by Petra Steinacker, Lubin Fang, Jens Kuhle, Axel Petzold, Hayrettin Tumani, Albert C. Ludolph, Markus Otto, Johannes Brettschneider
Biomarkers of disease progression in amyotrophic lateral sclerosis (ALS) could support the identification of beneficial drugs in clinical trials. We aimed to test whether soluble fragments of beta-amyloid precursor protein (sAPPa and sAPPß) correlated with clinical subtypes of ALS and were of prognostic value. Methodology/Principal Findings
In a cross-sectional study including patients with ALS (N?=?68) with clinical follow-up data over 6 months, Parkinson's disease (PD, N?=?20), and age-matched controls (N?=?40), cerebrospinal fluid (CSF) levels of sAPPa a, sAPPß and neurofilaments (NfHSMI35) were measured by multiplex assay, Progranulin by ELISA. CSF sAPPa and sAPPß levels were lower in ALS with a rapidly-progressive disease course (p?=?0.03, and p?=?0.02) and with longer disease duration (p?=?0.01 and p?=?0.01, respectively). CSF NfHSMI35 was elevated in ALS compared to PD and controls, with highest concentrations found in patients with rapid disease progression (p<0.01). High CSF NfHSMI3 was linked to low CSF sAPPa and sAPPß (p?=?0.001, and p?=?0.007, respectively). The ratios CSF NfHSMI35/CSF sAPPa,-ß were elevated in patients with fast progression of disease (p?=?0.002 each). CSF Progranulin decreased with ongoing disease (p?=?0.04). Conclusions
This study provides new CSF candidate markers associated with progression of disease in ALS. The data suggest that a deficiency of cellular neuroprotective mechanisms (decrease of sAPP) is linked to progressive neuro-axonal damage (increase of NfHSMI35) and to progression of disease.