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Alzheimer's & dementia : the journal of the Alzheimer's Association
Published

Unravelling the plasma proteome: Pioneering biomarkers for differential dementia diagnosis

Authors

Haşim Gezegen, Merve Alaylıoğlu, Erdi Şahin, Owen Swann, Elena Veleva, Gamze Güven, Umran Yaman, Derviş A Salih, Başar Bilgiç, Haşmet Hanağası, Hakan Gürvit, Murat Emre, Duygu Gezen-Ak, Erdinç Dursun, Henrik Zetterberg, John Hardy, Amanda Heslegrave, Maryam Shoai, Bedia Samanci

Abstract

Alzheimers Dement. 2025 Jul;21(7):e70162. doi: 10.1002/alz.70162.

ABSTRACT

INTRODUCTION: Diagnosing Alzheimer's disease (AD) is challenging due to overlapping symptoms with other dementias and the invasiveness of current biomarkers. This study introduces the NULISA platform, a novel proteomics technology, to evaluate diagnostic accuracy of known biomarkers and uncover novel biomarkers underlying different dementias.

METHODS: We analyzed plasma and cerebrospinal fluid (CSF) samples from 248 participants diagnosed with Alzheimer's disease (AD), dementia with Lewy bodies (DLB), frontotemporal dementia (FTD), and mild cognitive impairment (MCI). Plasma biomarkers were evaluated using regression models, receiver operating characteristics curve (ROC) analysis, and pathway enrichment.

RESULTS: Plasma phosphorylated Tau217 (pTau217) demonstrated the highest diagnostic accuracy for AD, DLB, and FTD (area under the curve [AUCs]: 0.9, 0.84, and 0.79, respectively). CXCL1 (fractalkine), synaptosomal-associated protein 25 (SNAP25), triggering receptor expressed on myeloid cells 1 (TREM1), β-synuclein, and tyrosine kinase (TEK) are expressed differently in DLB and FTD than AD. Ingenuity pathway analyses revealed astrocytic, synaptic, and inflammatory pathways as shared and distinct mechanisms across these dementia types.

CONCLUSION: Our findings establish plasma pTau217 as a robust diagnostic marker. This study provides new plasma biomarkers for differential diagnosis of dementias with a noninvasive method.

HIGHLIGHTS: Plasma pTau217 showed high diagnostic accuracy for AD, DLB, and FTD. CXCL1, SNAP25, TREM1, β-synuclein, and TEK are novel markers distinguishing other dementias from AD. Noninvasive plasma biomarkers enable diagnosis and differentiation of dementias.

PMID:40613333 | DOI:10.1002/alz.70162

UK DRI Authors

Owen Swann

Research Technician, UK DRI Biomarker Factory

Owen Swann

Elena Veleva

UK DRI Facility Co-ordinator

Facility Co-ordinator, UK DRI Biomarker Factory

Elena Veleva
Profile picture of Henrik Zetterberg

Prof Henrik Zetterberg

Group Leader

Pioneering the development of fluid biomarkers for dementia

Prof Henrik Zetterberg
John Hardy

Prof Sir John Hardy

Group Leader

Harnessing genetics to build a better understanding of dementia

Prof Sir John Hardy
Amanda Heslegrave

Dr Amanda Heslegrave

Principal Research Fellow

Co-leading the UK DRI Biomarker Factory platform based at UK DRI at UCL

Dr Amanda Heslegrave