Nerve growth factor (NGF) pathway biomarkers in Down syndrome prior to and after the onset of clinical Alzheimer's disease: A paired CSF and plasma study.

Pentz, RowanIulita, M FlorenciaDucatenzeiler, AdrianaVidela, LauraBenejam, BessyCarmona‐Iragui, MaríaBlesa, RafaelLleó, AlbertoFortea, JuanCuello, A Claudio


Recent discoveries about metabolism in those with Down syndrome (DS) show that nerve growth factor (NGF) metabolism is altered. The brains of those with DS have many similarities to brains of people without DS who had Alzheimer’s disease (AD). Because of this, AD brains can be used by researchers to help find new biomarkers that will help guide understanding and treatment of metabolic issues in those with DS. Researchers found that both plasma and cerebrospinal fluid samples can be used to monitor NGF metabolism.


The discovery that nerve growth factor (NGF) metabolism is altered in Down syndrome (DS) and Alzheimer's disease (AD) brains offered a framework for the identification of novel biomarkers signalling NGF deregulation in AD pathology. We examined levels of NGF pathway proteins (proNGF, neuroserpin, tissue plasminogen activator [tPA], and metalloproteases [MMP]) in matched cerebrospinal fluid (CSF)/plasma samples from AD-symptomatic (DSAD) and AD-asymptomatic (aDS) individuals with DS, as well as controls (HC). ProNGF and MMP-3 were elevated while tPA was decreased in plasma from individuals with DS. CSF from individuals with DS showed elevated proNGF, neuroserpin, MMP-3, and MMP-9. ProNGF and MMP-9 in CSF differentiated DSAD from aDS (area under the curve = 0.86, 0.87). NGF pathway markers associated with CSF amyloid beta and tau and differed by sex. Brain NGF metabolism changes can be monitored in plasma and CSF, supporting relevance in AD pathology. These markers could assist staging, subtyping, or precision medicine for AD in DS.


Alzheimer Disease