Alzheimer disease (AD) is a neurodegenerative disorder characterized by significant cognitive deficits, behavioral changes, sleep disorders and loss of functional autonomy. The number of patients suffering from AD is growing rapidly as the population ages worldwide. AD represents major cause of dementia and has become a major public health issue. Memory impairment is usually the earliest but also the core symptom of this disease. The diagnosis at a late stage is relatively easy. However, a delay in the diagnosis is damageable for the handling of patients in terms of optimal medical and social treatment. The actual interest of the scientific head-ways is to optimize the diagnosis in prodromal stage of the disease and to propose personalized therapeutic solutions to individual patients. New revised AD diagnostic criteria include alteration of cerebrospinal fluid (CSF) biomarkers: decrease of amyloïd peptides (Aß42), and increase of tau and phosphorylated-tau (p-tau) proteins. This recognition of CSF biological biomarkers for AD is a major step towards the “molecular” diagnosis and follow-up of the disease. Many issues are however still the subject of debate and further developments in this field focus on:
- First of all, there is a large debate on the appropriate and optimal use of the current CSF biomarkers that now face clinical implementation; when and how (alone, in combination..) to use them: for AD screening, in routine, for early or atypical AD cases etc..
- How to measure them in the most reliable way, a question which necessitates discussion on standard operating procedures, harmonization, quality control, establishment of reference material and methods, comparison of analytical platforms (immuno-detection, single and multiplex assays, mass spectrometry).
- How to improve the biological diagnosis of AD (in terms of sensitivity, specificity, and differentiation with other neurodegenerative disorders) with the help of new biomarkers. This major topic has two complementary aspects: the detection of additional Aß and tau isoforms, and the detection of completely new biomarkers (in particular from “omics” studies). Of note, there is not a week without the suggestion in the literature of a new putative biomarkers for AD.
- Related to the above item is the issue of a blood diagnosis of AD as most of the “interesting” biomarkers are being detected in the CSF which limits their usage.
- The use of biomarkers for the stratification, the follow-up and to predict therapeutic response of patients involved in therapeutic trails of AD.
- The last but not the least important issue of AD biomarkers is how they relate to the understanding of the pathophysiology of AD, and to new therapeutic leads.
In conclusion, the topic “Biomarkers of Alzheimer's disease” is a very active topic that has a major importance for medical diagnosis, basic research and therapeutics in the neurology and neuroscience field.
Alzheimer disease (AD) is a neurodegenerative disorder characterized by significant cognitive deficits, behavioral changes, sleep disorders and loss of functional autonomy. The number of patients suffering from AD is growing rapidly as the population ages worldwide. AD represents major cause of dementia and has become a major public health issue. Memory impairment is usually the earliest but also the core symptom of this disease. The diagnosis at a late stage is relatively easy. However, a delay in the diagnosis is damageable for the handling of patients in terms of optimal medical and social treatment. The actual interest of the scientific head-ways is to optimize the diagnosis in prodromal stage of the disease and to propose personalized therapeutic solutions to individual patients. New revised AD diagnostic criteria include alteration of cerebrospinal fluid (CSF) biomarkers: decrease of amyloïd peptides (Aß42), and increase of tau and phosphorylated-tau (p-tau) proteins. This recognition of CSF biological biomarkers for AD is a major step towards the “molecular” diagnosis and follow-up of the disease. Many issues are however still the subject of debate and further developments in this field focus on:
- First of all, there is a large debate on the appropriate and optimal use of the current CSF biomarkers that now face clinical implementation; when and how (alone, in combination..) to use them: for AD screening, in routine, for early or atypical AD cases etc..
- How to measure them in the most reliable way, a question which necessitates discussion on standard operating procedures, harmonization, quality control, establishment of reference material and methods, comparison of analytical platforms (immuno-detection, single and multiplex assays, mass spectrometry).
- How to improve the biological diagnosis of AD (in terms of sensitivity, specificity, and differentiation with other neurodegenerative disorders) with the help of new biomarkers. This major topic has two complementary aspects: the detection of additional Aß and tau isoforms, and the detection of completely new biomarkers (in particular from “omics” studies). Of note, there is not a week without the suggestion in the literature of a new putative biomarkers for AD.
- Related to the above item is the issue of a blood diagnosis of AD as most of the “interesting” biomarkers are being detected in the CSF which limits their usage.
- The use of biomarkers for the stratification, the follow-up and to predict therapeutic response of patients involved in therapeutic trails of AD.
- The last but not the least important issue of AD biomarkers is how they relate to the understanding of the pathophysiology of AD, and to new therapeutic leads.
In conclusion, the topic “Biomarkers of Alzheimer's disease” is a very active topic that has a major importance for medical diagnosis, basic research and therapeutics in the neurology and neuroscience field.
