Page 32 - Read Online

Kapaki et al. Neuroimmunol Neuroinflammation 2020;7:319-29 I http://dx.doi.org/10.20517/2347-8659.2019.26 Page 327
[37]
Aβ ratio has been associated with amyloid PET status in cognitively normal subjects .
40
Inflammation biomarkers in CSF and blood have received much attention; however, whether they offer any
added diagnostic value remains a matter of investigation. CSF α1-antichymotrypsin levels are increased
both in vascular cognitive impairment (VCI) and clinically evident AD, while elevated peripheral CRP
[38]
levels may be associated with increased risk for VCI, but not AD . Serum interleukin-15 levels have been
found to be significantly lower in patients with AD in comparison to healthy subjects and patients with
[39]
VCI . On the other hand, CSF interleukin-15 levels are increased in AD and FTD, compared to patients
[40]
with non-inflammatory neurological disorders , while CSF interleukin-12 is reduced in AD, indicating
[41]
altered inflammatory reactions .
In neurodegenerative disorders, diagnosis should be established as soon as possible and preferably in a
prodromal phase, before the onset of clinically significant dementia. Additionally, new emerging treatments
or medications under investigation may be more effective when given in early stages. Therefore, timely
and accurate diagnosis is mandatory to obtain potential benefits of novel treatments, but also for accurate
inclusion of patients in clinical trials and for determining prognosis. As noted above in case 4, clinical
phenotypes are not always tightly linked to the underlying pathology [5,6,9] in contrast to biomarkers, some of
which may have high molecular specificity. Nonetheless, CSF biomarkers are not a panacea, and their value
should not be over-rated. They have disadvantages mainly due to the heterogeneity of research to date,
but they still offer a very useful tool in early etiological diagnosis of neurodegenerative diseases, especially
[17]
when combined with clinical and neuroimaging data .

DECLARATIONS
Authors’ contributions
Concept and definition of intellectual content: Kapaki E, Paraskevas GP
Clinical data acquisition and interpretation: Kapaki E, Constantinides VC, Pyrgelis ES, Paraskevas PG,
Papatriantafyllou JD, Paraskevas GP
Biomarker determinations and interpretation of results: Kapaki E, Paraskevas GP
Manuscript preparation, editing and review: Kapaki E, Pyrgelis ES, Paraskevas PG, Papatriantafyllou JD,
Paraskevas GP

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
The authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
All patients and/or relatives gave informed consent for publication of their clinical, biochemical and
imaging data.

Copyright
© The Author(s) 2020.