PurposeThis study is part of a larger effort aiming to expand the knowledge of brain‐enriched proteins in human cerebrospinal fluid (CSF) and to provide novel insight into the relation between such proteins and different neurodegenerative diseases.Experimental designHere 280 brain‐enriched proteins in CSF from patients with Alzheimer's disease (AD), Parkinson's disease (PD) and dementia with Lewy bodies (DLB) are profiled. In total, 441 human samples of ventricular CSF collected post mortem and lumbar CSF collected ante mortem are analyzed using 376 antibodies in a suspension bead array setup, utilizing a direct labelling approach.ResultsAmong several proteins displaying differentiated profiles between sample groups, we focus here on two synaptic proteins, neuromodulin (GAP43) and neurogranin (NRGN). They are both found at elevated levels in CSF from AD patients in two independent cohorts, providing disease‐associated profiles in addition to verifying and strengthening previously observed patterns. Increased levels are also observed for patients for whom the AD diagnosis was not established at the time of sampling.Conclusions and clinical relevanceThese findings indicate that analyzing the brain‐enriched proteins in CSF is of particular interest to increase the understanding of the CSF proteome and its relation to neurodegenerative disorders. In addition, this study lends support to the notion that measurements of these synaptic proteins could potentially be of great relevance in future diagnostic tests for AD.
Apart from the well-defined factors in neuronal cells 1 , only few reports consider that variability of sporadic ALS progression can depend on the less-defined contributions from glia 2,3 and blood vessels 4 .In this study we use an expression weighted cell-type enrichment method to infer cell activity in spinal cord samples from sporadic ALS patients and mouse models of this disease. Here we report that sporadic ALS patients present cell activity patterns consistent with two mouse models in which enrichments of vascular cell genes preceded the microglial response. Notably, during the presymptomatic stage, perivascular fibroblast cells showed the strongest gene enrichments and their marker proteins SPP1 and COL6A1 accumulated in enlarged perivascular spaces in sporadic ALS patients. Moreover, in plasma of 574 ALS patients from four independent cohorts, increased levels of SPP1 at disease diagnosis repeatedly predicted shorter survival with stronger effect than the established risk factors of bulbar onset or neurofilament levels in cerebrospinal fluid. We propose that the activity of the recently-discovered perivascular fibroblast can predict ALS patient survival and provide a novel conceptual framework to re-evaluate definitions of ALS etiology.
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