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Alzheimers. Dement., Jan 2025, 21 (1) e14565 | https://doi.org/10.1002/alz.14565
Cross-cultural validation of plasma p-tau217 and p-tau181 as precision biomarkers for amyloid PET positivity: An East Asian study in Taiwan and Korea
Yung-Shuan Lin1,2,3 , Hyuk Sung Kwon4 , Wei-Ju Lee3,5,6 , Mina Hwang4 , Jee Hyang Jeong7 , Seong-Ho Koh4 , Seong Hye Choi8 , Jong-Ling Fuh1,2,3
1 Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
2 School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
3 Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
4 Department of Neurology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
5 Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
6 Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
7 Department of Neurology, Ewha Woman’s University College of Medicine, Seoul, Republic of Korea
8 Department of Neurology, Inha University College of Medicine, Incheon, Republic of Korea
Correspondence : Seong-Ho Koh, Seong Hye Choi, Jong-Ling Fuh
Seong-Ho Koh, Seong Hye Choi, and Jong-LingFuh are senior co-authors.
Yung-Shuan Lin and Hyuk Sung Kwon contributed equally to this work and should be considered co-first authors.
1 Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
2 School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
3 Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
4 Department of Neurology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
5 Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
6 Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
7 Department of Neurology, Ewha Woman’s University College of Medicine, Seoul, Republic of Korea
8 Department of Neurology, Inha University College of Medicine, Incheon, Republic of Korea
Correspondence : Seong-Ho Koh, Seong Hye Choi, Jong-Ling Fuh
Seong-Ho Koh, Seong Hye Choi, and Jong-LingFuh are senior co-authors.
Yung-Shuan Lin and Hyuk Sung Kwon contributed equally to this work and should be considered co-first authors.
Abstract
Introduction: Plasma phosphorylated tau (p-tau) biomarkers have improved Alzheimer's disease (AD) diagnosis, but data from diverse Asian populations are limited. This study evaluated plasma p-tau217 and p-tau181 levels in Korean and Taiwanese populations.
Methods: All participants (n = 270) underwent amyloid positron emission tomography (PET) and blood tests. Plasma p-tau model-derived probabilities of amyloid PET positivity (amyloid beta [Aβ]+) classified participants into low-, intermediate-, or high-risk groups.
Results: In both cohorts, plasma p-tau217 outperformed p-tau181, especially in cognitively unimpaired participants (area under the curve = 0.921 [p-tau217] vs. 0.769 [p-tau181], Pdifference = 0.022). Including apolipoprotein E status and glial fibrillary acidic protein improved model fit. The negative predictive value of the low-risk group and positive predictive value of the high-risk group were 97.5% and 86.0%, respectively.
Discussion: Plasma p-tau217 and p-tau181 effectively predict Aβ+ among culturally different Asian populations. P-tau217 performed better, especially in the early stages of AD. Plasma p-tau217-based models reduced intermediate-risk classifications, suggesting fewer amyloid PET scans needed to confirm the diagnosis.
Highlights: The efficacy of plasma phosphorylated tau (p-tau)217 and p-tau181 was analyzed in two Asian populations. Plasma p-tau217 performs better in predicting amyloid positron emission tomography positivity, especially in cognitively unimpaired subjects. Adding apolipoprotein E and glial fibrillary acidic protein to p-tau improved model accuracy. The models from each cohort were confirmed in the other cohort. Plasma p-tau-based risk stratification may reduce the need for confirmatory tests.
Methods: All participants (n = 270) underwent amyloid positron emission tomography (PET) and blood tests. Plasma p-tau model-derived probabilities of amyloid PET positivity (amyloid beta [Aβ]+) classified participants into low-, intermediate-, or high-risk groups.
Results: In both cohorts, plasma p-tau217 outperformed p-tau181, especially in cognitively unimpaired participants (area under the curve = 0.921 [p-tau217] vs. 0.769 [p-tau181], Pdifference = 0.022). Including apolipoprotein E status and glial fibrillary acidic protein improved model fit. The negative predictive value of the low-risk group and positive predictive value of the high-risk group were 97.5% and 86.0%, respectively.
Discussion: Plasma p-tau217 and p-tau181 effectively predict Aβ+ among culturally different Asian populations. P-tau217 performed better, especially in the early stages of AD. Plasma p-tau217-based models reduced intermediate-risk classifications, suggesting fewer amyloid PET scans needed to confirm the diagnosis.
Highlights: The efficacy of plasma phosphorylated tau (p-tau)217 and p-tau181 was analyzed in two Asian populations. Plasma p-tau217 performs better in predicting amyloid positron emission tomography positivity, especially in cognitively unimpaired subjects. Adding apolipoprotein E and glial fibrillary acidic protein to p-tau improved model accuracy. The models from each cohort were confirmed in the other cohort. Plasma p-tau-based risk stratification may reduce the need for confirmatory tests.
논문정보
- Research article
- 2025년 01월 (BRIC 등록일 2025-02-03)
- 국내(교신)+국외 연구진
- 의약학 > 응용의학
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