中国神经再生研究(英文版) ›› 2024, Vol. 19 ›› Issue (8): 1842-1848.doi: 10.4103/1673-5374.389357

• 原著:退行性病与再生 • 上一篇    下一篇

新开发的散发性肌萎缩侧索硬化循环蛋白组学生物标志物用于早期诊断和监测

  

  • 出版日期:2024-08-15 发布日期:2024-01-03
  • 基金资助:
    上海曙光计划项目(18SG15),上海市青年拔尖人才项目,上海市人才发展基金项目(2019044),上海交通大学“交大之星”计划医工交叉研究基金项目(YG2022QN009),国家自然科学基金项目(82201558)

Circulating proteomic biomarkers for diagnosing sporadic amyotrophic lateral sclerosis: a cross-sectional study

Lu He1, #, Qinming Zhou1, #, Chaoyang Xiu2, #, Yaping Shao3, Dingding Shen1, 4, Huanyu Meng1, Weidong Le5, *, Sheng Chen1, 4, 6, *   

  1. 1Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; 2Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China; 3Center for Translational Research on Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning Province, China; 4Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu Province, China; 5Institute of Neurology, Sichuan Academy of Medical Sciences-Sichuan Provincial Hospital, Chengdu, Sichuan Province, China; 6Department of Neurology, Xinrui Hospital, Wuxi, Jiangsu Province, China
  • Online:2024-08-15 Published:2024-01-03
  • Contact: Sheng Chen, MD, mztcs@163.com; Weidong Le, PhD, wdle@sibs.ac.cn.
  • Supported by:
    This study was supported by the grants from Shanghai Shuguang Plan Project, No. 18SG15 (to SC), Shanghai Outstanding Young Scholars Project, Shanghai Talent Development Project, No. 2019044 (to SC), Medical-engineering cross fund of Shanghai Jiao Tong University, No. YG2022QN009 (to QZ), and the National Natural Science Foundation of China, No. 82201558 (to QZ).

摘要:

既往虽然已使用高通量蛋白质组学方法探索新的肌萎缩侧索硬化生物标志物,但是由于方法学差异、验证样本量较小等因素,其可重复性受到限制,且多数肌萎缩侧索硬化生物标志物的研究重点仍集中在特定通路或特定类型的功能蛋白上,限制了对疾病全貌的理解和描述,其对疾病的表征能力有限。本课题研究首先通过使用无标记定量蛋白质组学分析肌萎缩侧索硬化患者(n=10)及正常对照(n=5)血清样本筛选明显差异表达的蛋白,获得8种差异表达蛋白FKBP1A,CD84,CAMP,ZYX,HBA1,HBB,TLN1和TPT1作为候选生物标志物。然后,招募了110例散发性肌萎缩侧索硬化患者和105名健康对照组成的队列,以验证潜在的诊断生物标志物的性能。可见8种差异表达蛋白的表达在散发性肌萎缩侧索硬化患者中均显著高于对照组。进一步行受试者工作特征分析得出CAMP蛋白在区分散发性肌萎缩侧索硬化和对照组的敏感性和特异性方面表现最好(AUC:0.713,P < 0.0001)。随后采用logistic回归模型构建了多蛋白组合,最终发现基于5种蛋白标志物HBB,CAMP,TLN1,ZYX和TPT1的组合具有较高的诊断效能(AUC:0.811,P < 0.0001),诊断散发性肌萎缩侧索硬化的敏感性和特异性得分分别为79%和71%。最后,发现基于2种蛋白TLN1和TPT1的诊断模型可辨别早期散发性肌萎缩侧索硬化患者,而基于3种蛋白FKBP1A,CAMP和HBA1的模型在不同ALSFRS-R评分患者中表达存在差异。此外,随着疾病临床评分进展,FKBP1A,CAMP和HBA1这3种蛋白的表达上调。提示这种新开发的蛋白组学标志物具有早期诊断和监测散发性肌萎缩侧索硬化疾病进展方面的潜力,这将为目前基于临床评分在肌萎缩侧索硬化诊断和评估预后的现状提供了一定程度的补充。

https://orcid.org/0000-0002-9733-3949 (Lu He); https://orcid.org/0000-0001-6211-0588 (Qinming Zhou); https://orcid.org/0000-0001-7428-7153 (Sheng Chen); https://orcid.org/0000-0001-7459-2705 (Weidong Le)

关键词:

肌萎缩侧索硬化, 血清生物标志物, 无标记定量蛋白组学, 多蛋白联合诊断集, 血红蛋白, CAMP, talin-1, zyxin, TPT1

Abstract: Biomarkers are required for the early detection, prognosis prediction, and monitoring of amyotrophic lateral sclerosis, a progressive disease. Proteomics is an unbiased and quantitative method that can be used to detect neurochemical signatures to aid in the identification of candidate biomarkers. In this study, we used a label-free quantitative proteomics approach to screen for substantially differentially regulated proteins in ten patients with sporadic amyotrophic lateral sclerosis compared with five healthy controls. Substantial upregulation of serum proteins related to multiple functional clusters was observed in patients with sporadic amyotrophic lateral sclerosis. Potential biomarkers were selected based on functionality and expression specificity. To validate the proteomics profiles, blood samples from an additional cohort comprising 100 patients with sporadic amyotrophic lateral sclerosis and 100 healthy controls were subjected to enzyme-linked immunosorbent assay. Eight substantially upregulated serum proteins in patients with sporadic amyotrophic lateral sclerosis were selected, of which the cathelicidin-related antimicrobial peptide demonstrated the best discriminative ability between patients with sporadic amyotrophic lateral sclerosis and healthy controls (area under the curve [AUC] = 0.713, P < 0.0001). To further enhance diagnostic accuracy, a multi-protein combined discriminant algorithm was developed incorporating five proteins (hemoglobin beta, cathelicidin-related antimicrobial peptide, talin-1, zyxin, and translationally-controlled tumor protein). The algorithm achieved an AUC of 0.811 and a P-value of < 0.0001, resulting in 79% sensitivity and 71% specificity for the diagnosis of sporadic amyotrophic lateral sclerosis. Subsequently, the ability of candidate biomarkers to discriminate between early-stage amyotrophic lateral sclerosis patients and controls, as well as patients with different disease severities, was examined. A two-protein panel comprising talin-1 and translationally-controlled tumor protein effectively distinguished early-stage amyotrophic lateral sclerosis patients from controls (AUC = 0.766, P < 0.0001). Moreover, the expression of three proteins (FK506 binding protein 1A, cathelicidin-related antimicrobial peptide, and hemoglobin beta-1) was found to increase with disease progression. The proteomic signatures developed in this study may help facilitate early diagnosis and monitor the progression of sporadic amyotrophic lateral sclerosis when used in combination with current clinical-based parameters.

Key words: amyotrophic lateral sclerosis, cathelicidin-related antimicrobial peptide, hemoglobin, label-free quantitative proteomics, multi-protein combined diagnostic panel, serum biomarkers, talin-1, translationally-controlled tumor protein, zyxin