{
  "abstract": "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.",
  "abstract_shown": true,
  "affiliations": [
    "Samsung Medical Center; Sungkyunkwan University School of Medicine"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 30,
  "authors": [
    {
      "name": "Y. Gu"
    },
    {
      "name": "J. P. Kim"
    },
    {
      "name": "B. H. Kim"
    },
    {
      "name": "H. Lee"
    },
    {
      "name": "J. Lee"
    },
    {
      "name": "H. Kang"
    },
    {
      "name": "S. Yim"
    },
    {
      "name": "D. Shin"
    },
    {
      "name": "H. K. Park"
    },
    {
      "name": "S. Kim"
    },
    {
      "name": "B. H. Lee"
    },
    {
      "name": "J. Lee"
    },
    {
      "name": "H. Kim"
    },
    {
      "name": "H. Zetterberg"
    },
    {
      "name": "M. Y. Chun"
    },
    {
      "name": "D. L. Na"
    },
    {
      "name": "J.-H. Lee"
    },
    {
      "name": "S. H. Cho"
    },
    {
      "name": "B. C. Kim"
    },
    {
      "name": "S. E. Kim"
    },
    {
      "name": "G. Sohn"
    },
    {
      "name": "J. Yun"
    },
    {
      "name": "J.-S. Lim"
    },
    {
      "name": "J. Kim"
    },
    {
      "name": "K. Lee"
    },
    {
      "name": "J. Kim"
    },
    {
      "name": "H. J. Kim"
    },
    {
      "name": "E.-J. Kim"
    },
    {
      "name": "H. Jang"
    },
    {
      "affs": [
        0
      ],
      "name": "S. W. Seo"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/b9m4tfp37yana.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.14.26362968",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.14.26362968v1.full",
  "id": "b9m4tfp37yana",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.14.26362968v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "neurology"
    ],
    [
      "openalex",
      "2738|Dementia and Cognitive Impairment Research"
    ]
  ],
  "openalex": "W7213261286",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.14.26362968v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-14",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/b9m4tfp37yana.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:33Z",
      "native_id": "10.64898/2026.09.14.26362968",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.14.26362968v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:neurology",
      "subfield": "neurology"
    }
  ],
  "title": "Plasma proteomics reveals stage-dependent biological remodelling in Alzheimer's disease",
  "title_text": "Plasma proteomics reveals stage-dependent biological remodelling in Alzheimer's disease",
  "type": "preprint",
  "updated_at": "2026-10-30T12:18:33Z",
  "url": "https://research.draconitic.com/paper/b9m4tfp37yana",
  "venue": "medRxiv",
  "versions": []
}