title: Evaluation of heme oxygenase-1 as a systemic biological marker of sporadic AD.
abstract: BACKGROUND
  Heme oxygenase-1 (HO-1) is a 32-kDa stress protein that catalyzes the degradation of heme to biliverdin. HO-1 immunoreactivity is greatly increased in neurons and astrocytes of the hippocampus and cerebral cortex of individuals with AD and colocalizes to senile plaques and neurofibrillary tangles.
  
  
  METHODS
  We investigated whether systemic HO-1 regulation is also deranged in AD patients and whether blood HO-1 measurements provide a peripheral biomarker of the disease. Plasma HO-1 protein levels were measured by competitive ELISA and lymphocyte HO-1 mRNA levels were determined by Northern analysis in patients with early probable sporadic AD, normal elderly controls (NEC), normal younger controls, individuals with age-associated cognitive decline (AACD) not meeting AD criteria, and patients with non-Alzheimer dementia, nondementing neurologic illness, and chronic medical disorders. CSF HO-1 protein concentrations were also determined by ELISA in pathologically confirmed AD and control cases.
  
  
  RESULTS
  Mean plasma HO-1 protein concentrations were significantly lower in AD patients (0.85 +/- 0.14 microg/mL) compared with NEC (1.77 +/- 0.34 microg/mL; p < 0.05) and control patients. The AACD group exhibited plasma HO-1 concentrations (1.06 +/- 0.33 microg/mL) intermediate between, but not different from, those of the AD patients and NEC. Lymphocyte HO-1 mRNA levels were lower in the AD cohort relative to NEC (p < 0.001) and individuals with AACD, non-Alzheimer dementia, nondementing neurologic illness, and chronic medical conditions. Lymphocyte HO-1 mRNA levels were also lower in the AACD group relative to NEC (p < 0.05). In comparison with all groups excluding AACD, the sensitivity and specificity of lymphocyte HO-1 mRNA measurement for diagnosis of early sporadic AD are 88% and 75%. Mean CSF HO-1 protein concentrations were lower (p < 0.01) in AD cases (19.07 ng/mL) relative to control values (32.48 ng/mL).
  
  
  CONCLUSIONS
  Plasma and CSF HO-1 protein and lymphocyte HO-1 mRNA levels are decreased in subjects with sporadic AD. Quantitative assay for lymphocyte HO-1 mRNA expression may serve as a useful biologic marker in early sporadic AD.
authors.affiliation: Department of Clinical Neurosciences, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada.
authors.forename: H M
authors.initials: HM
authors.lastname: Schipper
authors.forename: H
authors.initials: H
authors.lastname: Chertkow
authors.forename: K
authors.initials: K
authors.lastname: Mehindate
authors.forename: D
authors.initials: D
authors.lastname: Frankel
authors.forename: C
authors.initials: C
authors.lastname: Melmed
authors.forename: H
authors.initials: H
authors.lastname: Bergman
mesh_terms: D000328:Adult; D000368:Aged; D000544:Alzheimer Disease / Q000097:blood* / Q000134:cerebrospinal fluid / Q000523:psychology; D015415:Biomarkers / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005069:Evaluation Studies as Topic; D006419:Heme Oxygenase (Decyclizing) / Q000097:blood* / Q000134:cerebrospinal fluid; D051547:Heme Oxygenase-1; D006801:Humans; D008565:Membrane Proteins; D008875:Middle Aged; D009483:Neuropsychological Tests; D012313:RNA / Q000032:analysis
chemical_list: D015415:Biomarkers; D008565:Membrane Proteins; D012313:RNA; C496541:HMOX1 protein, human; D006419:Heme Oxygenase (Decyclizing); D051547:Heme Oxygenase-1