. Soluble beta-amyloid precursor protein is related to disease progression in amyotrophic lateral sclerosis. PLoS One. 2011;6(8):e23600. PubMed.

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  1. I think that sAPPα and sAPPβ are among the most interesting new biomarkers
    for a range of neurodegenerative disorders, including ALS and AD. In line
    with their previous report on this topic, Steinacker et al. clearly show
    that ALS has a significant impact on sAPP levels in cerebrospinal fluid (CSF). What makes the
    present report so interesting is that the results suggest that sAPPs might
    serve as accurate predictors of the disease course. This is a highly
    relevant topic, since the velocity of disease progression, and therefore the
    survival rate, varies from a few months to several years. The results will
    surely have to be replicated before they will have a significant impact on
    the diagnostic algorithms, but the findings are clearly relevant and
     promising.

    Even though it has been shown that sAPP levels in CSF are also
    altered in AD, the reasons are probably different, and I do not think that
    the findings offer a link between ALS and AD. sAPP levels are increased in
    AD, which is a probably a direct result of faulty Aβ clearance or
    overproduction, whereas Steinacker et al. report decreased CSF sAPP levels, probably related to dying neurons, resulting in lower sAPP production. Therefore, I think that sAPP concentration alterations in AD are specific
    for the disorder, whereas they are an unspecific phenomenon in ALS. The
    specificity of sAPP for AD pathology is probably the most important point;
    in my opinion, sAPP will not only be very useful for the early, pre-dementia
    diagnosis of AD (and maybe as an unspecific marker of neuronal damage such as
    in ALS), but it will also significantly improve the differentiation between
    AD versus other non-amyloid dementias such as frontotemporal lobar
    degenerations. The feasibility of sAPP measurements in blood, which have
    also been shown in the present paper, are of particular interest since they
    may provide the means for the first accurate non-invasive biological
    diagnostic procedure in this field.

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