Plasma biomarker changes following deep cervical lymphatic venous anastomosis: An exploratory study in Alzheimer's disease using single-molecule array technology

BackgroundDeep cervical lymphatic venous anastomosis (dcLVA) is a novel surgical approach for patients with Alzheimer's disease (AD). Its theoretical basis lies in the promotion of the clearance of large biomolecular metabolites in the central nervous system by unblocking the deep cervical lymphatic system. Currently, there is a lack of systematic and comprehensive research on biomarkers for monitoring disease progression and therapeutic efficacy in patients with AD after treatment. Single-molecule technology is applied widely in the field of medicine to detect trace amounts of proteins, especially for detecting the biomarkers related to neurodegenerative diseases such as AD.ObjectiveThis study presents the data of 30 AD patients who underwent dcLVA surgery and the results of analyzing AD biomarkers, exploring the efficacy of dcLVA treatment, and explores whether peripheral blood biomarkers could be used to monitor the treatment effects.MethodsUsing single-molecule technology to detect dynamic changes in blood biomarkers, combined with cognitive scores and Clinician's Interview-Based Impression of Change Plus (CIBIC-plus) data, a prognostic prediction model is constructed.ResultsThe results show that dcLVA surgery elevates peripheral blood amyloid-β (Aβ)₄₂ levels which correlate significantly with the CIBIC plus score. The combination of Aβ₄₂ and Aβ_42/40 achieved the highest AUC (0.737) at 180 days post-surgery, showing good diagnostic performance and potential as a prognostic biomarker for dcLVA surgery.ConclusionsBy leveraging the dynamic changes of blood biomarkers, it is helpful to adjust the treatment plan in a timely manner, thereby achieving personalized treatment and improving the treatment effectiveness.