Abstract

Exosomes are small extracellular vesicles (EVs) present in human biofluids that can transport specific disease-associated molecules. Consequently blood-derived exosomes have emerged as important peripheral biomarker sources for a wide range of diseases, among them Alzheimer’s disease (AD). Although there is no effective cure for AD, an accurate diagnosis, relying on easily accessible peripheral biofluids, is still necessary to discriminate this disease from other dementias, test potential therapies and even monitor rate of disease progression. The ultimate goal is to produce a cost-effective and widely available alternative, which can also be employed as a first clinical screen. In this study, EVs with exosome-like characteristics were isolated from serum of Controls and AD cases through precipitation- and column-based methods, followed by mass spectrometry analysis. The resulting proteomes were characterized by Gene Ontology (GO) and multivariate analyses. Although GO terms were similar for exosomes’ proteomes of Controls and ADs, using both methodologies, a clear segregation of disease cases was obtained when using the precipitation-based method. Nine significantly different abundant proteins were identified between Controls and AD cases, representing putative biomarker candidate targets. Among them are AACT and C4BPα, two Aβ-binding proteins, whose exosome levels were further validated in individuals from independent cohorts using antibody-based approaches. The findings discussed represent an important contribution to the identification of novel exosomal biomarker candidates useful as potential blood-based tools for AD diagnosis.

Highlights

  • Alzheimer’s disease (AD) is the most common form of dementia worldwide, and the number of individuals affected by this condition is expected to increase exponentially in the decades

  • In exosome-like particles isolated with ExoQ, an average of 136 proteins were identified in the Control group and 117 proteins were identified in AD cases

  • For ExoS, an average of 100 proteins were found in Controls and 85 proteins were identified in ADs (Table 1; Supplementary Tables 1 and 2), including protein isoforms

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Summary

Introduction

Alzheimer’s disease (AD) is the most common form of dementia worldwide, and the number of individuals affected by this condition is expected to increase exponentially in the decades. AD diagnosis is based on clinical symptom evaluation, cognitive testing and brain imaging and, in some cases, supported by the molecular diagnostics, namely the monitoring of the gold standard biomarker triplet (Aβ, totalTau and P-Tau 181) in the cerebrospinal fluid (CSF) [6, 7]. The latter neurochemical analysis has undeniable value in assisting AD differential diagnosis; it requires a lumbar puncture which is an invasive procedure, limiting its wide routine use or resource as a first screening tool. There are no reliable bloodbased biomarkers for AD, this is urgently needed in clinical practice

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