據(jù)英國(guó)《衛(wèi)報(bào)》12月27日?qǐng)?bào)道，科學(xué)家開發(fā)出了一種可以診斷阿爾茨海默病的新型血液測(cè)試，英媒報(bào)道稱，該測(cè)試較傳統(tǒng)方法更經(jīng)濟(jì)，并可更早發(fā)現(xiàn)疾病。當(dāng)前該測(cè)試方法仍在試驗(yàn)中。

Scientists have developed a blood test to diagnose Alzheimer’s disease without the need for expensive brain imaging or a painful lumbar puncture, where a sample of cerebrospinal fluid (CSF) is drawn from the lower back. If validated, the test could enable faster diagnosis of the disease, meaning therapies could be initiated earlier.

科學(xué)家們開發(fā)出一種可診斷阿爾茨海默病的新型血液檢測(cè)，無(wú)需進(jìn)行昂貴的腦部影像檢查或痛苦的腰椎穿刺（從下背部抽取腦脊液樣本）。如果該檢測(cè)方法得到驗(yàn)證，阿爾茲海默癥可以得到更快診斷，這意味著可以盡早開始治療。

Alzheimer’s is the most common form of dementia, but diagnosis remains challenging – particularly during the earlier stages of the disease.

阿爾茨海默癥是最常見的癡呆癥，但診斷仍具有難度，尤其是在疾病的早期階段。

Current guidelines recommend detection of three distinct markers: abnormal accumulations of amyloid and tau proteins, as well as neurodegeneration – the slow and progressive loss of neuronal cells in specified regions of the brain. This can be done through a combination of brain imaging and CSF analysis. However, a lumbar puncture can be painful and people may experience headaches or back pain after the procedure, while brain imaging is expensive and takes a long time to schedule.

目前的醫(yī)學(xué)指南建議檢測(cè)三種不同的標(biāo)志物：淀粉樣蛋白、Tau蛋白的異常積累，以及神經(jīng)變性（大腦特定區(qū)域神經(jīng)元細(xì)胞的緩慢和漸進(jìn)性喪失）。以上標(biāo)志物檢測(cè)可以結(jié)合腦成像和腦脊液分析來(lái)完成。然而，腰椎穿刺可能會(huì)很痛苦，術(shù)后患者可能會(huì)感到頭痛或背痛，而腦部成像費(fèi)用昂貴，需要等待很長(zhǎng)時(shí)間。

Prof Thomas Karikari at the University of Pittsburgh, in Pennsylvania, US, who was involved in the study, said: “A lot of patients, even in the US, don’t have access to MRI and PET scanners. Accessibility is a major issue.”

參與研究的美國(guó)賓夕法尼亞州匹茲堡大學(xué)教授托馬斯·卡里卡里表示：“很多患者，甚至在美國(guó)，都沒有機(jī)會(huì)進(jìn)行核磁共振成像和PET掃描儀檢查。這些檢查不夠普及是主要問題?！?/p>

The development of a reliable blood test would be an important step forwards. “A blood test is cheaper, safer and easier to administer, and it can improve clinical confidence in diagnosing Alzheimer’s and selecting participants for clinical trial and disease monitoring,” Karikari said.

開發(fā)可靠的血液測(cè)試將是一個(gè)重要的進(jìn)步。卡里卡里說(shuō)：“血檢更經(jīng)濟(jì)、安全、更容易實(shí)施，可以提高診斷阿爾茨海默病的臨床信心，并為臨床試驗(yàn)和疾病監(jiān)測(cè)征選研究對(duì)象?！?/p>

Although current blood tests can accurately detect abnormalities in amyloid and tau proteins, detecting markers of nerve cell damage that are specific to the brain has been harder. Karikari and his colleagues around the world focused on developing an antibody-based blood test that would detect a particular form of tau protein called brain-derived tau, which is specific to Alzheimer’s disease.

盡管目前的血液檢測(cè)可以準(zhǔn)確檢測(cè)淀粉樣蛋白和tau蛋白的異常，但檢測(cè)大腦特有的神經(jīng)細(xì)胞損傷的標(biāo)志物一直比較困難。卡里卡里和他在世界各地的同事致力于開發(fā)一種基于抗體的血液測(cè)試，該測(cè)試將檢測(cè)一種特殊形式的Tau蛋白，被稱為腦源性Tau蛋白。這種蛋白是阿爾茨海默病患者特有的。

They tested it in 600 patients at various stages of Alzheimer’s and found that levels of the protein correlated well with levels of tau in the CSF, and could reliably distinguish Alzheimer’s from other neurodegenerative diseases. Protein levels also closely corresponded with the severity of amyloid plaques and tau tangles in brain tissue from people who had died with Alzheimer’s. The research was published in the journal Brain.

研究人員在600名處于不同階段的阿爾茨海默病患者身上進(jìn)行了測(cè)試，發(fā)現(xiàn)腦源性Tau蛋白的水平與腦脊液中的Tau蛋白水平有很大的相關(guān)性，能可靠地將阿爾茨海默病與其他神經(jīng)退行性疾病區(qū)分開來(lái)。腦源性Tau蛋白質(zhì)水平還與阿爾茨海默病患者腦組織中的淀粉樣斑塊和Tau蛋白纏結(jié)的嚴(yán)重程度密切相關(guān)。這項(xiàng)研究發(fā)表在《大腦》雜志上。

The next step will be to validate the test in a broader range of patients, including those from varied racial and ethnic backgrounds, and those suffering from different stages of memory loss or other potential dementia symptoms.

下一步研究將在更廣泛的患者中驗(yàn)證該血液測(cè)試，包括來(lái)自不同種族和民族背景的患者，以及那些患有記憶喪失或其他潛在癡呆癥狀的不同階段患者。

Karikari also hopes that monitoring levels of brain-derived tau in the blood could improve the design of clinical trials for Alzheimer’s treatments.

卡里卡里還希望，通過監(jiān)測(cè)血液中腦源性Tau蛋白水平，可以改善阿爾茨海默病治療的臨床試驗(yàn)設(shè)計(jì)。

來(lái)源：衛(wèi)報(bào)

編輯：董靜