Absolut kvantifiering av A-beta<sub> 1-42</sub> I CSF med hjälp av en Masspektrometrisk Reference Measurement ordningen
Summary
A reference measurement procedure for the absolute quantification of Aβ1-42 in human CSF based on solid-phase extraction and liquid chromatography tandem mass spectrometry is described.
Abstract
Alzheimer’s disease (AD) is the most common neurodegenerative disease among the elderly and accounts for 60-80% of all cases of dementia. Currently, the diagnosis of AD is based on cognitive tests and mental state exams, but the peptide amyloid-beta (Aβ) in cerebrospinal fluid (CSF) is increasingly used in clinical trials and settings. As for most protein and peptide biomarkers, quantification is performed using antibody-based techniques, such as enzyme-linked immunosorbent assay (ELISA). However, intra- and inter-laboratory variability in these assays hamper its use as a diagnostic marker in clinical routine.
An antibody-independent Reference Measurement Procedure (RMP) was developed based on solid-phase extraction (SPE) and liquid chromatography (LC)-tandem mass spectrometry (MS/MS), where stable, isotope-labeled Aβ peptides were used as internal standards, enabling absolute quantification. A high-resolution quadrupole-orbitrap hybrid instrument was used for the measurements. The method allows for the quantification of CSF Aβ1-42 between 150-4,000 pg/mL.
Introduction
Alzheimers sjukdom (AD) är den vanligaste formen av demens och drabbar cirka 35 miljoner människor i världen en. De neuropatologiska kännetecknen för sjukdomen allmänt anses ligga i centrum av AD patogenes är intracellulära neurofibrillära nystan av hyperfosforylerat tau-protein 2 och extracellulära plack som består av aggregerade amyloid-beta (Ap) peptider 3. I linje med detta har bedömningen av plack patologi in vivo av biomarkörer nyligen förts upp på forsknings diagnostiska kriterierna för AD 4. För CSF mätningar av Ap 1-42, flera immunologiska metoder tillgängliga och används i många kliniska laboratorier 5. Koncentrationen av A-beta 1-42 i CSF är cirka 50% lägre hos AD-patienter än i den kognitivt normala äldre, vilket återspeglar den avsättning av peptiden i plack i brain 6, 7.
Dessa biomarkörer främst analyseras med hjälp av immun (dvs. antikroppsbaserade tekniker), men dessa analyser kan påverkas av matriseffekter 8. Användningen av immun på olika teknikplattformar och bristen på analys standardisering 9, 10 gör införandet av globala cut-off halter svåra 11, 12. En analytiskt validerade RMP skulle tillåta en enhetlig kalibrering av olika analys plattformar, helst resulterar i bättre jämförbarhet mellan analytiska plattformar och i bättre kontroll av faktorer som bidrar till den totala variationen mätningen.
Den absoluta kvantifiering av Ap 1-42 genom att använda den utvecklade LC-MS / MS-metoden övervinner många av de frågor som är förknippade med antikroppsbaserad tekniques. Metoden, listad som en RMP av gemensamma kommittén för spårbarhet i laboratoriemedicin (JCTLM databas identifikationsnummer C11RMP9), kommer att användas för att bestämma den absoluta koncentrationen av Ap 1-42 i ett certifierat referensmaterial (CRM) för att harmonisera CSF Ap 1 -42 mätningar över och analys plattformar. Den beskrivna arbetsflöde bör vara av betydelse för utvecklingen av referens kandidat metoder för peptider och proteiner inom andra områden inom medicinen.
Protocol
Representative Results
Discussion
För den beskrivna metoden, istället för att använda ett surrogat matris använde vi surrogat analyt metod 13, 14, 15, 16, som gör det möjligt för kalibrering i human CSF. Surrogat analyt synsätt innebär två olika isotopiskt märkta standarder. On (15 NAβ 142) används för att generera kalibreringskurvan i human CSF, medan en annan (13 CAβ 142)…
Disclosures
The authors have nothing to disclose.
Acknowledgements
This work was performed on behalf of the International Federation of Clinical Chemistry Working Group on CSF Proteins, which has the following composition: Kaj Blennow (Chair) and Henrik Zetterberg, Gothenburg University, Sweden; Les Shaw and Magdalena Korecka, University of Philadelphia, PA, USA; Ingrid Zegers, Institute for Reference Materials and Measurements, Geel, Belgium; Piotr Lewczuk, Universitätsklinikum Erlangen, Germany; and Rand Jenkins, PPD Bioanalytical Laboratory, Richmond, VA, USA; Randall Bateman, Washington University, MO, USA; and H Vanderstichele, Innogenetics NV, Ghent, Belgium. This work was also part of the Global Consortium for Biomarker Standardization CSF Reference Methods Working Group, which is led by Maria C. Carrillo, Ph.D., Senior Director, Medical & Scientific Relations, Alzheimer’s Association. The study was supported by The Swedish Research Council (grants #14002, #521-2011-4709, and #2013-2546); the Knut and Alice Wallenberg Foundation; Demensförbundet; and Emil and Wera Cornell’s, Aina Wallström and Mary-Ann Sjöblom’s, Gun and Bertil Stohne’s, Magnus Bergvall’s, and Gamla Tjänarinnor’s Foundations.
Materials
| Eppendorf Protein LoBind microcentrifuge tubes, 0.5 mL | Eppendorf | 022431081 | |
| Eppendorf Protein LoBind microcentrifuge tubes, 1.5 mL | Eppendorf | 022431081 | |
| Eppendorf Protein LoBind microcentrifuge tubes, 2 mL | Eppendorf | 022431102 | |
| Eppendorf Protein LoBind microcentrifuge tubes, 5 mL | Eppendorf | 0030 108.310 | |
| Eppendorf Protein LoBind Deepwell Plates 96 | Eppendorf | 951032905 | |
| Micronic 0.75 mL polypropylene tubes, V-bottom | Micronic | MPW32071BC3 | Tubes used for collecting SPE eluate, but other collection devices can be used such as 96-well plates. |
| Micronic Split TPE Capcluster for 96 ind. tubes | Micronic | MP53026 | Caps for Micronic tubes. |
| Micronic Loborack-96 white w high cover bar coded | Micronic | MPW51015BC3 | Holder for Micronic tubes. |
| Biohit Optifit tips 1.2 mL | Sartorius | 791210 | Used to reach all the way to the bottom of the LoBind deepwell plates (96-well). Other narrow tips might work as well. |
| Waters Oasis MCX 96-well µElution Plate | Waters | 186001830BA | |
| Waters Plate manifold reservoir tray | Waters | WAT058942 | |
| Waters Extraction Plate Manifold for Oasis 96-Well Plates | Waters | 186001831 | |
| Ammonium hydroxide solution, puriss. p.a., reag. ISO, reag. Ph. Eur., ~25% NH3 basis | Sigma-Aldrich | 30501-1L-D | |
| Acetonitrile, Far UV HPLC Gradient grade, 2.5 L | Fisher Scientific | A/0627/17X | |
| ortho-Phosphoric acid 85%, ACS,ISO,Reag. Ph Eur | Merck Millipore | 1005731000 | |
| Guanidine Hydrochloride, 500 g | Thermo Scientific | 24110 | |
| Thermo Scientific Q-exactive Hybrid Quadrupole Orbitrap Mass Spectrometer | Thermo Scientific | IQLAAEGAAPFALGMAZR | With bundled Dionex Ultimate 3000 LC & autosampler. |
| Dionex ProSwift RP-4H Monolith Column (1.0 x 250mm) | Dionex | 066640 | |
| Bovine Serum Albumin, lyophilized powder, suitable for (for molecular biology), Non-acetylated | Sigma-Aldrich | B6917 | |
| Beta-Amyloid (1-42), Ultra Pure, TFA | rPeptide | A-1002-2 | |
| 15N Beta-Amyloid (1-42), Uniformly labeled | rPeptide | A-1102-2 | |
| 13C Beta-Amyloid (1-42), Uniformly labeled | rPeptide | A-1106-2 | |
| Microplate shakers, TiMix 2 | Edmund Bühler | 6110 000 |
References
- Querfurth, H. W., LaFerla, F. M. Alzheimer’s disease. N Engl J Med. 362 (4), 329-344 (2010).
- Braak, H., Braak, E. Evolution of the neuropathology of Alzheimer’s disease. Acta Neurol Scand Suppl. 165, 3-12 (1996).
- Blennow, K., de Leon, M. J., Zetterberg, H. Alzheimer’s disease. Lancet. 368 (9533), 387-403 (2006).
- Dubois, B., et al. Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. Lancet Neurol. 13 (6), 614-629 (2014).
- Blennow, K., Hampel, H., Weiner, M., Zetterberg, H. Cerebrospinal fluid and plasma biomarkers in Alzheimer disease. Nat Rev Neurol. 6 (3), 131-144 (2010).
- Buchhave, P., et al. Cerebrospinal fluid levels of beta-amyloid 1-42, but not of tau, are fully changed already 5 to 10 years before the onset of Alzheimer dementia. Arch Gen Psychiatry. 69 (1), 98-106 (2012).
- Olsson, B., et al. CSF and blood biomarkers for the diagnosis of Alzheimer’s disease: a systematic review and meta-analysis. The Lancet Neurology. 15 (7), 673-684 (2016).
- Bjerke, M., et al. Confounding factors influencing amyloid Beta concentration in cerebrospinal fluid. Int J Alzheimers Dis. , (2010).
- Dumurgier, J., et al. Intersite variability of CSF Alzheimer’s disease biomarkers in clinical setting. Alzheimers Dement. 9 (4), 406-413 (2013).
- Mattsson, N., et al. CSF biomarker variability in the Alzheimer’s Association quality control program. Alzheimers Dement. 9 (3), 251-261 (2013).
- Kang, J. H., Korecka, M., Toledo, J. B., Trojanowski, J. Q., Shaw, L. M. Clinical Utility and Analytical Challenges in Measurement of Cerebrospinal Fluid Amyloid-beta1-42 and tau Proteins as Alzheimer Disease Biomarkers. Clin Chem. 59 (6), 903-916 (2013).
- Mattsson, N., et al. Reference measurement procedures for Alzheimer’s disease cerebrospinal fluid biomarkers: definitions and approaches with focus on amyloid beta42. Biomark Med. 6 (4), 409-417 (2012).
- Ahmadkhaniha, R., Shafiee, A., Rastkari, N., Kobarfard, F. Accurate quantification of endogenous androgenic steroids in cattle’s meat by gas chromatography mass spectrometry using a surrogate analyte approach. Anal Chim Acta. 631 (1), 80-86 (2009).
- Jemal, M., Schuster, A., Whigan, D. B. Liquid chromatography/tandem mass spectrometry methods for quantitation of mevalonic acid in human plasma and urine: method validation, demonstration of using a surrogate analyte, and demonstration of unacceptable matrix effect in spite of use of a stable isotope analog internal standard. Rapid Commun Mass Spectrom. 17 (15), 1723-1734 (2003).
- Leinenbach, A., et al. Mass spectrometry-based candidate reference measurement procedure for quantification of amyloid-beta in cerebrospinal fluid. Clin Chem. 60 (7), 987-994 (2014).
- Li, W., Cohen, L. H. Quantitation of endogenous analytes in biofluid without a true blank matrix. Anal Chem. 75 (21), 5854-5859 (2003).
- Perret-Liaudet, A., et al. Cerebrospinal fluid collection tubes: a critical issue for Alzheimer disease diagnosis. Clin Chem. 58 (4), 787-789 (2012).
- Lewczuk, P., et al. Effect of sample collection tubes on cerebrospinal fluid concentrations of tau proteins and amyloid beta peptides. Clin Chem. 52 (2), 332-334 (2006).
- Pannee, J., et al. Reference measurement procedure for CSF amyloid beta (Aβ)1-42 and the CSF Aβ1-42 /Aβ1-40 ratio – a cross-validation study against amyloid PET. J Neurochem. 139 (4), 651-658 (2016).
- Thienpont, L. M., Van Houcke, S. K. Traceability to a common standard for protein measurements by immunoassay for in-vitro diagnostic purposes. Clin Chim Acta. 411 (23-24), 2058-2061 (2010).
- Vesper, H. W., Thienpont, L. M. Traceability in laboratory medicine. Clin Chem. 55 (6), 1067-1075 (2009).
