Research Paper Volume 8, Issue 11 pp 2927—2935

Regulation of human cerebrospinal fluid malate dehydrogenase 1 in sporadic Creutzfeldt-Jakob disease patients

Matthias Schmitz1,2, , Franc Llorens1,2, , Alexander Pracht1, , Tobias Thom1, , Ângela Correia1, , Saima Zafar1,2, , Isidre Ferrer3, , Inga Zerr1,2, ,

  • 1 From the Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
  • 2 German Center for Neurodegenerative Diseases (DZNE) – Göttingen Campus, Göttingen, Germany
  • 3 Institute of Neuropathology, Bellvitge University Hospital, CIBERNED, Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain

Received: June 27, 2016       Accepted: October 26, 2016       Published: November 14, 2016
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The identification of reliable diagnostic biomarkers in differential diagnosis of neurodegenerative diseases is an ongoing topic. A previous two-dimensional proteomic study on cerebrospinal fluid (CSF) revealed an elevated level of an enzyme, mitochondrial malate dehydrogenase 1 (MDH1), in sporadic Creutzfeldt-Jakob disease (sCJD) patients. Here, we could demonstrate the expression of MDH1 in neurons as well as in the neuropil. Its levels are lower in sCJD brains than in control brains. An examination of CSF-MDH1 in sCJD patients by ELISA revealed a significant elevation of CSF-MDH1 levels in sCJD patients (independently from the PRNP codon 129 MV genotype or the prion protein scrapie (PrPSc) type) in comparison to controls. In combination with total tau (tau), CSF-MDH1 detection exhibited a high diagnostic accuracy for sCJD diagnosis with a sensitivity of 97.5% and a specificity of 95.6%. A correlation study of MDH1 level in CSF with other neurodegenerative marker proteins revealed a significant positive correlation between MDH1 concentration with tau, 14-3-3 and neuron specific enolase level. In conclusion, our study indicated the potential of MDH1 in combination with tau as an additional biomarker in sCJD improving diagnostic accuracy of tau markedly.


Aβ: Amyloid beta; AUC: relative area under the curve; CJD: Creutzfeldt-Jakob disease; sCJD: sporadic CJD; CSF: cerebrospinal fluid; MDH1: mitochondrial malate dehydrogenase 1; NSE: neuron specific enolase; PrPC: cellular prion protein; PrPSc: scrapie prion protein; ROC: receiver operating characteristic; rpm: revolutions per minute; RT-QuIC: real-time quaking-induced conversion; SEM: standard error of the mean; S-100B: S-100 calcium-binding protein B; TSE: transmissible spongiforme encephalopathies, total tau, tau.