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Derivation of cutoffs for the Elecsys® amyloid ? (1-42) assay in Alzheimer's disease.

ABSTRACT: Introduction:An Elecsys® Amyloid ? (A? [1-42]) immunoassay cutoff for classification of patients with Alzheimer's disease was investigated. Methods:Cerebrospinal fluid samples collected from patients with mild-to-moderate Alzheimer's disease were analyzed by Elecsys® immunoassays: (1) A? (1-42), (2) total tau, and (3) phosphorylated tau. Cutoffs (A? [1-42] and ratios with tau) were estimated by method comparison between AlzBio3 (n = 206), mixture modeling (n = 216), and concordance with florbetapir F 18 imaging-based classification (n = 75). Results:A 1065-pg/mL (95% confidence interval: 985-1153) Elecsys® A? (1-42) cutoff provided 94% overall percentage agreement with AlzBio3. Comparable cutoff estimates (95% confidence interval) were derived from mixture modeling (equally weighted: 1017 [949-1205] pg/mL; prevalence weighted: 1172 [1081-1344] pg/mL) and concordance with florbetapir F 18 imaging (visual read: 1198 [998-1591] pg/mL; automated: 1198 [1051-1638] pg/mL). Discussion:Based on three approaches, a 1100-pg/mL Elecsys® A? (1-42) cutoff is suitable for clinical trials with similar populations and preanalytical handling.

SUBMITTER: Shaw LM

PROVIDER: S-EPMC6222032 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Derivation of cutoffs for the Elecsys<sup>®</sup> amyloid β (1-42) assay in Alzheimer's disease.

Shaw Leslie M LM Waligorska Teresa T Fields Leona L Korecka Magdalena M Figurski Michal M Trojanowski John Q JQ Eichenlaub Udo U Wahl Simone S Quan Marian M Pontecorvo Michael J MJ Lachno D Richard DR Talbot Jayne A JA Andersen Scott W SW Siemers Eric R ER Dean Robert A RA

Alzheimer's & dementia (Amsterdam, Netherlands) 20180811

<h4>Introduction</h4>An Elecsys® Amyloid β (Aβ [1-42]) immunoassay cutoff for classification of patients with Alzheimer's disease was investigated.<h4>Methods</h4>Cerebrospinal fluid samples collected from patients with mild-to-moderate Alzheimer's disease were analyzed by Elecsys® immunoassays: (1) Aβ (1-42), (2) total tau, and (3) phosphorylated tau. Cutoffs (Aβ [1-42] and ratios with tau) were estimated by method comparison between AlzBio3 (<i>n</i> = 206), mixture modeling (<i>n</i> = 216), ...[more]

PMID: 30426066

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Project description:Accumulation of amyloid-? peptides is a dominant feature in the pathogenesis of Alzheimer's disease; however, it is not clear how individual amyloid-? species accumulate and affect other neuropathological and clinical features in the disease. Thus, we compared the accumulation of N-terminally truncated amyloid-? and full-length amyloid-?, depending on disease stage as well as brain area, and determined how these amyloid-? species respectively correlate with clinicopathological features of Alzheimer's disease. To this end, the amounts of amyloid-? species and other proteins related to amyloid-? metabolism or Alzheimer's disease were quantified by enzyme-linked immunosorbent assays (ELISA) or theoretically calculated in 12 brain regions, including neocortical, limbic and subcortical areas from Alzheimer's disease cases (n = 19), neurologically normal elderly without amyloid-? accumulation (normal ageing, n = 13), and neurologically normal elderly with cortical amyloid-? accumulation (pathological ageing, n = 15). We observed that N-terminally truncated amyloid-?42 and full-length amyloid-?42 accumulations distributed differently across disease stages and brain areas, while N-terminally truncated amyloid-?40 and full-length amyloid-?40 accumulation showed an almost identical distribution pattern. Cortical N-terminally truncated amyloid-?42 accumulation was increased in Alzheimer's disease compared to pathological ageing, whereas cortical full-length amyloid-?42 accumulation was comparable between Alzheimer's disease and pathological ageing. Moreover, N-terminally truncated amyloid-?42 were more likely to accumulate more in specific brain areas, especially some limbic areas, while full-length amyloid-?42 tended to accumulate more in several neocortical areas, including frontal cortices. Immunoprecipitation followed by mass spectrometry analysis showed that several N-terminally truncated amyloid-?42 species, represented by pyroglutamylated amyloid-?11-42, were enriched in these areas, consistent with ELISA results. N-terminally truncated amyloid-?42 accumulation showed significant regional association with BACE1 and neprilysin, but not PSD95 that regionally associated with full-length amyloid-?42 accumulation. Interestingly, accumulations of tau and to a greater extent apolipoprotein E (apoE, encoded by APOE) were more strongly correlated with N-terminally truncated amyloid-?42 accumulation than those of other amyloid-? species across brain areas and disease stages. Consistently, immunohistochemical staining and in vitro binding assays showed that apoE co-localized and bound more strongly with pyroglutamylated amyloid-?11-x fibrils than full-length amyloid-? fibrils. Retrospective review of clinical records showed that accumulation of N-terminally truncated amyloid-?42 in cortical areas was associated with disease onset, duration and cognitive scores. Collectively, N-terminally truncated amyloid-?42 species have spatiotemporal accumulation patterns distinct from full-length amyloid-?42, likely due to different mechanisms governing their accumulations in the brain. These truncated amyloid-? species could play critical roles in the disease by linking other clinicopathological features of Alzheimer's disease.

Project description:Key pointsAlzheimer's disease (AD) patients and transgenic mice have beta-amyloid (Aβ) aggregation in the gastrointestinal (GI) tract. It is possible that Aβ from the periphery contributes to the load of Aβ in the brain, as Aβ has prion-like properties. The present investigations demonstrate that Aβ injected into the GI tract of ICR mice is internalised into enteric cholinergic neurons; at 1 month, administration of Aβ into the body of the stomach and the proximal colon was observed to partly redistribute to the fundus and jejunum; at 1 year, vagal and cerebral β-amyloidosis was present, and mice exhibited GI dysfunction and cognitive deficits. These data reveal a previously undiscovered mechanism that potentially contributes to the development of AD.AbstractAlzheimer's disease (AD) is the most common age-related cause of dementia, characterised by extracellular beta-amyloid (Aβ) plaques and intracellular phosphorylated tau tangles in the brain. Aβ deposits have also been observed in the gastrointestinal (GI) tract of AD patients and transgenic mice, with overexpression of amyloid precursor protein. In the present studies, we investigate whether intra-GI administration of Aβ can potentially induce amyloidosis in the central nervous system (CNS) and AD-related pathology such as dementia. We micro-injected Aβ1-42 oligomers (4 μg per site, five sites) or vehicle (saline, 5 μl) into the gastric wall of ICR mice under general anaesthesia. Immunofluorescence staining and in vivo imaging showed that HiLyte Fluor 555-labelled Aβ1-42 had migrated within 3 h via the submucosa to nearby areas and was internalised into cholinergic neurons. At 1 month, HiLyte Fluor 555-labelled Aβ1-42 in the body of the stomach and proximal colon had partly re-distributed to the fundus and jejunum. At 1 year, the jejunum showed functional alterations in neuromuscular coupling (P < 0.001), and Aβ deposits were present in the vagus and brain, with animals exhibiting cognitive impairments in the Y-maze spontaneous alteration test (P < 0.001) and the novel object recognition test (P < 0.001). We found that enteric Aβ oligomers induce an alteration in gastric function, amyloidosis in the CNS, and AD-like dementia via vagal mechanisms. Our results suggest that Aβ load is likely to occur initially in the GI tract and may translocate to the brain, opening the possibility of new strategies for the early diagnosis and prevention of AD.

Dataset Information

Derivation of cutoffs for the Elecsys® amyloid ? (1-42) assay in Alzheimer's disease.

Publications

Derivation of cutoffs for the Elecsys<sup>®</sup> amyloid β (1-42) assay in Alzheimer's disease.

Similar Datasets

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