Cerebrospinal fluid markers in Creutzfeldt-Jakob disease
The objective was to assess the utility of total tau protein (tTau), the ratio of (tTau)/181 phosphorylated tau protein (P-Tau) and 14-3-3 protein, as diagnostic markers in cerebrospinal fluid (CSF) for Creutzfeldt-Jakob disease (CJD).
Methods: CSF samples received from Norwegian hospitals between August 2005 and August 2007 were retrospectively selected from consecutive patients with tTau values >1200 ng/L (n=38).
The samples from patients clinically diagnosed with CJD (n=12) were compared to those from patients with other degenerative neurological diseases: Alzheimer's/vascular dementia (AD/VaD, n=21), other neurological diseases (OND, n =5). Total Tau, P-Tau, and beta-Amyloid (Abeta42) were measured with commercial kits.
Additionally, 14-3-3 protein was measured semi-quantitatively by immunoblot.
Results: The minimum cut-off limits for diagnosis of CJD were chosen from the test results. For tTau the lower limit was fixed at 3000 ng/L, for the tTau/P-Tau ratio it was 60, and for 14-3-3 protein it was 0.75 arbitrary units.
For tTau and tTau/P-Tau ratio, all but three CJD patients had levels above the minimum, whereas almost all of the other patients were below. For the 14-3-3 protein, two CJD patients were below the minimum and five were above.
Only one of the other patients was higher than the limit. The sensitivities, specificities and diagnostic efficiencies were: tTau 75%, 92%, and 87%; tTau/P-Tau 75%, 96%, and 89%; and 14-3-3 protein 80%, 96%, and 91%.
Conclusion: The results suggestthat 14-3-3 protein may be the better marker for CJD, tTau/P-Tau ratio and tTau are also efficient markers, but showed slightly inferior diagnostic properties in this study, with tTau/P-Tau marginally better than tTau.
Author: Anders Skinningsrud, Vidar Stenset, Astrid S Gundersen and Tormod Fladby
Credits/Source: Cerebrospinal Fluid Research 2008, 5:14
Published on: 2008-08-27
Copyright by the authors listed above - made available via BioMedCentral (Open Access). Please
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