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Alpha‐synuclein in peripheral tissues and body fluids as a biomarker for P arkinson's disease – a systematic review
Author(s) -
Malek N.,
Swallow D.,
Grosset K. A.,
Anichtchik O.,
Spillantini M.,
Grosset D. G.
Publication year - 2014
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12247
Subject(s) - alpha synuclein , lewy body , pathology , biomarker , medicine , parkinson's disease , pathological , alpha (finance) , enteric nervous system , disease , biology , biochemistry , construct validity , nursing , patient satisfaction
Parkinson's disease ( PD ) is neuropathologically characterized as an alpha‐synucleinopathy. Alpha‐synuclein‐containing inclusions are stained as L ewy bodies and L ewy neurites in the brain, which are the pathological hallmark of PD . However, alpha‐synuclein‐containing inclusions in PD are not restricted to the central nervous system, but are also found in peripheral tissues. Alpha‐synuclein levels can also be measured in body fluids. The aim of this study was to conduct a systematic review of available evidence to determine the utility of alpha‐synuclein as a peripheral biomarker of PD . We searched PubMed (1948 to 26 M ay 2013), E mbase (1974 to 26 M ay 2013), the C ochrane L ibrary (up to 26 M ay 2013), LILACS (up to 26 M ay 2013) and CINAHL (up to 26 M ay 2013) for the studies of alpha‐synuclein in peripheral tissues or body fluids in PD . A total of 49 studies fulfilled the search criteria. Peripheral tissues such as colonic mucosa showed a sensitivity of 42–90% and a specificity of 100%; submandibular salivary glands showed sensitivity and specificity of 100%; skin biopsy showed 19% sensitivity and 80% specificity in detecting alpha‐synuclein pathology. CSF alpha‐synuclein had 71–94% sensitivity and 25–53% specificity for distinguishing PD from controls. Plasma alpha‐synuclein had 48–53% sensitivity and 69–85% specificity. Neither plasma nor CSF alpha‐synuclein is presently a reliable marker of PD . This differs from alpha‐synuclein in solid tissue samples of the enteric and autonomic nervous system, which offer some potential as a surrogate marker of brain synucleinopathy.