journal articles
ASSOCIATION OF PLASMA P-TAU AND P-TAU/AΒ RATIO WITH ALZHEIMER\'S PATHOLOGY
Xuhui Chen, Mingxing Jiang, Laihong Zhang, Jiayi Zhu, Anqi Li, Zhengbo He, Xin Zhou, Yalin Zhu, Chen Zhang, Cong Wang, Mingxu Li, Yiying Wang, Xinyue Ma, Binhui Liu, Rong Ma, Yipeng Jin, Xiang Fan, Zhen Liu, Tengfei Guo, Yong-An Sun, Guoyu Lan
J Prev Alz Dis 2026;3(13)
BACKGROUND: Plasma phosphorylated tau (p-tau) and β-amyloid (Aβ) are promising biomarkers for Alzheimer’s disease (AD). However, it remains unclear whether combining p-tau with Aβ provides better predictive performance than using p-tau alone.
OBJECTIVES: To evaluate the predictive utility of plasma p-tau and Aβ combinations for AD-related pathology, brain atrophy, and cognitive decline.
DESIGN, SETTING, AND PARTICIPANTS: This study included 352 participants from the Greater-Bay Area Healthy Aging Brain Study (GHABS) cohort in China, classified into 227 Aβ-negative and 125 Aβ-positive individuals.
MEASUREMENTS: Participants underwent Aβ positron emission tomography (PET) and plasma biomarker assessments. Plasma concentrations of p-tau181, p-tau217, p-tau231, Aβ42, and Aβ40 were quantified on the Quanterix HD-X and Lumipulse G1200 platform.
RESULTS: Among the individual plasma p-tau variants, p-tau217 consistently outperformed p-tau181 and p-tau231. The combination of p-tau biomarkers (p-tau181, p-tau217, and p-tau231) with Aβ42 or the Aβ42/40 ratio further improved discrimination between Aβ+/CU (cognitively unimpaired) and Aβ-/CU individuals. Both p-tau/Aβ42 and p-tau/(Aβ42/40) exhibited slightly stronger or comparable associations with Aβ PET burden, baseline and longitudinal measures of hippocampal atrophy, AD-typical cortical thinning, and cognitive decline, relative to p-tau alone.
CONCLUSIONS: The head-to-head comparisons indicate that p-tau217 is the most robust biomarker among the variants tested, and p-tau/Aβ ratios perform comparably or slightly better than p-tau alone in reflecting AD pathology, potentially providing complementary information for early detection and monitoring of disease progression.
CITATION:
Xuhui Chen ; Mingxing Jiang ; Laihong Zhang ; Jiayi Zhu ; Anqi Li ; Zhengbo He ; Xin Zhou ; Yalin Zhu ; Chen Zhang ; Cong Wang ; Mingxu Li ; Yiying Wang ; Xinyue Ma ; Binhui Liu ; Rong Ma ; Yipeng Jin ; Xiang Fan ; Zhen Liu ; Tengfei Guo ; Yong-An Sun ; Guoyu Lan (2026): Association of plasma p-tau and p-tau/Aβ ratio with Alzheimer's pathology. The Journal of Prevention of Alzheimer’s Disease (JPAD). https://doi.org/10.1016/j.tjpad.2025.100472