JAMA Neurology：阿尔茨海默病患者8种血浆淀粉样蛋白Aβ42/40检测方法的比较

2021-11-15 Naomi MedSci原创

检测阿尔茨海默病(AD)中淀粉样蛋白(Aβ)病理是生物标记物在临床治疗中实施的一个重大进步。某些基于高精度免疫沉淀-耦合质谱法的方法在检测脑Aβ病理时比大多数血浆Aβ42/40免疫分析方法表现更得更好

检测阿尔茨海默病(AD)中淀粉样蛋白(Aβ)病理的LOOD测试将是生物标记物在临床治疗中实施的一个重大进步，并在药物试验中非常有用。血液中Aβ的可靠测量被证明是具有挑战性的，直到先进的质谱和免疫检测方法的发展。在2016年，用超灵敏的SIMOA免疫测定法评估的血浆Aβ42/40被证明能以中等准确度检测异常的脑脊液β或β正电子发射断层扫描。高精度免疫沉淀-耦合质谱法(IP-MS)测定的血浆Aβ42/40后来被报道与β-PET相关，并与高精度的脑Aβ负荷异常或将来转为β-PET阳性的高风险个体相鉴别。不同的Aβ分析和平台在整个研究中的不同表现可能部分是由于队列特征(例如，样本大小、纳入的诊断组和结果测量)和分析前样本处理的差异。为了最大限度地减少这些偏倚，近日有研究人员对瑞典BIOFINDER研究中的同一组早期AD患者进行了8种Aβ检测方法的一一比较，以评估了不同方法测定的血浆Aβ42/40与正常脑脊液Aβ42/40或Aβ-PET状态的鉴别能力。

这项研究包括182 BIOFINDER队列中认知正常的参与者和104名轻度认知障碍的患者，他们在瑞典3家不同的医院登记，从2010年到2014年接受了β正电子发射断层扫描、脑脊液和血浆采集。

采用华盛顿大学开发的免疫沉淀耦合质谱法(IP-MS-WASU)、Araclon公司开发的无抗体液相色谱质谱(LC-MS-ARC)和罗氏诊断公司(IA-ELC)、欧洲免疫学公司(IA-EI)、阿姆斯特丹大学医学中心、ADX神经科学公司和Quanterix公司的免疫分析法(IA-N4PE)测定血浆Aβ42/40。用岛津的IP-MS法(IP-MS-SHIM)和哥德堡大学的IP-MS-UGOT法(IP-MS-UGOT)和Quanterix公司的免疫测定法(IA-Quan)分别测定了2 0 0名受试者的血浆Aβ42/40。

为了验证，来自阿尔茨海默病神经成像计划的12名参与者(51名认知正常，51名轻度认知障碍，20名AD痴呆)接受了Aβ-PET和血浆Aβ评估，使用IP-MS-WASU，IP-MS-SHIM，IP-MS-UGOT，IA-ELC，IA-N4PE和IA-Quan分析。

8种不同方法定量检测血浆A-β42/40对异常脑脊液A-β42/40和A-β-PET42/40状态的判别准确性

共有408名参与者参与了这项研究。
在BioFINDER队列中，平均年龄(SD)为71.6(5.6)岁，其中49.3%为女性。
血浆IP-MS-WASU Aβ42/40与LC-MS-Arc Aβ42/40、IA-EI Aβ42/40和IA-N4PE Aβ42/40的准确性(受试者工作特征曲线下面积分别为0.86和0.81~0.90)相比，差异有统计学意义(P<0.05)。
血浆IP-MS-WASU Aβ42/40显著优于IP-MS-UGOT Aβ42/40和IA-QUAβ42/40(AUC0.84vs0.68和0.64；P<0.001)，而IP-MS-WASU Aβ42/40和IP-MS-Shim Aβ42/40的AUC无明显差异(0.87vs0.83；P=0.16)。
当使用Aβ-PET作为结果时，结果是相似的。
血浆IPMS-WASU Aβ42/40和IPMS-Shim Aβ42/40与脑脊液Aβ42/40的相关系数最高(r=0.56~0.65)。
BioFINDER的结果在阿尔茨海默病神经成像倡议队列(平均[SD]年龄，72.4[5.4]岁；43.4%的女性)中得到了复制，其中IP-MS-WASU检测的表现明显优于IP-MS-UGOT、IA-ELC、IA-N4PE和IA-Quan检测，但IP-MS-Shim检测没有。

两个独立队列的结果表明，某些基于MS的方法在检测脑Aβ病理时比大多数血浆Aβ42/40免疫分析方法表现得更好。

文献来源：https://jamanetwork-com.washington.80599.net/journals/jamaneurology/fullarticle/2784411

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2022-09-26 feifers

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2022-02-01 yinhl1978

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2022-05-18 zhaojie88

#阿尔茨#

97 0
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2022-02-19 12498da4m32(暂无昵称)

#阿尔茨海#

86 0
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2021-11-16 ms7405317358118777

#淀粉样蛋白#

108 0
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2021-11-16 gracezdd

#检测方法#

108 0
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2021-11-16 yhj-time

#阿尔茨海默#

74 0
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2021-11-16 膀胱癌

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