Role of astrocyte biomarker GFAP in early diagnosis and prognosis assessment of dementia: A comprehensive review.

Int J Biol Macromol 2026

Li S, Wei S, Wang L, Yu T, Wang H et al.

Abstract

As a key component of the neurovascular unit, astrocytes play an important role in dementia. They regulate cerebral blood flow, promote myelin regeneration, and maintain central nervous system (CNS) homeostasis. However, glial fibrillary acidic protein (GFAP), a biomarker of reactive astrocytes and an emerging indicator of dementia, has often been overlooked. There is still a lack of systematic reviews on its clinical progress in early diagnosis and prognosis assessment of dementia. This review first explores the pathophysiological mechanisms of astrocytes in dementia and describes the biological characteristics of GFAP. We then summarize the role of GFAP in early diagnosis and prognosis of different dementia types, including Alzheimer’s disease (AD), vascular dementia (VaD), and frontotemporal dementia (FTD), with a focus on advances in AD research. We also discuss the latest GFAP detection technologies, such as SIMOA and Lumipulse, and issues like differences between plasma and CSF GFAP measurements. This review aims to provide a comprehensive understanding of GFAP’s role in dementia research and clinical practice, offering a theoretical basis for developing more effective diagnostics and therapies.

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