Blood-based biomarkers for Alzheimer disease: mapping the road to the clinic

Abstract

<p class="first" id="P6">Biomarker discovery and development for clinical research, diagnostics and therapy monitoring in clinical trials have advanced rapidly in key areas of medicine, notably oncology and cardiovascular diseases, allowing for rapid early detection and supporting the evolution of biomarker-guided precision medicine-based targeted therapies. </p><p id="P7">In Alzheimer’s disease (AD), breakthroughs in biomarker identification and validation include the cerebrospinal fluid (CSF) and positron emission tomography (PET) markers of amyloid β (Aβ) and tau proteins, which are highly accurate in detecting the presence of pathophysiological and neuropathological changes of AD. However, their high cost, insufficient accessibility, or invasiveness may limit their use as viable first-line tools for detecting patterns of pathophysiology. Therefore, a multi-stage, tiered approach is needed, prioritizing development of an initial screen to exclude from these tests the high numbers of people with cognitive deficits who do not demonstrate evidence of underlying AD pathophysiology. </p><p id="P8">This perspective summarizes the efforts of a working group that aimed to survey the current landscape of blood-based AD biomarkers, and outlines operational steps for an effective academic-industry co-development and path forward from identification and assay development to validation for clinical use. </p>