Mount Sinai Health System Among First to Use Blood Tests for Early Alzheimer’s Detection
Mount Sinai Health System among the first in the world to use blood tests as an early detection tool for Alzheimer’s disease and related dementias in patients
Mount Sinai Health System today announced that they will be among the first in the world to deploy blood-based biomarkers (blood tests) and confirmatory tests for Alzheimer’s disease and related dementias to patients across primary and specialty care settings—early detection tools that have never before been offered to patients in the clinical setting—as part of the Davos Alzheimer’s Collaborative (DAC) Healthcare System Preparedness Accurate Diagnosis project.
Click here to learn more about blood-based biomarkers for neurological diseases.
DAC is a pioneering worldwide initiative seeking to cure Alzheimer’s disease and dementia. The effort at Mount Sinai, part of this initiative, will be co-led by Fanny Elahi, MD, PhD, director of fluid biomarkers at the Maurice Deane Center for Wellness and Cognitive Health at Mount Sinai, and Georges Naasan, MD, co-medical director of the Deane Center.
A unique opportunity for early disease detection
“Knowledge gained from blood-based biomarkers of Alzheimer’s and related dementias provides a unique opportunity for early disease detection and consequently, intervention, and will enable implementation of existing treatments as well as discovery of novel therapeutics,” said Elahi, associate professor of neurology and neuroscience at the Icahn School of Medicine at Mount Sinai. “Our work with the DAC Accurate Diagnosis project will not only help us stratify patients rapidly, noninvasively, and cost-effectively, but also shed light on the best practices for implementation of these revolutionary diagnostic tests in real-world clinical settings. We are excited to bring blood-based biomarkers to the clinic.”
The treatment of Alzheimer’s disease has moved into a new era with the introduction of new therapies that target underlying disease biology, but these therapies need to be introduced early in the disease course in order to have the most benefit. The current gold standard for the accurate diagnosis of neurodegenerative disease pathology in the brain are positron emission tomography (PET) scans of amyloid (the protein buildup in the brain that is a hallmark of the disease) and analysis of proteins in cerebrospinal fluid—both of which are invasive, expensive and not widely available, particularly in economically disadvantaged regions. However, because pathological processes in the brain produce proteins that leak into the bloodstream, early detection is possible from a simple blood draw.
“Clinicians have been waiting for a long time for ways to confirm the presence of Alzheimer’s disease biomarkers that do not pose risks to patients or financially strain the health system. This project is a first step in this direction and has the potential of revolutionizing clinical care for Alzheimer’s disease, said Dr. Naasan. “Blood-based biomarkers also have the potential of becoming the tests needed to select patients for targeted therapies, including the newly FDA-approved monoclonal antibodies, which currently can only be administered to those who obtain a PET scan or a spinal tap that confirms the presence of Alzheimer’s disease.”
Transitioning blood-based biomarkers to real-world clinical settings
Through a $1.3 million grant from the Davos Alzheimer’s Collaborative, Elahi and Naasan will lead a team of physicians, nurses, social workers, and clinical research coordinators from Mount Sinai to recruit 900 patients over the next nine months as part of this project. Patients will be recruited from the hospital’s Barbara and Maurice Deane Center for Wellness and Cognitive Health (the Deane Center), the hospital-based memory loss center, and from the hospital’s geriatric and primary care clinics and followed for six months afterward.
Mount Sinai is one of the largest academic health systems in the New York metro area, with a strong track record of enrolling both socioeconomically and racial-ethnically diverse patients into research studies. This will prove incredibly helpful in informing the most effective ways to transition these blood-based biomarkers from the research world, which tends to have a high level of homogeneity, to the highly diverse real world, Elahi said.
“Mt. Sinai Health System will play a critical role in the Davos Alzheimer’s Collaborative global Accurate Diagnosis project—helping to catalyze healthcare system change and making patient-centered care and support more widely accessible,” said George Vradenburg, founding chairman, Davos Alzheimer’s Collaborative.
Determining the risk of Alzheimer’s disease
“Many people think of the protein amyloid-beta as the culprit associated with Alzheimer’s disease pathology; however, we now know that pathological forms of the protein tau are the more toxic substrates of disease. We are utilizing a biomarker that captures a toxic form of this protein and also predicts brain deposits of amyloid-beta. The p-tau 217 will be the primary biomarker in this study, and we will also examine levels of two more proteins (NfL and GFAP) that indicate whether the brain is degenerating,” said Elahi.
“Notably, these additional proteins are not specific to any subtype of disease. Their levels go up across the spectrum of brain degenerative disorders from dementia-causing disease to multiple sclerosis, and infection- or concussion-related brain dysfunction. By quantifying three proteins in blood, we will be able to determine risk of Alzheimer’s disease, as well as brain degeneration of any cause.”
The Mount Sinai team will be utilizing the LucentAD p-Tau 217 assay, a noninvasive blood test that relies on quantitation of the tau isoform that is phosphorylated at the 217 amino acid residue (p-Tau 217) in plasma. This quantification provides rule-in/rule-out data that could impact final diagnosis of Alzheimer’s disease in patients with cognitive impairment. Lucent Diagnostics, the commercial brand of Quanterix, is powered by ultrasensitive Simoa™ technology that bridges the gap between research and clinical implementation. The Mount Sinai team chose Lucent as their industry partner because they were able to provide highly accurate tests for all three proteins.
Providing noninvasive, low-cost tests for Alzheimer’s and dementia
“This project is critical for providing noninvasive, low-cost testing options and improving how we diagnose and treat these disorders,” said Elahi. “What we’re measuring today is just a tip of the iceberg of so much more to come. There are numerous additional pathologies for which my lab and others are developing novel biomarker tests. Moving detection of brain degenerative disorders to blood is an incredible leap forward toward slowing down disease progression and ultimately, developing cures for dementia-causing pathologies.”
Mount Sinai will share learnings with the Davos Alzheimer’s Collaborative Healthcare System Preparedness project in regular community-of-practice meetings throughout the 18-month project. To benefit other health systems interested in adopting similar efforts, the learnings and practical resources from the Accurate Diagnosis project will be shared as part of the Davos Alzheimer’s Collaborative Early Detection Blueprint.
Other sites participating in the Accurate Diagnosis project include University of Kansas Health System and University of Kansas Alzheimer’s Disease Research Center, Wake Forest University School of Medicine, Alzheimer Center Amsterdam at Amsterdam University Medical Center, Imperial College London and Imperial College Healthcare NHS Trust, Ludwig-Maximillians University (LMU) Hospital Munich–Alzheimer’s Therapy and Research Center, and Tokyo Metropolitan Institute for Geriatrics and Gerontology.
- This press release was originally published by Mount Sinai Health System