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Published in: NeuroMolecular Medicine 1/2012

01-03-2012 | Original Paper

Cerebrospinal Fluid Profiles of Amyloid β-Related Biomarkers in Alzheimer’s Disease

Authors: Christoffer Rosén, Ulf Andreasson, Niklas Mattsson, Jan Marcusson, Lennart Minthon, Niels Andreasen, Kaj Blennow, Henrik Zetterberg

Published in: NeuroMolecular Medicine | Issue 1/2012

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Abstract

The amyloid cascade hypothesis on the pathogenesis of Alzheimer’s disease (AD) states that amyloid β (Aβ) accumulation in the brain is a key factor that initiates the neurodegenerative process. Aβ is generated from amyloid precursor protein (APP) through sequential cleavages by BACE1 (the major β-secretase in the brain) and γ-secretase. The purpose of this study was to characterize APP metabolism in vivo in AD patients versus cognitively healthy subjects by examining alterations in cerebrospinal fluid (CSF) biomarkers. We measured BACE1 activity and concentrations of α- and β-cleaved soluble APP (sAPPα and sAPPβ, respectively) and Aβ40 in CSF, biomarkers that all reflect the metabolism of APP, in 75 AD patients and 65 cognitively healthy controls. These analytes were also applied in a multivariate model to determine whether they provided any added diagnostic value to the core CSF AD biomarkers Aβ42, T-tau, and P-tau. We found no significant differences in BACE1 activity or sAPPα, sAPPβ, and Aβ40 concentrations between AD patients and controls. A multivariate model created with all analytes did not improve the separation of AD patients from controls compared with using the core AD biomarkers alone, highlighting the strong diagnostic performance of Aβ42, T-tau, and P-tau for AD. However, AD patients in advanced clinical stage, as determined by low MMSE score (≤20), had lower BACE1 activity and sAPPα, sAPPβ, and Aβ40 concentrations than patients with higher MMSE score, suggesting that these markers may be related to the severity of the disease.
Literature
go back to reference American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders: DSM-III-R (3rd ed.). Washington, DC: American Psychiatric Association. American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders: DSM-III-R (3rd ed.). Washington, DC: American Psychiatric Association.
go back to reference Andreasen, N., Hesse, C., Davidsson, P., Minthon, L., Wallin, A., Winblad, B., et al. (1999). Cerebrospinal fluid beta-amyloid(1–42) in Alzheimer disease: Differences between early- and late-onset Alzheimer disease and stability during the course of disease. Archives of Neurology, 56, 673–680.PubMedCrossRef Andreasen, N., Hesse, C., Davidsson, P., Minthon, L., Wallin, A., Winblad, B., et al. (1999). Cerebrospinal fluid beta-amyloid(1–42) in Alzheimer disease: Differences between early- and late-onset Alzheimer disease and stability during the course of disease. Archives of Neurology, 56, 673–680.PubMedCrossRef
go back to reference Blennow, K., Hampel, H., Weiner, M., & Zetterberg, H. (2010). Cerebrospinal fluid and plasma biomarkers in Alzheimer disease. Nature Reviews Neurology, 6, 131–144.PubMedCrossRef Blennow, K., Hampel, H., Weiner, M., & Zetterberg, H. (2010). Cerebrospinal fluid and plasma biomarkers in Alzheimer disease. Nature Reviews Neurology, 6, 131–144.PubMedCrossRef
go back to reference Blennow, K., Wallin, A., Agren, H., Spenger, C., Siegfried, J., & Vanmechelen, E. (1995). Tau protein in cerebrospinal fluid: A biochemical marker for axonal degeneration in Alzheimer disease? Molecular and Chemical Neuropathology, 26, 231–245.PubMedCrossRef Blennow, K., Wallin, A., Agren, H., Spenger, C., Siegfried, J., & Vanmechelen, E. (1995). Tau protein in cerebrospinal fluid: A biochemical marker for axonal degeneration in Alzheimer disease? Molecular and Chemical Neuropathology, 26, 231–245.PubMedCrossRef
go back to reference Blennow, K., Zetterberg, H., Minthon, L., Lannfelt, L., Strid, S., Annas, P., et al. (2007). Longitudinal stability of CSF biomarkers in Alzheimer’s disease. Neuroscience Letters, 419, 18–22.PubMedCrossRef Blennow, K., Zetterberg, H., Minthon, L., Lannfelt, L., Strid, S., Annas, P., et al. (2007). Longitudinal stability of CSF biomarkers in Alzheimer’s disease. Neuroscience Letters, 419, 18–22.PubMedCrossRef
go back to reference Bylesjö, M., Rantalainen, M., Cloarec, O., Nicholson, J. K., Holmes, E. A., & Trygg, J. (2006). OPLS discriminant analysis: Combining the strengths of PLS-DA and SIMCA classification. Journal of Chemometrics, 20, 341–351.CrossRef Bylesjö, M., Rantalainen, M., Cloarec, O., Nicholson, J. K., Holmes, E. A., & Trygg, J. (2006). OPLS discriminant analysis: Combining the strengths of PLS-DA and SIMCA classification. Journal of Chemometrics, 20, 341–351.CrossRef
go back to reference Cirrito, J. R., Kang, J. E., Lee, J., Stewart, F. R., Verges, D. K., Silverio, L. M., et al. (2008). Endocytosis is required for synaptic activity-dependent release of amyloid-beta in vivo. Neuron, 58, 42–51.PubMedCrossRef Cirrito, J. R., Kang, J. E., Lee, J., Stewart, F. R., Verges, D. K., Silverio, L. M., et al. (2008). Endocytosis is required for synaptic activity-dependent release of amyloid-beta in vivo. Neuron, 58, 42–51.PubMedCrossRef
go back to reference Fagan, A. M., Shaw, L. M., Xiong, C., Vanderstichele, H., Mintun, M. A., Trojanowski, J. Q., et al. (2011). Comparison of analytical platforms for cerebrospinal fluid measures of beta-amyloid 1–42, total tau, and p-tau181 for identifying Alzheimer disease amyloid plaque pathology. Archives of Neurology, 68, 1137–1144.PubMedCrossRef Fagan, A. M., Shaw, L. M., Xiong, C., Vanderstichele, H., Mintun, M. A., Trojanowski, J. Q., et al. (2011). Comparison of analytical platforms for cerebrospinal fluid measures of beta-amyloid 1–42, total tau, and p-tau181 for identifying Alzheimer disease amyloid plaque pathology. Archives of Neurology, 68, 1137–1144.PubMedCrossRef
go back to reference Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.PubMedCrossRef Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.PubMedCrossRef
go back to reference Fukumoto, H., Cheung, B. S., Hyman, B. T., & Irizarry, M. C. (2002). Beta-secretase protein and activity are increased in the neocortex in Alzheimer disease. Archives of Neurology, 59, 1381–1389.PubMedCrossRef Fukumoto, H., Cheung, B. S., Hyman, B. T., & Irizarry, M. C. (2002). Beta-secretase protein and activity are increased in the neocortex in Alzheimer disease. Archives of Neurology, 59, 1381–1389.PubMedCrossRef
go back to reference Höistad, M., Samskog, J., Jacobsen, K. X., Olsson, A., Hansson, H. A., Brodin, E., et al. (2005). Detection of beta-endorphin in the cerebrospinal fluid after intrastriatal microinjection into the rat brain. Brain Research, 1041, 167–180.PubMedCrossRef Höistad, M., Samskog, J., Jacobsen, K. X., Olsson, A., Hansson, H. A., Brodin, E., et al. (2005). Detection of beta-endorphin in the cerebrospinal fluid after intrastriatal microinjection into the rat brain. Brain Research, 1041, 167–180.PubMedCrossRef
go back to reference Holsinger, R. M., Lee, J. S., Boyd, A., Masters, C. L., & Collins, S. J. (2006). CSF BACE1 activity is increased in CJD and Alzheimer disease versus [corrected] other dementias. Neurology, 67, 710–712.PubMedCrossRef Holsinger, R. M., Lee, J. S., Boyd, A., Masters, C. L., & Collins, S. J. (2006). CSF BACE1 activity is increased in CJD and Alzheimer disease versus [corrected] other dementias. Neurology, 67, 710–712.PubMedCrossRef
go back to reference Holsinger, R. M., McLean, C. A., Beyreuther, K., Masters, C. L., & Evin, G. (2002). Increased expression of the amyloid precursor beta-secretase in Alzheimer’s disease. Annals of Neurology, 51, 783–786.PubMedCrossRef Holsinger, R. M., McLean, C. A., Beyreuther, K., Masters, C. L., & Evin, G. (2002). Increased expression of the amyloid precursor beta-secretase in Alzheimer’s disease. Annals of Neurology, 51, 783–786.PubMedCrossRef
go back to reference Holsinger, R. M., McLean, C. A., Collins, S. J., Masters, C. L., & Evin, G. (2004). Increased beta-secretase activity in cerebrospinal fluid of Alzheimer’s disease subjects. Annals of Neurology, 55, 898–899.PubMedCrossRef Holsinger, R. M., McLean, C. A., Collins, S. J., Masters, C. L., & Evin, G. (2004). Increased beta-secretase activity in cerebrospinal fluid of Alzheimer’s disease subjects. Annals of Neurology, 55, 898–899.PubMedCrossRef
go back to reference Jack, C. R., Jr, Knopman, D. S., Jagust, W. J., Shaw, L. M., Aisen, P. S., Weiner, M. W., et al. (2010). Hypothetical model of dynamic biomarkers of the Alzheimer’s pathological cascade. Lancet Neurology, 9, 119–128.PubMedCrossRef Jack, C. R., Jr, Knopman, D. S., Jagust, W. J., Shaw, L. M., Aisen, P. S., Weiner, M. W., et al. (2010). Hypothetical model of dynamic biomarkers of the Alzheimer’s pathological cascade. Lancet Neurology, 9, 119–128.PubMedCrossRef
go back to reference Johansson, P., Mattsson, N., Hansson, O., Wallin, A., Johansson, J. O., Andreasson, U., et al. (2011). Cerebrospinal fluid biomarkers for Alzheimer’s disease: Diagnostic performance in a homogeneous mono-center population. Journal of Alzheimers Disease, 24, 537–546. Johansson, P., Mattsson, N., Hansson, O., Wallin, A., Johansson, J. O., Andreasson, U., et al. (2011). Cerebrospinal fluid biomarkers for Alzheimer’s disease: Diagnostic performance in a homogeneous mono-center population. Journal of Alzheimers Disease, 24, 537–546.
go back to reference Johnston, J. A., Liu, W. W., Todd, S. A., Coulson, D. T., Murphy, S., Irvine, G. B., et al. (2005). Expression and activity of beta-site amyloid precursor protein cleaving enzyme in Alzheimer’s disease. Biochemical Society Transactions, 33, 1096–1100.PubMedCrossRef Johnston, J. A., Liu, W. W., Todd, S. A., Coulson, D. T., Murphy, S., Irvine, G. B., et al. (2005). Expression and activity of beta-site amyloid precursor protein cleaving enzyme in Alzheimer’s disease. Biochemical Society Transactions, 33, 1096–1100.PubMedCrossRef
go back to reference Lewczuk, P., Kamrowski-Kruck, H., Peters, O., Heuser, I., Jessen, F., Popp, J., et al. (2010). Soluble amyloid precursor proteins in the cerebrospinal fluid as novel potential biomarkers of Alzheimer’s disease: A multicenter study. Molecular Psychiatry, 15, 138–145.PubMedCrossRef Lewczuk, P., Kamrowski-Kruck, H., Peters, O., Heuser, I., Jessen, F., Popp, J., et al. (2010). Soluble amyloid precursor proteins in the cerebrospinal fluid as novel potential biomarkers of Alzheimer’s disease: A multicenter study. Molecular Psychiatry, 15, 138–145.PubMedCrossRef
go back to reference Mattson, M. P., Barger, S. W., Furukawa, K., Bruce, A. J., Wyss-Coray, T., Mark, R. J., et al. (1997). Cellular signaling roles of TGF beta, TNF alpha and beta APP in brain injury responses and Alzheimer’s disease. Brain Research Reviews, 23, 47–61.PubMedCrossRef Mattson, M. P., Barger, S. W., Furukawa, K., Bruce, A. J., Wyss-Coray, T., Mark, R. J., et al. (1997). Cellular signaling roles of TGF beta, TNF alpha and beta APP in brain injury responses and Alzheimer’s disease. Brain Research Reviews, 23, 47–61.PubMedCrossRef
go back to reference Mattsson, N., Axelsson, M., Haghighi, S., Malmeström, C., Wu, G., Anckarsäter, R., et al. (2009). Reduced cerebrospinal fluid BACE1 activity in multiple sclerosis. Multiple Sclerosis, 15, 448–454.PubMedCrossRef Mattsson, N., Axelsson, M., Haghighi, S., Malmeström, C., Wu, G., Anckarsäter, R., et al. (2009). Reduced cerebrospinal fluid BACE1 activity in multiple sclerosis. Multiple Sclerosis, 15, 448–454.PubMedCrossRef
go back to reference Mattsson, N., Bremell, D., Anckarsäter, R., Blennow, K., Anckarsäter, H., Zetterberg, H., et al. (2010). Neuroinflammation in Lyme neuroborreliosis affects amyloid metabolism. BMC Neurology, 10, 51. doi:10.1186/1471-2377-10-51.PubMedCrossRef Mattsson, N., Bremell, D., Anckarsäter, R., Blennow, K., Anckarsäter, H., Zetterberg, H., et al. (2010). Neuroinflammation in Lyme neuroborreliosis affects amyloid metabolism. BMC Neurology, 10, 51. doi:10.​1186/​1471-2377-10-51.PubMedCrossRef
go back to reference Mattsson, N., Zetterberg, H., Bianconi, S., Yanjanin, N. M., Fu, R., Månsson, J. E., et al. (2011). Gamma-secretase-dependent amyloid-beta is increased in Niemann-Pick type C: A cross-sectional study. Neurology, 76, 366–372.PubMedCrossRef Mattsson, N., Zetterberg, H., Bianconi, S., Yanjanin, N. M., Fu, R., Månsson, J. E., et al. (2011). Gamma-secretase-dependent amyloid-beta is increased in Niemann-Pick type C: A cross-sectional study. Neurology, 76, 366–372.PubMedCrossRef
go back to reference May, P. C., Dean, R. A., Lowe, S. L., Martenyi, F., Sheehan, S. M., Boggs, L. N., et al. (2011). Robust central reduction of amyloid-beta in humans with an orally available, non-peptidic beta-secretase inhibitor. Journal of Neuroscience, 31, 16507–16516.PubMedCrossRef May, P. C., Dean, R. A., Lowe, S. L., Martenyi, F., Sheehan, S. M., Boggs, L. N., et al. (2011). Robust central reduction of amyloid-beta in humans with an orally available, non-peptidic beta-secretase inhibitor. Journal of Neuroscience, 31, 16507–16516.PubMedCrossRef
go back to reference McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS-ADRDA Work Group under the auspices of department of health and human services task force on Alzheimer’s disease. Neurology, 34, 939–944.PubMed McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS-ADRDA Work Group under the auspices of department of health and human services task force on Alzheimer’s disease. Neurology, 34, 939–944.PubMed
go back to reference Mungas, D. (1991). In-office mental status testing: A practical guide. Geriatrics, 46, 54–58.PubMed Mungas, D. (1991). In-office mental status testing: A practical guide. Geriatrics, 46, 54–58.PubMed
go back to reference Olsson, A., Vanderstichele, H., Andreasen, N., De Meyer, G., Wallin, A., Holmberg, B., et al. (2005). Simultaneous measurement of beta-amyloid(1–42), total tau, and phosphorylated tau (Thr181) in cerebrospinal fluid by the xMAP technology. Clinical Chemistry, 51, 336–345.PubMedCrossRef Olsson, A., Vanderstichele, H., Andreasen, N., De Meyer, G., Wallin, A., Holmberg, B., et al. (2005). Simultaneous measurement of beta-amyloid(1–42), total tau, and phosphorylated tau (Thr181) in cerebrospinal fluid by the xMAP technology. Clinical Chemistry, 51, 336–345.PubMedCrossRef
go back to reference Perneczky, R., Tsolakidou, A., Arnold, A., Diehl-Schmid, J., Grimmer, T., Förstl, H., et al. (2011). CSF soluble amyloid precursor proteins in the diagnosis of incipient Alzheimer disease. Neurology, 77, 35–38.PubMedCrossRef Perneczky, R., Tsolakidou, A., Arnold, A., Diehl-Schmid, J., Grimmer, T., Förstl, H., et al. (2011). CSF soluble amyloid precursor proteins in the diagnosis of incipient Alzheimer disease. Neurology, 77, 35–38.PubMedCrossRef
go back to reference Selnes, P., Blennow, K., Zetterberg, H., Grambaite, R., Rosengren, L., Johnsen, L., et al. (2010). Effects of cerebrovascular disease on amyloid precursor protein metabolites in cerebrospinal fluid. Cerebrospinal Fluid Research, 7, 10. doi:10.1186/1743-8454-7-10.PubMedCrossRef Selnes, P., Blennow, K., Zetterberg, H., Grambaite, R., Rosengren, L., Johnsen, L., et al. (2010). Effects of cerebrovascular disease on amyloid precursor protein metabolites in cerebrospinal fluid. Cerebrospinal Fluid Research, 7, 10. doi:10.​1186/​1743-8454-7-10.PubMedCrossRef
go back to reference Shi, X. P., Tugusheva, K., Bruce, J. E., Lucka, A., Chen-Dodson, E., Hu, B., et al. (2005). Novel mutations introduced at the beta-site of amyloid beta protein precursor enhance the production of amyloid beta peptide by BACE1 in vitro and in cells. Journal of Alzheimers Disease, 7, 139–148. Shi, X. P., Tugusheva, K., Bruce, J. E., Lucka, A., Chen-Dodson, E., Hu, B., et al. (2005). Novel mutations introduced at the beta-site of amyloid beta protein precursor enhance the production of amyloid beta peptide by BACE1 in vitro and in cells. Journal of Alzheimers Disease, 7, 139–148.
go back to reference Vanmechelen, E., Vanderstichele, H., Davidsson, P., Van Kerschaver, E., Van Der Perre, B., Sjögren, M., et al. (2000). Quantification of tau phosphorylated at threonine 181 in human cerebrospinal fluid: a sandwich ELISA with a synthetic phosphopeptide for standardization. Neuroscience Letters, 285, 49–52.PubMedCrossRef Vanmechelen, E., Vanderstichele, H., Davidsson, P., Van Kerschaver, E., Van Der Perre, B., Sjögren, M., et al. (2000). Quantification of tau phosphorylated at threonine 181 in human cerebrospinal fluid: a sandwich ELISA with a synthetic phosphopeptide for standardization. Neuroscience Letters, 285, 49–52.PubMedCrossRef
go back to reference Verheijen, J. H., Huisman, L. G., van Lent, N., Neumann, U., Paganetti, P., Hack, C. E., et al. (2006). Detection of a soluble form of BACE-1 in human cerebrospinal fluid by a sensitive activity assay. Clinical Chemistry, 52, 1168–1174.PubMedCrossRef Verheijen, J. H., Huisman, L. G., van Lent, N., Neumann, U., Paganetti, P., Hack, C. E., et al. (2006). Detection of a soluble form of BACE-1 in human cerebrospinal fluid by a sensitive activity assay. Clinical Chemistry, 52, 1168–1174.PubMedCrossRef
go back to reference Yang, L. B., Lindholm, K., Yan, R., Citron, M., Xia, W., Yang, X. L., et al. (2003). Elevated beta-secretase expression and enzymatic activity detected in sporadic Alzheimer disease. Nature Medicine, 9, 3–4.PubMedCrossRef Yang, L. B., Lindholm, K., Yan, R., Citron, M., Xia, W., Yang, X. L., et al. (2003). Elevated beta-secretase expression and enzymatic activity detected in sporadic Alzheimer disease. Nature Medicine, 9, 3–4.PubMedCrossRef
go back to reference Zetterberg, H., Andreasson, U., Hansson, O., Wu, G., Sankaranarayanan, S., Andersson, M. E., et al. (2008). Elevated cerebrospinal fluid BACE1 activity in incipient Alzheimer disease. Archives of Neurology, 65, 1102–1107.PubMedCrossRef Zetterberg, H., Andreasson, U., Hansson, O., Wu, G., Sankaranarayanan, S., Andersson, M. E., et al. (2008). Elevated cerebrospinal fluid BACE1 activity in incipient Alzheimer disease. Archives of Neurology, 65, 1102–1107.PubMedCrossRef
go back to reference Zhong, Z., Ewers, M., Teipel, S., Bürger, K., Wallin, A., Blennow, K., et al. (2007). Levels of beta-secretase (BACE1) in cerebrospinal fluid as a predictor of risk in mild cognitive impairment. Archives of General Psychiatry, 64, 718–726.PubMedCrossRef Zhong, Z., Ewers, M., Teipel, S., Bürger, K., Wallin, A., Blennow, K., et al. (2007). Levels of beta-secretase (BACE1) in cerebrospinal fluid as a predictor of risk in mild cognitive impairment. Archives of General Psychiatry, 64, 718–726.PubMedCrossRef
Metadata
Title
Cerebrospinal Fluid Profiles of Amyloid β-Related Biomarkers in Alzheimer’s Disease
Authors
Christoffer Rosén
Ulf Andreasson
Niklas Mattsson
Jan Marcusson
Lennart Minthon
Niels Andreasen
Kaj Blennow
Henrik Zetterberg
Publication date
01-03-2012
Publisher
Humana Press Inc
Published in
NeuroMolecular Medicine / Issue 1/2012
Print ISSN: 1535-1084
Electronic ISSN: 1559-1174
DOI
https://doi.org/10.1007/s12017-012-8171-4

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