Early diagnosis of mild cognitive impairment and Alzheimer's disease based on salivary lactoferrin.
Early diagnosis of mild cognitive impairment and Alzheimer's disease based on salivary lactoferrin.
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DOI：
10.1016/j.dadm.2017.04.002
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Orive G
中科院分区：
文献类型：
--
作者：
Carro E;Bartolomé F;Bermejo-Pareja F;Villarejo-Galende A;Molina JA;Ortiz P;Calero M;Rabano A;Cantero JL;Orive G
阿尔茨海默病（AD）过程可能在临床发作前许多年开始。临床前疾病的生物标志物对于疾病改善甚至预防性治疗的发展至关重要。目前用于早期疾病的生物标志物，包括脑脊液tau和淀粉样蛋白β（Aβ）水平、结构和功能磁共振成像以及脑淀粉样蛋白成像的使用，都受到限制，因为它们具有很大的侵入性或昂贵。非侵入性生物标志物可能是一种更容易获得的替代方法，但目前还没有一种能够以所需的灵敏度和特异性检测临床前AD。在这里，我们展示了一种新的，直接的，非侵入性的方法来评估早期认知能力下降。对遗忘型轻度认知障碍（aMCI）和AD病例以及神经病学对照的唾液样本进行了分析。我们发现并验证了一种新的单一唾液生物标志物乳铁蛋白，在我们的横断面调查中，它可以完美地区分临床诊断的aMCI和AD患者与认知健康的对照组。通过唾液乳铁蛋白显示的AD诊断准确性高于从核心脑脊液（CSF）生物标志物（包括总tau和CSF Aβ42）获得的准确性。此外，唾液乳铁蛋白可用于人群筛查和用于鉴定那些患有非常早期的轻度认知障碍和AD的诊断不足的受试者。这种生物标志物可能为AD的早期诊断提供新的见解。
The Alzheimer's disease (AD) process is likely initiated many years before clinical onset. Biomarkers of preclinical disease are critical for the development of disease-modifying or even preventative therapies. Current biomarkers for early disease, including cerebrospinal fluid tau and amyloid β (Aβ) levels, structural and functional magnetic resonance imaging, and the use of brain amyloid imaging, are limited because they are very invasive or expensive. Noninvasive biomarkers may be a more accessible alternative, but none can currently detect preclinical AD with the required sensitivity and specificity. Here, we show a novel, straight-forward, and noninvasive approach for assessment of early stages of cognitive decline. Salivary samples from cases of amnestic mild cognitive impairment (aMCI) and AD, and neurology controls were analyzed. We have discovered and validated a new single saliva biomarker, lactoferrin, which in our cross-sectional investigation perfectly discriminates clinically diagnosed aMCI and AD patients from a cognitively healthy control group. The accuracy for AD diagnosis shown by salivary lactoferrin was greater than that obtained from core cerebrospinal fluid (CSF) biomarkers, including total tau and CSF Aβ42. Furthermore, salivary lactoferrin can be used for population screening and for identifying those underdiagnosed subjects with very early stages of mild cognitive impairment and AD. This biomarker may offer new insights in the early diagnostics for AD.