Diagnostic Accuracy of Blood-Based Biomarker Panels: A Systematic Review

Anette Hardy-Sosa; Karen León-Arcia; Jorge J Llibre-Guerra; Jorge Berlanga-Acosta; Saiyet de la C Baez; Gerardo Guillen-Nieto; Pedro A Valdes-Sosa

doi:10.3389/fnagi.2022.683689

Diagnostic Accuracy of Blood-Based Biomarker Panels: A Systematic Review

Front Aging Neurosci. 2022 Mar 11:14:683689. doi: 10.3389/fnagi.2022.683689. eCollection 2022.

Authors

Anette Hardy-Sosa^{1

2}, Karen León-Arcia³, Jorge J Llibre-Guerra⁴, Jorge Berlanga-Acosta², Saiyet de la C Baez^{1

2}, Gerardo Guillen-Nieto², Pedro A Valdes-Sosa^{1

3}

Affiliations

¹ The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.
² Centro de Ingeniería Genética y Biotecnología, La Habana, Cuba.
³ Centro de Neurociencias de Cuba, La Habana, Cuba.
⁴ Instituto de Neurología y Neurocirugía, La Habana, Cuba.

Abstract

Background: Because of high prevalence of Alzheimer's disease (AD) in low- and middle-income countries (LMICs), there is an urgent need for inexpensive and minimally invasive diagnostic tests to detect biomarkers in the earliest and asymptomatic stages of the disease. Blood-based biomarkers are predicted to have the most impact for use as a screening tool and predict the onset of AD, especially in LMICs. Furthermore, it has been suggested that panels of markers may perform better than single protein candidates.

Methods: Medline/Pubmed was searched to identify current relevant studies published from January 2016 to December 2020. We included all full-text articles examining blood-based biomarkers as a set of protein markers or panels to aid in AD's early diagnosis, prognosis, and characterization.

Results: Seventy-six articles met the inclusion criteria for systematic review. Majority of the studies reported plasma and serum as the main source for biomarker determination in blood. Protein-based biomarker panels were reported to aid in AD diagnosis and prognosis with better accuracy than individual biomarkers. Conventional (amyloid-beta and tau) and neuroinflammatory biomarkers, such as amyloid beta-42, amyloid beta-40, total tau, phosphorylated tau-181, and other tau isoforms, were the most represented. We found the combination of amyloid beta-42/amyloid beta-40 ratio and APOEε4 status to be most represented with high accuracy for predicting amyloid beta-positron emission tomography status.

Conclusion: Assessment of Alzheimer's disease biomarkers in blood as a non-invasive and cost-effective alternative will potentially contribute to early diagnosis and improvement of therapeutic interventions. Given the heterogeneous nature of AD, combination of markers seems to perform better in the diagnosis and prognosis of the disease than individual biomarkers.

Keywords: Alzheimer’s disease (AD); biomarker panel; blood-based biomarker; diagnosis; preclinical AD.