβ1-42 levels in the CSF. Characterizing subjects with preclinical AD using neuroinflammatory biomarkers is important for subject selection in new disease-modifying clinical trials. Trial registration ISRCTN.org identifier: ISRCTN79036545 (retrospectively registered).https://doi.org/10.1186/s13195-022-01051-2Preclinical Alzheimer’s diseaseNeuroinflammationGFAPYKL-40MCP-1Eotaxin-1
spellingShingle Samantha Prins
Marieke L. de Kam
Charlotte E. Teunissen
Geert Jan Groeneveld
Inflammatory plasma biomarkers in subjects with preclinical Alzheimer’s disease
Alzheimer’s Research & Therapy
Preclinical Alzheimer’s disease
Neuroinflammation
GFAP
YKL-40
MCP-1
Eotaxin-1
title Inflammatory plasma biomarkers in subjects with preclinical Alzheimer’s disease
title_full Inflammatory plasma biomarkers in subjects with preclinical Alzheimer’s disease
title_fullStr Inflammatory plasma biomarkers in subjects with preclinical Alzheimer’s disease
title_full_unstemmed Inflammatory plasma biomarkers in subjects with preclinical Alzheimer’s disease
title_short Inflammatory plasma biomarkers in subjects with preclinical Alzheimer’s disease
title_sort inflammatory plasma biomarkers in subjects with preclinical alzheimer s disease
topic Preclinical Alzheimer’s disease
Neuroinflammation
GFAP
YKL-40
MCP-1
Eotaxin-1
url https://doi.org/10.1186/s13195-022-01051-2
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