Nerve growth factor (NGF) pathway biomarkers in Down syndrome prior to and after the onset of clinical Alzheimer's disease: A paired CSF and plasma study

Alzheimers Dement. 2021 Apr;17(4):605-617. doi: 10.1002/alz.12229. Epub 2020 Nov 23.

Abstract

Background: The discovery that nerve growth factor (NGF) metabolism is altered in Down syndrome (DS) and Alzheimer's disease (AD) brains offered a framework for the identification of novel biomarkers signalling NGF deregulation in AD pathology.

Methods: We examined levels of NGF pathway proteins (proNGF, neuroserpin, tissue plasminogen activator [tPA], and metalloproteases [MMP]) in matched cerebrospinal fluid (CSF)/plasma samples from AD-symptomatic (DSAD) and AD-asymptomatic (aDS) individuals with DS, as well as controls (HC).

Results: ProNGF and MMP-3 were elevated while tPA was decreased in plasma from individuals with DS. CSF from individuals with DS showed elevated proNGF, neuroserpin, MMP-3, and MMP-9. ProNGF and MMP-9 in CSF differentiated DSAD from aDS (area under the curve = 0.86, 0.87). NGF pathway markers associated with CSF amyloid beta and tau and differed by sex.

Discussion: Brain NGF metabolism changes can be monitored in plasma and CSF, supporting relevance in AD pathology. These markers could assist staging, subtyping, or precision medicine for AD in DS.

Keywords: Alzheimer's disease; Down syndrome; MMP-1; MMP-3; MMP-9; NGF metabolic pathway; biomarkers; blood; cerebrospinal fluid; cholinergic; metalloproteases; nerve growth factor; neuroserpin; plasma; proNGF; tissue plasminogen activator.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alzheimer Disease / blood
  • Alzheimer Disease / cerebrospinal fluid
  • Alzheimer Disease / diagnosis*
  • Biomarkers* / blood
  • Biomarkers* / cerebrospinal fluid
  • Brain / physiopathology
  • Down Syndrome / complications
  • Down Syndrome / metabolism*
  • Down Syndrome / physiopathology*
  • Female
  • Humans
  • Male
  • Matrix Metalloproteinase 3 / blood
  • Matrix Metalloproteinase 3 / cerebrospinal fluid
  • Matrix Metalloproteinase 9 / blood
  • Matrix Metalloproteinase 9 / cerebrospinal fluid
  • Middle Aged
  • Nerve Growth Factor / metabolism*
  • Neuropeptides / blood
  • Neuropeptides / cerebrospinal fluid
  • Neuroserpin
  • Serpins / blood
  • Serpins / cerebrospinal fluid
  • Signal Transduction
  • tau Proteins / metabolism

Substances

  • Biomarkers
  • Neuropeptides
  • Serpins
  • tau Proteins
  • Nerve Growth Factor
  • MMP3 protein, human
  • Matrix Metalloproteinase 3
  • Matrix Metalloproteinase 9