NR AJCF
AU Otto,M.; Wiltfang,J.; Cepek,L.; Neumann,M.; Mollenhauer,B.; Steinacker,P.; Ciesielczyk,B.; Schulz-Schaeffer,W.J.; Kretzschmar,H.A.; Poser,S.
TI Tau protein and 14-3-3 protein in the differential diagnosis of Creutzfeldt-Jakob disease
QU Neurology 2002 Jan 22; 58(2): 192-7
PT evaluation studies; journal article
AB BACKGROUND: Diagnosis of Creutzfeldt-Jakob disease (CJD) is made according to the typical clinical picture and can be supported by a positive 14-3-3 CSF immunoblot. Promising results for the diagnostic sensitivity and specificity of tau-protein measurement in CSF already have been described in a smaller group of patients. Both tests in a larger group of patients with the differential diagnosis of CJD were evaluated. METHODS: CSF of 297 patients under the differential diagnosis of CJD (109 definite, 55 probable, 39 possible; 85 others, 1 iatrogenic, 8 genetic), 23 nondemented control subjects, and 15 non-CJD patients with positive 14-3-3 immunoblots were analyzed. The 14-3-3 immunoblot bands were semiquantitatively rated as strong, medium, and weak. Tau-protein was analyzed using a commercially available ELISA. In addition, patients were neuropathologically classified according to prion protein type and polymorphism at codon 129. RESULTS: A diagnostic sensitivity of 94%, a diagnostic specificity of 90%, and a positive predictive value of 92% were achieved for tau-protein at a cut-off of 1,300 pg/mL. These results are comparable with those of the 14-3-3 immunoblot. For patients with type II prion protein and methionine/valine or valine/valine polymorphism at codon 129, tau-protein has a higher diagnostic sensitivity than 14-3-3 protein. Tau-protein levels were significantly higher in patients with higher-rated 14-3-3 immunoblot bands. CONCLUSION: The differential diagnostic significance of the 14-3-3 immunoblot is similar to that of the tau-protein ELISA. The advantage of the tau-protein ELISA is that it is easy to use in routine laboratories. Patients with a negative 14-3-3 immunoblot already have measurable tau-protein levels. This increases information on 14-3-3-negative patients with CJD and especially on patients with other diseases.
MH Adolescent; Adult; Aged; Aged, 80 and over; Creutzfeldt-Jakob Syndrome/cerebrospinal; fluid/*diagnosis/genetics/physiopathology; Dementia/etiology/physiopathology; Diagnosis, Differential; Enzyme Inhibitors/metabolism; Enzyme-Linked Immunosorbent Assay; Female; Human; Immunoblotting; Male; Middle Age; Sensitivity and Specificity; Support, Non-U.S. Gov't; Tyrosine 3-Monooxygenase/*cerebrospinal fluid; tau Proteins/*cerebrospinal fluid
AD Neurologische Klinik und Poliklinik, Georg-August-Universität Göttingen, Germany. motto@gwdg.de
SP englisch
PO USA