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Original Article
Dementia and Neurocognitive Disorders 2013: 12: 1: 1-8

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알츠하이머병 뇌척수액 생물표지자 다기관 연구를 위한 예비연구
박선아*·김종헌†·김형준*·김태은*·김윤정*·이동현*·박정호*·채원석‡·임수재§·서상원||·나덕렬||·최성혜¶
순천향대학교 부천병원 신경과*, 국민건강보험 일산병원 신경과†, 순천향대학교 부천병원 마취과‡, 순천향대학교 부천병원 정형외과§, 성균관대학교 의과대학 삼성서울병원 신경과||, 인하대학교 의과대학 신경과¶
Preliminary Study for a Multicenter Study of Alzheimer’s Disease Cerebrospinal Fluid Biomarkers
Sun Ah Park, M.D.*, Jung Hun Kim, M.D.†, Hyeong Jun Kim, M.D.*, Tae Eun Kim, M.D.*, Yoon-Jeong Kim, M.S.*, Dong Hyun Lee, M.D.*, Jeong Ho Park, M.D.*, Won Seok Chae, M.D.‡, Soo Jae Yim, M.D.§, Sang Won Seo, M.D.||, Duk L. Na, M.D.||, Seong Hye Choi, M.D.¶
Departments of Neurology*, Anesthesiology‡, and Orthopedic surgery§, Soonchunhyang University Bucheon Hospital, Bucheon; Department of Neurology†, Ilsan Hospital, National Health Insurance Corporation, Goyang; Department of Neurology||, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology¶, Inha University School of Medicine, Incheon, Korea
Background: The usefulness of cerebrospinal fluid (CSF) concentrations of amyloid beta protein 1-42 (Aβ42), phosphorylated tau (pTau) and total tau (tTau) have been increasing in Alzheimer’s disease (AD). However, the direct adoption of previously reported standard values is not appropriate due to interlaboratory variability. We started this study to set up an accessible system to measure CSF biomarkers in our country with high reproducibility and validity. Methods: Including CSFs from four different institutes the levels of Aβ42, pTau181 and tTau were measured in one lab. The intertest variability and difference in the levels of biomarkers depending on diseases were assessed. Through analysis of receiver operating characteristic cut points and binary logistic regression the cut-off values of Aβ42, pTau and tTau level were obtained, and their validity was evaluated. Results: The intertest consistency was high in measuring CSF biomarkers. The value of Aβ42 was markedly decreased in AD (n= 17) and other dementia (n= 9) compared to normal control (n= 12). The levels of pTau181 and tTau were high in AD, but not in other dementia and normal control. The threshold values of Aβ42, pTau181 and tTau were 290.3 pg/mL, 54.3 pg/ mL, and 320.7 pg/mL in differentiating AD from normal control showing high sensitivity and specificity. Especially, the ratios of pTau181/Aβ42 (> 0.16) and tTau/Aβ42 (> 0.76) showed the prime validity. Conclusions: Our data of CSF Aβ42, pTau181, and tTau levels were highly reproducible. PTau181/Aβ42 and tTau/Aβ42 ratios were the greatly helpful in differentiating AD from normal control.
Key Words: Alzheimer’s disease, Amyloid beta protein, Biomarker, Enzyme-linked immunosorbent assay, Cerebrospinal fluid, Tau
대한치매학회지 (Dementia and Neurocognitive Disorders)