Validation of α-synuclein in L1CAM-immunocaptured exosomes as a biomarker for the stratification of Parkinsonian syndromes

<p><strong>Background:</strong> Parkinson’s disease is characterised by intraneuronal α-synuclein aggregation. Currently there is no α-synuclein-based blood test in clinical practice.</p> <p><strong>Objectives:</strong> Our aim was to assess by means of fur...

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主要な著者: Jiang, C, Hopfner, F, Berg, D, Hu, M, Pilotto, A, Borroni, B, Davis, JJ, Tofaris, G
フォーマット: Journal article
言語:English
出版事項: Wiley 2021
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author Jiang, C
Hopfner, F
Berg, D
Hu, M
Pilotto, A
Borroni, B
Davis, JJ
Tofaris, G
author_facet Jiang, C
Hopfner, F
Berg, D
Hu, M
Pilotto, A
Borroni, B
Davis, JJ
Tofaris, G
author_sort Jiang, C
collection OXFORD
description <p><strong>Background:</strong> Parkinson’s disease is characterised by intraneuronal α-synuclein aggregation. Currently there is no α-synuclein-based blood test in clinical practice.</p> <p><strong>Objectives:</strong> Our aim was to assess by means of further testing and analysis whether α-synuclein measurements in serum L1CAM-immunocaptured exosomes can differentiate Parkinson’s disease from related movement disorders.</p> <p><strong>Methods:</strong> We used poly(carboxybetaine-methacrylate) coated magnetic beads to isolate L1CAMpositive exosomes and triplexed electrochemiluminescence to measure exosomal a-synuclein, clusterin and syntenin-1 from 267 serum samples. Combined analysis of our current and previously published data from Oxford, Kiel, Brescia and PROSPECT cohorts consisting of individuals (total n=735) with Parkinson’s disease (PD, n=290), Multiple system atrophy (MSA, n=50), Progressive supranuclear palsy (PSP, n=116), Corticobasal syndrome (CBS, n=88) and healthy controls (HC, n=191) was done using two-stage (training vs validation) ROC analysis.</p> <p><strong>Results:</strong> We established that α-synuclein levels in L1CAM-immunocaptured exosomes above 14 pg/mL is a robust biomarker across cohorts that distinguishes Parkinson’s disease from MSA (AUC=0.90 vs 0.98) or four-repeat tauopathies (AUC=0.93 vs 0.94). We confirmed that exosomal clusterin is elevated in subjects with four-repeat tauopathy and when combined with α-synuclein it improved the performance of the assay in differentiating Parkinson’s disease from four-repeat tauopathies to AUC=0.98 vs 0.99. Correction for the generic exosomal protein syntenin-1 did not consistently improve the performance of the assay.</p> <p><strong>Conclusions:</strong> α-Synuclein and clusterin in L1CAM-immunocaptured serum exosomes is a validated blood test for the molecular stratification of neuronal α-synucleinopathy (i.e. Lewy body pathology) versus phenotypically related neurodegenerative movement disorders.</p>
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spelling oxford-uuid:74b75d8f-da94-4ee4-ab94-b15ce000d2572022-03-26T20:04:46ZValidation of α-synuclein in L1CAM-immunocaptured exosomes as a biomarker for the stratification of Parkinsonian syndromesJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:74b75d8f-da94-4ee4-ab94-b15ce000d257EnglishSymplectic ElementsWiley2021Jiang, CHopfner, FBerg, DHu, MPilotto, ABorroni, BDavis, JJTofaris, G<p><strong>Background:</strong> Parkinson’s disease is characterised by intraneuronal α-synuclein aggregation. Currently there is no α-synuclein-based blood test in clinical practice.</p> <p><strong>Objectives:</strong> Our aim was to assess by means of further testing and analysis whether α-synuclein measurements in serum L1CAM-immunocaptured exosomes can differentiate Parkinson’s disease from related movement disorders.</p> <p><strong>Methods:</strong> We used poly(carboxybetaine-methacrylate) coated magnetic beads to isolate L1CAMpositive exosomes and triplexed electrochemiluminescence to measure exosomal a-synuclein, clusterin and syntenin-1 from 267 serum samples. Combined analysis of our current and previously published data from Oxford, Kiel, Brescia and PROSPECT cohorts consisting of individuals (total n=735) with Parkinson’s disease (PD, n=290), Multiple system atrophy (MSA, n=50), Progressive supranuclear palsy (PSP, n=116), Corticobasal syndrome (CBS, n=88) and healthy controls (HC, n=191) was done using two-stage (training vs validation) ROC analysis.</p> <p><strong>Results:</strong> We established that α-synuclein levels in L1CAM-immunocaptured exosomes above 14 pg/mL is a robust biomarker across cohorts that distinguishes Parkinson’s disease from MSA (AUC=0.90 vs 0.98) or four-repeat tauopathies (AUC=0.93 vs 0.94). We confirmed that exosomal clusterin is elevated in subjects with four-repeat tauopathy and when combined with α-synuclein it improved the performance of the assay in differentiating Parkinson’s disease from four-repeat tauopathies to AUC=0.98 vs 0.99. Correction for the generic exosomal protein syntenin-1 did not consistently improve the performance of the assay.</p> <p><strong>Conclusions:</strong> α-Synuclein and clusterin in L1CAM-immunocaptured serum exosomes is a validated blood test for the molecular stratification of neuronal α-synucleinopathy (i.e. Lewy body pathology) versus phenotypically related neurodegenerative movement disorders.</p>
spellingShingle Jiang, C
Hopfner, F
Berg, D
Hu, M
Pilotto, A
Borroni, B
Davis, JJ
Tofaris, G
Validation of α-synuclein in L1CAM-immunocaptured exosomes as a biomarker for the stratification of Parkinsonian syndromes
title Validation of α-synuclein in L1CAM-immunocaptured exosomes as a biomarker for the stratification of Parkinsonian syndromes
title_full Validation of α-synuclein in L1CAM-immunocaptured exosomes as a biomarker for the stratification of Parkinsonian syndromes
title_fullStr Validation of α-synuclein in L1CAM-immunocaptured exosomes as a biomarker for the stratification of Parkinsonian syndromes
title_full_unstemmed Validation of α-synuclein in L1CAM-immunocaptured exosomes as a biomarker for the stratification of Parkinsonian syndromes
title_short Validation of α-synuclein in L1CAM-immunocaptured exosomes as a biomarker for the stratification of Parkinsonian syndromes
title_sort validation of α synuclein in l1cam immunocaptured exosomes as a biomarker for the stratification of parkinsonian syndromes
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