Original article
Erythrocyte sphingolipid species as biomarkers of Alzheimer's disease

https://doi.org/10.1016/j.jpha.2021.07.005Get rights and content
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Highlights

Erythrocytes are metabolically active, and are a useful and accessible source of AD biomarkers.

750 metabolites were detected; 31 were significantly altered.

In AD, there is a consistent decrease in the relative concentrations of some sphingolipid and sphingolipid-related species.

A decrease in sphingolipid species in erythrocytes could suggest an overall systemic alteration.

Abstract

Diagnosing Alzheimer's disease (AD) in the early stage is challenging. Informative biomarkers can be of great value for population-based screening. Metabolomics studies have been used to find potential biomarkers, but commonly used tissue sources can be difficult to obtain. The objective of this study was to determine the potential utility of erythrocyte metabolite profiles in screening for AD. Unlike some commonly-used sources such as cerebrospinal fluid and brain tissue, erythrocytes are plentiful and easily accessed. Moreover, erythrocytes are metabolically active, a feature that distinguishes this sample source from other bodily fluids like plasma and urine. In this preliminary pilot study, the erythrocyte metabolomes of 10 histopathologically confirmed AD patients and 10 patients without AD (control (CTRL)) were compared. Whole blood was collected post-mortem and erythrocytes were analyzed using ultra-performance liquid chromatography tandem mass spectrometry. Over 750 metabolites were identified in AD and CTRL erythrocytes. Seven were increased in AD while 24 were decreased (P<0.05). The majority of the metabolites increased in AD were associated with amino acid metabolism and all of the decreased metabolites were associated with lipid metabolism. Prominent among the potential biomarkers were 10 sphingolipid or sphingolipid-related species that were consistently decreased in AD patients. Sphingolipids have been previously implicated in AD and other neurological conditions. Furthermore, previous studies have shown that erythrocyte sphingolipid concentrations vary widely in normal, healthy adults. Together, these observations suggest that certain erythrocyte lipid phenotypes could be markers of risk for development of AD.

Keywords

Alzheimer's disease
Neurodegenerative disease
Mass spectrometry
Erythrocytes
Biomarkers
Metabolomics

Peer review under responsibility of Xi’an Jiaotong University.