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Plasma proteomics reveals stage-dependent biological remodelling in Alzheimer's disease
Gu, Y.; Kim, J. P.; Kim, B. H.; Lee, H.; Lee, J.; Kang, H.; Yim, S.; Shin et al.. medRxiv (preprint), 2026-09-14
Topic: Amyloid, tau and blood-test diagnosis
Plasma biomarkers of amyloid-associated tau phosphorylation (T1) and established tau proteinopathy (T2) can approximate Alzheimers disease stage, but whether plasma-defined stages correspond to broader biological states is unknown. In 1,035 participants from a multicentre Korean cohort, we used a 220-plex immunoassay platform to compare T1/T2 biomarkers against amyloid and tau positron emission tomography anchors and construct a five-stage framework. Brain-derived phosphorylated tau 217 and endogenously cleaved microtubule-binding-region tau formed the parsimonious backbone. Baseline stage ordered Clinical Dementia Rating-Sum of Boxes trajectories, and forward within-person stage movement was associated with faster clinical worsening. Among 197 non-tau proteins, 34 were stage-associated; the T1-positive transition showed the broadest proteomic shift, with more selective remodelling later. In serial samples, 15 proteins changed longitudinally, with 13 recapitulating the cross-sectional stage pattern. Thus, plasma-defined disease position mapped onto distinct, partly dynamic biological states beyond the defining T1/T2 biomarkers.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Gu, Y., Kim, J. P., Kim, B. H., Lee, H., Lee, J., Kang, H., et al. (2026). Plasma proteomics reveals stage-dependent biological remodelling in Alzheimer's disease. medRxiv (preprint). https://doi.org/10.64898/2026.09.14.26362968
Vancouver
Gu Y, Kim JP, Kim BH, Lee H, Lee J, Kang H, et al. Plasma proteomics reveals stage-dependent biological remodelling in Alzheimer's disease. medRxiv (preprint). 2026. doi:10.64898/2026.09.14.26362968.
BibTeX
@article{gu2026-531152d3,
author = {Gu, Y. and Kim, J. P. and Kim, B. H. and Lee, H. and Lee, J. and Kang, H. and Yim, S. and Shin and others},
title = {{Plasma proteomics reveals stage-dependent biological remodelling in Alzheimer's disease}},
journal = {medRxiv (preprint)},
year = {2026},
doi = {10.64898/2026.09.14.26362968},
url = {https://doi.org/10.64898/2026.09.14.26362968}
}
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Key findings
- Baseline stage ordered Clinical Dementia Rating-Sum of Boxes trajectories, and forward within-person stage movement was associated with faster clinical worsening.
Why it matters
This study used plasma proteomics to define five stages of Alzheimer's disease that mapped onto distinct biological states and ordered clinical trajectories. It is about staging and understanding disease biology, not about treating, curing, or preventing Alzheimer's disease.
New to this subject? Start with our plain-English guide: Blood tests & biomarkers →
Study details
- Study designcross-sectional
- Participants1,035
- Evidence strengthModerate
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 36 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for effect reported and randomised / blinded because the record does not state it. We have no data on impact for its field and year, so that was left out: it earned 34 of the 94 points we could judge it on, which is 36 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (medRxiv (preprint)) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 3 / 4 | 1,035 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Sang Won Seo: h-index 47 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University College London: institution h-index 2,029 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 19 institution(s) in 3 countries |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Points | 34 / 94 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 34 of the 94 points we could judge it on is 36 out of 100. |
| Total | 36 / 100 | Capped to 16 because this is not a peer-reviewed article. |
What each of these 20 components measures, and what this score is not →
Read the original
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