Plasma p‐tau217 and p‐tau217/Aβ1‐42 are effective biomarkers for identifying CSF‐ and PET imaging‐diagnosed Alzheimer's disease: Insights for research and clinical practice

作者：Xiaomei Zhong, Qiang Wang, Mingfeng Yang, Gaohong Lin, Kexin Yao, Zhangying Wu, Danyan Xu, Huarong Zhou, Ben Chen, Haishan Shi, Min Zhang, Xiaolei Shi, Yijie Zeng, Jingyi Lao, Shuang Liang, Jingyuan Li, Qin Liu, Huanmin Liu, Yunheng Chen, Yicheng Lin, Cong Ouyang, Jieqin Lv, Xiang Liang, Yuwang Cheng, Pengcheng Ran, Baoying Gong, Bin Zhang, Jianwen Guo, Hong Zhang, Sen Liu, Jihui Zhang, Haiying Liu, Yuping Ning · 发表于：Alzheimer s & Dementia · 年份：2025 · DOI：10.1002/alz.14536 · 被引用次数：66 · 研究领域：Dementia and Cognitive Impairment Research、Alzheimer's disease research and treatments、Intracerebral and Subarachnoid Hemorrhage Research

INTRODUCTION: With the advancement of disease-modifying therapies for Alzheimer's disease (AD), validating plasma biomarkers against cerebrospinal fluid (CSF) and positron emission tomography (PET) standards is crucial in both research and real-world settings. METHODS: We measured plasma phosphorylated tau (p-tau)217, p-tau181, amyloid beta (Aβ)1-40, Aβ1-42, and neurofilament light chain in research and real-world cohorts. Participants were categorized by brain amyloid status using US Food and Drug Administration/European Medicines Agency-approved CSF or PET methods. RESULTS: Plasma p-tau217 and p-tau217/Aβ1-42 demonstrated superior accuracy in detecting brain amyloid pathologies, with area under the curve from 0.94 to 0.97 in all cohorts. Specificity was lower in the real-world cohort but improved significantly by integrating demographic and clinical factors, aligning performance with research cohorts. Additionally, plasma biomarkers exhibited strong correlations with their CSF counterparts and PET standardized uptake value ratios, with significant associations in amyloid-positive participants. DISCUSSION: Plasma p-tau217 and p-tau217/Aβ1-42 are effective diagnostic tools. However, patient demographics, apolipoprotein E ε4 status, and cognitive condition must be considered to improve specificity in the clinical practice. HIGHLIGHTS: Plasma phosphorylated tau (p-tau)217 and p-tau217/amyloid beta (Aβ)1-42 demonstrated exceptional accuracy (area under the curve: 0.94-0.97) in d...