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Ore be a subgroup of neurodegenerative diseases with cerebral protein aggregation. Interestingly, Serpin A1 is not only involved in folding of other proteins but also is, like tau protein and amyloid-beta peptides, able to polymerise and form aggregates itself [44,45,46]. Those aggregates were investigated in some diseases with liver-cirrhosis where Serpin A1-aggregation can be detected in liver tissue [45]. Additionally, those aggregations were found to be relevant in the development of a dementia syndrome caused by autosomaldominant familiar encephalopathy with neuroserpin inclusion bodies, indicating that both diseases may belong to the common disease entity of serpinopathies [45,47,48]. One could hypothesize that the formation of Serpin A1 aggregates takes place in PDD, possibly triggered by differences in posttranslational modifications ?(hyper-)sialylation instead of phosphorylation ?leading to a different structure and (mal-)function of the protein so that the formation of aggregates is favoured. In order to refute or confirm this theory, further investigations especially pathophysiological-, histological- and animal-based ones are necessary. Here, a comprehensive amount of patients should be investigated. Independent of these pathophysiological hypotheses, we suppose that the hypersialylated isoforms of Serpin A1 have a predictive value for the development of dementia in 26001275 PD patients which is worth to be followed up.Materials and Methods Ethics StatementThis study was conducted according to the principles expressed in the Declaration of Helsinki. The local ethics committees (EthikKommission der Medizinischen Fakultat der Universitat Ulm, ??approval numbers: 8801 and 100305 and the regional Ethical Committee Board (CEAS) of the University of Perugia, protocol number 19369/08/AV as well as the Ethics Committee of Kuopio University Hospital, number 5/2002) approved all experiments within our study. All patients provided written informed consent for the collection of samples and subsequent analysis. In case of severe demented patients, their relatives gave written informed consent to their participation in the study. The capacitiy of the patients to consent was assessed by means of clinical, neurological and neuroradiological examinations as well as a neuropsychological screening to investigate global cognitive functions. All PD and PDD patients underwent a detailed psychometric test battery (in detail described in [26]), covering the following tests: MMSE, Geriatric Depression scale, Parkinson Neuropsychometric Dementia Assessment, A-196 price Regensburger Wortfluessigkeitstest (RWT), Doors Test, Alertness/Go/NoGo/geteilte Aufmerkamkeit, Boston Naming Test, Wechsler Memory Scale (WMS-R), Melmstaedter, Coloured Progressive Marices, VOSP, Clock Test.PatientsAll CSF samples used for the proteomic approach were taken from patients attending the general outpatient clinic (University of Ulm, AKT inhibitor 2 Department of Neurology) in 2006/2007. CSF was stored atSerpin A1 in the Diagnosis of Parkinson-DementiaFigure 3. 1D- and 2D-immunoblots of Serpin A1. 3A shows 1D-immunoblot band volumes (adjusted for membrane background) of Serpin A1. 3B shows the statistical analysis for the 1D-immunoblot validation of all proteins found to be regulated in the 2D DIGE experiment. Only Serpin A1 displayed a significant regulation. 3C illustrates the 2D immunoblot of Serpin A1 with the different spot-pattern in PD/CON and PDD with the relevant additional spots 1 and/or 2 in PDD.Ore be a subgroup of neurodegenerative diseases with cerebral protein aggregation. Interestingly, Serpin A1 is not only involved in folding of other proteins but also is, like tau protein and amyloid-beta peptides, able to polymerise and form aggregates itself [44,45,46]. Those aggregates were investigated in some diseases with liver-cirrhosis where Serpin A1-aggregation can be detected in liver tissue [45]. Additionally, those aggregations were found to be relevant in the development of a dementia syndrome caused by autosomaldominant familiar encephalopathy with neuroserpin inclusion bodies, indicating that both diseases may belong to the common disease entity of serpinopathies [45,47,48]. One could hypothesize that the formation of Serpin A1 aggregates takes place in PDD, possibly triggered by differences in posttranslational modifications ?(hyper-)sialylation instead of phosphorylation ?leading to a different structure and (mal-)function of the protein so that the formation of aggregates is favoured. In order to refute or confirm this theory, further investigations especially pathophysiological-, histological- and animal-based ones are necessary. Here, a comprehensive amount of patients should be investigated. Independent of these pathophysiological hypotheses, we suppose that the hypersialylated isoforms of Serpin A1 have a predictive value for the development of dementia in 26001275 PD patients which is worth to be followed up.Materials and Methods Ethics StatementThis study was conducted according to the principles expressed in the Declaration of Helsinki. The local ethics committees (EthikKommission der Medizinischen Fakultat der Universitat Ulm, ??approval numbers: 8801 and 100305 and the regional Ethical Committee Board (CEAS) of the University of Perugia, protocol number 19369/08/AV as well as the Ethics Committee of Kuopio University Hospital, number 5/2002) approved all experiments within our study. All patients provided written informed consent for the collection of samples and subsequent analysis. In case of severe demented patients, their relatives gave written informed consent to their participation in the study. The capacitiy of the patients to consent was assessed by means of clinical, neurological and neuroradiological examinations as well as a neuropsychological screening to investigate global cognitive functions. All PD and PDD patients underwent a detailed psychometric test battery (in detail described in [26]), covering the following tests: MMSE, Geriatric Depression scale, Parkinson Neuropsychometric Dementia Assessment, Regensburger Wortfluessigkeitstest (RWT), Doors Test, Alertness/Go/NoGo/geteilte Aufmerkamkeit, Boston Naming Test, Wechsler Memory Scale (WMS-R), Melmstaedter, Coloured Progressive Marices, VOSP, Clock Test.PatientsAll CSF samples used for the proteomic approach were taken from patients attending the general outpatient clinic (University of Ulm, Department of Neurology) in 2006/2007. CSF was stored atSerpin A1 in the Diagnosis of Parkinson-DementiaFigure 3. 1D- and 2D-immunoblots of Serpin A1. 3A shows 1D-immunoblot band volumes (adjusted for membrane background) of Serpin A1. 3B shows the statistical analysis for the 1D-immunoblot validation of all proteins found to be regulated in the 2D DIGE experiment. Only Serpin A1 displayed a significant regulation. 3C illustrates the 2D immunoblot of Serpin A1 with the different spot-pattern in PD/CON and PDD with the relevant additional spots 1 and/or 2 in PDD.

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