JAMA neurology

Differences in Glial Protein Levels in Blood and Brain Fluid Across Stages of Alzheimer’s Disease

Updated

Abstract

Plasma GFAP levels were significantly higher in individuals with preclinical Alzheimer's disease compared to cognitively unimpaired individuals.

  • Plasma GFAP levels increased with the progression of Alzheimer's disease, showing higher levels in symptomatic stages compared to preclinical stages.
  • In the TRIAD cohort, plasma GFAP levels in cognitively unimpaired Aβ-positive individuals averaged 285.0 pg/mL, while those with mild cognitive impairment averaged 332.5 pg/mL, and Alzheimer's dementia averaged 388.1 pg/mL.
  • Plasma GFAP changes were consistently greater than those observed in cerebrospinal fluid (CSF) GFAP levels.
  • Plasma GFAP was more effective at distinguishing between Aβ-positive and Aβ-negative individuals compared to CSF GFAP, with area under the curve values ranging from 0.69 to 0.86 for plasma and 0.59 to 0.76 for CSF.
  • Additionally, plasma GFAP levels showed a positive association with tau pathology, but this was only observed in individuals with concurrent Aβ pathology.

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Funding

Competing interests

Conflict of Interest Disclosures: Dr Vrillon reported receiving grants from Fondation Ophtalmologique Adolphe de Rothschild, Fondation Philipe Chatrier, Amicale des Anciens Internes des Hôpitaux de Paris, and Fondation Vaincre Alzheimer during the conduct of the study. Dr Gispert reported receiving grants from GE Healthcare, Roche Diagnostics, and F. Hoffman-La Roche; and speaker’s fees from Philips and Biogen during the conduct of the study. Dr Suridjan reported being an employee of and owning stocks in Roche Diagnostics. Dr Zetterberg reported receiving personal fees from Alector, Eisai, Denali, Roche Diagnostics, Wave, Samumed, Siemens Healthineers, Pinteon Therapeutics, Nervgen, AZTherapies, CogRx, Red Abbey Labs, Cellectricon, Alzecure, Fujirebio, and Biogen and also reported being cofounder of and holding stock in Brain Biomarker Solutions in Gothenburg AB outside the submitted work. Dr Molinuevo reported receiving in-kind reagents from Roche Diagnostics and GE Healthcare and grants from “La Caixa” Foundation NA and Alzheimer’s Association NA during the conduct of the study as well as being an employee of Lundbeck A/S and serving on the advisory board for Genentech, Roche Diagnostics, Novartis, Genentech, Oryzon, Biogen, Lilly, Janssen, Green Valley, MSD, Eisai, Alector, BioCross, and ProMis Neurosciences outside the submitted work. Dr Paquet reported receiving personal fees from Roche, Biogen, and Lilly during the conduct of the study. Dr Blennow reported personal fees from Abcam, Axon, Biogen, JOMDD/Shimadzu, Lilly, MagQu, Novartis, Roche Diagnostics, and Siemens outside the submitted work and being cofounder of Brain Biomarker Solutions in Gothenburg AB, which is a part of the GU Ventures Incubator Program. Dr Suárez-Calvet reported receiving personal fees from Roche Diagnostics International and Roche Farma, SA outside the submitted work. No other disclosures were reported.
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