The search for Alzheimer's disease biomarkers goes on, with a number of biomarkers beginning to emerge. The latest research focuses on biomarkers that signal damage to neurons, which might allow doctors to spot decline at an early stage. In the research published in Neurology, a team from Washington University School of Medicine in St. Louis measured biomarkers in the cerebrospinal fluid (CSF) from lumbar punctures in people with very mild or mild Alzheimer's disease over an average of 2.6 years. They measured the biomarkers visinin-like protein-1 (VILIP-1), tau, p-tau181 and Aβ42 (amyloid beta), as well as tracking changes in mental activity and memory with annual assessments.
VILIP-1 measures damage to brain cells, and tau and Aβ42 reflect the plaques starting to form in the brain. Alzheimer's disease in people with higher levels of these biomarkers, particularly VILIP-1, progressed more quickly.
"VILIP-1 appears to be a strong indicator of ongoing injury to brain cells as a result of Alzheimer's disease. Memory and other mental abilities declined faster in patients with the highest levels of VILIP-1," says lead author Dr. Rawan Tarawneh, now at the University of Jordan. "In patients with early symptoms of Alzheimer's disease, VILIP-1 seems to be at least as good as--and potentially even better than--the other prognostic indicators we used in the study. That could be very useful in predicting the course of the disease and in evaluating new treatments in clinical trials."
This research is early but shows promise for predicting disease progression and prognosis, and tracking outcomes in clinical trials, and further development is under way at Washington University. However, it is still a CSF-based biomarker, and until simple blood-based biomarker tests are available, broader screening for Alzheimer's disease to allow early diagnosis and treatment isn't really going to be feasible.