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A dual proteomics analysis of paired cerebrospinal fluid and plasma from patients with neurodegenerative diseases

Kowal, I.; Scholz, S. W.; Epstein, J.; Traynor, B. J.; Danielian, L. E.; Hao, Y.; Crook, J.; Li, Z.; Porter, K.; Sellers, B.; Langowski, T. J.; Denkinger, M. N.; Ashton, N. J.; Van Keuron-Jensen, K.; Cookson, M. R.; Kwan, J. Y.; Qi, Y. A. A.; Snyder, A.

2026-09-06 neurology
10.64898/2026.09.02.26361977 medRxiv
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INTRODUCTION: Understanding concordance across biofluids and platforms is critical for understanding neurodegenerative biomarkers results and translating them into clinical use; yet systematic comparisons remain limited. To address this gap, we performed large-scale proteomic profiling of patient-paired plasma and CSF to characterize cross-modal relationships. METHODS: We profiled paired plasma and CSF from 67 individuals using SomaScan 11K and NULISAseq CNS panels. Disease severity was assessed with the CDR+NACC FTLD-M Global Score. RESULTS: We identified 269 SomaScan and 18 NULISA proteins with significant cross-biofluid correlation. Cross-platform concordance within biofluids was strong. NEFL, NPTX2, TREM2, and CHIT1 demonstrated consistent cross-platform agreement. Associations with disease severity were compartment-specific, with decreased NPTX2 in CSF, increased NEFL and GFAP in plasma, and decreased TREM2 across biofluids. DISCUSSION: Cross-platform consistency supports biomarker robustness, while limited cross-biofluid concordance highlights compartmental biology. Given additional clinical correlations despite varying underlying pathology, these findings may point to shared neurodegenerative disorder pathways.

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