A comparison of tau and 14-3-3 protein in the diagnosis of Creutzfeldt-Jakob disease.

Abstract

OBJECTIVE:

To compare the respective efficiency of CSF tau (quantitative) and CSF 14-3-3 protein (qualitative) in the diagnosis of prion disease.

METHODS:

We made measurements on 420 live subjects, who subsequently underwent a postmortem neuropathology examination, including protein chemistry, immunohistochemistry, and histology. We performed tau by ELISA. We detected 14-3-3 protein by Western blot. Both assays were optimized for maximum efficiency (accuracy).

RESULTS:

We found tau and 14-3-3 proteins to be closely correlated, but tau had a significantly better ability to predict disease status than 14-3-3 protein. Also, tau distinguished disease status at least as well as when both assays' results are combined in a variety of ways. Importantly, the area under the receiver operating characteristic curve for tau (0.82) was significantly larger than that for 14-3-3 protein (0.68) (p < 0.001). Diagnostic test statistics are provided for the study subjects with 58.3% prevalence, and for a more typical, nonselected, 7.5% prevalence as received by our center.

CONCLUSION:

In this study, tau is superior to 14-3-3 protein as a marker in the diagnosis of Creutzfeldt-Jakob disease, and is as efficient singly compared to a variety of combinations with 14-3-3 protein. This is the first study of this magnitude to examine prion disease diagnostic tests in a carefully characterized patient population with detailed statistical evaluation.

• Authors: Clive Hamlin, Gianfranco Puoti, Sally Berri, Elliott Sting, Carrie Harris, Mark Cohen, Charles Spear, Alberto Bizzi, Sara M Debanne, Douglas Y Rowland
• Journal: Neurology (Neurology) Vol. 79 Issue 6 Pg. 547-52 (Aug 07 2012) ISSN: 1526-632X [Electronic] United States
• PMID: 22843257 (Publication Type: Comparative Study, Journal Article, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• 14-3-3 Proteins
• Biomarkers
• tau Proteins

Topics

• 14-3-3 Proteins (cerebrospinal fluid)
• Area Under Curve
• Biomarkers (cerebrospinal fluid)
• Creutzfeldt-Jakob Syndrome (cerebrospinal fluid, diagnosis)
• Humans
• ROC Curve
• Sensitivity and Specificity
• tau Proteins (cerebrospinal fluid)