2026-01-14 ミュンヘン大学(LMU)
<関連情報>
- https://www.lmu.de/en/newsroom/news-overview/news/new-blood-test-shows-extent-of-brain-injury-after-stroke-and-reveals-treatment-effects-c0f73443.html
- https://www.science.org/doi/10.1126/scitranslmed.adz1280
急性虚血性脳卒中の脳損傷モニタリングのための脳由来タウ Brain-derived tau for monitoring brain injury in acute ischemic stroke
Naomi Vlegels, Nicoló L. Knuth, Konstantin A. Steiner, Linjie Zhang, […] , and Steffen Tiedt
Science Translational Medicine Published:14 Jan 2026
DOI:https://doi.org/10.1126/scitranslmed.adz1280
Editor’s summary
Blood tests to monitor evolving brain injury in ischemic stroke could be a cost-effective and fast alternative to currently used noninvasive approaches such as MRI. Here, Vlegels et al. used a single-molecule detection assay on blood samples and found that brain-derived tau abundance was associated with the severity of brain injury in three cohorts of patients with ischemic stroke. Brain-derived tau in blood tracked the trajectory of brain injury (including treatment effects of recanalization and the neuroprotectant nerinetide) and could predict functional outcomes for up to 36 months. These findings suggest that brain-derived tau in blood could be used to monitor brain injury and treatment effects in patients with ischemic stroke. —Daniela Neuhofer
Abstract
A specific and accurate blood test for acute brain injury could help monitor infarct growth in ischemic stroke and serve as a surrogate end point in clinical trials. Using a single-molecule detection assay, we assessed plasma brain-derived tau (BD-tau), a marker selectively quantifying tau protein from the central nervous system, in a prospective cohort of 502 patients with acute ischemic stroke with serial blood sampling from admission to day 7. Higher BD-tau concentrations at admission were associated with more extensive early brain injury on computed tomography and predicted larger final infarct volumes. BD-tau increases from admission to day 2 were related to infarct growth. BD-tau concentrations rose until day 7 and were higher in patients with secondary events, including recurrent stroke. After thrombectomy, the rise of BD-tau was smaller in patients with complete versus incomplete recanalization. BD-tau outperformed other blood markers and imaging metrics in predicting 90-day functional outcome across infarct size strata and time points. In an independent multicenter prospective cohort (N = 519), BD-tau showed higher performance than magnetic resonance imaging–derived final infarct volume in predicting functional outcomes at 3, 12, and 36 months. In the biomarker substudy of a phase 3 trial assessing nerinetide in patients with ischemic stroke (N = 193), BD-tau showed predictive performance comparable to the other cohorts, mediated the relationship between recanalization and functional outcome, and showed a 49% smaller increase in the nerinetide group versus placebo. Overall, plasma BD-tau tracked ischemic brain injury over time, outperformed other biomarkers in predicting functional outcomes, and identified possible treatment responses.
