Background: Heme oxygenase-1 (HO-1) is a 32-kDa stress protein that catalyz
es the degradation of heme to biliverdin. HO-1 immunoreactivity is greatly
increased in neurons and astrocytes of the hippocampus and cerebral cortex
of individuals with AD and colocalizes to senile plaques and neurofibrillar
y tangles. Methods: We investigated whether systemic HO-1 regulation is als
o deranged in AD patients and whether blood HO-1 measurements provide a per
ipheral biomarker of the disease. Plasma HO-1 protein levels were measured
by competitive ELISA and lymphocyte HO-1 mRNA levels were determined by Nor
thern analysis in patients with early probable sporadic AD, normal elderly
controls (NEC), normal younger controls, individuals with age-associated co
gnitive decline (AACD) not meeting AD criteria, and patients with non-Alzhe
imer dementia, nondementing neurologic illness, and chronic medical disorde
rs. CSF HO-1 protein concentrations were also determined by ELISA in pathol
ogically confirmed AD and control cases. Results: Mean plasma HO-1 protein
concentrations were significantly lower in AD patients (0.85 +/- 0.14 mu g/
mL) compared with NEC (1.77 +/- 0.34 mu g/mL; p < 0.05) and control patient
s. The AACD group exhibited plasma HO-1 concentrations (1.06 +/- 0.33 mu g/
mL) intermediate between, but not different from, those of the AD patients
and NEC. Lymphocyte HO-1 mRNA levels were lower in the AD cohort relative t
o NEC (p < 0.001) and individuals with AACD, non-Alzheimer dementia, nondem
enting neurologic illness, and chronic medical conditions. Lymphocyte HO-1
mRNA levels were also lower in the AACD group relative to NEC (p < 0.05). I
n comparison with all groups excluding AACD, the sensitivity and specificit
y of lymphocyte HO-1 mRNA measurement for diagnosis of early sporadic AD ar
e 88% and 75%. Mean CSF HO-1 protein concentrations were lower (p < 0.01) i
n AD cases (19.07 ng/mL) relative to control values (32.48 ng/mL). Conclusi
ons: Plasma and CSF HO-1 protein and lymphocyte HO-1 mRNA levels are decrea
sed in subjects with sporadic AD. Quantitative assay for lymphocyte HO-1 mR
NA expression may serve as a useful biologic marker in early sporadic AD.