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Published in: Acta Neuropathologica 4/2010

01-04-2010 | Review

Protein coding of neurodegenerative dementias: the neuropathological basis of biomarker diagnostics

Authors: Gabor G. Kovacs, Gergő Botond, Herbert Budka

Published in: Acta Neuropathologica | Issue 4/2010

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Abstract

Neuropathological diagnosis of neurodegenerative dementias evolved by adapting the results of neuroanatomy, biochemistry, and cellular and molecular biology. Milestone findings of intra- and extracellular argyrophilic structures, visualizing protein deposition, initiated a protein-based classification. Widespread application of immunohistochemical and biochemical investigations revealed that (1) there are modifications of proteins intrinsic to disease (species that are phosphorylated, nitrated, oligomers, proteinase-resistant, with or without amyloid characteristics; cleavage products), (2) disease forms characterized by the accumulation of a single protein only are rather the exception than the rule, and (3) some modifications of proteins elude present neuropathological diagnostic procedures. In this review, we summarize how neuropathology, together with biochemistry, contributes to disease typing, by demonstrating a spectrum of disorders characterized by the deposition of various modifications of various proteins in various locations. Neuropathology may help to elucidate how brain pathologies alter the detectability of proteins in body fluids by upregulation of physiological forms or entrapment of different proteins. Modifications of at least the five most relevant proteins (amyloid-β, prion protein, tau, α-synuclein, and TDP-43), aided by analysis of further “attracted” proteins, are pivotal to be evaluated simultaneously with different methods. This should complement the detection of biomarkers associated with pathogenetic processes, and also neuroimaging and genetic analysis, in order to obtain a highly personalized diagnostic profile. Defining clusters of patients based on the patterns of protein deposition and immunohistochemically or biochemically detectable modifications of proteins (“codes”) may have higher prognostic predictive value, may be useful for monitoring therapy, and may open new avenues for research on pathogenesis.
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Metadata
Title
Protein coding of neurodegenerative dementias: the neuropathological basis of biomarker diagnostics
Authors
Gabor G. Kovacs
Gergő Botond
Herbert Budka
Publication date
01-04-2010
Publisher
Springer-Verlag
Published in
Acta Neuropathologica / Issue 4/2010
Print ISSN: 0001-6322
Electronic ISSN: 1432-0533
DOI
https://doi.org/10.1007/s00401-010-0658-1

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