Tau seeding activity in skin biopsy differentiates tauopathies from synucleinopathies

Most neurodegenerative diseases lack definitive diagnostic tests, and the identification of easily accessible and reliable biomarkers remains a critical unmet need. Since tau protein is highly expressed in skin of tauopathies patients, we aimed to exploit the ultrasensitive seeding activity assay (S...

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Published inNPJ Parkinson's Disease Vol. 10; no. 1; pp. 116 - 12
Main Authors Dellarole, Ilaria Linda, Vacchi, Elena, Ruiz-Barrio, Inigo, Pinton, Sandra, Raimondi, Andrea, Rossi, Stefania, Morandi, Sara, Bianco, Giovanni, Begum Bacinoglu, Merve, Lombardo, Annalisa, Celauro, Luigi, Staedler, Claudio, Galati, Salvatore, Pagonabarraga, Javier, Kulisevsky, Jaime, Legname, Giuseppe, Gobbi, Claudio, Kaelin-Lang, Alain, Moda, Fabio, Melli, Giorgia
Format Journal Article
LanguageEnglish
Published London Nature Publishing Group UK 15.06.2024
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ISSN2373-8057
2373-8057
DOI10.1038/s41531-024-00728-9

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Abstract Most neurodegenerative diseases lack definitive diagnostic tests, and the identification of easily accessible and reliable biomarkers remains a critical unmet need. Since tau protein is highly expressed in skin of tauopathies patients, we aimed to exploit the ultrasensitive seeding activity assay (SAA) to assess tau seeding activity in skin of patients with tauopathies. In this multicentric, case-control study, patients with tauopathies and synucleinopathies were consecutively recruited and sex-matched to healthy controls (HC). Subjects underwent a double 3 mm skin biopsy in cervical area and ankle. Skin tau-SAA, using TauK18 and TauK19 as reaction substrates for 4R and 3R isoforms, seeding score, clinical scales, biochemical and morphological characterization of SAA end-products were evaluated. We analyzed 58 subjects: 24 tauopathies (18 progressive supranuclear palsy, PSP, and 6 corticobasal degeneration, CBD), 20 synucleinopathies (14 Parkinson’s disease, PD, and 6 multiple system atrophy, MSA), and 14 HC. PSP and CBD showed higher tau seeding activity at both anatomical sites. A greater sensitivity of 4R-SAA than 3R-SAA was observed. 4R tau-SAA identified tauopathies with 71% sensitivity and 93% specificity. Accuracy was higher for PSP than CBD: PSP vs HC / PD (AUC 0.825), while CBD vs HC / PD (AUC 0.797), and PSP vs MSA (AU 0.778). SAA end-products showed differences in biochemical and morphological characterization according to the anatomical site. Skin tau-SAA identifies tauopathies with good accuracy and can be used to implement the in-vivo clinical diagnosis of patients with neurodegenerative diseases. Further characterization of peripheral tau seed in skin may elucidate the structure of tau deposits in brain.
AbstractList Abstract Most neurodegenerative diseases lack definitive diagnostic tests, and the identification of easily accessible and reliable biomarkers remains a critical unmet need. Since tau protein is highly expressed in skin of tauopathies patients, we aimed to exploit the ultrasensitive seeding activity assay (SAA) to assess tau seeding activity in skin of patients with tauopathies. In this multicentric, case-control study, patients with tauopathies and synucleinopathies were consecutively recruited and sex-matched to healthy controls (HC). Subjects underwent a double 3 mm skin biopsy in cervical area and ankle. Skin tau-SAA, using TauK18 and TauK19 as reaction substrates for 4R and 3R isoforms, seeding score, clinical scales, biochemical and morphological characterization of SAA end-products were evaluated. We analyzed 58 subjects: 24 tauopathies (18 progressive supranuclear palsy, PSP, and 6 corticobasal degeneration, CBD), 20 synucleinopathies (14 Parkinson’s disease, PD, and 6 multiple system atrophy, MSA), and 14 HC. PSP and CBD showed higher tau seeding activity at both anatomical sites. A greater sensitivity of 4R-SAA than 3R-SAA was observed. 4R tau-SAA identified tauopathies with 71% sensitivity and 93% specificity. Accuracy was higher for PSP than CBD: PSP vs HC / PD (AUC 0.825), while CBD vs HC / PD (AUC 0.797), and PSP vs MSA (AU 0.778). SAA end-products showed differences in biochemical and morphological characterization according to the anatomical site. Skin tau-SAA identifies tauopathies with good accuracy and can be used to implement the in-vivo clinical diagnosis of patients with neurodegenerative diseases. Further characterization of peripheral tau seed in skin may elucidate the structure of tau deposits in brain.
Most neurodegenerative diseases lack definitive diagnostic tests, and the identification of easily accessible and reliable biomarkers remains a critical unmet need. Since tau protein is highly expressed in skin of tauopathies patients, we aimed to exploit the ultrasensitive seeding activity assay (SAA) to assess tau seeding activity in skin of patients with tauopathies. In this multicentric, case-control study, patients with tauopathies and synucleinopathies were consecutively recruited and sex-matched to healthy controls (HC). Subjects underwent a double 3 mm skin biopsy in cervical area and ankle. Skin tau-SAA, using TauK18 and TauK19 as reaction substrates for 4R and 3R isoforms, seeding score, clinical scales, biochemical and morphological characterization of SAA end-products were evaluated. We analyzed 58 subjects: 24 tauopathies (18 progressive supranuclear palsy, PSP, and 6 corticobasal degeneration, CBD), 20 synucleinopathies (14 Parkinson's disease, PD, and 6 multiple system atrophy, MSA), and 14 HC. PSP and CBD showed higher tau seeding activity at both anatomical sites. A greater sensitivity of 4R-SAA than 3R-SAA was observed. 4R tau-SAA identified tauopathies with 71% sensitivity and 93% specificity. Accuracy was higher for PSP than CBD: PSP vs HC / PD (AUC 0.825), while CBD vs HC / PD (AUC 0.797), and PSP vs MSA (AU 0.778). SAA end-products showed differences in biochemical and morphological characterization according to the anatomical site. Skin tau-SAA identifies tauopathies with good accuracy and can be used to implement the in-vivo clinical diagnosis of patients with neurodegenerative diseases. Further characterization of peripheral tau seed in skin may elucidate the structure of tau deposits in brain.
Most neurodegenerative diseases lack definitive diagnostic tests, and the identification of easily accessible and reliable biomarkers remains a critical unmet need. Since tau protein is highly expressed in skin of tauopathies patients, we aimed to exploit the ultrasensitive seeding activity assay (SAA) to assess tau seeding activity in skin of patients with tauopathies. In this multicentric, case-control study, patients with tauopathies and synucleinopathies were consecutively recruited and sex-matched to healthy controls (HC). Subjects underwent a double 3 mm skin biopsy in cervical area and ankle. Skin tau-SAA, using TauK18 and TauK19 as reaction substrates for 4R and 3R isoforms, seeding score, clinical scales, biochemical and morphological characterization of SAA end-products were evaluated. We analyzed 58 subjects: 24 tauopathies (18 progressive supranuclear palsy, PSP, and 6 corticobasal degeneration, CBD), 20 synucleinopathies (14 Parkinson's disease, PD, and 6 multiple system atrophy, MSA), and 14 HC. PSP and CBD showed higher tau seeding activity at both anatomical sites. A greater sensitivity of 4R-SAA than 3R-SAA was observed. 4R tau-SAA identified tauopathies with 71% sensitivity and 93% specificity. Accuracy was higher for PSP than CBD: PSP vs HC / PD (AUC 0.825), while CBD vs HC / PD (AUC 0.797), and PSP vs MSA (AU 0.778). SAA end-products showed differences in biochemical and morphological characterization according to the anatomical site. Skin tau-SAA identifies tauopathies with good accuracy and can be used to implement the in-vivo clinical diagnosis of patients with neurodegenerative diseases. Further characterization of peripheral tau seed in skin may elucidate the structure of tau deposits in brain.Most neurodegenerative diseases lack definitive diagnostic tests, and the identification of easily accessible and reliable biomarkers remains a critical unmet need. Since tau protein is highly expressed in skin of tauopathies patients, we aimed to exploit the ultrasensitive seeding activity assay (SAA) to assess tau seeding activity in skin of patients with tauopathies. In this multicentric, case-control study, patients with tauopathies and synucleinopathies were consecutively recruited and sex-matched to healthy controls (HC). Subjects underwent a double 3 mm skin biopsy in cervical area and ankle. Skin tau-SAA, using TauK18 and TauK19 as reaction substrates for 4R and 3R isoforms, seeding score, clinical scales, biochemical and morphological characterization of SAA end-products were evaluated. We analyzed 58 subjects: 24 tauopathies (18 progressive supranuclear palsy, PSP, and 6 corticobasal degeneration, CBD), 20 synucleinopathies (14 Parkinson's disease, PD, and 6 multiple system atrophy, MSA), and 14 HC. PSP and CBD showed higher tau seeding activity at both anatomical sites. A greater sensitivity of 4R-SAA than 3R-SAA was observed. 4R tau-SAA identified tauopathies with 71% sensitivity and 93% specificity. Accuracy was higher for PSP than CBD: PSP vs HC / PD (AUC 0.825), while CBD vs HC / PD (AUC 0.797), and PSP vs MSA (AU 0.778). SAA end-products showed differences in biochemical and morphological characterization according to the anatomical site. Skin tau-SAA identifies tauopathies with good accuracy and can be used to implement the in-vivo clinical diagnosis of patients with neurodegenerative diseases. Further characterization of peripheral tau seed in skin may elucidate the structure of tau deposits in brain.
ArticleNumber 116
Author Ruiz-Barrio, Inigo
Melli, Giorgia
Legname, Giuseppe
Celauro, Luigi
Pagonabarraga, Javier
Rossi, Stefania
Dellarole, Ilaria Linda
Raimondi, Andrea
Kaelin-Lang, Alain
Pinton, Sandra
Vacchi, Elena
Morandi, Sara
Lombardo, Annalisa
Kulisevsky, Jaime
Bianco, Giovanni
Begum Bacinoglu, Merve
Gobbi, Claudio
Staedler, Claudio
Moda, Fabio
Galati, Salvatore
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ArmstrongMJCriteria for the diagnosis of corticobasal degenerationNeurology20138049650323359374359005010.1212/WNL.0b013e31827f0fd1
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SlettenDMSuarezGALowPAMandrekarJSingerWCOMPASS 31: a refined and abbreviated Composite Autonomic Symptom ScoreMayo Clin. Proc.2012871196120123218087354192310.1016/j.mayocp.2012.10.013
GersteneckerAExecutive dysfunction is the primary cognitive impairment in progressive supranuclear palsyArch. Clin. Neuropsychol.2013281041132312788210.1093/arclin/acs098
DopplerKDistinctive distribution of phospho-alpha-synuclein in dermal nerves in multiple system atrophyMov. Disord.201530168816921:CAS:528:DC%2BC2MXhslSrurrL2617530110.1002/mds.26293
GoedertMEisenbergDSCrowtherRAPropagation of Tau Aggregates and NeurodegenerationAnnu Rev. Neurosci.2017401892101:CAS:528:DC%2BC2sXht1yit7bF2877210110.1146/annurev-neuro-072116-031153
CandeliseNSeeding variability of different alpha synuclein strains in synucleinopathiesAnn. Neurol.2019856917031:CAS:528:DC%2BC1MXnvFOrtL8%3D3080595710.1002/ana.25446
KuzkinaADermal Real-Time Quaking-Induced Conversion Is a Sensitive Marker to Confirm Isolated Rapid Eye Movement Sleep Behavior Disorder as an Early alpha-SynucleinopathyMov. Disord.202338107710821:CAS:528:DC%2BB3sXjtVGgtL4%3D3675075510.1002/mds.29340
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Movement Disorder Society Task Force on Rating Scales for Parkinson’s Disease. The Unified Parkinson’s Disease Rating Scale (UPDRS): status and recommendations. Mov. Disord.18, 738–750 (2003).
NolanoMSmall fiber pathology parallels disease progression in Parkinson disease: a longitudinal studyActa Neuropathol.20181365015032991603610.1007/s00401-018-1876-1
LauriaGEpidermal innervation: changes with aging, topographic location, and in sensory neuropathyJ. Neurol. Sci.19991641721781:STN:280:DyaK1MzivVCmtQ%3D%3D1040203010.1016/S0022-510X(99)00063-5
KrausASeeding selectivity and ultrasensitive detection of tau aggregate conformers of Alzheimer diseaseActa Neuropathol.20191375855983057067510.1007/s00401-018-1947-3
TomlinsonCLSystematic review of levodopa dose equivalency reporting in Parkinson’s diseaseMov. Disord.201025264926532106983310.1002/mds.23429
De LucaCMGEfficient RT-QuIC seeding activity for alpha-synuclein in olfactory mucosa samples of patients with Parkinson’s disease and multiple system atrophyTransl. Neurodegener.201982431406572668641110.1186/s40035-019-0164-x
GilmanSSecond consensus statement on the diagnosis of multiple system atrophyNeurology2008716706761:STN:280:DC%2BD1crktlWmsA%3D%3D18725592267699310.1212/01.wnl.0000324625.00404.15
ManneSBlinded RT-QuIC Analysis of alpha-Synuclein Biomarker in Skin Tissue From Parkinson’s Disease PatientsMov. Disord.202035223022391:CAS:528:DC%2BB3MXlvFaqtg%3D%3D32960470774903510.1002/mds.28242
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PaltaPSex differences in in vivo tau neuropathology in a multiethnic sample of late middle-aged adultsNeurobiol. Aging20211031091161:CAS:528:DC%2BB3MXhs1yrt7zM33894641817820910.1016/j.neurobiolaging.2021.03.007
VacchiETau protein quantification in skin biopsies differentiates tauopathies from alpha-synucleinopathiesBrain2022145275527683548552710.1093/brain/awac161
ModaFPrions in the urine of patients with variant Creutzfeldt-Jakob diseaseN. Engl. J. Med.201437153053925099577416274010.1056/NEJMoa1404401
LimorenkoGLashuelHARevisiting the grammar of Tau aggregation and pathology formation: how new insights from brain pathology are shaping how we study and target TauopathiesChem. Soc. Rev.2022515135651:CAS:528:DC%2BB3MXislGis7%2FN3488993410.1039/D1CS00127B
SaijoEUltrasensitive and selective detection of 3-repeat tau seeding activity in Pick disease brain and cerebrospinal fluidActa Neuropathol.20171337517651:CAS:528:DC%2BC2sXkt1Wmu7c%3D2829379310.1007/s00401-017-1692-z
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KuzkinaADiagnostic value of skin RT-QuIC in Parkinson’s disease: a two-laboratory studyNPJ Parkinsons Dis.20217991:CAS:528:DC%2BB38XivFOhtLo%3D34782640859312810.1038/s41531-021-00242-2
SaijoE4-Repeat tau seeds and templating subtypes as brain and CSF biomarkers of frontotemporal lobar degenerationActa Neuropathol.202013963771:CAS:528:DC%2BC1MXhvFKrtrnK3161698210.1007/s00401-019-02080-2
BarghornSBiernatJMandelkowEPurification of recombinant tau protein and preparation of Alzheimer-paired helical filaments in vitroMethods Mol. Biol.200529935511:CAS:528:DC%2BD2MXkt12rtbc%3D15980594
GolbeLIOhman-StricklandPAA clinical rating scale for progressive supranuclear palsyBrain2007130155215651740576710.1093/brain/awm032
MelliGCervical skin denervation associates with alpha-synuclein aggregates in Parkinson diseaseAnn. Clin. Transl. Neurol.20185139414071:CAS:528:DC%2BC1cXitlGgtrzI30480033624338510.1002/acn3.669
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DopplerKCutaneous neuropathy in Parkinson’s disease: a window into brain pathologyActa Neuropathol.2014128991091:CAS:528:DC%2BC2cXntlyrtrs%3D24788821405996010.1007/s00401-014-1284-0
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CombsBMuellerRLMorfiniGBradySTKanaanNMTau and Axonal Transport Misregulation in TauopathiesAdv. Exp. Med. Biol.2019118481951:CAS:528:DC%2BB3cXis1anu7jJ32096030709958110.1007/978-981-32-9358-8_7
Stiasny-KolsterKThe REM sleep behavior disorder screening questionnaire-a new diagnostic instrumentMov. Disord.200722238623931789433710.1002/mds.21740
FolsteinMFFolsteinSEMcHughPRMini Mental State Examination (MMSE) - probably one of the most cited papers in health science - ReplyActa Psychiat Scand.200711615715710.1111/j.1600-0447.2007.01038.x
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Snippet Most neurodegenerative diseases lack definitive diagnostic tests, and the identification of easily accessible and reliable biomarkers remains a critical unmet...
Abstract Most neurodegenerative diseases lack definitive diagnostic tests, and the identification of easily accessible and reliable biomarkers remains a...
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Morphology
Neurology
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Title Tau seeding activity in skin biopsy differentiates tauopathies from synucleinopathies
URI https://link.springer.com/article/10.1038/s41531-024-00728-9
https://www.ncbi.nlm.nih.gov/pubmed/38879633
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