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1. Validation of biomarkers in Huntington disease to support the development of disease-modifying therapies: A systematic review and critical appraisal scheme

Author

Thilo van Eimeren, Hanna Tang, Tiago A. Mestre, and Cristina Sampaio

Subjects
Adult, Male, medicine.medical_specialty, Validity, Disease, Huntington's disease, Drug Development, Validation, medicine, Humans, ddc:610, Adverse effect, Intensive care medicine, business.industry, Reproducibility of Results, diagnosis [Huntington Disease], Middle Aged, Huntington disease, medicine.disease, Checklist, Critical appraisal, Huntington Disease, Neurology, Drug development, Biomarker (medicine), Female, Neurology (clinical), Geriatrics and Gerontology, business, analysis [Biomarkers], Biomarkers
Abstract

Background There are promising novel genetic-based therapies under development intended to modify the disease trajectory in Huntington disease. Valid biomarkers that can facilitate the development of such disease-modifying therapies are urgently needed. There are currently no studies that appraise the quality of research for validation of biomarkers in HD. Objective To review studies for disease progression biomarkers in HD and evaluate their methodological quality. Methods A systematic review of all HD biomarker studies up to June 2020 was conducted. Each study was assessed for methodological quality using a 24-item standardized checklist. We completed a subgroup analyses based on year of publication and biomarker type. Results We included 218 HD biomarker studies, 76 (34.9%) were longitudinal and 161 (74%) included premanifest HD. On average, 10 ± 3 items (out of 24) were rated as good quality. The items more commonly rated as poor quality were: reporting of validity and reliability of assessments, sampling method, report of adverse events associated with the biomarker test, power calculation and appropriateness of study enrolment. Publications from 2016 to 2020 (mean score = 11.2 ± 2.3) had a better methodological quality than publications prior to 2016 (mean score = 9.8 ± 3.1; p = 0.018). Conclusion Overall, the reported methodological quality of the existing research on biomarkers for disease progression is low, which undermines the confidence of biomarkers use in drug development studies. It will be important to invest in better designed studies to support the use of biomarkers as valid drug development tools.

Published
2021

2. PLCG2 protective variant p.P522R modulates tau pathology and disease progression in patients with mild cognitive impairment

Author

KLEINEIDAM, Luca, Chouraki, Vincent, Próchnicki, Tomasz, van der Lee, Sven, Madrid‑Márquez, Laura, Wagner-Thelen, Holger, Karaca, Ilker, WEINHOLD, Leonie, Wolfsgruber, Steffen, Boland, Anne, Martino Adami, Pamela, Lewczuk, Piotr, POPP, Julius, Brosseron, Frederic, Jansen, Iris, HULSMAN, Marc, Kornhuber, Johannes, Peters, Oliver, Berr, Claudine, Heun, Reinhard, Frölich, Lutz, Tzourio, Christophe, Dartigues, Jean-François, Hüll, Michael, Espinosa, Ana, Hernández, Isabel, de Rojas, Itziar, ORELLANA, Adelina, VALERO, Sergi, STRINGA, Najada, Van Schoor, Natasja, Huisman, Martijn, Scheltens, Philip, For The Alzheimer'S Disease Neuroimaging Initiative, (ADNI), Rüther, Eckart, Deleuze, Jean-François, Wiltfang, Jens, Tarraga, Lluis, Schmid, Matthias, Scherer, Martin, Riedel-Heller, Steffi, Heneka, Michael, Amouyel, Philippe, Jessen, Frank, Boada, Merce, Maier, Wolfgang, Schneider, Anja, González‑Pérez, Antonio, van der Flier, Wiesje, Wagner, Michael, Lambert, Jean-Charles, Holstege, Henne, Saez, Mª Eugenia, Latz, Eicke, Ruiz, Agustin, Ramirez, Alfredo, University Hospital Bonn, Universität zu Köln, German Research Center for Neurodegenerative Diseases - Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 (RID-AGE), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'Epidémiologie et de Santé Publique [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Amsterdam UMC, Vrije Universiteit Amsterdam [Amsterdam] (VU), Centro andaluz de estudios bioinformáticos - Andalusian Bioinformatics Research Centre [Sevilla] (CAEBi), Centre National de Recherche en Génomique Humaine (CNRGH), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Institut de Biologie François JACOB (JACOB), Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Universitätsklinikum Erlangen [Erlangen], Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), University of Bialystok, Lausanne University Hospital, University hospital of Zurich [Zurich], Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Universität Heidelberg [Heidelberg], Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Albert-Ludwigs-Universität Freiburg, Universitat Internacional de Catalunya [Barcelona] (UIC), Instituto de Salud Carlos III [Madrid] (ISC), University Medical Center Göttingen (UMG), Universidade de Aveiro, Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] (UKE), Universität Leipzig [Leipzig], University of Massachusetts Medical School [Worcester] (UMASS), University of Massachusetts System (UMASS), Norwegian University of Science and Technology [Trondheim] (NTNU), Norwegian University of Science and Technology (NTNU), Open Access funding provided by Projekt DEAL. This publication was funded in part by the German Federal Ministry of Education and Research (BMBF) (grants KND: 01GI0102, 01GI0420, 01GI0422, 01GI0423, 01GI0429, 01GI0431, 01GI0433, 01GI0434, grants KNDD: 01GI0710, 01GI0711, 01GI0712, 01GI0713, 01GI0714, 01GI0715, 01GI0716, 01ET1006B). Analyses were also funded by the German Federal Ministry of Education and Research (BMBF 01EA1410A) within the project 'Diet-Body-Brain: from epidemiology to evidence-based communication'. Part of the work was funded by the JPND EADB grant (German Federal Ministry of Education and Research (BMBF) grant: 01ED1619A). Part of the analysis was funded by the German Research Foundation (DFG) grant: RA 1971/6-1 to Alfredo Ramirez. Research of the Alzheimer Center Amsterdam is part of the neurodegeneration research program of Amsterdam Neuroscience. The Alzheimer Center Amsterdam is supported by Stichting Alzheimer Nederland and Stichting VUmc fonds. The clinical database structure was developed with funding from Stichting Dioraphte. Genotyping of the Dutch case–control samples was performed in the context of EADB (European Alzheimer DNA biobank) funded by the JPco-fuND FP-829-029 (ZonMW project number 733051061). Data collection and sharing for this project were funded by the Alzheimer’s Disease Neuroimaging Initiative (ADNI) (National Institutes of Health Grant U01 AG024904) and DOD ADNI (Department of Defense award number W81XWH-12-2-0012). ADNI is funded by the National Institute on Aging, the National Institute of Biomedical Imaging and Bioengineering, and through generous contributions from the following: AbbVie, Alzheimer’s Association, Alzheimer’s Drug Discovery Foundation, Araclon Biotech, BioClinica, Inc., Biogen, Bristol-Myers Squibb Company, CereSpir, Inc., Cogstate, Eisai Inc., ElanPharmaceuticals, Inc., Eli Lilly and Company, EuroImmun, F. Hoffmann-La Roche Ltd. and its affiliated company Genentech, Inc., Fujirebio, GE Healthcare, IXICO Ltd., Janssen Alzheimer Immunotherapy Research and Development, LLC., Johnson and Johnson Pharmaceutical Research and Development LLC., Lumosity, Lundbeck, Merck and Co., Inc., Meso Scale Diagnostics, LLC., NeuroRx Research, Neurotrack Technologies, Novartis Pharmaceuticals Corporation, Pfizer Inc., Piramal Imaging, Servier, Takeda Pharmaceutical Company, and transition Therapeutics. The Canadian Institutes of Health Research is providing funds to support ADNI clinical sites in Canada. Private sector contributions are facilitated by the Foundation for the National Institutes of Health (www.fnih.org). The grantee organization is the Northern California Institute for Research and Education, and the study is coordinated by the Alzheimer’s Therapeutic Research Institute at the University of Southern California. ADNI data are disseminated by the Laboratory for NeuroImaging at the University of Southern California. The Three-City Study genotyping and analysis was funded by the GENMED Labex, the Joint Programming Initiative on Neurodegenerative Diseases Research (JPND, PERADES project), the Institute Pasteur de Lille, the University of Lille, and the Nord-Pas de Calais Regional Council. This work also benefited from the Lille Métropole Communauté Urbaine Council, the French government’s LABEX DISTALZ program (development of innovative strategies for a transdisciplinary approach to Alzheimer’s disease). In addition, the Three-City Study was performed as part of a collaboration between the Institut National de la Santé et de la Recherche Médicale (Inserm), the Victor Segalen Bordeaux II University and Sanofi-Synthélabo. The Fondation pour la Recherche Médicale funded the preparation and initiation of the study. Additional funding for the 3C Study was also obtained from the Caisse Nationale Maladie des Travailleurs Salariés, Direction Générale de la Santé, MGEN, Institut de la Longévité, Agence Française de Sécurité Sanitaire des Produits de Santé, the Aquitaine and Bourgogne Regional Councils, Fondation de France and the joint French Ministry of Research/INSERM 'Cohortes et collections de données biologiques' programme. Lille Génopôle received an unconditional grant from Eisai. Fundacio ACE cohort receives support from the Innovative Medicines Initiative 2 Joint Undertaking which receives support from the European Union’s Horizon 2020 research and innovation programme (ADAPTED Grant No. 115975). A. Ruiz’s research is also supported by Instituto de Salud Carlos III (ISCIII) grants PI13/02434, PI16/01861, and PI19/01301. Acción Estratégica en Salud, integrated in the Spanish National R + D + I Plan and financed by ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER-'Una manera de Hacer Europa'), by Fundación bancaria 'La Caixa' and Grifols SA (GR@ACE project). For the Longitudinal Aging Study Amsterdam (LASA) supports was largely obtained from a grant from the Netherlands Ministry of Health, Welfare and Sports, Directorate of Long-Term Care. The data collection in 2012–2013 was financially supported by the Netherlands Organization for Scientific Research (NWO) in the framework of the project 'New Cohorts of young old in the twenty-first century' (File Number 480-10-014). Genotyping using Axiom-NL array was financially supported by EMGO+ Research Institute. PL was supported by the Innovative Medicines Initiative Joint Undertaking under EMIF grant agreement no 115372, resources of which are composed of financial contribution from the European Union’s Seventh Framework Programme (FP7/2007-2013) and EFPIA companies in kind contribution. JW is supported by an Ilídio Pinho professorship and iBiMED (UID/BIM/04501/2013), at the University of Aveiro, Portugal. JP was supported by a grant from the Swiss National Science Foundation (320030L_141179)., Universität zu Köln = University of Cologne, Amsterdam UMC - Amsterdam University Medical Center, Universität Heidelberg [Heidelberg] = Heidelberg University, Universität Leipzig, Alzheimer's Disease Neuroimaging Initiative (ADNI), Kleineidam, L., Karaca, I., Heneka, M.T., Maier, W., Schneider, A., Wagner, M., Chouraki, V., Amouyel, P., Lambert, J.C., Próchnicki, T., Latz, E., van der Lee, S.J., Jansen, I.E., Hulsman, M., Scheltens, P., van der Flier, W.M., Holstege, H., Madrid-Márquez, L., González-Pérez, A., Sáez, M.E., Wagner-Thelen, H., Martino Adami, P.V., Jessen, F., Ramirez, A., Weinhold, L., Schmid, M., Wolfsgruber, S., Brosseron, F., Boland, A., Deleuze, J.F., Lewczuk, P., Kornhuber, J., Popp, J., Peters, O., Berr, C., Heun, R., Frölich, L., Tzourio, C., Dartigues, J.F., Hüll, M., Espinosa, A., Hernández, I., de Rojas, I., Orellana, A., Valero, S., Ruiz, A., Tarraga, L., Boada, M., Stringa, N., van Schoor, N.M., Huisman, M., Rüther, E., Wiltfang, J., Scherer, M., Riedel-Heller, S., Neurology, Human genetics, Epidemiology and Data Science, APH - Aging & Later Life, APH - Societal Participation & Health, Amsterdam Neuroscience - Complex Trait Genetics, APH - Personalized Medicine, APH - Methodology, Sociology, and The Social Context of Aging (SoCA)

Subjects
Apolipoprotein E, Male, pathology [Cognitive Dysfunction], Cognitive decline, genetics [Alzheimer Disease], Disease, SEPIA, pathology [Alzheimer Disease], 0302 clinical medicine, Cognition, genetics [Amyloid beta-Peptides], Medicine, Aged, 80 and over, 0303 health sciences, education.field_of_study, Microglia, physiology [Cognition], Middle Aged, medicine.anatomical_structure, Disease Progression, Female, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], analysis [Biomarkers], Alzheimer’s disease, Amyloid, Phospholipase C gamma 2, Population, tau Proteins, Pathology and Forensic Medicine, PLCG2, 03 medical and health sciences, Cellular and Molecular Neuroscience, SDG 3 - Good Health and Well-being, Alzheimer Disease, Humans, Cognitive Dysfunction, ddc:610, education, Mild cognitive impairment, HEALTHY, 030304 developmental biology, Aged, metabolism [Phospholipase C gamma], Original Paper, Amyloid beta-Peptides, TREM2, business.industry, Phospholipase C gamma, genetics [Cognitive Dysfunction], metabolism [tau Proteins], cerebrospinal fluid [tau Proteins], [SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics, Immunology, Neurology (clinical), business, 030217 neurology & neurosurgery, Biomarkers
Abstract

A rare coding variant (rs72824905, p.P522R) conferring protection against Alzheimer’s disease (AD) was identified in the gene encoding the enzyme phospholipase-C-γ2 (PLCG2) that is highly expressed in microglia. To explore the protective nature of this variant, we employed latent process linear mixed models to examine the association of p.P522R with longitudinal cognitive decline in 3595 MCI patients, and in 10,097 individuals from population-based studies. Furthermore, association with CSF levels of pTau181, total tau, and Aβ1-42 was assessed in 1261 MCI patients. We found that MCI patients who carried the p.P522R variant showed a slower rate of cognitive decline compared to non-carriers and that this effect was mediated by lower pTau181 levels in CSF. The effect size of the association of p.P522R with the cognitive decline and pTau181 was similar to that of APOE-ε4, the strongest genetic risk factor for AD. Interestingly, the protective effect of p.P522R was more pronounced in MCI patients with low Aβ1-42 levels suggesting a role of PLCG2 in the response to amyloid pathology. In line with this hypothesis, we observed no protective effect of the PLCG2 variant on the cognitive decline in population-based studies probably due to the lower prevalence of amyloid positivity in these samples compared to MCI patients. Concerning the potential biological underpinnings, we identified a network of co-expressed proteins connecting PLCG2 to APOE and TREM2 using unsupervised co-regulatory network analysis. The network was highly enriched for the complement cascade and genes differentially expressed in disease-associated microglia. Our data show that p.P522R in PLCG2 reduces AD disease progression by mitigating tau pathology in the presence of amyloid pathology and, as a consequence, maintains cognitive function. Targeting the enzyme PLCG2 might provide a new therapeutic approach for treating AD.

Published
2020

3. PRediction of acute coronary syndrome in acute ischemic StrokE (PRAISE) – protocol of a prospective, multicenter trial with central reading and predefined endpoints

Author

Nolte, Christian H., Rennenberg, Regina Von, Litmeier, Simon, Scheitz, Jan F., Leistner, David M., Blankenberg, Stephan, Dichgans, Martin, Katus, Hugo, Petzold, Gabor C., Pieske, Burkert, Regitz-Zagrosek, Vera, Wegscheider, Karl, Zeiher, Andreas M., Landmesser, Ulf, and Endres, Matthias

Subjects
methods [Electrocardiography], Acute ischemic stroke, Myocardial Infarction, Coronary Artery Disease, diagnosis [Myocardial Infarction], Coronary Angiography, lcsh:RC346-429, analysis [Troponin], Brain Ischemia, Electrocardiography, Study Protocol, Chronic coronary disease, methods [Coronary Angiography], Humans, complications [Stroke], ddc:610, Prospective Studies, lcsh:Neurology. Diseases of the nervous system, diagnosis [Acute Coronary Syndrome], diagnosis [Coronary Artery Disease], complications [Brain Ischemia], Troponin, Stroke, Stroke-heart-syndrome, Troponin elevation, Heart-and-brain interaction, Acute coronary syndrome, analysis [Biomarkers], 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit, Biomarkers
Abstract

Background Current guidelines recommend measurement of troponin in acute ischemic stroke (AIS) patients. In AIS patients, troponin elevation is associated with increased mortality and worse outcome. However, uncertainty remains regarding the underlying pathophysiology of troponin elevation after stroke, particularly regarding diagnostic and therapeutic consequences. Troponin elevation may be caused by coronary artery disease (CAD) and more precisely acute coronary syndrome (ACS). Both have a high prevalence in stroke patients and contribute to poor outcome. Therefore, better diagnostic algorithms are needed to identify those AIS patients likely to have ACS or other manifestations of CAD. Methods/design The primary goal of the “PRediction of Acute coronary syndrome in acute Ischemic StrokE” (PRAISE) study is to develop a diagnostic algorithm for prediction of ACS in AIS patients. The primary hypothesis will test whether dynamic high-sensitivity troponin levels determined by repeat measurements (i.e., “rise or fall-pattern”) indicate presence of ACS when compared to stable (chronic) troponin elevation. PRAISE is a prospective, multicenter, observational trial with central reading and predefined endpoints guided by a steering committee. Clinical symptoms, troponin levels as well as findings on electrocardiogram, echocardiogram, and coronary angiogram will be recorded and assessed by central academic core laboratories. Diagnosis of ACS will be made by an endpoint adjudication committee. Severe adverse events will be evaluated by a critical event committee. Safety will be judged by a data and safety monitoring board. Follow-up will be conducted at three and twelve months and will record new vascular events (i.e., stroke and myocardial infarction) as well as death, functional and cognitive status. According to sample size calculation, 251 patients have to be included. Discussion PRAISE will prospectively determine the frequency of ACS and characterize cardiac and coronary pathologies in a large, multicenter cohort of AIS patients with troponin elevation. The findings will elucidate the origin of troponin elevation, shed light on its impact on necessary diagnostic procedures and provide data on the safety and diagnostic yield of coronary angiography early after stroke. Thereby, PRAISE will help to refine algorithms and develop guidelines for the cardiac workup in AIS. Trial registration NCT03609385 registered 1st August 2018.

Published
2020

4. YKL-40 in the brain and cerebrospinal fluid of neurodegenerative dementias

Author

Llorens Torres, Franc, Thune, Katrin, Tahir, Waqas, Kanata, Eirini, Diaz-Lucena, Daniela, Xanthopoulos, Konstantinos, Kovatsi, Eleni, Pleschka, Catharina, Garcia Esparcia, Paula, Schmitz, Matthias, Ozbay, Duru, Correia, Susana, Correia, Ângela, Milosevic, Ira, Andreoletti, Olivier, Fernández Borges, Natalia, Vorberg, Ina M., Glatzel, Markus, Sklaviadis, Theodoros, Torres, Juan Maria, Krasemann, Susanne, Sánchez del Valle Díaz, Raquel, Ferrer, Isidro (Ferrer Abizanda), Zerr, Inga, Universitat de Barcelona, Centro de Investigacion Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III [Madrid] (ISC), university medical school, Partenaires INRAE, German Center for Neurodegenerative Diseases, Aristotle University of Thessaloniki, San Raffaele Scientific Institute, Research Institute, Interactions hôtes-agents pathogènes [Toulouse] (IHAP), Institut National de la Recherche Agronomique (INRA)-Ecole Nationale Vétérinaire de Toulouse (ENVT), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Centro de Investigacion en Sanidad Animal (INIA-CISA), Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria = National Institute for Agricultural and Food Research and Technology (INIA), Institute of Neuropathology, Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] (UKE), and Institut d'Investigacions Biomèdiques August Pi i Sunyer

Subjects
Male, musculoskeletal diseases, YKL-40, Médecine humaine et pathologie, Mice, Transgenic, lcsh:Geriatrics, metabolism [Neurodegenerative Diseases], lcsh:RC346-429, metabolism [Cerebrospinal Fluid], Mice, Neuroinflammation, ddc:570, mental disorders, Animals, Humans, metabolism [Dementia], Chitinase-3-Like Protein 1, lcsh:Neurology. Diseases of the nervous system, Glycoproteins, Aged, Brain, Cerebrospinal fluid, Chitinase 3-like 1, Neurodegenerative dementias, biosynthesis [Chitinase-3-Like Protein 1], Malalties neurodegeneratives, Neurodegenerative diseases, Microbiology and Parasitology, CHI3L1 protein, human, Neurodegenerative Diseases, Middle Aged, Microbiologie et Parasitologie, lcsh:RC952-954.6, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, metabolism [Brain], analysis [Chitinase-3-Like Protein 1], Dementia, Female, Human health and pathology, analysis [Biomarkers], [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Biomarkers, Research Article, Glicoproteïnes
Abstract

Background YKL-40 (also known as Chitinase 3-like 1) is a glycoprotein produced by inflammatory, cancer and stem cells. Its physiological role is not completely understood but YKL-40 is elevated in the brain and cerebrospinal fluid (CSF) in several neurological and neurodegenerative diseases associated with inflammatory processes. Yet the precise characterization of YKL-40 in dementia cases is missing. Methods In the present study, we comparatively analysed YKL-40 levels in the brain and CSF samples from neurodegenerative dementias of different aetiologies characterized by the presence of cortical pathology and disease-specific neuroinflammatory signatures. Results YKL-40 was normally expressed in fibrillar astrocytes in the white matter. Additionally YKL-40 was highly and widely expressed in reactive protoplasmic cortical and perivascular astrocytes, and fibrillar astrocytes in sporadic Creutzfeldt-Jakob disease (sCJD). Elevated YKL-40 levels were also detected in Alzheimer’s disease (AD) but not in dementia with Lewy bodies (DLB). In AD, YKL-40-positive astrocytes were commonly found in clusters, often around β-amyloid plaques, and surrounding vessels with β-amyloid angiopathy; they were also distributed randomly in the cerebral cortex and white matter. YKL-40 overexpression appeared as a pre-clinical event as demonstrated in experimental models of prion diseases and AD pathology. CSF YKL-40 levels were measured in a cohort of 288 individuals, including neurological controls (NC) and patients diagnosed with different types of dementia. Compared to NC, increased YKL-40 levels were detected in sCJD (p 0.05, AUC = 0.71) or in DLB/Parkinson’s disease dementia (PDD) (p > 0.05, AUC = 0.70). Further, two independent patient cohorts were used to validate the increased CSF YKL-40 levels in sCJD. Additionally, increased YKL-40 levels were found in genetic prion diseases associated with the PRNP-D178N (Fatal Familial Insomnia) and PRNP-E200K mutations. Conclusions Our results unequivocally demonstrate that in neurodegenerative dementias, YKL-40 is a disease-specific marker of neuroinflammation showing its highest levels in prion diseases. Therefore, YKL-40 quantification might have a potential for application in the evaluation of therapeutic intervention in dementias with a neuroinflammatory component.

Published
2017

5. Consensus paper of the WFSBP Task Force on Biological Markers: Criteria for biomarkers and endophenotypes of schizophrenia, part III: Molecular mechanisms

Author

Schmitt, Andrea, Martins-de-Souza, Daniel, Grünblatt, Edna, Halene, Tobias, Hasan, Alkomiet, Hashimoto, Kenij, Kim, Yong-Ku, Kirchner, Sophie-Kathrin, Kornhuber, Johannes, Kraus, Theo F J, Malchow, Berend, Nascimento, Juliana M, Akbarian, Schahram, Rossner, Moritz, Schwarz, Markus, Steiner, Johann, Talib, Leda, Thibaut, Florence, Riederer, Peter, Falkai, Peter, Markers, Members of the WFSBP Task Force on Biological, Cassoli, Juliana S, Ehrenreich, Hannelore, Fischer, Andre, Fonteh, Alfred, Gattaz, Wagner F, Gawlik, Michael, and Gerlach, Manfred

Subjects
0301 basic medicine, Proteomics, Consensus, Endophenotypes, Schizophrenia (object-oriented programming), Advisory Committees, Gene Expression, Disease, analysis [MicroRNAs], Bioinformatics, Epigenesis, Genetic, 03 medical and health sciences, 0302 clinical medicine, microRNA, Humans, genetics [Schizophrenia], Epigenetics, ddc:610, Biological Psychiatry, biology, DNA Methylation, Psychiatry and Mental health, MicroRNAs, 030104 developmental biology, Histone, Endophenotype, DNA methylation, biology.protein, Schizophrenia, analysis [Biomarkers], 030217 neurology & neurosurgery, Biomarkers
Abstract

Despite progress in identifying molecular pathophysiological processes in schizophrenia, valid biomarkers are lacking for both the disease and treatment response.This comprehensive review summarises recent efforts to identify molecular mechanisms on the level of protein and gene expression and epigenetics, including DNA methylation, histone modifications and micro RNA expression. Furthermore, it summarises recent findings of alterations in lipid mediators and highlights inflammatory processes. The potential that this research will identify biomarkers of schizophrenia is discussed.Recent studies have not identified clear biomarkers for schizophrenia. Although several molecular pathways have emerged as potential candidates for future research, a complete understanding of these metabolic pathways is required to reveal better treatment modalities for this disabling condition.Large longitudinal cohort studies are essential that pair a thorough phenotypic and clinical evaluation for example with gene expression and proteome analysis in blood at multiple time points. This approach might identify biomarkers that allow patients to be stratified according to treatment response and ideally also allow treatment response to be predicted. Improved knowledge of molecular pathways and epigenetic mechanisms, including their potential association with environmental influences, will facilitate the discovery of biomarkers that could ultimately be effective tools in clinical practice.

Published
2017

6. Comparison of Visual and Quantitative Florbetapir F 18 Positron Emission Tomography Analysis in Predicting Mild Cognitive Impairment Outcomes

Author

Schreiber, Stefanie, Landau, Susan M, Gamst, Anthony, Cellar, Janet S, Burns, Jeffrey M, Anderson, Heather S, Laubinger, Mary M, Bartzokis, George, Silverman, Daniel H S, Lu, Po H, Graff-Radford, Neill R, Parfitt, Francine, Johnson, Heather, Soares, Holly, Farlow, Martin, Herring, Scott, Hake, Ann M, van Dyck, Christopher H, MacAvoy, Martha G, Benincasa, Amanda L, Chertkow, Howard, Bergman, Howard, Hosein, Chris, Black, Sandra, Green, Robert C, Graham, Simon, Caldwell, Curtis, Hsiung, Ging-Yuek Robin, Feldman, Howard, Assaly, Michele, Kertesz, Andrew, Rogers, John, Trost, Dick, Bernick, Charles, Munic, Donna, Montine, Tom, Wu, Chuang-Kuo, Johnson, Nancy, Mesulam, Marsel, Sadowsky, Carl, Martinez, Walter, Villena, Teresa, Turner, Scott, Johnson, Kathleen B, Behan, Kelly E, Sperling, Reisa A, Thomas, Ronald G, Rentz, Dorene M, Johnson, Keith A, Rosen, Allyson, Tinklenberg, Jared, Ashford, Wes, Sabbagh, Marwan, Connor, Donald, Jacobson, Sandra, Killiany, Ronald, Norbash, Alexander, Donohue, Michael, Nair, Anil, Obisesan, Thomas O, Jayam-Trouth, Annapurni, Wang, Paul, Lerner, Alan, Hudson, Leon, Ogrocki, Paula, DeCarli, Charles, Fletcher, Evan, Carmichael, Owen, Walter, Sarah, Kittur, Smita, Mirje, Seema, Borrie, Michael, Lee, T-Y, Bartha, Rob, Johnson, Sterling, Asthana, Sanjay, Carlsson, Cynthia M, Potkin, Steven G, Preda, Adrian, Dale, Anders, Nguyen, Dana, Tariot, Pierre, Fleisher, Adam, Reeder, Stephanie, Bates, Vernice, Capote, Horacio, Rainka, Michelle, Hendin, Barry A, Scharre, Douglas W, Kataki, Maria, Bernstein, Matthew, Zimmerman, Earl A, Celmins, Dzintra, Brown, Alice D, Gandy, Sam, Marenberg, Marjorie E, Rovner, Barry W, Pearlson, Godfrey, Blank, Karen, Anderson, Karen, Saykin, Andrew J, Felmlee, Joel, Santulli, Robert B, Englert, Jessica, Williamson, Jeff D, Sink, Kaycee M, Watkins, Franklin, Ott, Brian R, Cohen, Ronald, Salloway, Stephen, Malloy, Paul, Fero, Allison, Fox, Nick, Correia, Stephen, Rosen, Howard J, Miller, Bruce L, Mintzer, Jacobo, Thompson, Paul, Schuff, Norbert, Alexander, Gene, Bandy, Dan, Chen, Kewei, Morris, John, Lee, Virginia M-Y, Korecka, Magdalena, Schreiber, Frank, Crawford, Karen, Neu, Scott, Harvey, Danielle, Kornak, John, Foroud, Tatiana M, Potkin, Steven, Shen, Li, Buckholtz, Neil, Kaye, Jeffrey, Jagust, William J, Dolen, Sara, Quinn, Joseph, Schneider, Lon, Pawluczyk, Sonia, Spann, Bryan M, Brewer, James, Vanderswag, Helen, Heidebrink, Judith L, Lord, Joanne L, Petersen, Ronald, Initiative, Alzheimer's Disease Neuroimaging, Johnson, Kris, Doody, Rachelle S, Villanueva-Meyer, Javier, Chowdhury, Munir, Stern, Yaakov, Honig, Lawrence S, Bell, Karen L, Morris, John C, Mintun, Mark A, Schneider, Stacy, Aisen, Paul, Marson, Daniel, Griffith, Randall, Clark, David, Grossman, Hillel, Tang, Cheuk, Marzloff, George, deToledo-Morrell, Leyla, Shah, Raj C, Duara, Ranjan, Varon, Daniel, Jack, Clifford R, Roberts, Peggy, Albert, Marilyn S, Pedroso, Julia, Toroney, Jaimie, Rusinek, Henry, de Leon, Mony J, De Santi, Susan M, Doraiswamy, P Murali, Petrella, Jeffrey R, Aiello, Marilyn, Toga, Arthur W, Clark, Christopher M, Pham, Cassie, Nunez, Jessica, Smith, Charles D, Given, Curtis A, Hardy, Peter, Lopez, Oscar L, Oakley, MaryAnn, Simpson, Donna M, Ismail, M Saleem, Beckett, Laurel, Brand, Connie, BA, Jennifer Richard, Mulnard, Ruth A, Thai, Gaby, Mc-Adams-Ortiz, Catherine, Diaz-Arrastia, Ramon, Martin-Cook, Kristen, DeVous, Michael, Levey, Allan I, and Lah, James J

Subjects
Male, medicine.medical_specialty, diagnostic imaging [Cognitive Dysfunction], metabolism [Amyloid beta-Peptides], Context (language use), Standardized uptake value, Neuroimaging, Alzheimer Disease, Fluorodeoxyglucose F18, Predictive Value of Tests, medicine, Humans, Cognitive Dysfunction, therapy [Cognitive Dysfunction], ddc:610, Longitudinal Studies, Psychiatry, Aged, Aged, 80 and over, Amyloid beta-Peptides, medicine.diagnostic_test, therapy [Alzheimer Disease], business.industry, methods [Positron-Emission Tomography], diagnosis [Alzheimer Disease], complications [Alzheimer Disease], Middle Aged, medicine.disease, Inter-rater reliability, Treatment Outcome, Positron emission tomography, Positron-Emission Tomography, Predictive value of tests, Biomarker (medicine), Female, Neurology (clinical), Alzheimer's disease, Psychology, Nuclear medicine, business, analysis [Biomarkers], complications [Cognitive Dysfunction], Biomarkers
Abstract

Importance The applicability of β-amyloid peptide (Aβ) positron emission tomography (PET) as a biomarker in clinical settings to aid in selection of individuals at preclinical and prodromal Alzheimer disease (AD) will depend on the practicality of PET image analysis. In this context, visual-based Aβ PET assessment seems to be the most feasible approach. Objectives To determine the agreement between visual and quantitative Aβ PET analysis and to assess the ability of both techniques to predict conversion from mild cognitive impairment (MCI) to AD. Design, Setting, and Participants A longitudinal study was conducted among the Alzheimer’s Disease Neuroimaging Initiative (ADNI) sites in the United States and Canada during a 1.6-year mean follow-up period. The study was performed from September 21, 2010, to August 11, 2014; data analysis was conducted from September 21, 2014, to May 26, 2015. Participants included 401 individuals with MCI receiving care at a specialty clinic (219 [54.6%] men; mean [SD] age, 71.6 [7.5] years; 16.2 [2.7] years of education). All participants were studied with florbetapir F 18 [ 18 F] PET. The standardized uptake value ratio (SUVR) positivity threshold was 1.11, and one reader rated all images, with a subset of 125 scans rated by a second reader. Main Outcomes and Measures Sensitivity and specificity of positive and negative [ 18 F] florbetapir PET categorization, which was estimated with cerebrospinal fluid Aβ1-42 as the reference standard. Risk for conversion to AD was assessed using Cox proportional hazards regression models. Results The frequency of Aβ positivity was 48.9% (196 patients; visual analysis), 55.1% (221 patients; SUVR), and 64.8% (166 patients; cerebrospinal fluid), yielding substantial agreement between visual and SUVR data (κ = 0.74) and between all methods (Fleiss κ = 0.71). For approximately 10% of the 401 participants in whom visual and SUVR data disagreed, interrater reliability was moderate (κ = 0.44), but it was very high if visual and quantitative results agreed (κ = 0.92). Visual analysis had a lower sensitivity (79% vs 85%) but higher specificity (96% vs 90%), respectively, compared with SUVR. The conversion rate was 15.2% within a mean of 1.6 years, and a positive [ 18 F] florbetapir baseline scan was associated with a 6.91-fold (SUVR) or 11.38-fold (visual) greater hazard for AD conversion, which changed only modestly after covariate adjustment for apolipoprotein e4, concurrent fludeoxyglucose F 18 PET scan, and baseline cognitive status. Conclusions and Relevance Visual and SUVR Aβ PET analysis may be equivalently used to determine Aβ status for individuals with MCI participating in clinical trials, and both approaches add significant value for clinical course prognostication.

Published
2015

7. Measuring Compounds in Exhaled Air to Detect Alzheimer's Disease and Parkinson’s Disease

Author

Richard Dodel, Frank Jessen, Sabina Janciauskiene, Jörg Ingo Baumbach, Joan Philipp Michelis, Björn Tackenberg, Akira Hattesohl, Christoph Nell, Sasidhar Maddula, Severin Schmid, Judith Alferink, Michael T. Heneka, David Mengel, Andreas Rembert Koczulla, Claus Vogelmeier, Jan-Philipp Bach, Tobias Boeselt, Jürgen Rieke, Wolfgang H. Oertel, Maike Gold, and Dirk Lubbe

Subjects
Male, Parkinson's disease, lcsh:Medicine, Disease, Gastroenterology, Mice, Exhaled breath condensate, 610 Medicine & health, lcsh:Science, Lung, Mice, Inbred C3H, Multidisciplinary, biology, diagnosis [Alzheimer Disease], Parkinson Disease, analysis [Amyloid beta-Peptides], Middle Aged, amyloid beta-protein (1-42), Pathophysiology, chemistry [Lung], Breath Tests, Female, ddc:500, Alzheimer's disease, analysis [Biomarkers], methods [Breath Tests], methods [Spectrum Analysis], diagnosis [Parkinson Disease], Research Article, medicine.medical_specialty, Amyloid beta, Blotting, Western, Enzyme-Linked Immunosorbent Assay, Mice, Transgenic, Sensitivity and Specificity, Alzheimer Disease, Internal medicine, medicine, Animals, Humans, Medical history, ddc:610, Aged, Amyloid beta-Peptides, business.industry, Spectrum Analysis, lcsh:R, Case-control study, analysis [Peptide Fragments], Reproducibility of Results, amyloid beta-protein (1-40), medicine.disease, Peptide Fragments, Mice, Inbred C57BL, Case-Control Studies, Immunology, biology.protein, lcsh:Q, business, Biomarkers
Abstract

PLoS one 10(7), e0132227 (2015). doi:10.1371/journal.pone.0132227, Published by PLoS, Lawrence, Kan.

Published
2015
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8. Prevalence of Cerebral Amyloid Pathology in Persons Without Dementia A Meta-analysis

Author

Jansen, Willemijn J, Ossenkoppele, Rik, Alcolea, Daniel, Rodríguez-Rodríguez, Eloy, Roe, Catherine M, Rot, Uros, Rowe, Christopher C, Rüther, Eckart, Sabri, Osama, Sanchez-Juan, Páscual, Santana, Isabel, Sarazin, Marie, Schröder, Johannes, Alexander, Myriam, Schütte, Christin, Seo, Sang W, Soetewey, Femke, Soininen, Hilkka, Spiru, Luiza, Struyfs, Hanne, Teunissen, Charlotte E, Tsolaki, Magda, Vandenberghe, Rik, Verbeek, Marcel M, Almdahl, Ina S, Villemagne, Victor L, Vos, Stephanie J B, van Waalwijk van Doorn, Linda J C, Waldemar, Gunhild, Wallin, Anders, Wallin, Åsa K, Wiltfang, Jens, Wolk, David A, Zboch, Marzena, Zetterberg, Henrik, Arnold, Steven E, Baldeiras, Inês, Barthel, Henryk, van Berckel, Bart N M, Bibeau, Kristen, Blennow, Kaj, Brooks, David J, Knol, Dirk L, van Buchem, Mark A, Camus, Vincent, Cavedo, Enrica, Chen, Kewei, Chetelat, Gael, Cohen, Ann D, Drzezga, Alexander, Engelborghs, Sebastiaan, Fagan, Anne M, Fladby, Tormod, Tijms, Betty M, Fleisher, Adam S, van der Flier, Wiesje M, Ford, Lisa, Förster, Stefan, Fortea, Juan, Foskett, Nadia, Frederiksen, Kristian S, Freund-Levi, Yvonne, Frisoni, Giovanni B, Froelich, Lutz, Scheltens, Philip, Gabryelewicz, Tomasz, Gill, Kiran Dip, Gkatzima, Olymbia, Gómez-Tortosa, Estrella, Gordon, Mark Forrest, Grimmer, Timo, Hampel, Harald, Hausner, Lucrezia, Hellwig, Sabine, Herukka, Sanna-Kaisa, Verhey, Frans R J, Hildebrandt, Helmut, Ishihara, Lianna, Ivanoiu, Adrian, Jagust, William J, Johannsen, Peter, Kandimalla, Ramesh, Kapaki, Elisabeth, Klimkowicz-Mrowiec, Aleksandra, Klunk, William E, Köhler, Sebastian, Visser, Pieter Jelle, Koglin, Norman, Kornhuber, Johannes, Kramberger, Milica G, Van Laere, Koen, Landau, Susan M, Lee, Dong Young, de Leon, Mony, Lisetti, Viviana, Lleó, Alberto, Madsen, Karine, Group, Amyloid Biomarker Study, Maier, Wolfgang, Marcusson, Jan, Mattsson, Niklas, de Mendonça, Alexandre, Meulenbroek, Olga, Meyer, Philipp T, Mintun, Mark A, Mok, Vincent, Molinuevo, José Luis, Møllergård, Hanne M, Aalten, Pauline, Morris, John C, Mroczko, Barbara, Van der Mussele, Stefan, Na, Duk L, Newberg, Andrew, Nordberg, Agneta, Nordlund, Arto, Novak, Gerald P, Paraskevas, George P, Parnetti, Lucilla, Aarsland, Dag, Perera, Gayan, Peters, Oliver, Popp, Julius, Prabhakar, Sudesh, Rabinovici, Gil D, Ramakers, Inez H G B, Rami, Lorena, Resende de Oliveira, Catarina, Rinne, Juha O, Rodrigue, Karen M, Clinical sciences, Neurology, Promovendi MHN, Psychiatrie & Neuropsychologie, MUMC+: MA Med Staf Spec Psychiatrie (9), RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, Neuroscience Campus Amsterdam - Neurodegeneration, Amyloid Biomarker Study Group, Frisoni, Giovanni, Popp, Julius, Radiology and nuclear medicine, Epidemiology and Data Science, and NCA - neurodegeneration

Subjects
Apolipoprotein E, Male, Pediatrics, Alzheimer`s disease Donders Center for Medical Neuroscience [Radboudumc 1], Neurology, pathology [Cognitive Dysfunction], Apolipoprotein E4, pathology [Dementia], Biomarkers/analysis, ddc:616.89, Risk Factors, pathology [Brain], chemistry [Cerebrospinal Fluid], 80 and over, Prevalence, Medicine, risk factors, Apolipoprotein E4/genetics, genetics [Apolipoprotein E4], Cerebrospinal Fluid, Cerebrospinal Fluid/chemistry, Aged, 80 and over, Medicine(all), pathology [Mild Cognitive Impairment], Adult, Age Factors, Aged, Amyloid beta-Peptides, Biomarkers, Brain, Cognitive Dysfunction, Dementia, Female, Genotype, Humans, Middle Aged, Positron-Emission Tomography, Medicine (all), Cognitive Dysfunction/pathology, Cognition, General Medicine, analysis [Amyloid beta-Peptides], Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], 3. Good health, Amyloid beta-Peptides/analysis, Meta-analysis, Alzheimer's disease, analysis [Biomarkers], medicine.medical_specialty, Amyloid, Dementia/pathology, ta3112, Article, mental disorders, Brain/pathology, ddc:610, Psychiatry, Pathological, Mild Cognitive Impairment/pathology, analysis [Biological Markers], business.industry, Biological Markers/analysis, medicine.disease, ta3124, business, aged, 80 and over
Abstract

Item does not contain fulltext IMPORTANCE: Cerebral amyloid-beta aggregation is an early pathological event in Alzheimer disease (AD), starting decades before dementia onset. Estimates of the prevalence of amyloid pathology in persons without dementia are needed to understand the development of AD and to design prevention studies. OBJECTIVE: To use individual participant data meta-analysis to estimate the prevalence of amyloid pathology as measured with biomarkers in participants with normal cognition, subjective cognitive impairment (SCI), or mild cognitive impairment (MCI). DATA SOURCES: Relevant biomarker studies identified by searching studies published before April 2015 using the MEDLINE and Web of Science databases and through personal communication with investigators. STUDY SELECTION: Studies were included if they provided individual participant data for participants without dementia and used an a priori defined cutoff for amyloid positivity. DATA EXTRACTION AND SYNTHESIS: Individual records were provided for 2914 participants with normal cognition, 697 with SCI, and 3972 with MCI aged 18 to 100 years from 55 studies. MAIN OUTCOMES AND MEASURES: Prevalence of amyloid pathology on positron emission tomography or in cerebrospinal fluid according to AD risk factors (age, apolipoprotein E [APOE] genotype, sex, and education) estimated by generalized estimating equations. RESULTS: The prevalence of amyloid pathology increased from age 50 to 90 years from 10% (95% CI, 8%-13%) to 44% (95% CI, 37%-51%) among participants with normal cognition; from 12% (95% CI, 8%-18%) to 43% (95% CI, 32%-55%) among patients with SCI; and from 27% (95% CI, 23%-32%) to 71% (95% CI, 66%-76%) among patients with MCI. APOE-epsilon4 carriers had 2 to 3 times higher prevalence estimates than noncarriers. The age at which 15% of the participants with normal cognition were amyloid positive was approximately 40 years for APOE epsilon4epsilon4 carriers, 50 years for epsilon2epsilon4 carriers, 55 years for epsilon3epsilon4 carriers, 65 years for epsilon3epsilon3 carriers, and 95 years for epsilon2epsilon3 carriers. Amyloid positivity was more common in highly educated participants but not associated with sex or biomarker modality. CONCLUSIONS AND RELEVANCE: Among persons without dementia, the prevalence of cerebral amyloid pathology as determined by positron emission tomography or cerebrospinal fluid findings was associated with age, APOE genotype, and presence of cognitive impairment. These findings suggest a 20- to 30-year interval between first development of amyloid positivity and onset of dementia.

Published
2015

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