基于血液的生物标志物和阿尔茨海默病的早期诊断

摘要(中文译文)

阿尔茨海默病是一种常见的神经退行性疾病，其特征是渐进性记忆丧失、认知能力下降和行为改变。基于血液的生物标志物最近因其可及性和成本效益而受到广泛关注。本综述重点介绍了阿尔茨海默病血液生物标志物多个关键领域的最新进展。对于早期诊断，淀粉样蛋白-β和磷酸化tau等基于血液的生物标志物甚至可以在临床症状出现之前识别阿尔茨海默病。包括p-tau217和神经丝轻链在内的血液生物标志物的动态变化反映了疾病进展，并与认知能力下降相关，从而能够持续监测阿尔茨海默病的进展。此外，基于血液的生物标志物，如p-tau181和胶质纤维酸性蛋白，通过将阿尔茨海默病与额颞叶痴呆等其他痴呆症区分开来，有助于鉴别诊断。与神经修复相关的血液生物标志物为追踪神经再生和治疗反应开辟了新的途径，特别是脑源性神经营养因子。此外，单分子阵列和免疫沉淀质谱等先进检测技术显著提高了基于血液的生物标志物的敏感性和特异性，促进了它们的临床转化。总之，基于血液的生物标志物在改善阿尔茨海默病的早期诊断、监测进展、鉴别诊断和评估治疗方面具有巨大的潜力。本综述对基于血液的生物标志物的转化潜力进行了全面和最新的评估，强调了它们在临床环境中的实用性，并为大规模应用的未来方向提供了见解。本综述强调了优先分配科学资源的必要性，加快基于血液的生物标志物向临床实施的过渡，并最终使用这些生物标志物实现阿尔茨海默病的精确治疗。

Abstract

Alzheimer's disease is a common neurodegenerative disease characterized by progressive memory loss, cognitive decline, and behavioral changes. Blood-based biomarkers have recently gained significant attention due to their accessibility and cost-effectiveness. This review highlights the latest progress in multiple key areas of blood-based biomarkers for Alzheimer's disease. For early diagnosis, blood-based biomarkers such as amyloid-β and phosphorylated tau can identify Alzheimer's disease even before clinical symptoms emerge. Dynamic changes in blood-based biomarkers, including p-tau217 and neurofilament light chain, reflect disease progression and correlate with cognitive decline, enabling continuous monitoring of Alzheimer's disease progression. Additionally, blood-based biomarkers such as p-tau181 and glial fibrillary acidic protein aid in differential diagnosis by distinguishing Alzheimer's disease from other dementias such as frontotemporal dementia. Blood-based biomarkers related to nerve repair have opened up new avenues for tracking nerve regeneration and therapeutic response, especially brain-derived neurotrophic factor. Furthermore, advanced detection technologies such as single-molecule array and immunoprecipitation-mass spectrometry have significantly improved the sensitivity and specificity of blood-based biomarkers, facilitating their clinical translation. In summary, blood-based biomarkers hold strong potential to improve early diagnosis, monitor progression, differential diagnosis, and evaluate therapies in Alzheimer's disease. This review provides a comprehensive and updated evaluation of the translational potential of blood-based biomarkers, emphasizing their practical utility in clinical settings and offering insights into future directions for large-scale application. This review emphasizes the need to prioritize the allocation of scientific resources, expedite the transition of blood-based biomarkers to clinical implementation, and ultimately achieve precise treatment of Alzheimer's disease using these biomarkers.

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