Cross‐cultural validation of plasma p‐tau217 and p‐tau181 as precision biomarkers for amyloid PET positivity: An East Asian study in Taiwan and Korea
Yung‐Shuan Lin, Hyuk Sung Kwon, Wei‐Ju Lee, Mina Hwang, Jee Hyang Jeong, Seong‐Ho Koh, Seong Hye Choi, Jong‐Ling Fuh
Abstract
INTRODUCTION: Plasma phosphorylated tau (p-tau) biomarkers have improved Alzheimer's disease (AD) diagnosis, but data from diverse Asian populations are limited. This study evaluated plasma p-tau217 and p-tau181 levels in Korean and Taiwanese populations. METHODS: All participants (n = 270) underwent amyloid positron emission tomography (PET) and blood tests. Plasma p-tau model-derived probabilities of amyloid PET positivity (amyloid beta [Aβ]+) classified participants into low-, intermediate-, or high-risk groups. RESULTS: = 0.022). Including apolipoprotein E status and glial fibrillary acidic protein improved model fit. The negative predictive value of the low-risk group and positive predictive value of the high-risk group were 97.5% and 86.0%, respectively. DISCUSSION: Plasma p-tau217 and p-tau181 effectively predict Aβ+ among culturally different Asian populations. P-tau217 performed better, especially in the early stages of AD. Plasma p-tau217-based models reduced intermediate-risk classifications, suggesting fewer amyloid PET scans needed to confirm the diagnosis. HIGHLIGHTS: The efficacy of plasma phosphorylated tau (p-tau)217 and p-tau181 was analyzed in two Asian populations. Plasma p-tau217 performs better in predicting amyloid positron emission tomography positivity, especially in cognitively unimpaired subjects. Adding apolipoprotein E and glial fibrillary acidic protein to p-tau improved model accuracy. The models from each cohort were confirmed in the other cohort. Plasma p-tau-based risk stratification may reduce the need for confirmatory tests.