β-Secretase1 biological markers for Alzheimer's disease: state-of-art of validation and qualification.

β-Secretase1 biological markers for Alzheimer's disease: state-of-art of validation and qualification.
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DOI:
10.1186/s13195-020-00686-3
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发表时间:
2020-10-16
期刊:
Alzheimer's research & therapy
影响因子:
--
通讯作者:
Alzheimer’s Precision Medicine Initiative (APMI)
Alzheimer’s Precision Medicine Initiative (APMI)
中科院分区:
其他
文献类型:
--
作者:
Hampel H;Lista S;Vanmechelen E;Zetterberg H;Giorgi FS;Galgani A;Blennow K;Caraci F;Das B;Yan R;Vergallo A;Alzheimer’s Precision Medicine Initiative (APMI)

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在人体体液中分析的β-分泌酶1(BACE 1)蛋白浓度和酶活性速率是有希望的候选生物标志物,可用于指导研究BACE 1抑制剂以阻止或延迟阿尔茨海默病(AD)中淀粉样蛋白-β通路失调的临床试验。大量证据表明脑脊液/血液BACE 1生物标志物与AD的核心病理生理机制(如脑蛋白质错误折叠和聚集、神经变性和突触功能障碍)之间存在关联。在药理学试验中,BACE 1候选生物标志物可应用于广泛的使用背景(CoU),包括机制证明,剂量发现,反应和毒性剂量估计。对于临床CoU,BACE 1生物标志物显示出良好的预后和疾病预测性能。BACE 1生物标志物的验证和鉴定路线图需要标准化的分析前和分析方案,以减少可能导致结果不一致的研究中心间差异。BACE 1生物标志物-药物联合开发计划,包括生物标志物指导的结局和终点,可能支持识别更有可能从BACE 1抑制剂中获益的亚群,同时降低不良反应风险,符合不断发展的精准医学范式。
β-Secretase1 (BACE1) protein concentrations and rates of enzyme activity, analyzed in human bodily fluids, are promising candidate biological markers for guidance in clinical trials investigating BACE1 inhibitors to halt or delay the dysregulation of the amyloid-β pathway in Alzheimer’s disease (AD). A robust body of evidence demonstrates an association between cerebrospinal fluid/blood BACE1 biomarkers and core pathophysiological mechanisms of AD, such as brain protein misfolding and aggregration, neurodegeneration, and synaptic dysfunction. In pharmacological trials, BACE1 candidate biomarkers may be applied to a wide set of contexts of use (CoU), including proof of mechanism, dose-finding, response and toxicity dose estimation. For clinical CoU, BACE1 biomarkers show good performance for prognosis and disease prediction. The roadmap toward validation and qualification of BACE1 biomarkers requires standardized pre-analytical and analytical protocols to reduce inter-site variance that may have contributed to inconsistent results. BACE1 biomarker-drug co-development programs, including biomarker-guided outcomes and endpoints, may support the identification of sub-populations with a higher probability to benefit from BACE1 inhibitors with a reduced risk of adverse effects, in line with the evolving precision medicine paradigm.
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