title: A consensus in Korea regarding a protocol to reduce preanalytical sources of variability in the measurement of the cerebrospinal fluid biomarkers of Alzheimer's disease.
abstract: Cerebrospinal fluid (CSF) can provide vital informative about pathological processes occurring in the brain. In particular, the CSF concentrations of Aβ42, tTau, and pTau181 are useful for the early diagnosis of Alzheimer's disease (AD). However, many studies have demonstrated that confounding factors related to the preanalytical processing of CSF can seriously influence measurements of these AD biomarkers. It is therefore important to develop a standardized protocol for the acquisition and handling of CSF, particularly with regard to the types of tube used for collection and storage, the proper aliquot volume, blood contamination, and the number of tube transfers and freeze-thaw cycles, because these aspects of the procedure have been shown to affect AD biomarker measurements. A survey of the impact of several individual preanalytical procedures on the measurement of AD biomarkers in CSF was conducted for this review article, and the implications of the differences among them are discussed. Furthermore, following a review of the procedures used in Korean and international biomarker laboratories, a consensus was reached among a cooperative Korean multicenter research group regarding a standardized protocol for the analysis of AD biomarkers in CSF. All efforts were made to be stringent regarding the controversial issues associated with this protocol, thus minimizing the confounding influence of various factors on current investigations using established AD biomarkers and on future studies using novel biomarkers of AD and other neurodegenerative disorders.
authors: Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea. sapark@schmc.ac.kr.
authors: Sun Ah
authors: SA
authors: Park
authors: Department of Pharmacology & Clinical Pharmacology, Inha University School of Medicine, Incheon, Korea.; Department of Pathology & Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors: Ju Hee
authors: JH
authors: Kang
authors: Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Eun Suk
authors: ES
authors: Kang
authors: Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Chang Seok
authors: CS
authors: Ki
authors: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Jee Hoon
authors: JH
authors: Roh
authors: Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Young Chul
authors: YC
authors: Youn
authors: Department of Neurology, Chung-Ang University Hospital, Seoul, Korea.
authors: Seong Yoon
authors: SY
authors: Kim
authors: Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea. neuroksy@snu.ac.kr.
authors: Sang Yun
authors: SY
authors: Kim
keywords: Alzheimer's disease; biomarker; cerebrospinal fluid; protocol; standardization