Cerebrospinal fluid protein dynamics as biomarkers of Alzheimer's disease: from pathophysiology to clinical applications
Keywords:
cerebrospinal fluid protein dynamics, Alzheimer's disease biomarkers, Alzheimer's disease pathophysiologyAbstract
Introduction: Alzheimer's disease represents a global health challenge, making the validation of reliable biomarkers crucial for its diagnosis and management. cerebrospinal fluid, due to its direct contact with the extracellular space of the brain, constitutes an ideal source for this purpose.
Objective: To delve into the dynamics of proteins in cerebrospinal fluid, analyzing their pathophysiological basis, their integrated utility within the AT(N) framework, and their role in the modern management of Alzheimer's disease.
Method: A comprehensive review of the scientific literature examining changes in key biomarkers such as beta-amyloid peptide (Aβ), tau, and novel analytes.
Development: The decrease in the Aβ42/Aβ40 ratio in cerebrospinal fluid reflects the sequestration of amyloid in brain plaques, while the increase in phosphorylated tau (p-tau) indicates the formation of neurofibrillary tangles. Emerging biomarkers (sTREM2, Neurogranin) capture neuroinflammation processes and synaptic dysfunction.
Conclusions: The integration of these biomarkers into the AT(N) framework has transformed the management of Alzheimer's disease, enabling precise biological diagnosis, improved prognosis, and the selection of candidates for disease-modifying therapies, thus establishing precision medicine in neurology.
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