Cutting through the noise: A narrative review of Alzheimer's disease plasma biomarkers for routine clinical use

叙述的 医学 疾病 噪音(视频) 重症监护医学 心理学 内科学 计算机科学 艺术 文学类 人工智能 图像(数学)
作者
Michael Schöll,Agathe Vrillon,Takeshi Ikeuchi,Frances C. Quevenco,Leonardo Iaccarino,S. Vasileva-Metodiev,Samantha Burnham,James A. Hendrix,Stéphane Epelbaum,Henrik Zetterberg,Sebastian Palmqvist
出处
期刊:JPAD [Springer Science+Business Media]
卷期号:: 100056-100056
标识
DOI:10.1016/j.tjpad.2024.100056
摘要

As novel, anti-amyloid therapies have become more widely available, access to timely and accurate diagnosis has become integral to ensuring optimal treatment of patients with early-stage Alzheimer's disease (AD). Plasma biomarkers are a promising tool for identifying AD pathology; however, several technical and clinical factors need to be considered prior to their implementation in routine clinical use. Given the rapid pace of advancements in the field and the wide array of available biomarkers and tests, this review aims to summarize these considerations, evaluate available platforms, and discuss the steps needed to bring plasma biomarker testing to the clinic. We focus on plasma phosphorylated(p)-tau, specifically plasma p-tau217, as a robust candidate across both primary and secondary care settings. Despite the high performance and robustness demonstrated in research, plasma p-tau217, like all plasma biomarkers, can be affected by analytical and pre-analytical variability as well as patient comorbidities, sex, ethnicity, and race. This review also discusses the advantages of the two-point cut-off approach to mitigating these factors, and the challenges raised by the resulting intermediate range measurements, where clinical guidance is still unclear. Further validation of plasma p-tau217 in heterogeneous, real-world cohorts will help to increase confidence in testing and support establishing a standardized approach. Plasma biomarkers are poised to become a more affordable and less invasive alternative to PET and CSF testing. However, understanding the factors that impact plasma biomarker measurement and interpretation is critical prior to their implementation in routine clinical use.
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