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Prion protein quantification in human cerebrospinal fluid as a tool for prion disease drug development

Vallabh, SM; Nobuhara, CK; Llorens, F; Zerr, I; Parchi, P; Capellari, S; Kuhn, E; ... Schreiber, SL; + view all (2019) Prion protein quantification in human cerebrospinal fluid as a tool for prion disease drug development. Proceedings of the National Academy of Sciences , 116 (16) pp. 7793-7798. 10.1073/pnas.1901947116. Green open access

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Abstract

Reduction of native prion protein (PrP) levels in the brain is an attractive strategy for the treatment or prevention of human prion disease. Clinical development of any PrP-reducing therapeutic will require an appropriate pharmacodynamic biomarker: a practical and robust method for quantifying PrP, and reliably demonstrating its reduction in the central nervous system (CNS) of a living patient. Here we evaluate the potential of ELISA-based quantification of human PrP in human cerebrospinal fluid (CSF) to serve as a biomarker for PrP-reducing therapeutics. We show that CSF PrP is highly sensitive to plastic adsorption during handling and storage, but its loss can be minimized by the addition of detergent. We find that blood contamination does not affect CSF PrP levels, and that CSF PrP and hemoglobin are uncorrelated, together suggesting that CSF PrP is CNS derived, supporting its relevance for monitoring the tissue of interest and in keeping with high PrP abundance in brain relative to blood. In a cohort with controlled sample handling, CSF PrP exhibits good within-subject test-retest reliability (mean coefficient of variation, 13% in samples collected 8-11 wk apart), a sufficiently stable baseline to allow therapeutically meaningful reductions in brain PrP to be readily detected in CSF. Together, these findings supply a method for monitoring the effect of a PrP-reducing drug in the CNS, and will facilitate development of prion disease therapeutics with this mechanism of action.

Type: Article
Title: Prion protein quantification in human cerebrospinal fluid as a tool for prion disease drug development
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1073/pnas.1901947116
Publisher version: https://doi.org/10.1073/pnas.1901947116
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Creutzfeldt-Jakob disease, biomarker, cerebrospinal fluid, human prion disease, prion protein
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Neurodegenerative Diseases
URI: https://discovery.ucl.ac.uk/id/eprint/10072066
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