A blood-based multi-pathway biomarker assay for early detection and staging of Alzheimer's disease across ethnic groups

Jiang, Yuanbing; Ortiz Romero, Paula, 1994-; Puig-Pijoan, Albert; Fernández-Lebrero, Aida; Contador, José; Suárez-Calvet, Marc; Ip, Nancy Y.

doi:http://dx.doi.org/10.1002/alz.13676

A blood-based multi-pathway biomarker assay for early detection and staging of Alzheimer's disease across ethnic groups

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Jiang Y, Uhm H, Ip FC, Ouyang L, Lo RMN, Cheng EYL, et al. A blood-based multi-pathway biomarker assay for early detection and staging of Alzheimer's disease across ethnic groups. Alzheimers Dement. 2024 Mar;20(3):2000-15. DOI: 10.1002/alz.13676

Abstract

Introduction: Existing blood-based biomarkers for Alzheimer's disease (AD) mainly focus on its pathological features. However, studies on blood-based biomarkers associated with other biological processes for a comprehensive evaluation of AD status are limited. Methods: We developed a blood-based, multiplex biomarker assay for AD that measures the levels of 21 proteins involved in multiple biological pathways. We evaluated the assay's performance for classifying AD and indicating AD-related endophenotypes in three independent cohorts from Chinese or European-descent populations. Results: The 21-protein assay accurately classified AD (area under the receiver operating characteristic curve [AUC] = 0.9407 to 0.9867) and mild cognitive impairment (MCI; AUC = 0.8434 to 0.8945) while also indicating brain amyloid pathology. Moreover, the assay simultaneously evaluated the changes of five biological processes in individuals and revealed the ethnic-specific dysregulations of biological processes upon AD progression. Discussion: This study demonstrated the utility of a blood-based, multi-pathway biomarker assay for early screening and staging of AD, providing insights for patient stratification and precision medicine. Highlights: The authors developed a blood-based biomarker assay for Alzheimer's disease. The 21-protein assay classifies AD/MCI and indicates brain amyloid pathology. The 21-protein assay can simultaneously assess activities of five biological processes. Ethnic-specific dysregulations of biological processes in AD were revealed.