Avances y desafíos en la detección de α-sinucleína como biomarcador en sinucleinopatías
Filiación institucional
Francisco Bordón Cueto
Autor de contacto. Doctor en Ciencias Farmacéuticas - Investigador y Docente - Cátedra Módulo Clínico Fisiopatológico I y II - Facultad de Ciencias Médicas Universidad Fasta. Código ORCiD 0009-0003-9984-7788.
E-mail: alpena@ufasta.edu.ar
Alberto Peña
Médico psiquiatra- Investigador y Docente - Catedra de Medicina, Persona y Comunidad I-Cátedra de Salud mental II y III-Facultad de Ciencias Médicas-Universidad Fasta.
E-mail: franzb@ufasta.edu.ar
Resumen
La α-sinucleína (α-Syn) se ha consolidado como un biomarcador clave en sinucleinopatías como la enfermedad de Parkinson, la demencia con cuerpos de Lewy y la atrofia multisistémica. Inicialmente estudiada por la disminución de α-Syn total en líquido cefalorraquídeo, el campo avanzó hacia técnicas ultrasensibles como RT-QuIC y PMCA, capaces de detectar especies patológicas en fases prodrómicas. Estos ensayos incrementan la precisión diagnóstica y facilitan la estratificación de pacientes, mientras que matrices alternativas como sangre o lágrimas ofrecen enfoques menos invasivos. No obstante, la falta de estandarización y la variabilidad limitan su implementación clínica.
Bibliografía
Alexander Maximilian Bernhardt, M. N. (2024). α-Synuclein Seed Amplification Assays from Blood-Based Extracellular Vesicles in Parkinson's Disease: An Evaluation of the Evidence. Movement Disorders, 39(8), 1269-1271. DOI: 10.1002/mds.29923
Alfaidi M, B. R. (2024). An update on immune-based alpha-synuclein trials in Parkinson's disease. J Neurol., 272(1), 1-9. 10.1007/s00415-024-12770-x
Atik, A. S. (2016). Alpha-Synuclein as a Biomarker for Parkinson’s Disease. Brain Pathology, 26(3), 410–418. DOI: 10.1111/bpa.12370
Burré J, S. M. (2015). Definition of a molecular pathway mediating α-synuclein neurotoxicity. J Neurosci., 1(35), 5221-32. DOI: 10.1523/JNEUROSCI.4650-14.2015
Cabin DE, S. K. (2002). Synaptic vesicle depletion correlates with attenuated synaptic responses to prolonged repetitive stimulation in mice lacking alpha-synuclein. . J Neurosci., 34(6), 971–82. DOI: 10.1523/JNEUROSCI.22-20-08797.2002
Candelise, N. B. (2020). Ultrasensitive RT-QuIC assay with high sensitivity and specificity for Lewy body-associated synucleinopathies. Acta Neuropathologica, 140(1), 49–62. DOI: 10.1007/s00401-020-02160-8
Carnazza KE, K. L. (2022). Synaptic vesicle binding of α-synuclein is modulated by β- and γ-synucleins. Cell Rep., 39(2), 110675. doi: 10.3390/biomedicines10123241
Caughey, B. &. (2020). Proteopathic seed amplification assays for neurodegenerative disorders. Clinics in Laboratory Medicine, 40(2), 257–270. DOI: 10.1016/j.cllc.2020.01.005
Chen, L. e. (2024). α-Syn SAA para diagnóstico de sinucleinopatías: avance del campo. Translational Neurodegeneration, 13, 14. DOI: 10.1186/s40035-024-00449-2
Eusebi, P. G. (2017). Diagnostic utility of cerebrospinal fluid α-synuclein in Parkinson’s disease: A systematic review and meta-analysis. Movement Disorders, 32(10), 1389–1400. DOI: 10.1002/mds.27110
Fairfoul, G. M. (2016). Alpha-synuclein RT-QuIC in the CSF of patients with alpha-synucleinopathies. Annals of Clinical and Translational Neurology, 3(10), 812–818. DOI: 10.1002/acn3.338
Graves NJ, G. Y. (2023). α-Synuclein Strains and Their Relevance to Parkinson's Disease, Multiple System Atrophy, and Dementia with Lewy Bodies. Int J Mol Sci., 24(15), 12134. DOI: 10.3390/ijms241512134
Groveman BR, O. C. (2018). Rapid and ultra-sensitive quantitation of disease-associated α-syn seeds by αSyn RT-QuIC. Acta Neuropathologica Communications, 6(1), 7. DOI: 10.1186/s40478-018-0508-2
Iranzo A, F. G.-V. (2021). Detection of α-synuclein in CSF by RT-QuIC in patients with isolated rapid-eye-movement sleep behaviour disorder: a longitudinal observational study. Lancet Neurol., 20(3), 203-212. DOI: 10.1016/S1474-4422(20)30449-X
Jankovic J, G. I. (2018). Safety and Tolerability of Multiple Ascending Doses of PRX002/RG7935, an Anti–α-Synuclein Monoclonal Antibody, in Patients With Parkinson Disease: A Randomized Clinical Trial. JAMA Neurol.,75(10), 1206–1214. DOI: 10.1001/jamaneurol.2018.1487
Kang UJ, B. A. (2019). Comparative study of cerebrospinal fluid α-synuclein seeding aggregation assays for diagnosis of Parkinson's disease. Mov Disord., 34(4), 536-544. DOI: 10.1002/mds.27646
Korat S, B. N. (2021). Alpha-synuclein PET tracer development-an overview about current efforts. Pharmaceuticals (Basel), 14(9), 2-47. DOI: 10.3390/ph14090847
Lambertsen, K. L. (2020). Increased alpha-synuclein tear fluid levels in patients with Parkinson’s disease. Scientific Reports, 10, 9503. DOI: 10.1038/s41598-020-65503-1
Lashuel HA, O. C. (2013). The many faces of α-synuclein: from structure and toxicity to therapeutic target. Nat Rev Neurosci., 14(1), 38-48. DOI: 10.1038/nrn3406
Lashuel HA, S. D. (2025). Alpha-synuclein seed amplification assays: Data sharing, standardization needed for clinical use. Sci Adv., 11(14), eadt7195. DOI: 10.1126/sciadv.adt7195
Lin CH, Y. S. (2017). Plasma α-synuclein predicts cognitive decline in Parkinson's disease. J Neurol Neurosurg Psychiatry, 88(10), 818–824. DOI: 10.1136/jnnp-2016-314857
azzetti, S. B. (2022). Alpha-synuclein oligomers in CSF of patients with synucleinopathies: Correlation with disease phenotype and progression. Brain, 145(2), 584–596. DOI: 10.1093/brain/awab466
Mollenhauer, B. &. (2019). CSF and blood biomarkers for Parkinson’s disease. The Lancet Neurology, 18(6), 573–586. DOI: 10.1016/S1474-4422(19)30024-9
Pagano G, B. F.-C. (2021). A Phase II Study to Evaluate the Safety and Efficacy of Prasinezumab in Early Parkinson's Disease (PASADENA): Rationale, Design, and Baseline Data. Front Neurol., 12, 1-17. DOI: 10.3389/fneur.2021.705407
Pagano, G. M. (2024). Sustained effect of prasinezumab on Parkinson’s disease motor progression in the open-label extension of the PASADENA trial. Nat Med, 30, 3669–3675. DOI: 10.1038/s41591-024-03270-6
Poggiolini I, G. V.-T.-C.-D.-S.-L.-S. (2022). Diagnostic value of cerebrospinal fluid alpha-synuclein seed quantification in synucleinopathies. Brain, 145(2), 584-595. DOI: 10.1093/brain/awab431
Polymeropoulos MH, e. a. (1997). Mutation in the α-Synuclein Gene Identified in Families with Parkinson's Disease . Science, 276(5321), 2045-2047.
Rossi M, B. S.-M. (2021). Diagnostic Value of theCSF α-Synuclein Real-Time Quaking-Induced Conversion Assay at the Prodromal MCI Stage of Dementia With Lewy Bodies. Neurology, 97(9), e930-e940. doi: 10.3389/fmolb.2023.1193458
Rossi M, C. N.-B. (2020). Ultrasensitive RT-QuIC assay with high sensitivity and specificity for Lewy body-associated synucleinopathies. Acta Neuropathol., 140(1), 49-62. DOI: 10.1007/s00401-020-02160-8
Russo MJ, O. C.-M.-G. (2021). High diagnostic performance of independent alpha-synuclein seed amplification assays for detection of early Parkinson's disease. Acta Neuropathol Commun., 9(1), 179. DOI: 10.1186/s40478-021-01282-8
Sezgi Canaslan, M. S. (2025). Detection of alpha synuclein seeding activity in tear fluid in patients with Parkinson’s disease. bioRxiv his article is a preprint and has not been certified by peer review, This article is a preprint and has not been certified by peer review, 1-17. https://www.nature.com/articles/s41531-026-01282-2
Shahnawaz, M. M. (2020). Discriminating α-synuclein strains in Parkinson’s disease and multiple system atrophy. Nature, 578 (7794), 273–277. DOI: 10.1038/s41586-020-1984-7
Shahnawaz, M. T. (2017). Development of a biochemical diagnosis of Parkinson disease by detection of alpha-synuclein misfolded aggregates in cerebrospinal fluid. JAMA Neurology, 74(2), 163–172. DOI: 10.1001/jamaneurol.2016.4547
Siderowf, A. C.-M. (2023). Assessment of heterogeneity among participants in the Parkinson's Progression Markers Initiative cohort using α-synuclein seed amplification: a cross-sectional study. The Lancet. Neurology, 22(5), 407–417. DOI: 10.1016/S1474-4422(23)00109-6
Spillantini, M. S. (1997). α-sinucleína en cuerpos de Lewy. Nature, 388, 839–840. DOI: 10.1038/42166
Surendranathan, A. K. (2020). Clinical diagnosis of Lewy body dementia. BJPsych open, 6(4), 1-8. DOI: 10.1192/bjo.2020.44
Vekrellis, K. &. (2012). Targeting intracellular and extracellular alpha-synuclein as a therapeutic strategy in Parkinson's disease and other synucleinopathies. Expert Opinion on Therapeutic Targets, 16(4), 421–432 . 10.1016/j.pharmthera.2013.01.013
Yu Z, L. G. (2022). Erythrocytic α-Synuclein Species for Parkinson's Disease Diagnosis and the Correlations With Clinical Characteristics. Front Aging Neurosci., 14(827493), 1-7. DOI: 10.3389/fnagi.2022.827493