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

Background: Parkinson’s disease is now considered to begin decades before motor symptoms appear; diagnosis is made on the basis of clinical presentation. There is no biomarker which can exactly diagnose disease at the early stage or differentiate between IPD and PPS. We studied the role of Apo A1 and DJ1 as biomarkers in our population.

Methods: This is a cross-sectional observational study conducted at PGIMER, Chandigarh, India from Dec 2015 to Dec 2016. A total of 100 patients, IPD (n=77) and PPS (n=23) [PSP (n=14), MSA (n=7), CBD (n=2)] along with age and sex-matched controls (n=69). Written and informed consent was taken from all participants. All cases underwent detailed neurological examination, Hoehn and Yahr (H and Y) staging and MDS-UPDRS scoring. Estimation of DJ-1 and Apo A1 was done from the serum of patients and controls by ELISA.

Results: Mean age of onset was 56.55 years in IPD and 60.59 years in PPS, majority were males (M: F=78: 22). Serum DJ-1 levels were significantly decreased in cases as compared to controls (p< 0.001), but there was no difference between IPD and PPS (p< 0.852). Similarly serum Apo A1 levels were significantly lower in cases (p<0.001), but no difference between IPD and PPS (p=0.207). There was no correlation of serum DJ-1 with the age of onset (r=0.196, p=0.051), duration of illness (r=0.035, p=0.732), severity of disease as measured by UPDRS motor score (r=0.055, p=0.588) and H and Y staging (p=0.088). There was no correlation of serum Apo A1 with the age of onset (r=0.119, p=0.239), duration of illness (r=0.016, p=0.878), severity of disease as measured by UPDRS motor score (r=0.071, p=0.482) and H and Y staging (p=0.873).

Conclusions: Present study confirmed that serum Apo A1 deceases in PD patients as shown in previous studies1, however serum Apo A1 and DJ-1 could neither differentiate between IPD and PPS nor guide about the severity of illness. Serum DJ-1 levels were found to be decreased in cases as compared to healthy controls contrary to the previously studies which reports increased levels in PD2. Further studies are needed to clarify the role of these biomarkers.

References: 1. Qiang JK, Wong YC, Siderowf A, Hurtig HI, Xie SX, Lee VM, et al. Plasma apolipoprotein A1 as a biomarker for Parkinson disease. Annals of neurology. 2013;74(1):119-27. 2. Waragai M, Nakai M, Wei J, Fujita M, Mizuno H, Ho G, et al. Plasma levels of DJ-1 as a possible marker for progression of sporadic Parkinson’s disease. Neuroscience letters. 2007;425(1):18-22.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/can-blood-biomarkers-differentiate-idiopathic-parkinsons-disease-from-parkinson-plus-syndromes-a-study-from-north-indian-population/