Identification and Validation of Novel Cerebrospinal Fluid Biomarkers for Staging Early Alzheimer's Disease

Ideally, disease modifying therapies for Alzheimer disease (AD) will be applied during the 'preclinical' stage (pathology present with cognition intact) before severe neuronal damage occurs, or upon recognizing very mild cognitive impairment. Developing and judiciously administering such therapies will require biomarker panels to identify early AD pathology, classify disease stage, monitor pathological progression, and predict cognitive decline. To discover such biomarkers, we measured AD-associated changes in the cerebrospinal fluid (CSF) proteome.CSF samples from individuals with mild AD (Clinical Dementia Rating [CDR] 1) (n = 24) and cognitively normal controls (CDR 0) (n = 24) were subjected to two-dimensional difference-in-gel electrophoresis. Within 119 differentially-abundant gel features, mass spectrometry (LC-MS/MS) identified 47 proteins. For validation, eleven proteins were re-evaluated by enzyme-linked immunosorbent assays (ELISA). Six of these assays (NrCAM, YKL-40, chromogranin A, carnosinase I, transthyretin, cystatin C) distinguished CDR 1 and CDR 0 groups and were subsequently applied (with tau, p-tau181 and Aβ42 ELISAs) to a larger independent cohort (n = 292) that included individuals with very mild dementia (CDR 0.5). Receiver-operating characteristic curve analyses using stepwise logistic regression yielded optimal biomarker combinations to distinguish CDR 0 from CDR>0 (tau, YKL-40, NrCAM) and CDR 1 from CDR<1 (tau, chromogranin A, carnosinase I) with areas under the curve of 0.90 (0.85-0.94 95% confidence interval [CI]) and 0.88 (0.81-0.94 CI), respectively.Four novel CSF biomarkers for AD (NrCAM, YKL-40, chromogranin A, carnosinase I) can improve the diagnostic accuracy of Aβ42 and tau. Together, these six markers describe six clinicopathological stages from cognitive normalcy to mild dementia, including stages defined by increased risk of cognitive decline. Such a panel might improve clinical trial efficiency by guiding subject enrollment and monitoring disease progression. Further studies will be required to validate this panel and evaluate its potential for distinguishing AD from other dementing conditions

Application of double-phase liquid phase microextraction in the determination of partition coefficients and analysis of pesticides in water samples

A simple and solvent-minimized sample preparation technique based on two-phase hollow fiber-protected liquid-phase microextraction has been developed and used for the determination of partition coefficient and analysis of selected pesticides in environmental water samples. The analysis was performed by gas chromatography–electron capture detector. Three pesticides namely hexaconazole, quinalphos, and methidathion were considered as target analytes. Extraction conditions such as solvent identity, salt concentration, stirring speed, extraction time, length of the hollow fiber, and volume of donor phase were optimized. The analytes were extracted from a donor phase (water sample) through 3 µL of an organic solvent immobilized in the pores of a porous polypropylene hollow fiber and then into the acceptor phase present inside the hollow fiber. Excellent extractions of the analytes were achieved under the optimized conditions, with relative standard deviations of 4.6–7.9%, correlation coefficients (r2) of 0.9954–0.9986 and limits of detection of 3–7 ng L-1. The proposed method provided good average enrichment factors of up to 250-fold. The partition coefficients of the analytes determined were found to be directly correlated with the enrichment factor. The present methodology also confirms the robustness of microextraction for monitoring trace levels of pesticides in environmental water samples