The Search for Biomarkers: from Diagnosis to Progression Assessment
Prof. Thomas Müller E-Mail
Professor at Department of Neurology, St. Joseph Hospital Berlin-Weissensee, Berlin, Germany
Research Keywords: functional brain imaging techniques; neurodegenerative diseases; Parkinson’s disease; Huntington’s disease and dementia; chronic neuroinflammatory diseases; Alzheimer's disease
A biomarker represents a characteristic feature of biological or pathogenic processes or pharmacological responses following a therapeutic intervention. Biomarker as surrogate indicator support the understanding of physiological or pathological mechanisms in terms of diagnosis, prediction, monitoring of health and disease.
A biomarker is particularly suitable, when taken from body fluids or tissues. Commonly analyses are performed by biochemical, molecular, cellular and histological procedures.
Generally, disease causing and promoting pathomechanisms are often diverse and involve various molecular and cellular aspects. They may include conformational changes, propagation and biologic alterations of certain proteins. They may also reflect cellular damage, which results – as popular example- in an increased synthesis of neurofilaments. Modification of small non-coding RNA levels, lymphocyte and inflammatory profiles may also serve as biomarker.
However, the underlying disease processes do not consistently translate to individual clinical presentations. The individual disease course is different. These clinical features often limit the value of biomarkers. Currently a clinical applicable biomarker with a high sensitivity and specificity does not exist for diagnostic and/or therapeutic purposes in chronic neurodegeneration, since its heterogeneity applies to both phenotype and genotype or epigenetic factors. Molecular genetic investigations have raised hopes of earlier diagnosis and opened new therapeutic neuroprotective and disease modifying approaches. To date, many studies outcomes scrutinize the chronic disease theories on development and pathological mechanisms, which have been favored for a long time. The idea of a single, ideal biomarker for diagnostic, progression purposes or monitoring therapeutic interventions in chronic neurodegeneration to develop neuroprotective therapies is fascinating, but failed to date in clinical practice. This compilation aims to present new windows in biomarker research and to facilitate accurate diagnosis and treatment in chronic neurodegeneration and chronic neuroinflammation to pave the road to better future success.
Keywords: chronic neurodegeneration; chronic neuroinflammation; neuroprotection; disease modification; nervous system