Anti-heparan sulfate antibodies: Possible marker for vascular dementia?

The availability of specific biologic markers may greatly improve early diagnosis of dementia. Whereas CSF tau and beta42 peptide levels are sensitive markers of Alzheimer's Disease (AD), no reliable biochemical tests are so far available for Vascular Dementia (VD). Increasing evidence supports a pathogenic role of Heparan Sulfate (HS) in the development of dementia. Using an innovative ELISA, we tested sera from patients with AD and other neurological diseases, for the presence of antibodies (Abs) to HS. We did not find increased titres of anti-HS Abs in AD patients. Interestingly, however, high titres were present in subjects with vascular damage, due to cerebral vasculitis/vasculopathy. Because HS proteoglycans arc present in the endothelial cells and perivascular basement membrane, these findings rise the possibility of assessing these Abs as possible markers of VD, in which the combined analysis of CSF tau and beta42 peptide yields the lowest specificity. Only a prospective study on a large cohort of patients with cognitive impairment of different ethiology will clarify whether anti-HS Abs could be diagnostic or predictive markers of VD.