Journal Home > Volume 7 , Issue 1

Alzheimer’s disease (AD) increasingly affects society due to aging populations. Even at pre-clinical stages, earlier and accurate diagnoses are essential for optimal AD management and improved clinical outcomes. Biomarkers such as beta-amyloid (Aβ) or tau protein in cerebrospinal fluid (CSF) have been used as reliable markers to distinguish AD from non-AD, and predicting clinical outcomes, to attain these goals. However, given CSF access methods’ invasiveness, these biomarkers are not used extensively in clinical settings. Blood Aβ has been proposed as an alternative biomarker since it is less invasive than CSF; however, sampling heterogeneity has limited its clinical applicability. In this review, we investigated blood Aβ as a biomarker in AD and explored how Aβ can be facilitated as a viable biomarker for successful AD management.


menu
Abstract
Full text
Outline
About this article

Can blood amyloid levels be used as a biomarker for Alzheimer’s disease?

Show Author's information Yuan-Han Yang1,2,3( )Rocksy FV Situmeang4Paulus Anam Ong5
Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, China
Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, China
Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan, China
Siloam Hospitals Lippo Village, Pelita Harapan University, Banten, Indonesia
Department of Neurology, Hasan Sadikin Hospital, Bandung, Indonesia

Abstract

Alzheimer’s disease (AD) increasingly affects society due to aging populations. Even at pre-clinical stages, earlier and accurate diagnoses are essential for optimal AD management and improved clinical outcomes. Biomarkers such as beta-amyloid (Aβ) or tau protein in cerebrospinal fluid (CSF) have been used as reliable markers to distinguish AD from non-AD, and predicting clinical outcomes, to attain these goals. However, given CSF access methods’ invasiveness, these biomarkers are not used extensively in clinical settings. Blood Aβ has been proposed as an alternative biomarker since it is less invasive than CSF; however, sampling heterogeneity has limited its clinical applicability. In this review, we investigated blood Aβ as a biomarker in AD and explored how Aβ can be facilitated as a viable biomarker for successful AD management.

Keywords: Alzheimer’s disease, apolipoprotein E, plasma, amyloid precursor protein, Aβ1–40, Aβ1–42, cerebrospinal fluid

References(54)

[1]
Prince M, Wimo A, Guerchet M, et al. World Alzheimer Report 2015 - The Global Impact of Dementia: An Analysis of Prevalence, Incidence, Cost and Trends. 2015.
[2]
Dennis CV, Suh LS, Rodriguez ML, et al. Human adult neurogenesis across the ages: an immunohisto chemical study. Neuropathol Appl Neurobiol 2016, 42(7): 621-638.
[3]
Ertekin-Taner N, Younkin LH, Yager DM, et al. Plasma amyloid beta protein is elevated in late-onset Alzheimer disease families. Neurology 2008, 70(8): 596-606.
[4]
Rissman RA, Trojanowski JQ, Shaw LM, et al. Longitudinal plasma amyloid beta as a biomarker of Alzheimer's disease. J Neural Transm: Vienna 2012, 119(7): 843-850.
[5]
Blasko I, Jellinger K, Kemmler G, et al. Conversion from cognitive health to mild cognitive impairment and Alzheimer's disease: prediction by plasma amyloid beta 42, medial temporal lobe atrophy and homocysteine. Neurobiol Aging 2008, 29(1): 1-11.
[6]
Kawas CH, Kim RC, Sonnen JA, et al. Multiple pathologies are common and related to dementia in the oldest-old: The 90+ Study. Neurology 2015, 85(6): 535-542.
[7]
Thal DR, Rüb U, Orantes M, et al. Phases of A beta-deposition in the human brain and its relevance for the development of AD. Neurology 2002, 58(12): 1791-1800.
[8]
Thal DR, Arendt T, Waldmann G, et al. Progression of neurofibrillary changes and PHF-tau in end-stage Alzheimer's disease is different from plaque and cortical microglial pathology. Neurobiol Aging 1998, 19(6): 517-525.
[9]
Toledo JB, Vanderstichele H, Figurski M, et al. Factors affecting Aβ plasma levels and their utility as biomarkers in ADNI. Acta Neuropathol 2011, 122(4): 401-413.
[10]
Caselli RJ, Beach TG, Knopman DS, et al. Alzheimer disease: scientific breakthroughs and translational challenges. Mayo Clin Proc 2017, 92(6): 978-994.
[11]
Tharp WG, Sarkar IN. Origins of amyloid-Β. BMC Genom 2013, 14: 290.
[12]
von Koch CS, Zheng H, Chen H, et al. Generation of APLP2 KO mice and early postnatal lethality in APLP2/APP double KO mice. Neurobiol Aging 1997, 18(6): 661-669.
[13]
Quiñones-Hinojosa A, Sanai N, Soriano-Navarro, et al. Cellular composition and cytoarchitecture of the adult human subventricular zone: a niche of neural stem cells. J Comp Neurol 2006, 494(3): 415-434.10.1002/cne.20798
[14]
Noctor SC, Martínez-Cerdeño V, Ivic L, et al. Cortical neurons arise in symmetric and asymmetric division zones and migrate through specific phases. Nat Neurosci 2004, 7(2): 136-144.10.1038/nn1172
[15]
Demars MP, Batholomew A, Strakova Z, et al. Soluble amyloid precursor protein: a novel proliferation factor of adult progenitor cells of ectodermal and mesodermal origin. Stem Cell Res Ther 2011, 2(4): 36.
[16]
Freude KK, Penjwini M, Davis JL, et al. Soluble amyloid precursor protein induces rapid neural differentiation of human embryonic stem cells. J Biol Chem 2011, 286(27): 24264-24274.
[17]
Pimplikar SW, Ghosal K. Amyloid precursor protein: more than just neurodegeneration. Stem Cell Res Ther 2011, 2(5): 39.
[18]
Cirrito JR, Yamada KA, Finn MB, et al. Synaptic activity regulates interstitial fluid amyloid-b levels in vivo. Neuron 2005, 48(6): 913-922.
[19]
Hampel H, Shen Y, Walsh DM, et al. Biological markers of amyloid beta-related mechanisms in Alzheimer's disease. Exp Neurol 2010, 223(2): 334-346.
[20]
Selkoe DJ, Hardy J. The amyloid hypothesis of Alzheimer's disease at 25 years. EMBO Mol Med 2016, 8(6): 595-608.
[21]
Sagare A, Deane R, Bell RD, et al. Clearance of amyloid-beta by circulating lipoprotein receptors. Nat Med 2007, 13(9): 1029-1031.
[22]
Donahue JE, Flaherty SL, Johanson CE, et al. RAGE, LRP-1, and amyloid-beta protein in Alzheimer’s disease. Acta Neuropathol 2006, 112: 405-415
[23]
Wei S, Gao L, Jiang Y, et al. Apolipoprotein E epsilon4 allele is associated with plasma amyloid beta and amyloid beta transporter levels: a cross-sectional study in a rural area of Xi'an, China. Am J Geriatr Psychiatry 2020, 28(2): 194-204.
[24]
Petersen RC, Thomas RG, Grundman M, et al. Vitamin E and donepezil for the treatment of mild cognitive impairment. N Engl J Med 2005, 352(23): 2379-2388.
[25]
Donohue MC, Moghadam SH, Roe AD, et al. Longitudinal plasma amyloid beta in Alzheimer's disease clinical trials. Alzheimers Dement 2015, 11(9): 1069-1079.
[26]
Yang YH, Huang LC, Hsieh SW, et al. Dynamic blood concentrations of Aβ1–40 and Aβ1–42 in Alzheimer’s disease. Front Cell Dev Biol 2020, 8: 768.
[27]
Olsson B, Lautner R, Andreasson U, et al. CSF and blood biomarkers for the diagnosis of Alzheimer's disease: a systematic review and meta-analysis. Lancet Neurol 2016, 15(7): 673-684.
[28]
Paterson RW, Slattery CF, Poole T, et al. Cerebrospinal fluid in the differential diagnosis of Alzheimer’s disease: clinical utility of an extended panel of biomarkers in a specialist cognitive clinic. Alzheimers Res Ther 2018, 10: 32
[29]
Skoog I, Davidsson P, Aevarsson O, et al. Cerebrospinal fluid beta-amyloid 42 is reduced before the onset of sporadic dementia: A population-based study in 85-year-olds. Dement Geriatr Cogn Disord 2003, 15: 169-176.
[30]
Gustafson DR, Skoog I, Rosengren L, et al. Cerebrospinal fluid beta-amyloid 1-42 concentration may predict cognitive decline in older women. J Neurol Neurosurg Psychiatry 2007, 78(5): 461-464.
[31]
Wang C, Holtzman DM. Bidirectional relationship between sleep and Alzheimer's disease: role of amyloid, tau, and other factors. Neuropsychopharmacology 2020, 45(1): 104-120.
[32]
Bateman RJ, Wen GL, Morris JC, et al. Fluctuations of CSF amyloid-beta levels: implications for a diagnostic and therapeutic biomarker. Neurology 2007, 68(9): 666-669.
[33]
Mattsson N, Andreasson U, Persson S, et al. The Alzheimer’s association external quality control program for cerebrospinal fluid biomarkers. Alzheimers Dement 2011, 7(4): 386–395.e6.
[34]
Mehta PD, Pirttilä T, Mehta SP, et al. Plasma and cerebrospinal fluid levels of amyloid beta proteins 1-40 and 1-42 in Alzheimer disease. Arch Neurol 2000, 57(1): 100-105.
[35]
Mehta PD, Pirttila T, Patrick BA, et al. Amyloid beta protein 1-40 and 1-42 levels in matched cerebrospinal fluid and plasma from patients with Alzheimer disease. Neurosci Lett 2001, 304(1/2): 102-106.
[36]
Mehta PD, Dalton AJ, Mehta SP, et al. Increased plasma amyloid beta protein 1-42 levels in Down syndrome. Neurosci Lett 1998, 241(1): 13-16.
[37]
Scheuner D, Eckman C, Jensen M, et al. Secreted amyloid beta-protein similar to that in the senile plaques of Alzheimer's disease is increased in vivo by the presenilin 1 and 2 and APP mutations linked to familial Alzheimer's disease. Nat Med 1996, 2(8): 864-870.
[38]
Tokuda T, Fukushima T, Ikeda S, et al. Plasma levels of amyloid beta proteins Abeta1-40 and Abeta1-42(43) are elevated in Down's syndrome. Ann Neurol 1997, 41(2): 271-273.
[39]
Mayeux R, Honig LS, Tang MX, et al. Plasma Aβ40 and Aβ42 and Alzheimer's disease: relation to age, mortality, and risk. Neurology 2003, 61(9): 1185-1190.
[40]
Lopez OL, Kuller LH, Mehta PD, et al. Plasma amyloid levels and the risk of AD in normal subjects in the Cardiovascular Health Study. Neurology 2008, 70(19): 1664-1671.
[41]
Graff-Radford NR, Crook JE, Lucas J, et al. Association of low plasma Abeta42/Abeta40 ratios with increased imminent risk for mild cognitive impairment and Alzheimer disease. Arch Neurol 2007, 64(3): 354-362.
[42]
Okereke OI, Xia WM, Selkoe DJ, et al. Ten-year change in plasma amyloid beta levels and late-life cognitive decline. Arch Neurol 2009, 66(10): 1247-1253.
[43]
Matsubara E, Ghiso J, Frangione B, et al. Lipoprotein-free amyloidogenic peptides in plasma are elevated in patients with sporadic Alzheimer's disease and Down's syndrome. Ann Neurol 1999, 45(4): 537-541.
DOI
[44]
Giedraitis V, Sundelöf J, Irizarry MC, et al. The normal equilibrium between CSF and plasma amyloid beta levels is disrupted in Alzheimer's disease. Neurosci Lett 2007, 427(3): 127-131.
[45]
Hanon O, Vidal JS, Lehmann S, et al. Plasma amyloid levels within the Alzheimer's process and correlations with central biomarkers. Alzheimers Dement 2018, 14(7): 858-868.
[46]
Dugger BN, Davis K, Malek-Ahmadi M, et al. Neuropathological comparisons of amnestic and nonamnestic mild cognitive impairment. BMC Neurol 2015, 15: 146.
[47]
de Meyer S, Schaeverbeke JM, Verberk IMW, et al. Comparison of ELISA- and SIMOA-based quantification of plasma Aβ ratios for early detection of cerebral amyloidosis. Alzheimers Res Ther 2020, 12(1): 162.
[48]
Doecke JD, Pérez-Grijalba V, Fandos N, et al. Total Aβ42/Aβ40 ratio in plasma predicts amyloid-PET status, independent of clinical AD diagnosis. Neurology 2020, 94(15): e1580-e1591.
[49]
Xin SH, Tan L, Cao XP, et al. Clearance of amyloid beta and tau in Alzheimer's disease: from mechanisms to therapy. Neurotox Res 2018, 34(3): 733-748.
[50]
Xiang Y, Bu XL, Liu YH, et al. Physiological amyloid-beta clearance in the periphery and its therapeutic potential for Alzheimer's disease. Acta Neuropathol 2015, 130(4): 487-499.
[51]
Sun HL, Chen SH,Yu ZY, et al. Blood cell-produced amyloid-β induces cerebral Alzheimer-type pathologies and behavioral deficits. Mol Psychiatry 2020, in press, .
[52]
Sano M, Bell KL, Galasko D, et al. A randomized, double-blind, placebo-controlled trial of simvastatin to treat Alzheimer disease. Neurology 2011, 77(6): 556-563.
[53]
Bibl M, Welge V, Esselmann H, et al. Stability of amyloid-β peptides in plasma and serum. Electrophoresis 2012, 33(3): 445-450.
[54]
Okereke OI, Xia WM, Irizarry MC, et al. Performance characteristics of plasma amyloid-beta 40 and 42 assays. J Alzheimers Dis 2009, 16(2): 277-285.
Publication history
Copyright
Rights and permissions

Publication history

Received: 03 December 2020
Revised: 01 February 2021
Accepted: 22 February 2021
Published: 05 March 2021
Issue date: March 2021

Copyright

© The authors 2021

Rights and permissions

This article is published with open access at journals.sagepub.com/home/BSA

Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/ en-us/nam/open-access-at-sage).

Return