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Review
. 2021 Apr 1;34(2):266-274.
doi: 10.1097/WCO.0000000000000904.

Current advances in plasma and cerebrospinal fluid biomarkers in Alzheimer's disease

Antoine Leuzy  1 , Nicholas C Cullen  1 , Niklas Mattsson-Carlgren  1   2   3 , Oskar Hansson  1   4
Affiliations
Review

Current advances in plasma and cerebrospinal fluid biomarkers in Alzheimer's disease

Antoine Leuzy et al. Curr Opin Neurol. .

Abstract

Purpose of review: This review provides a concise overview of recent advances in cerebrospinal fluid (CSF) and blood-based biomarkers of Alzheimer's disease lesions.

Recent findings: Important recent advances for CSF Alzheimer's disease biomarkers include the introduction of fully automated assays, the development and implementation of certified reference materials for CSF Aβ42 and a unified protocol for handling of samples, which all support reliability and availability of CSF Alzheimer's disease biomarkers. Aβ deposition can be detected using Aβ42/Aβ40 ratio in both CSF and plasma, though a much more modest change is seen in plasma. Tau aggregation can be detected using phosphorylated tau (P-tau) at threonine 181 and 217 in CSF, with similar accuracy in plasma. Neurofilament light (NfL) be measured in CSF and shows similar diagnostic accuracy in plasma. Though total tau (T-tau) can also be measured in plasma, this measure is of limited clinical relevance for Alzheimer's disease in its current immunoassay format.

Summary: Alzheimer's disease biomarkers, including Aβ, P-tau and NfL can now be reliably measured in both CSF and blood. Plasma-based measures of P-tau show particular promise, with potential applications in both clinical practice and in clinical trials.

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