TY - JOUR
T1 - Fluid biomarkers in cerebral amyloid angiopathy
AU - Savar, Seyed Mehrdad
AU - Ma, Bin
AU - Hone, Eugene
AU - Jahan, Farzana
AU - Markovic, Shaun
AU - Pedrini, Steve
AU - Shemehsavar, Soudabeh
AU - Easwaran, Vandhana
AU - Taddei, Kevin
AU - Gardener, Samantha
AU - Chhatwal, Jasmeer P.
AU - van Etten, Ellis S.
AU - van Osch, Matthias J. P.
AU - Clarke, Daniel
AU - Gnjec, Anastazija
AU - van Buchem, Mark A.
AU - Wermer, Marieke J. H.
AU - Hankey, Graeme J.
AU - Greenberg, Steven M.
AU - Martins, Ralph N.
AU - Sohrabi, Hamid R.
N1 - Copyright the Author(s) 2024. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.
PY - 2024/1/26
Y1 - 2024/1/26
N2 - Cerebral amyloid angiopathy (CAA) is a type of cerebrovascular disorder characterised by the accumulation of amyloid within the leptomeninges and small/medium-sized cerebral blood vessels. Typically, cerebral haemorrhages are one of the first clinical manifestations of CAA, posing a considerable challenge to the timely diagnosis of CAA as the bleedings only occur during the later disease stages. Fluid biomarkers may change prior to imaging biomarkers, and therefore, they could be the future of CAA diagnosis. Additionally, they can be used as primary outcome markers in prospective clinical trials. Among fluid biomarkers, blood-based biomarkers offer a distinct advantage over cerebrospinal fluid biomarkers as they do not require a procedure as invasive as a lumbar puncture. This article aimed to provide an overview of the present clinical data concerning fluid biomarkers associated with CAA and point out the direction of future studies. Among all the biomarkers discussed, amyloid β, neurofilament light chain, matrix metalloproteinases, complement 3, uric acid, and lactadherin demonstrated the most promising evidence. However, the field of fluid biomarkers for CAA is an under-researched area, and in most cases, there are only one or two studies on each of the biomarkers mentioned in this review. Additionally, a small sample size is a common limitation of the discussed studies. Hence, it is hard to reach a solid conclusion on the clinical significance of each biomarker at different stages of the disease or in various subpopulations of CAA. In order to overcome this issue, larger longitudinal and multicentered studies are needed.
AB - Cerebral amyloid angiopathy (CAA) is a type of cerebrovascular disorder characterised by the accumulation of amyloid within the leptomeninges and small/medium-sized cerebral blood vessels. Typically, cerebral haemorrhages are one of the first clinical manifestations of CAA, posing a considerable challenge to the timely diagnosis of CAA as the bleedings only occur during the later disease stages. Fluid biomarkers may change prior to imaging biomarkers, and therefore, they could be the future of CAA diagnosis. Additionally, they can be used as primary outcome markers in prospective clinical trials. Among fluid biomarkers, blood-based biomarkers offer a distinct advantage over cerebrospinal fluid biomarkers as they do not require a procedure as invasive as a lumbar puncture. This article aimed to provide an overview of the present clinical data concerning fluid biomarkers associated with CAA and point out the direction of future studies. Among all the biomarkers discussed, amyloid β, neurofilament light chain, matrix metalloproteinases, complement 3, uric acid, and lactadherin demonstrated the most promising evidence. However, the field of fluid biomarkers for CAA is an under-researched area, and in most cases, there are only one or two studies on each of the biomarkers mentioned in this review. Additionally, a small sample size is a common limitation of the discussed studies. Hence, it is hard to reach a solid conclusion on the clinical significance of each biomarker at different stages of the disease or in various subpopulations of CAA. In order to overcome this issue, larger longitudinal and multicentered studies are needed.
KW - Amyloid beta
KW - Cerebral amyloid angiopathy
KW - Differential diagnosis
KW - Familial cerebral amyloid angiopathy
KW - Fluid biomarkers
KW - Surrogate endpoints
UR - http://www.scopus.com/inward/record.url?scp=85184512044&partnerID=8YFLogxK
U2 - 10.3389/fnins.2024.1347320
DO - 10.3389/fnins.2024.1347320
M3 - Review article
C2 - 38344467
SN - 1662-4548
VL - 18
SP - 1
EP - 15
JO - Frontiers in Neuroscience
JF - Frontiers in Neuroscience
M1 - 1347320
ER -