A meta-analysis of neurogenic exosomes in the diagnosis of Alzheimer's disease

BACKGROUND: Alzheimer's disease (AD) is an irreversible and difficult-to-treat neurodegenerative disease. It is necessary to search for reliable biomarkers for the early diagnosis of AD in a timely and effective manner in high-risk or preclinical AD populations. Studies have shown that neurogenic exosomes in the blood can be effectively used as biomarkers for AD. OBJECTIVE: In this meta-analysis, we aimed to find reliable biomarkers (Aβ42, T-tau, and P-tau181 in peripheral blood neurogenic exosomes) for the early diagnosis of AD to provide theoretical support for the early diagnosis of high-risk or preclinical AD populations. METHODS: By searching the literature database, relevant studies on AD diagnostic markers were collected. The study period was from April 1, 2012, to April 1, 2022. The average concentrations of Aβ42, T-tau, and P-tau181 in the exosomes of the AD group and healthy control group were compared using RevMan 5.3 software. RESULTS: A total of 13 studies were screened, including 842 subjects. Meta-analysis showed that the combined SMD value of neurogenic exosome Aβ42 was 1.70 (95% CI = [1.20,2.20], Z = 6.69, P < 0.05). The combined SMD value of T-tau was 1.02 (95% CI = [0.27,1.77], Z = 2.67, P < 0.05). The combined SMD value of P-tau181 was 1.75 (95% CI = [1.16, 2.35], Z = 5.75, P < 0.05). The levels of neurogenic exosomes Aβ42, T-tau, and P-tau181 in AD patients were significantly higher than those in healthy controls. CONCLUSION: Aβ42, T-tau, and P-tau181 in blood neurogenic exosomes can be effectively used as biomarkers for AD and can be applied in the diagnosis, screening, prognosis prediction and disease monitoring of AD.