Objective: To study the role of serum DJ-1 and Apo A1 in the diagnosis and differentiation of Idiopathic Parkinson Disease (IPD) and Parkinson Plus Syndromes(PPS) in Indian Population. 

Background: Premotor phase of Parkinson’s disease and Parkinson plus syndromes start decades before the onset of motor symptoms. We planned to study role of Apo A1 and DJ1 as biomarkers in our population.

Methods: This cross-sectional observational study conducted at PGIMER, Chandigarh, India, included 100 patients of Parkinsonism {Idiopathic Parkinson Disease (77 patients) and Parkinson Plus Syndrome (23)}, and 69 age and sex matched controls. All cases underwent detailed neurological examination, Hoehn and Yahr (H and Y) staging and MDS-UPDRS scoring. Serum of all the cases and controls was collected for estimation of DJ-1 and Apo A1 by ELISA. 

Results: Mean age of onset was 56.55 years in IPD and 60.59 years in PPS. Males were affected more than females, M: F = 78: 22. Mean UPDRS motor score-III for IPD was 37.4. Mean UPDRS motor score-III was highest in CBD (55) with lowest duration of illness of 1.5 years (onset to diagnosis). Most of the patients fall into H and Y stage II (59%).

Plasma DJ-1 levels were significantly decreased in the serum of cases of IPD and PPS (p value< 0.001), but there was no difference between IPD and PPS (p value< 0.849). We did not find any correlation of serum DJ-1 levels with disease severity as measured by Hoehn and Yahr staging (p= 0.08).

Serum Apo A1 levels were significantly lower compared to age and sex matched healthy controls (p<0.001).  However, we could not find any correlation with the age of onset of PD, severity of disease, (p=0.378), Hoehn and Yahr staging (p=0.873), duration of illness; Also, no difference was there between IPD and PPS (p=0.182). 

Conclusions: Present study concludes that Apo A1 is a potential blood based biomarker to stratify patients at risk for development of Parkinson disease. However, serum Apo A1 could neither differentiate between Idiopathic Parkinson disease and various Parkinson Plus Syndromes nor guide about the severity of illness. The present study also indicate that serum DJ-1 levels were decreased in cases as compared to normal healthy controls. Possibly DJ-1 has antioxidant properties which are reduced in our patient population and hence they are more prone to degenerative diseases. 

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MDS Abstracts - https://www.mdsabstracts.org/abstract/to-study-the-role-of-biomarkers-dj-1-and-apo-a1-in-idiopathic-parkinsons-disease-and-parkinson-plus-syndromes-in-indian-population/