Diagnostics | Industry Spotlights & Insight Articles

Urinary Biomarker Detects Early Onset of Alzheimer’s Disease

Discovery of a new sensitive urinary biomarker could pave the way for cost-effective and large-scale screening of neurodegenerative disease.

Shanghai Jiao Tong University researchers have identified formic acid as a urinary biomarker for early Alzheimer’s Disease (AD) screening. Published in the journal Frontier in Aging Neuroscience, the paper proposed “the possibility of urinary formic acid as a potential novel biomarker for the early diagnosis of AD”.

AD is the most common form of neurodegenerative disease and can often remain undetected until it is too late. According to the paper, “the main pathological features of AD include abnormal accumulation of extracellular β-amyloid (Aβ), abnormal accumulation of neurofibrillary tangles of Tau protein, and synaptic damage.” However, the co-authors explained how the pathogenesis of AD is not understood fully.

To rectify this, the researchers investigated biomarkers for intervention and treatment. They stated, “given the ageing of the global population and the enormous social costs caused by AD, large-scale early screening of AD is necessary.” For instance, whilst positron emission tomography-computed tomography (PET-CT) scans can detect premature signs of Aβ deposits, the technique can expose patients to radiation and is extremely expensive. Other commonly used biomarkers include invasive cerebrospinal fluid testing. 

Therefore, the study aimed to investigate alternative methods of biomarker testing and consequent screening potential. Researchers set out to further establish the already-known relationship between urinary formic acid and plasma biomarkers in AD by testing 574 participants.

Each participant was split into the following five groups according to their diagnosis: normal cognitive (71), subjective cognitive decline (101), cognitive impairment without mild cognitive impairment (131), mild cognitive impairment (158), and those with confirmed AF (113). Urine and blood samples were taken and analysed from each participant to identify the differences in urinary biomarkers. Researchers performed psychological evaluations alongside.

Results showed that urinary formic acid levels increased with disease progression.

Results showed that urinary formic acid levels increased with disease progression. The researchers concluded that “urinary formaldehyde levels were related to APOE ε4 genotype and the presence of Aβ depositions in the brain. Urinary formic acid and formaldehyde levels could not only be used for differentiation between AD and [normal cognition] but also could improve the prediction accuracy of plasma biomarkers for disease stages of AD.”  

The investigation’s systematic evaluation demonstrated the potential of using urinary formic acid as a biomarker for early diagnosis and detection of AD.

Wang, Y., Wang, Y., Zhu, J., Guan, Y., Xie, F., Cai, X., Deng, J., Wei, Y., He, R., Fang, Z., & Guo, Q. (2022). Systematic evaluation of urinary formic acid as a new potential biomarker for Alzheimer’s disease. Frontiers in Aging Neuroscience, 14. https://doi.org/10.3389/fnagi.2022.1046066

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