Neural Regeneration Research ›› 2026, Vol. 21 ›› Issue (10): 4843-4853.doi: 10.4103/NRR.NRR-D-25-00759

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Blood-based biomarkers and early diagnosis of Alzheimer’s disease.

Zhikang Cui1, Guixia Li2, Shuyong Wei3, Qian Cheng1, Qian Yu1, Shuai Zong1, Pengfei Zhang1, Hang Chen1, Shuyi Yu1, Shuang Wu4, Ming Li1, *, Zhiming Lu1, 4, *   

  1. 1Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China; 
    2Department of Laboratory Medicine, Heze Municipal Hospital, Heze, Shandong Province, China; 
    3Xiajin County People’s Hospital, Dezhou, Shandong Province, China; 
    4Department of Laboratory Medicine, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
  • Online:2026-10-15 Published:2026-06-12
  • Contact: Ming Li, MD, drmingli@yeah.net; Zhiming Lu, MD, luzhiming@sdu.edu.cn.
  • Supported by:
    This work was supported by the National Natural Science Foundation of China, No. 82272414 (to ZL); the Key Research and Development Program of Shandong Province in China, No. 2022CXGC010507 (to ZL); and the Taishan Scholars Program of Shandong Province, No. tsqnz20240852 (to ML).

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Abstract: Alzheimer’s disease is a common neurodegenerative disease characterized by progressive memory loss, cognitive decline, and behavioral changes. Blood-based biomarkers have recently gained significant attention due to their accessibility and cost-effectiveness. This review highlights the latest progress in multiple key areas of blood-based biomarkers for Alzheimer’s disease. For early diagnosis, blood-based biomarkers such as amyloid-β and phosphorylated tau can identify Alzheimer’s disease even before clinical symptoms emerge. Dynamic changes in blood-based biomarkers, including p-tau217 and neurofilament light chain, reflect disease progression and correlate with cognitive decline, enabling continuous monitoring of Alzheimer’s disease progression. Additionally, blood-based biomarkers such as p-tau181 and glial fibrillary acidic protein aid in differential diagnosis by distinguishing Alzheimer’s disease from other dementias such as frontotemporal dementia. Blood-based biomarkers related to nerve repair have opened up new avenues for tracking nerve regeneration and therapeutic response, especially brain-derived neurotrophic factor. Furthermore, advanced detection technologies such as single-molecule array and immunoprecipitation-mass spectrometry have significantly improved the sensitivity and specificity of blood-based biomarkers, facilitating their clinical translation. In summary, blood-based biomarkers hold strong potential to improve early diagnosis, monitor progression, differential diagnosis, and evaluate therapies in Alzheimer’s disease. This review provides a comprehensive and updated evaluation of the translational potential of blood-based biomarkers, emphasizing their practical utility in clinical settings and offering insights into future directions for large-scale application. This review emphasizes the need to prioritize the allocation of scientific resources, expedite the transition of blood-based biomarkers to clinical implementation, and ultimately achieve precise treatment of Alzheimer’s disease using these biomarkers.

Key words: Alzheimer’s disease, amyloid plaques, biomarkers, dementia, early diagnosis, nerve regeneration, neurodegenerative diseases, neurofibrillary tangles, neuroinflammation, neuropathology