Game-Changer for Alzheimer’s Disease Diagnostics

Molecular Epidemiology

In a recent interview published by Technology Networks, Zetterberg highlighted the profound shift that could result from this development. ”If you do a finger prick test on yourself and put this blood on a collection device, preferably so that you get dried plasma-like material, then you can measure all of the important blood biomarkers for Alzheimer’s disease,” using the advanced multiplexed, ultra-sensitive technique NULISA by Alamar Biosciences, ”these measures correlate extremely well with standard venous blood-based measurements,” Zetterberg explains.

Democratize AD diagnostics

Zetterberg and his team have been early adopters of the Capitainer®B50 device and among the early access users of the new Capitainer®SEP10 device pre-launch. These technologies enable biomarkers in dried blood and plasma spots to remain stable for up to six months at room temperature. Zetterberg sees this as a game-changer for AD diagnostics, especially for those in remote regions. “This work sort of helps us, I sometimes say, democratize AD diagnostics,” Zetterberg emphasizes. The reduced need for costly laboratory equipment and specialized handling makes it possible for patients in rural or underserved areas, and even those outside hospital systems, to access early diagnostic testing.

This newfound accessibility tackles one of the long-standing frustrations in the biomarker field. “I’ve been so jealous of the people doing genetic studies,” Zetterberg admits. Genetic research has been able to scale globally, exploring risk factors across diverse populations without the logistical hurdles of fluid biomarker studies, which traditionally require specialized collection devices, centrifuges, and cold storage. But now, with advancements like dried plasma microsampling, those barriers are breaking down. “We could do the same type of sampling as the geneticists have been able to do for years and measure all of the important blood biomarkers for neurodegenerative diseases,” he says, opening up the potential for global “molecular epidemiology” of AD and related disorders.

Biomarker Discovery

The implications of this technology are vast. By making it possible to collect diagnostic information on a global scale, researchers could gain invaluable insights into how neurodegenerative diseases vary across different populations and regions. This, in turn, could influence the development of targeted therapies and lead to more personalized treatment approaches.

Zetterberg also underscores the importance of short-term goals in AD diagnostics, especially as new treatments emerge.” I think we should rapidly now develop a solid and well-validated blood-based algorithm to help diagnose early Alzheimer’s disease,” he asserts. Such an algorithm would allow clinicians to prescribe treatments earlier, potentially slowing the progression of the disease. Furthermore, Zetterberg highlights the need for biomarkers to detect ”dangerous aria”, a common side effect of anti-amyloid antibody treatments. Developing these biomarkers would enable safer monitoring and treatment protocols.

Beyond Alzheimer’s, Zetterberg’s vision extends to other neurodegenerative diseases. While promising early results have emerged for conditions like Parkinson’s disease and frontotemporal dementia, more work is needed. Zetterberg points to ongoing research into biomarkers for proteins like alpha-synuclein and TDP43, both of which are implicated in these diseases. He also calls for improved biomarkers for neuroinflammation and cerebrovascular dysfunction, two key aspects of neurodegenerative conditions that have yet to be fully addressed.

The significance of these biomarkers stems from the brain’s remarkable ability to compensate for early disease pathology. “These neurodegenerative diseases, their pathology, start to develop about 15 to 20 years before you get clinically recognizable symptoms,” Zetterberg explains. While the brain can tolerate protein clumps and network disturbances for many years, once symptoms manifest, the damage is often severe. This underscores the urgency of early detection and the role biomarkers play in identifying diseases before they progress to an irreversible stage.

Looking to the Future

Looking to the future, Zetterberg envisions that simplified biomarker testing reaches broader populations. “Simplified testing for biomarkers will be crucial because then one could do these types of testing of people who are not in the hospital system,” he says. He imagines a scenario where individuals can gather health information independently, using digital cognitive assessments and sending blood samples from their homes—perhaps even before visiting a physician.

Zetterberg’s work offers a glimpse into a future where access to life-saving diagnostics and treatments is not restricted by geography or resources. By combining innovations like quantitative dried blood plasma microsampling with multiplexed, ultra-sensitive techniques, the field of neurodegenerative disease diagnostics is on the cusp of being democratized, offering hope to millions of people worldwide.