Science News: Tau Protein as a Diagnostic and Prognostic Biomarker in Amyotrophic Lateral Sclerosis

Submitted by: Shan Chen, MD
Edited by: Pritikanta Paul, MD

Agnello L, Colletti T, Lo Sasso B, et al. Tau protein as a diagnostic and prognostic biomarker in amyotrophic lateral sclerosis. Eur J Neurol. 2021;28(6):1868-1875. doi:10.1111/ene.14789

Summary: Tau is a neuronal microtubule-associated protein which when phosphorylated (pTau) loses its affinity for tubulin leading to insoluble aggregates and cytoskeleton disintegration. Total Tau (tTau) and pTau have been proposed as biomarkers for neurodegenerative conditions but its usefulness as biomarker in amyotrophic lateral sclerosis (ALS) is not very well-known.

In this retrospective cross-sectional study, the authors enrolled 196 ALS patients and 91 controls, including patients with ALS-mimicking diseases and those with nonneurodegenerative conditions. All patients underwent lumbar puncture for CSF analysis, and they measured tTau and pTau levels in the CSF by chemiluminescence enzyme immunoassay.

Patients with ALS showed significantly higher levels of CSF tTau and a lower pTau/tTau ratio than controls (p < 0.001) but no differences in pTau levels were detected.  Additionally, based on receiver-operating characteristic curve (ROC) analysis authors suggested CSF tTau and pTau/tTau ratio could be good diagnostic biomarkers. The authors also found increased CSF tTau level to be an independent negative predictor of overall survival in ALS patients. Furthermore, positive association of CSF tTau level was noted with advanced age of onset, rate of disease progression, and decreased survival.

Comments: This study highlights role of Tau protein as a potential diagnostic and prognostic biomarker in ALS patients.

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