Аннотация
В современной научной литературе сформировано представление о значении лабораторных параметров крови и ликвора, к которым относят tau-белки и бета-амилоидные белки в диагностике болезни Альцгеймера. Не менее важны биомаркёры когнитивных функций на додементной стадии — при умеренных когнитивных нарушениях (УКН). Новые возможности в данном направлении открывает неинвазивная диагностика — исследование маркеров ротовой жидкости (РЖ).
Цель: решение вопроса — существуют ли потенциальные саливарные биомаркёры УКН? Для его решения в поисковой системе по биомедицинским исследованиям PubMed за 10 лет по ключевым словам «salivary biomarkers of mild cognitive impairment» найдено 47 публикаций. Из них, как соответствующих цели обзора, отобрано 28 статей, относящихся к предмету исследования. Они включали 7 описательных обзоров, 4 систематических обзора, 1 метаанализ, 16 оригинальных статей (в том числе, одну с результатами многоцентрового исследования). Среди проанализированных параметров — лёгкие цепи нейрофиламентов, глиальный фибриллярный кислый белок, каспаза-8, общий белок, гаптоглобин, матриксная металлопротеиназа 9, цистатин С, стратифин (белок 14.3.3), витамин В12, фолиевая кислота, витамин D3, холестерин и его фракции, триглицериды, С-реактивный белок, кортизол и некоторые другие. Особое внимание среди них привлекает лактоферрин (ЛФ), обладающий высокой диагностической эффективностью. Анализ концентрации саливарного ЛФ позволяет различать пациентов от когнитивно здоровых лиц c высокой долей достоверности. Уровень данного биомаркёра в РЖ коррелировал с содержанием tau-белков в ликворе и низкими показателями шкалы MMSE, указывающими на наличие когнитивных расстройств. В прогнозировании снижения когнитивных функций важна оценка аллелей генов APOE, CR1, CLU, PICALM. Новые перспективы в развития саливадиагностики когнитивных нарушений исследователи связывают с развитием протеомного анализа и исследованием внеклеточных везикул.
Annotation
Yekaterinburg Medical Research Center for Prophylaxis and Health Protection in Industrial Workers, Yekaterinburg, Russia
Currently is known an idea of the importance of laboratory parameters, which include p tau- proteins and beta-amyloid proteins (in plasma and liquor) in the diagnosis of Alzheimer’s disease. Biomarkers of cognitive impairment at the pre-segment stage are equally important. New opportunities in this direction are opened by noninvasive diagnostics — the study of salivary markers. The aim of this review was to solve the question — are there potential salivary biomarkers of moderate cognitive impairment? In the search engine for biomedical research PubMed for 10 years, 47 publications were found using the keywords «salivary biomarkers of mild cognitive impairment». Of these, 28 articles were selected as corresponding to the purpose of this review. They included 7 descriptive reviews, 4 systematic reviews, 1 meta-analysis, 16 original articles (including one with the results of a multicenter study). Among the analyzed parameters are light chains of neurofilaments, glial fibrillar acid protein, caspase-8, total protein, haptoglobin, matrix metalloproteinase 9, cystatin C, stratifin (protein 14.3.3), vitamin B12, folic acid, vitamin D3, cholesterol and its fractions, triglycerides, C-reactive protein, cortisol and others. Lactoferrin (LF) has a high diagnostic efficiency. Analysis of the salivary LF concentration makes it possible to distinguish patients from cognitively healthy individuals with a high degree of confidence. The level of this biomarker in oral fluid correlated with the content of tau proteins in the cerebrospinal fluid and low MMSE scores indicating the presence of cognitive disorders. It is important to evaluate alleles of APOE, CR1, CLU, PICALM genes in predicting cognitive decline. We associate new prospects in the development of salivadiagnostics of cognitive disorders with the development of proteomic analysis and the study of extracellular vesicles.
Key words: biomarkers; mild cognitive impairment; oral fluid; review.
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