Die Zukunft der Biomarker in der Demenzdiagnostik
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Zusammenfassung
Die neurochemische Demenzdiagnostik (NDD) ist ein Routineinstrument in der Diagnostik neurodegenerativer Erkrankungen wie der Alzheimer-Erkrankung (Alzheimer’s disease, AD). Gegenwärtig werden zwei Biomarkergruppen verwendet, die im Liquor cerebrospinalis („cerebrospinal fluid“, CSF) gemessen werden. Es handelt sich um Amyloid-β-Peptide (Aβ) und Tau-Proteine einschließlich hyperphosphorylierte Formen (pTau). Aktuell geht die Entwicklung der NDD in folgende Richtungen: 1. Suche nach neuen Biomarkern mit verbesserter diagnostischer Leistung; 2. Suche nach Biomarkern im Blut; 3. Anwendung neuer Technologien zur ökonomischeren Handhabung der Patientenproben; 4. Optimierung der Bestimmung bereits verwendeter Biomarker (z. B. durch verbesserte Qualitätskontrolle und Vergleichbarkeit der Ergebnisse unterschiedlicher Labore). In diesem Artikel geben wir einen kurzen Überblick über die gegenwärtige Situation auf dem Gebiet der liquorbasierten NDD und fassen einige Hypothesen zur möglichen zukünftigen Entwicklung zusammen.
Schlüsselwörter
Alzheimer-Erkrankung Liquor cerebrospinalis Amyloid β Tau-Protein Klinische NeurochemieThe future of biomarkers in dementia diagnostics
Summary
Neurochemical dementia diagnostics (NDD) is a routine laboratory tool in the diagnostic process of patients with neurodegenerative disorders, such as Alzheimer’s disease (AD). Currently, two groups of biomarkers analyzed in the cerebrospinal fluid (CSF) are being considered, namely amyloid β (Aβ) peptides and tau proteins, along with the hyperphosphorylated forms of the latter (p-tau). Current directions in the development of NDD include the following: 1. search for novel biomarkers with improved analytical or diagnostic performance; 2. search for biomarkers in the blood; 3. applications of novel technologies enabling better management of patient samples; 4. optimization of the analysis of the biomarkers already available (for example, by improved quality control and inter-laboratory comparison of results). This review presents the state of the art in the field of CSF-based NDD and also summarizes some of the hypotheses of how the future development of NDD tools might look.
Keywords
Alzheimer disease Cerebrospinal fluid Amyloid β Tau proteine Clinical neurochemistryNotes
Interessenkonflikte
Der korrespondierende Autor weist auf folgende Beziehungen hin: PL ist Fachberater für Innogenetics. Die anderen Autoren geben an, dass kein Interessenkonflikt bestehe.
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