Unveiling Plasma Tau as a Promising Biomarker for Alzheimer's Disease Neurodegeneration
In a groundbreaking study, a team of international researchers has uncovered a promising new biomarker for Alzheimer's disease (AD) – brain-derived tau (BD-tau) in the blood. This discovery could revolutionize the way we diagnose, monitor, and potentially treat this devastating neurodegenerative disorder.
The study, conducted across four independent cohorts, reveals that plasma/serum BD-tau levels increase in accordance with the presence of amyloid-beta (Aβ) pathology and neurodegeneration in the brain. Importantly, the researchers found that individuals with both abnormal Aβ and neurodegeneration (as determined by cerebrospinal fluid biomarkers) exhibited the fastest cognitive decline and brain atrophy rates, regardless of their baseline cognitive status.
Notably, the researchers were able to establish a blood-based biomarker classification system by combining plasma p-tau (a marker of Aβ pathology) and BD-tau (a marker of neurodegeneration). This approach allowed them to identify individuals at the highest risk of short-term cognitive decline and brain atrophy – a critical finding in the era of emerging anti-Aβ therapies.
Unlike other blood-based markers, such as total-tau and neurofilament light chain, BD-tau showed minimal associations with age, kidney function, and other comorbidities/risk factors, including self-identified race/ethnicity. This suggests that BD-tau may be a more specific and reliable indicator of Alzheimer's-related neurodegeneration.
"Our findings demonstrate that blood-based BD-tau is a biomarker for identifying Aβ-positive individuals at risk of short-term cognitive decline and atrophy," explained the study's senior author. "This has important implications for clinical trials and the implementation of anti-Aβ therapies, as it allows us to prioritize high-risk individuals for immediate treatment."
The researchers also found that the association between BD-tau and Aβ pathology/neurodegeneration was more pronounced in the later stages of the Alzheimer's continuum, suggesting that blood-brain barrier dysfunction may contribute to elevated blood BD-tau levels in more advanced cases.
This groundbreaking study not only advances our understanding of Alzheimer's disease but also provides a crucial tool for identifying individuals most likely to benefit from emerging disease-modifying therapies. As we enter a new era of Alzheimer's treatment, these findings could have a profound impact on the way we manage and care for patients with this devastating condition.
Source: https://www.nature.com/articles/s41467-024-47286-5
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