Blood Tests Being Developed In Oslo
Tormod Fladby at OUS is also working on developing a blood test-based diagnostics.
We use immune cells in the blood, monocytes and macrophages, and see how these interact with Alzheimer’s-related proteins. We believe this will also be a simple and useful method, he said.
The reason why they and their colleagues in Sweden are making great progress now is that the technology for measuring small amounts of protein has become more advanced, he said.
What Did The Scientists Do
The UCL team led by Prof Jonathan Schott worked with a unique group of over 400 volunteers, recruited from the Medical Research Council National Survey of Health and Development 1946 British Birth Cohort. They were all born in the same week in 1946 and did not have dementia. They had amyloid PET scans and blood tests as part of the Alzheimers Research UK-funded Insight 46 study, Blood tests were done at UCL and through collaboration with researchers at the University of Gothenburg, Sweden.
The researchers compared three different ways of measuring proteins of interest in the blood and compared the results of the blood tests to those from the PET scans.
See The Hunt For A Blood Test For Alzheimers Disease
The C2N test relies on the ratio of two isoforms of the amyloid- protein, A42 and A40, that aggregate to form amyloid plaques in the brain, combined with the presence of isoforms of apolipoprotein E that reflect whether the patient caries a genetic variant associated with Alzheimers risk. The results are combined into a score that indicates the probability that a patient would be found to have amyloid plaques if they were to undergo an amyloid PET scan. Doctors can then consider the test results along with other information about the patient to arrive at a diagnosis. According to data posted on the companys website, a study in 686 patients with cognitive impairment found that those with scores above a certain cutoff point had a positive amyloid PET scan 92 percent of the time, while those with scores below a certain cutoff had a 77 percent chance of having a negative result on the PET scan.
While no drugs have yet been approved to treat Alzheimers, being able to distinguish it from other possible causes of cognitive impairment is nonetheless valuable, Fillit and Schindler say. As a clinician, Schindler says, I want to know what my patients have. That can be complicated because in many cases, they dont just have memory impairment, theyre taking multiple medications, they have all sorts of health issues, she says. And sometimes its really hard to know whether the symptoms theyre experiencing are due to something like Alzheimers or something else.
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Detecting Alzheimers Gets Easier With A Simple Blood Test
New assays could reduce the need for costlier, more invasive brain scans and spinal fluid measures
When a patient complains of forgetfulness, a neurologist might not know immediately whether it results from normal aging, reduced blood flow to the brainor, more ominously, Alzheimers disease. For much of the past century, a definitive Alzheimers diagnosis could only be made during an autopsy. Brain imaging and spinal fluid tests now make it possible to spot the disease in patients even before the initial symptoms appear. But these invasive tests are expensive and generally limited to research settings that are not part of routine care for the millions of people suffering from the most common neurodegenerative disorder.
An era in which an Alzheimers diagnosis can begin in a doctors office is now arriving. Advances in technologies to detect early signs of disease from a blood sample are helping doctors to identify the memory-robbing disorder more accurately and to screen participants more quickly for trials of potential treatments for the more than five million people in the U.S. afflicted with Alzheimers.
The development of a blood-based test for Alzheimers disease is just phenomenal, says Michelle Mielke, a neuroscientist and epidemiologist at the Mayo Clinic. The field has been thinking about this for a very long time. Its really been in the last couple of years that the possibility has come to fruition.
How Is Alzheimers Disease Usually Detected
Paulson: Doctors usually make a clinical diagnosis of Alzheimers disease based on the history of the illness, cognitive assessment, a neurologic examination and often standard brain imaging. It is an imperfect science and we are not always right in concluding that the diagnosis is Alzheimers rather than some other form of dementia.
Testing the cerebrospinal fluid for biomarkers of Alzheimers can lead to a more precise diagnosis, but many patients are not eager to undergo the spinal tap needed to get this answer, and sometimes insurance companies wont pay for the test.
New imaging methods allow is to visualize the key Alzheimers proteins in the brain, namely beta-amyloid and tau, but these imaging procedures are expensive and not yet covered by insurance.
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The Need For Fda Approval
Some concerns stem from the fact that the company has not obtained Food and Drug Administration approval. However, Holtzman says that CN Diagnostics is in the process of obtaining FDA approval for PrecivityAD.
It takes a lot longer to get FDA approval for anything so we started going through that process at least a year ago, says Holtzman. The company is confident that the test is very good and accurate and so we thought it would be valuable to make it available to patients if they want that information.
Scientists Develop Simple Blood Test For Early Detection Of Alzheimer’s Disease
- Hong Kong University of Science and Technology
- An international research team has developed a simple but robust blood test from Chinese patient data for early detection and screening of Alzheimer’s disease with an accuracy level of over 96%.
An international research team led by HKUST has developed a simple but robust blood test from Chinese patient data for early detection and screening of Alzheimer’s disease for the first time, with an accuracy level of over 96%.
Currently, doctors mainly rely on cognitive tests to diagnose a person with AD. Besides clinical assessment, brain imaging and lumbar puncture are the two most commonly used medical procedures to detect changes in the brain caused by AD. However, these methods are expensive, invasive, and frequently unavailable in many countries.
“With the advancement of ultrasensitive blood-based protein detection technology, we have developed a simple, noninvasive, and accurate diagnostic solution for AD, which will greatly facilitate population-scale screening and staging of the disease,” said Prof. Nancy Ip, Morningside Professor of Life Science and the Director of the State Key Laboratory of Molecular Neuroscience at HKUST.
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Potential New Blood Test In Alzheimers Disease Could Advance Treatment
Experts describe a method that could be used to spot the complex brain disease.
Since its discovery, Alzheimers disease has been a challenge to test for and predict in patients. Currently, testing is primarily done through brain imaging and behavioral tests, which are costly and often fail to detect the disease in its earliest stages.
However, research presented at the last Alzheimers Association International Conference show a promising blood test that may detect Alzheimers before symptoms appear, in an affordable and accessible manner.
Henry Paulson, M.D., Ph.D, professor of neurology and director of the Michigan Alzheimers Disease Center andNicholas M. Kanaan, Ph.D., associate professor of translational neuroscience at Michigan State University, joined forces to share their opinions on what this development could mean for the future of Alzheimers testing. Paulson directs the statewide Michigan Alzheimers Disease Research Center, while Kanaan leads the centers biomarker core.
Here Are Some Of The New Biomarkers Discovered So Far:
Biomarker: a42 and a40: The presence of a42 and a40 isoforms show a buildup of amyloid plaques in the brain, which triggers a sequence of pathological processes. Lower ratios of a42:a40 and levels of a42 in the cerebrospinal fluid are the best indicators of Alzheimers Disease.
Biomarker: Neurofilament Light: A recent study shows patients with Alzheimers experience an increase in neurofilament light chain protein in the spinal fluid and the blood 16 years before onset. The study also found the rate of increase in the protein correlated with the shrinking of the brains precuneus region, and the patients performed worse in cognitive tests. The protein makes a reliable biomarker to track the progression of the disease non-invasively.
Biomarker: Tau and p-tau: Studies presented at the 2020 Alzheimers Association International Conference showed the tau protein p-tau217 is an indication of the presence of Alzheimers disease. High levels of tau or the phosphorylated form, p-tau, make a reliable biomarker candidate because it also indicates the presence of damaging neurofibrillary tangles in the brain. According to another Alzheimers researcher, Dr. Michael Weiner at the University of California, San Francisco , this blood test accurately predicts the presence of the disease in the brain.
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Limitations Of The C2n Alzheimers Blood Test
The company has not published any data on the tests accuracy, though their promotional materials compare accuracy rates to the accuracy seen with PET scans.
The facts that 1) key test results have yet to be published, and 2) the test isnt FDA approved, raised red flags for some experts. According to CBS:
Independent experts are leery because key test results have not been published and the test has not been approved by the U.S. Food and Drug Administration its being sold under more general rules for commercial labs. But they agree that a simple test that can be done in a doctors office has long been needed.
I think there are two key steps that need to happen before this test really becomes more widespread, internal medicine specialist Dr. Karen Abrashkin said on CBSN Tuesday. One is that we need to see the data thats being used to develop the test. We havent seen that data yet. It hasnt been published and so we dont know how sensitive or specific this test is for Alzheimers.
The other, according to Abrashkin, is FDA clearance.
Thats really a stamp of approval that needs to happen before the test becomes more widespread, she said.
But Dr. Marwan Sabbagh, a leading investigator for many prominent national Alzheimers prevention and treatment trials at the Cleveland Clinic, told Being Patient in a recent interview that he was optimistic about the tests accuracy.
Blood Test Could Bring New Hope To Alzheimers Clinical Trials
19 January 2021
A team of scientists at UCL have found that blood tests measuring the hallmark Alzheimers protein, b-amyloid , could radically reduce the cost of clinical trials and potentially open the door to treating the disease earlier. The scientists studied a unique group of volunteers, who were all born in the same week in 1946. The findings are published on Tuesday 19 January, in the journal Brain.
Amyloid is a protein that builds up in the brain in Alzheimers, and it is thought to set off a cascade of processes that result in damage to the brain and the symptoms of the disease. Amyloid accumulates in the brain years before symptoms appear and clearing this protein has been a major focus of Alzheimers research for the last two decades.
Most amyloid-lowering drug trials so far involve people who already have symptoms an approach that has yet to result in a new treatment. Many researchers believe that by the time symptoms set in, the window of opportunity for preventing cognitive decline may have already passed. These drugs are likely to be more effective earlier on, in people who have amyloid build-up but dont yet have symptoms.
Scientists have developed radioactive tags that attach to the amyloid protein. A PET scanner can pick up the radiation from these tags to reveal the extent of amyloid build up in a persons brain.
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Future Of Alzheimers Blood Tests
When blood tests become mainstream, they will significantly impact the way doctors diagnose and even treat the condition.
Beyond the Preclivity AD and Simoa described above, there are multiple other types of blood tests in development some are looking at protective fats in the blood. Research shows that an increase in fatty amide levels indicates more beta amyloid in the brain. Beta amyloid plaques have been found in the brains of people with Alzheimers.
Other blood tests will measure proteins such as tau proteins and the neurofilament light chain protein. Researchers have found that neuron death, characteristic in people with Alzheimers, may be detected by the corresponding increase of these proteins in the blood.
It is also possible that the probable link between insulin resistance, diabetes and Alzheimers means blood tests could show the disease in someone well before symptoms occur. Another protein called IRS-1 is commonly associated with diabetes but has also been linked to Alzheimers. Studies have shown that someone with Alzheimers has more IRS-1 than even someone with diabetes.
The New Swedish Blood Test Is Described As A Breakthrough In Alzheimer’s Research
Alzheimer’s disease is the most common form of dementia. But when a patient begins to show symptoms, the breakdown processes in the brain have been ongoing for years. For some, decades may have passed since the onslaught of the disease.
That means when a patient is given a diagnosis, the brain has already undergone irreparable damage.
Researchers have for years tried to develop a simple method for figuring out who is at risk. If they can then receive treatment that works, this could slow further development of the disease.
Now, researchers at the Sahlgrenska Academy at the University of Gothenburg have developed simple blood tests and published three studies that document how accurate they are, according to forskning.se .
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Other Scans And Procedures To Diagnose Dementia
Other types of scan, such as a SPECT scan or a PET scan, may be recommended if the result of your MRI or CT scan is uncertain.
However, most people will not need these types of scans.
Both SPECT and PET scans look at how the brain functions, and can pick up abnormalities with the blood flow in the brain.
If a specialist is worried that epilepsy may be causing the dementia symptoms, an EEG may be taken to record the brain’s electrical signals , but this is rare.
Page last reviewed: 3 July 2020 Next review due: 3 July 2023
First Alzheimer’s Blood Test Now On The Market Without Fda Approval
A company has started selling the first blood test to help diagnose Alzheimer’s disease, a leap for the field that could make it much easier for people to learn whether they have dementia. It also raises concern about the accuracy and impact of such life-altering news.
Independent experts are leery because key test results have not been published and the test has not been approved by the U.S. Food and Drug Administration it’s being sold under more general rules for commercial labs. But they agree that a simple test that can be done in a doctor’s office has long been needed.
“I think there are two key steps that need to happen before this test really becomes more widespread,” internal medicine specialist Dr. Karen Abrashkin said on CBSN Tuesday. “One is that we need to see the data that’s being used to develop the test. We haven’t seen that data yet. It hasn’t been published and so we don’t know how sensitive or specific this test is for Alzheimer’s.”
The other, according to Abrashkin, is FDA clearance.
“That’s really a stamp of approval that needs to happen before the test becomes more widespread,” she said.
A test that might have spared Tammy Maida a decade of futile trips to doctors who chalked up her symptoms to depression, anxiety or menopause before a $5,000 brain scan last year finally showed she had Alzheimer’s.
“I now have an answer,” said the 63-year-old former nurse from San Jose, California.
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About The Test And Its Limitations
The test is not intended for general screening or for people without symptoms it’s aimed at people 60 and older who are having thinking problems and are being evaluated for Alzheimer’s. It’s not covered by insurance or Medicare the company charges $1,250 and offers discounts based on income. Only doctors can order the test and results come within 10 days. It’s sold in all but a few states in the U.S. and just was cleared for sale in Europe.
It measures two types of amyloid particles plus various forms of a protein that reveal whether someone has a gene that raises risk for the disease. These factors are combined in a formula that includes age, and patients are given a score suggesting low, medium or high likelihood of having amyloid buildup in the brain.
If the test puts them in the low category, “it’s a strong reason to look for other things” besides Alzheimer’s, Bateman said.
“There are a thousand things that can cause someone to be cognitively impaired,” from vitamin deficiencies to medications, Holtzman said.
“I don’t think this is any different than the testing we do now” except it’s from a blood test rather than a brain scan, he said. “And those are not 100% accurate either.”
While there is still no cure for the disease, Dr. Abrashkin agreed that the goal of early detection is important.
“Should we be holding that technology back when it could have a big impact on patient care?” he asked.