Abstract
The identification of reliable diagnostic biomarkers in differential diagnosis of neurodegenerative diseases is an ongoing topic. A previous two-dimensional proteomic study on cerebrospinal fluid (CSF) revealed an elevated level of an enzyme, mitochondrial malate dehydrogenase 1 (MDH1), in sporadic Creutzfeldt-Jakob disease (sCJD) patients. Here, we could demonstrate the expression of MDH1 in neurons as well as in the neuropil. Its levels are lower in sCJD brains than in control brains. An examination of CSF-MDH1 in sCJD patients by ELISA revealed a significant elevation of CSF-MDH1 levels in sCJD patients (independently from the PRNP codon 129 MV genotype or the prion protein scrapie (PrPSc) type) in comparison to controls. In combination with total tau (tau), CSF-MDH1 detection exhibited a high diagnostic accuracy for sCJD diagnosis with a sensitivity of 97.5% and a specificity of 95.6%. A correlation study of MDH1 level in CSF with other neurodegenerative marker proteins revealed a significant positive correlation between MDH1 concentration with tau, 14-3-3 and neuron specific enolase level. In conclusion, our study indicated the potential of MDH1 in combination with tau as an additional biomarker in sCJD improving diagnostic accuracy of tau markedly.
Highlights
Transmissible spongiform encephalopathies (TSE) belong to the group of neurodegenerative disorders, which are characterised by the conversion of the cellular prion protein (PrPC) to the disease-associated misfolded form PrPScrapie (PrPSc)
Immunohistochemical staining of cytosolic malate dehydrogenase 1 (MDH1) was performed in the frontal cortex region of sporadic Creutzfeldt‐Jakob disease (sCJD) (MM1) patients in comparison to non-prion disease controls
The intensity of MDH1 staining was lower in sCJD cases than in controls, which was in agreement with the western blot observations (Fig. 1B)
Summary
Transmissible spongiform encephalopathies (TSE) belong to the group of neurodegenerative disorders, which are characterised by the conversion of the cellular prion protein (PrPC) to the disease-associated misfolded form PrPScrapie (PrPSc). This group includes Creutzfeldt-Jakob disease (CJD), the most common form of prion disease in humans. The PRNP codon 129 polymorphism influences the conformational structure of the cellular PrP (PrPC) [1] and it may influence the disease course, symptoms at onset, type of the pathological changes such as the PrPSc deposition pattern and the sensitivity of diagnostic tests [2,3,4,5]
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