A method to solubilise protein aggregates for immunoassay quantification which overcomes the neurofilament “hook” effect
Graphical abstract
Research highlights
▶ Plasma neurofilament (Nf) levels may be a biomarker of neurodegenerative disease. ▶ Nf aggregates cause a ‘hook effect’ that prevents accurate quantification by ELISA. ▶ A new method to dissolve Nf aggregates and abolish the hook effect was developed. ▶ The method is sensitive, accurate and reproducible. ▶ Detects pathological increases in Nf levels in plasma of mSOD1 mice that model ALS.
Introduction
Neurodegeneration is the final pathological pathway for a number of neurological conditions in which the presence of protein aggregates is a common feature (Troy et al., 1997, David et al., 2010). Current strategies to treat these fatal conditions are largely focused on neuroprotection as neuronal death and axonal loss are still irreversible in the human central nervous system (CNS). For the patient this means an inexorable loss of function, progressive disability and premature death. An important limitation for the assessment of disease progression and the effectiveness of neuroprotective treatments is that accurate quantification of loss of function on a clinical scale remains the primary outcome measure (Winhammar et al., 2005, Tuner et al., 2009). Because of functional redundancy in the CNS, a large number of neurons need to be lost before disease progression becomes detectable clinically. Consequently clinical scales are not very sensitive for picking up early or small levels of neurodegeneration. Therefore it would be desirable to quantify and monitor the loss of neurons and axons in vivo before deterioration becomes detectable with current clinical scales (Shefner, 2001, Petzold, 2005, Winhammar et al., 2005, Tuner et al., 2009). One approach is to measure proteins which are released from the degenerating neurons and axons into the adjacent body fluid compartment. Neurofilaments are specific protein biomarkers that have been previously investigated for neurodegenerative disorders (Petzold, 2005, Shaw et al., 2005).
Neurofilaments (Nf) are heteropolymers consisting of at least four subunits, a heavy (NfH), medium (NfM), light (NfL) chain and alpha-internexin (Petzold, 2005, Perrot et al., 2008). Typically these heteropolymers can readily be dissolved with the aid of Ca2+-chelators (Yabe et al., 2001a, Yabe et al., 2001b, Kushkuley et al., 2009, Kushkuley et al., 2010). For this reason the sample incubation buffer of ELISA systems used to quantify Nf levels typically contain EDTA or EGTA (Yabe et al., 2001a, Yabe et al., 2001b). We have previously shown that formation of NfH protein aggregates may occur in vitro and that this aggregation can be overcome mechanically by sonication or by time (Petzold et al., 2003). Nf aggregate formation is known to occur in vivo in a number of neurodegenerative diseases and animal models (see Table 1) and in many cases Nf aggregates increase as disease progresses. Accurate measurement of Nf levels may therefore be a useful biomarker of disease progression in such disorders. However, precise quantification of NfH levels in biological samples by immunoassay may be corrupted in at least four ways: (i) the immunoassay relevant NfH epitope may be masked by the aggregate, (ii) there may be reduced solubility of NfH aggregates, (iii) the protein stability of NfH monomers in solution may differ from the stability of NfH in aggregates, (iv) aggregates may bind soluble NfH. All of these mechanisms will cause a doubling dilution of biological samples to behave differently from a doubling dilution of a soluble, stable NfH protein standard. Typically in biological samples such as blood, cerebrospinal fluid (CSF) or other body fluids, one observes a “hook effect” diverging from the linear range of the NfH standard curve. If this is the case, then parallelism is not achieved (Plikaytis et al., 1994). Consequently the results are inconclusive because after correcting for the dilution factor, the protein concentrations calculated from a 1:1 dilution will still be very different to the protein concentrations calculated from other sample dilutions.
Protein aggregate formation and lack of parallelism is likely to be a fundamental problem for the accurate measurement of NfH levels in a number of neurodegenerative conditions and models. In this study, using plasma samples from 120-day SOD1G93A mice that model ALS, we tested a number of protocols designed to overcome protein aggregate formation and achieve parallelism without compromising protein stability or damaging the relevant epitope or NfH phosphorylation status.
Section snippets
Experimental animals
Mice expressing the human SOD1G93A mutant protein were bred and maintained within the biological services facility of the UCL Institute of Neurology under licence from the UK Home Office and following ethical approval from the Institute. The presence of the SOD1G93A mutation was confirmed by PCR reaction from ear biopsies of 3 weeks old mice. Male SOD1 mice were examined at 120 days of age, near to end stage in our colony of SOD1G93A mice (Kalmar et al., 2008). Wild type (WT), age- and
Plasma NfH aggregates cause a “hook effect”
A “hook effect” was observed for the dilution of plasma samples from 120-day-old SOD1G93A mice (Fig. 1A), while the plasma levels from their age-matched WT littermates were undetectable (data not shown). The resulting lack of parallelism between SOD1G93A plasma samples and standards introduced an analytical error averaging at 300% for a 1:16 dilution (Fig. 1B). Subsequent immunoblotting showed that this lack of parallelism was likely to be due to a combination of NfH aggregate formation (see
Discussion
Here we describe a method which overcomes a crucial analytical problem for the accurate quantification of NfH levels, a protein biomarker for neurodegenerative disorders such as amyotrophic lateral sclerosis, Alzheimer's and Parkinson's diseases. We and others (Personal communication Robert Bowser, Pittsburg, USA; Jens Kuhle, Basel, CH) have previously experienced analytical difficulties with reliable and reproducible quantification of NfH levels in blood samples of mutant SOD1 mice and
Conclusion
Nf aggregates are a hallmark of ALS and other neurodegenerative disorders and pose an important pre-analytical problem for quantitative immunoassay of Nf levels. In this study we showed that the presence of these aggregates is a source of endogenous binding for NfH in plasma which leads to a ‘hook effect’ during serial dilutions. To overcome this problem we developed a method which allows us to gently break up Nf aggregates, improving parallelism and thus allowing for quantification of plasma
Acknowledgements
This project is funded by Motor Neuron Disease Association. LG is the Graham Watts Senior Research Fellow, funded by The Brain Research Trust.
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