变异型克罗伊茨费尔特-雅各布病患者的CSF磷酸-tau蛋白浓度升高:诊断和病理学意义

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Objective: To investigate whether phosphorylated tau protein (tau-pT181) is increased in variant Creutzfeldt-Jakob disease (vCJD) and if the tau-pT181/tau protein ratio is useful for distinguishing between patients with and without CJD. Methods: CSF tau protein and tau-pT181 were measured in 50 patients with sporadic CJD (sCJD), 51 patients with vCJD, 46 sCJD controls, and 37 vCJD controls, using Innotest hTau and Innotest P-Thr181, Innogenetics. Results: Concentrations of CSF tau protein were increased in sCJD (5120 v 367 pg/ml in controls, p < 0.001) and vCJD (952 v 106 pg/ml, p < 0.001); tau-pT181 was also raised in sCJD (61 v 35 pg/ml in controls, p = 0.002) and vCJD (114 v 33 pg/ml, p < 0.001). Median concentrations of tau-pT181 were higher in vCJD than in sCJD (p < 0.001). The tau-pT181/tau protein ratio was lower than in controls in both sCJD (12 v 128 (p < 0.001)) and vCJD (119 v 279 (p < 0.001)). Mean tau-pT181/tau protein ratio was 10-fold higher in vCJD than in sCJD. Raised CSF tau protein had the highest efficiency for distinguishing sCJD and vCJD from controls. Conclusions: CSF tau-pT181 concentrations are raised in vCJD and are higher than in CJD. Measurement of CSF tau-pT181/tau protein ratio does not improve the diagnostic efficiency of CSF tau protein alone for either vCJD or sCJD. The higher concentration of CSF tau-pT181 found in vCJD suggests that unexplained pathogenic factors influence the phosphorylation of tau protein in vCJD patients. Objective: To investigate whether phosphorylated tau protein (tau-pT181) is increased in variant Creutzfeldt-Jakob disease (vCJD) and if the tau-pT181 / tau protein ratio is useful for distinguishing between patients with and without CJD. Methods: CSF tau protein and tau-pT181 were measured in 50 patients with sporadic CJD (sCJD), 51 patients with vCJD, 46 sCJD controls, and 37 vCJD controls, using Innotest hTau and Innotest P-Thrl18, Innogenetics. Results: Concentrations of CSF tau protein were increased (5120 v367 pg / ml in controls, p <0.001) and vCJD (952 v106 pg / ml, p <0.001); tau-pT181 was also raised in sCJD (61 v 35 pg / ml in controls, p = 0.002) and vCJD (114 v 33 pg / ml, p <0.001). Median concentrations of tau-pT181 were higher in vCJD than in sCJD (p <0.001). The tau-pT181 / tau protein ratio was lower than in controls The mean tau-pT181 / tau protein ratio was 10-fold higher in vCJD than in sCJD. Both the sCJD (12 v 128 (p <0.001)) and vCJD CSF tau protein had the highest efficiency for distinguishing sCJD and vCJD from controls. Conclusions: CSF tau-pT181 concentrations are raised in vCJD and are higher than in CJD. Measurement of CSF tau-pT181 / tau protein ratio does not improve the diagnostic efficiency of CSF tau protein alone for either vCJD or sCJD. The higher concentration of CSF tau-pT181 found in vCJD suggests that unexplained pathogenic factors influence the phosphorylation of tau protein in vCJD patients.
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