# Patent

## Title
Biomarker for psychiatric diseases including cognitive impairment and methods for detecting psychiatric diseases including cognitive impairment using the biomarkers

## Abstract

Methods are provided that detect cognitive impairment including mild cognitive impairment and Alzheimer disease by using a protein or its partial peptide that differs in presence or absence. Novel biomarkers are also provided for cognitive impairment and non-psychiatric disease, as well as methods for detecting cognitive impairment using such biomarkers. Specifically, a biomarker for diagnosis is provided that comprises a protein fragment or peptide of not less than 5 amino acid residues arising from at least one protein or peptide selected from the group of proteins consisting of an amino acid sequence expressed by SEQ ID NO: 1, 3, 6, 8, 10, 13, 15, 18, or 20 and selected from the group of partial peptide in these proteins consisting of an amino acid sequence expressed by SEQ ID NO: 2, 4, 5, 7, 9, 11, 12, 14, 16, 17, 19, or 21.

## Background
TECHNICAL FIELD
The present invention relates to novel biomarkers for cognitive impairment including mild cognitive impairment and Alzheimer disease and methods for detecting cognitive impairment using such biomarkers. Simultaneously, the present invention relates to novel biomarkers for non-demented neurological disease like depression, schizophrenia, etc. and methods for detecting non-demented neurological disease using such biomarkers.
BACKGROUND ART
The commonly used means to differentiate between normal and non-normal states of a human subject using his or her biological materials are mainly those which have been used in the field of diagnostics. Most frequently used are those methods which target biomarkers in blood. It has been practiced in this field to comparatively measure the amount of a specific protein or a peptide that is less than 10,000 in molecular weight or, in the case of enzyme protein, enzyme activities in samples from normal (healthy) subjects and those from diseased individuals to help diagnosis. Here, prior to testing real samples, measurements are done on a fixed number each of samples from healthy controls and patients with certain disease with respect to the amount (s) or activity (activities) of single or multiple specific proteins or peptides and the ranges of abnormal and normal values are respectively determined. The sample to be evaluated is then analyzed by the same method and the resultant value is judged with respect to whether it is in normal or in abnormal range.
In the actual measurements, the amount(s) of specified protein(s) or peptide(s) in test samples, as such or after dilution, are determined by the use of enzyme-linked immunosorbent assay (ELISA) which uses a primary, or secondary, antibody labeled with an enzyme reacting with a substrate that yields a color upon reaction, chemiluminescent immunoassay (CLIA), radioimmunoassay (RIA) which uses a primary, or secondary, antibody labeled with a radioisotope, and, if the protein is an enzyme, the measurement of the activity of the enzyme by adding its substrate and determining the intensity of produced color, etc. These antibody-based methods are called as enzyme-, fluorescence- or radioisotope-labeled methods, respectively. In addition, there is a method where an enzyme reaction product derived from the corresponding substrate is determined by high performance liquid chromatography (HPLC). In further addition, there is a method where HPLC is combined with mass spectrometer, called LC-MS/MS, and there is a method called selected reaction monitoring (SRM)/multiple reaction monitoring (MRM) that utilizes LC-MS/MS. In another method to determine the concentration in a sample, it is appropriately pretreated, and separation of proteins or peptides is attained by 2-dimensional polyacrylamide gel electrophoresis (2D-PAGE), and target protein or peptide is determined by silver staining, Coomassie blue staining or immunological staining (Western blotting) that uses an antibody to target protein or peptide. In still further addition, there is a method which utilizes mass spectrometry to determine the amount of target protein or peptide in samples fractionated by column chromatography. Instead of column chromatography, protein chips and magnetic beads may also be utilized for purpose of pretreatment.
Furthermore, these inventors have developed an immunoMS method, where target protein or peptide is captured by beads (including magnetic ones) with linked antibody to the protein or peptide, eluted from the beads, and determined by mass spectrometry. Further, intact proteins have been reported to be analyzed by mass spectrometry using above-mentioned methods after digestion with trypsin etc. (PTL 1). Here, intact target proteins are selected either by fractionation or by adsorption to an adsorbent specific to them and then determined by mass spectrometry.
Number of patients suffered from cognitive impairment like Alzheimer disease is increasing rapidly along with increasing of old-age population in Japan. It is estimated that number of patients is 1.3 million in 1995 and it will be 1.9 million in 2005 and will reach to about 3.0 million in 2020. It is reported that 60-90% of cognitive impairment is Alzheimer disease. As manifestation of Alzheimer disease is not only loss of memory but several disturbance in daily life, increase of patients of this disease is becoming an important social issue to be solved. In Japan, Donepezil-hydrochloride, anti-acetylcholine esterase inhibitor has been available for medical treatment for Alzheimer disease since 1999, and it let progress of cognitive impairment in these patients be ‘slow-down’ efficiently, if the patient is diagnosed at early stage. Thus, in medication of Alzheimer disease, most important issue is ‘early diagnosis’ to treat the patients effectively by drug available at present and new coming drug.
Followings are major criteria for diagnosis of Alzheimer disease described in DSM-IV, which is published by American Psychiatric Association (Non-patent reference 1).

    
    
        A. The development of multiple cognitive deficits manifested by both
        
            (1) memory impairment (impaired ability to learn new information or to recall previously learned information)
            (2) one (or more) of the following cognitive disturbances:
            
                a) aphasia (language disturbance)
                b) apraxia (impaired ability to carry out motor activities despite intact motor function)
                c) agnosia (failure to recognize or identify objects despite intact sensory function)
                d) disturbance in executive functioning (i.e., planning, organizing, sequencing, abstracting)
            
            
        
        
        B. The cognitive deficits in Criteria A1 and A2 each cause significant impairment in social
        or occupational functioning and represent a significant decline from a previous level of functioning.
    
    


There are several types of neurological disorders related to Alzheimer disease (AD). As cognitive dysfunction appears gradually in dementia including AD, there is a disease status of pre-stage of dementia. This stage is called as mild cognitive impairment (MCI). In United States, 10% MCI develops to AD within 1 year, and 50% of MCI develops to AD within 4 years. MCI is defined as a condition characterized by newly acquired cognitive decline to an extent that is beyond that expected for age or educational background, yet not causing significant functional impairment, and not showing disturbance in daily life. Frontotemporal dementia (frontotemporal lobar degeneration) (FTD) shows loss of personal awareness, loss of social awareness, hyperorality, and stereotyped, perseverative behavior. These clinical characteristics are different from AD. FTD includes Pick's disease, which is characterized by microscopically Pick bodies usually found in limbic, paralimbic, and ventral temporal lobe cortex. Dementia with Lewy bodies (DLB) is characterized by progressive disease and psychiatric symptoms include anxiety, depression, hallucinations (usually visual) and delusions (false beliefs). DLB is thought to be the second most common subtype and 10-30% of dementia is DLB. The symptoms of DLB are caused by the build-up of Lewy bodies histologically. FTD and DLB belong to demented neurological disease as they also lose of memory, their ability to solve problems and maintain emotional control (NPL 1). In description in present patent, cognitive impairment includes AD, MCI and the demented neurological disease.
The screening tests for dementia widely used are the Hasegawa Dementia Scale-revised (HDS-R) and Mini-Mental State Examination (MMSE). In these screening tests, inspector asks several questions and evaluates level of cognitive impairment of each subject by scores. HDS-R is revised version of HDS published in 1991. In HDS-R, test consists 9 questions to analyses orientation, remembrance, calculation, retain and recall ability, and common sense. Full score is 30 and a person whose score is less than 23 is suspected as dementia. MMSE has been developed in United States to screen and diagnose dementia, and analyses global cognitive function, with items assessing orientation, word recall, attention and calculation, language abilities, and visuospatial (drawing) ability. This test consists of 11 questions, and full score is 30 and a person who has score less than 23 is suspected as dementia. The results of HDS-R and MMSE coincide with each other. Both are used for screening, not for diagnosis and not for staging of disease progression (NPL 1).
Neuroimaging test for dementia are Computed tomography (CT) and Magnetic resonance imaging (MRI) which evaluate morphological changes like brain atrophy and ventricular dilation and single-photon emission computed tomography (SPECT) which analyses regional cerebral blood flow and PET which shows brain metabolism by measurement of consumption of oxygen and sugar. SPECT and PET, nuclear imaging technologies, can identify neuronal dysfunction at preclinical stage (NPL 1). However, these neuroimaging can not be widely used in hospitals because they need special facilities to perform nuclear imaging, and neuroimaging may not be objective test as imaging diagnosis is completely depend on the skill of physician who analyses the mages.
Thus, methods for screening and diagnosis of dementia including AD that are available at present is dependent on tests lacking objectivity and is dependent on expensive instruments, and so it is very difficult to use these tests for screening of early stage-cognitive impairment. If we get blood (serum/plasma) biomarker for cognitive impairment, which enables us objective test using specimens we can easily obtain, we can identify cognitive impairment at early stage (preclinical stage) by blood test using such biomarker. Present patent provides novel biomarkers and a novel and potent diagnostic method for cognitive impairment by using such biomarkers and biomarkers described here. In addition, present patent provides diagnostic method and novel biomarkers for non-demented neurological disease like depression, schizophrenia, etc.
CITATION LIST
Patent Literature


    PTL 1, JP-A-2004-333274
    PTL 2, JP-A-2006-308533


Non Patent Literature


    NPL 1, “Alzheimer's disease's textbook.,” edited by Imaharu Nakano and Hldehiro Mizusawa., Nagai Shoten Co., Ltd., 2004 (in Japanese)
    NPL 2, Benkirane, N. et al., J. Biol. Chem. Vol. 268, 26279-26285, 1993


SUMMARY OF INVENTION
Technical Problem
The present invention aims to present methods to detect cognitive impairment including mild cognitive impairment and Alzheimer disease by using a protein or its partial peptide that differs in presence or absence, or in quantity between non-cognitive impairment subjects (Including healthy people, the human subjects that may be affected with any disease and unaffected with cognitive impairment) and patients with cognitive impairment and further aims to present biomarkers comprising said proteins and said partial peptides to be used to detect cognitive impairment including mild cognitive impairment and Alzheimer disease. Simultaneously, the present invention aims to present novel biomarkers for non-demented neurological disease like depression, schizophrenia, etc. and methods for detecting cognitive impairment using such biomarkers.
Solution to Problem
These inventors investigated to find out means to detect cognitive impairment and found a peptide capable of detecting cognitive impairment and psychiatric disease including mild cognitive impairment and Alzheimer disease in the serum. Said peptides found in the present invention are those with significance as a biomarker to detecting in the case of serum not only other biological materials such as blood, plasma, cerebrospinal fluid, and urine. Simultaneously, protein or peptide is the origin of these peptides (hereinafter referred to as intact proteins or peptides) also has significance as biomarkers.
Specifically, these inventors found that a biomarker comprising at least one protein or peptide selected from the group consisting of Neurexin-2-beta precursor consisting of amino acid sequence expressed by SEQ ID NO: 1, Prothrombin precursor consisting of amino acid sequence expressed by SEQ ID NO: 3, Pendrin consisting of amino acid sequence expressed by SEQ ID NO: 6, Coatomer subunit zeta-1 consisting of amino acid sequence expressed by SEQ ID NO: 8, Retinoic acid receptor responder protein 2 precursor consisting of amino acid sequence expressed by SEQ ID NO: 10, Gelsolin precursor consisting of amino acid sequence expressed by SEQ ID NO: 13, Clusterin precursor consisting of amino acid sequence expressed by SEQ ID NO: 15, Eukaryotic translation initiation factor 3 subunit J consisting of amino acid sequence expressed by SEQ ID NO: 18, and Leucine-rich repeat-containing protein 27 consisting of amino acid sequence expressed by SEQ ID NO: 20 could be used as biomarkers to detect psychiatric disease or cognitive impairment.
Furthermore, these inventors found that a biomarker comprising at least one peptide selected from the group consisting of Neurexin-2-beta precursor-derived peptide NRX2B consisting of amino acid sequence expressed by SEQ ID NO: 2, Prothrombin precursor-derived peptide THRB(R−) consisting of amino acid sequence expressed by SEQ ID NO: 4, Prothrombin precursor-derived peptide THRB(R+) consisting of amino acid sequence expressed by SEQ ID NO: 5, Pendrin-derived peptide S26A4 consisting of amino acid sequence expressed by SEQ ID NO: 7, Coatomer subunit zeta-1-derived peptide COPZ1 consisting of amino acid sequence expressed by SEQ ID NO: 9, Retinoic acid receptor responder protein 2 precursor-derived peptide RARR2(S−) consisting of amino acid sequence expressed by SEQ ID NO: 11, Retinoic acid receptor responder protein 2 precursor-derived peptide RARR2(S+) consisting of amino acid sequence expressed by SEQ ID NO: 12, Gelsolin precursor-derived peptide GELS consisting of amino acid sequence expressed by SEQ ID NO: 14, Clusterin precursor-derived peptide CLUS(N-term SDVP) consisting of amino acid sequence expressed by SEQ ID NO: 16, Clusterin precursor-derived peptide CLUS(N-term RFFT) consisting of amino acid sequence expressed by SEQ ID NO: 17, Eukaryotic translation initiation factor 3 subunit J-derived peptide EIF3J consisting of amino acid sequence expressed by SEQ ID NO: 19, and Leucine-rich repeat-containing protein 27-derived peptide LRC27 consisting of amino acid sequence expressed by SEQ ID NO: 21 could be used as biomarkers to detect psychiatric disease or cognitive impairment.
These inventors brought the present invention to perfection by further succeeding in determining simultaneously these many proteins and its partial peptides by using two-dimensional high performance liquid chromatography-MALDI TOFMS method (mass spectrometry) and immunoMS method.
The features of the present invention are shown below.
[1] A biomarker for detection of psychiatric disease or cognitive impairment comprising protein fragment or peptide of not less than 5 amino acid residues arising from at least one protein or peptide selected from the group consisting of Neurexin-2-beta precursor consisting of amino acid sequence expressed by SEQ ID NO: 1, Prothrombin precursor consisting of amino acid sequence expressed by SEQ ID NO: 3, Pendrin consisting of amino acid sequence expressed by SEQ ID NO: 6, Coatomer subunit zeta-1 consisting of amino acid sequence expressed by SEQ ID NO: 8, Retinoic acid receptor responder protein 2 precursor consisting of amino acid sequence expressed by SEQ ID NO: 10, Gelsolin precursor consisting of amino acid sequence expressed by SEQ ID NO: 13, Clusterin precursor consisting of amino acid sequence expressed by SEQ ID NO: 15, Eukaryotic translation initiation factor 3 subunit J consisting of amino acid sequence expressed by SEQ ID NO: 18, Leucine-rich repeat-containing protein 27 consisting of amino acid sequence expressed by SEQ ID NO: 20.
[2] A biomarker for detection of psychiatric disease comprising at least one peptide selected from the group consisting of Neurexin-2-beta precursor-derived peptide NRX2B consisting of amino acid sequence expressed by SEQ ID NO: 2, Prothrombin precursor-derived peptide THRB(R−) consisting of amino acid sequence expressed by SEQ ID NO: 4, Prothrombin precursor-derived peptide THRB(R+) consisting of amino acid sequence expressed by SEQ ID NO: 5, Pendrin-derived peptide S26A4 consisting of amino acid sequence expressed by SEQ ID NO: 7, Coatomer subunit zeta-1-derived peptide COPZ1 consisting of amino acid sequence expressed by SEQ ID NO: 9, Retinoic acid receptor responder protein 2 precursor-derived peptide RARR2(S−) consisting of amino acid sequence expressed by SEQ ID NO: 11, Retinoic acid receptor responder protein 2 precursor-derived peptide RARR2(S+) consisting of amino acid sequence expressed by SEQ ID NO: 12, Gelsolin precursor-derived peptide GELS consisting of amino acid sequence expressed by SEQ ID NO: 14, Clusterin precursor-derived peptide CLUS(N-term SDVP) consisting of amino acid sequence expressed by SEQ ID NO: 16, Clusterin precursor-derived peptide CLUS(N-term RFFT) consisting of amino acid sequence expressed by SEQ ID NO: 17, Eukaryotic translation initiation factor 3 subunit J-derived peptide EIF3J consisting of amino acid sequence expressed by SEQ ID NO: 19, and Leucine-rich repeat-containing protein 27-derived peptide LRC27 consisting of amino acid sequence expressed by SEQ ID NO: 21.
[3] A biomarker for detection of cognitive impairment comprising at least one peptide selected from the group consisting of Neurexin-2-beta precursor-derived peptide NRX2B consisting of amino acid sequence expressed by SEQ ID NO: 2, Prothrombin precursor-derived peptide THRB(R−) consisting of amino acid sequence expressed by SEQ ID NO: 4, Prothrombin precursor-derived peptide THRB(R+) consisting of amino acid sequence expressed by SEQ ID NO: 5, Pendrin-derived peptide S26A4 consisting of amino acid sequence expressed by SEQ ID NO: 7, Coatomer subunit zeta-1-derived peptide COPZ1 consisting of amino acid sequence expressed by SEQ ID NO: 9, Retinoic acid receptor responder protein 2 precursor-derived peptide RARR2(S−) consisting of amino acid sequence expressed by SEQ ID NO: 11, Retinoic acid receptor responder protein 2 precursor-derived peptide RARR2(S+) consisting of amino acid sequence expressed by SEQ ID NO: 12, Gelsolin precursor-derived peptide GELS consisting of amino acid sequence expressed by SEQ ID NO: 14, Clusterin precursor-derived peptide CLUS(N-term SDVP) consisting of amino acid sequence expressed by SEQ ID NO: 16, Clusterin precursor-derived peptide CLUS(N-term RFFT) consisting of amino acid sequence expressed by SEQ ID NO: 17, Eukaryotic translation initiation factor 3 subunit J-derived peptide EIF3J consisting of amino acid sequence expressed by SEQ. ID NO: 19, and Leucine-rich repeat-containing protein 27-derived peptide LRC27 consisting of amino acid sequence expressed by SEQ ID NO: 21.
[4] A biomarker of cognitive impairment comprising the peptides selected from the group consisting of amino acid sequence expressed by SEQ ID NO: 2, 5, 7, 9, 11, 12, 14, and 16 that is appeared or increased in biological material of patients of cognitive impairment as compared to biological material of subjects not suffering from psychiatric disease.
[5] A biomarker of cognitive impairment comprising the peptides selected from the group consisting of amino acid sequence expressed by SEQ ID NO: 4, 17, 19, and 21 that is disappeared or decreased in biological material of patients of cognitive impairment as compared to biological material of subjects not suffering from psychiatric disease.
[6] A biomarker of Alzheimer disease comprising the peptides selected from the group consisting of amino acid sequence expressed by SEQ ID NO: 2 that is appeared or increased in biological material of patients of Alzheimer disease as compared to biological material of subjects not suffering from non-demented neurological disease.
[7] A biomarker of Alzheimer disease comprising the peptides selected from the group consisting of amino acid sequence expressed by SEQ ID NO: 4 that is disappeared or decreased in biological material of patients of Alzheimer disease as compared to biological material of subjects not suffering from non-demented neurological disease.
[8] Method for detection of psychiatric disease involving determination in biological material of at least one biomarker for psychiatric disease as described in [1] or [2].
[9] Method for detection of cognitive impairment involving determination in biological material of at least one biomarker for cognitive impairment as described in [1] or [3].
[10] Method for detection of cognitive impairment in which patient is judged as suffering from cognitive impairment when, after determination in biological material of at least one biomarker for cognitive impairment as described in [4], said biomarker is found to be present in higher quantity than in subjects not suffering from psychiatric disease.
[11] Method for detection of cognitive impairment in which patient is judged as suffering from cognitive impairment when, after determination in biological material of at least one biomarker for cognitive impairment as described in [5], said biomarker is found to be present in lower quantity than in subjects not suffering from psychiatric disease.
[12] Method for detection of psychiatric disease as described in [8] wherein detection is made either by immunoblot procedure, Western blotting, enzyme-, fluorescence-, or radioisotope-labeled antibody method, mass spectrometry, immunoMS method or surface plasmon resonance method.
[13] Method for detection of cognitive impairment as described in any of [9] to [11] wherein detection is made either by immunoblot procedure, Western blotting, enzyme-, fluorescence-, or radioisotope-labeled antibody method, mass spectrometry, immunoMS method or surface plasmon resonance method.
[14] A kit for detection of psychiatric disease to determine at least one biomarker as described in [1] or [2].
[15] A kit for detection of cognitive impairment to determine at least one biomarker as described in any of claims [1], [3] to [5].
[16] A kit for detection of psychiatric disease containing antibody or aptamer to at least one biomarker as described in [1] or [2].
[17] A kit for detection of psychiatric disease containing antibody or aptamer to at least one biomarker as described in any of claims [1], [3] to [5].
[18] A kit for detection as described in [16] or [17] wherein antibody or aptamer is solidified on a plate or plates.
Advantageous Effects of Invention
According to the present invention, it is possible to diagnose a subject as to whether said subject has suffered from psychiatric disease or cognitive impairment by determining in biological material obtained from said subject the kind and amount of at least one peptide selected from the group consisting of Neurexin-2-beta precursor-derived peptide NRX2B consisting of amino acid sequence expressed by SEQ ID NO: 2, Prothrombin precursor-derived peptide THRB(R−) consisting of amino acid sequence expressed by SEQ ID NO: 4, Prothrombin precursor-derived peptide THRB(R+) consisting of amino acid sequence expressed by SEQ ID NO: 5, Pendrin-derived peptide S26A4 consisting of amino acid sequence expressed by SEQ ID NO: 7, Coatomer subunit zeta-1-derived peptide COPZ1 consisting of amino acid sequence expressed by SEQ ID NO: 9, Retinoic acid receptor responder protein 2 precursor-derived peptide RARR2(S−) consisting of amino acid sequence expressed by SEQ ID NO: 11, Retinoic acid receptor responder protein 2 precursor-derived peptide RARR2(S+) consisting of amino acid sequence expressed by SEQ ID NO: 12, Gelsolin precursor-derived peptide GELS consisting of amino acid sequence expressed by SEQ ID NO: 14, Clusterin precursor-derived peptide CLUS(N-term SDVP) consisting of amino acid sequence expressed by SEQ ID NO: 16, Clusterin precursor-derived peptide CLUS(N-term RFFT) consisting of amino acid sequence expressed by SEQ ID NO: 17, Eukaryotic translation initiation factor 3 subunit J-derived peptide EIF3J consisting of amino acid sequence expressed by SEQ ID NO: 19, and Leucine-rich repeat-containing protein 27-derived peptide LRC27 consisting of amino acid sequence expressed by SEQ ID NO: 21. In addition, it is possible to diagnose a subject has suffering from Alzheimer's disease when compared with the increase in biological material of patients of non-demented neurological disease by determining amount of peptide consisting of amino acid sequence expressed by SEQ ID NO: 2, and it is possible to diagnose a subject has suffering from Alzheimer's disease when compared with the decrease in biological material of patients of non-demented neurological disease by determining amount of peptide consisting of amino acid sequence expressed by SEQ ID NO: 4.
The present invention presents a diagnostic system that is high in both accuracy and specificity. The present invention enables highly accurate diagnosis of cognitive impairment in which there have been no specific test methods for such biological materials as blood. Furthermore, the biomarkers disclosed in the present invention are highly useful in judgement of drug efficacy.



BRIEF DESCRIPTION OF DRAWINGS
[FIG. 1]
FIG. 1 illustrates the isolation of serum of Alzheimer's disease by 2D-LC-MALDI TOF-MS method. (Example 1)
[FIG. 2]
FIG. 2 illustrates the case of Marker A that is the one example of the result of differential analysis. As shown in FIG. 3, Marker A is Neurexin-2-beta precursor-derived peptides NRX2B. FIG. 2A) illustrates the comparison between ADN, MCI and AD, and FIG. 2B) illustrates the comparison between ADN, AD, NDall, NDdem and NDnon. For each samples, the average value (divided by 1,000) and (SD) (devided by 1,000) are as follows. A) ADN 0.1 (0.1); MCI 45.8 (42.2); AD 41.7 (22.2). B) ADN 0.1 (0.2); AD 34.0 (27.8); NDall 19.2 (15.8); NDdem 24.3 (20.8); NDnon 14.0 (6.1). C), D) and E) illustrates respectively the ROC curve of the comparison of MCI vs. ADN, AD vs. ADN, and AD vs. NDnon. (Example 1) Abbreviations used are; AD (Alzheimer's disease), ADN (subjects not suffering from psychiatric disease and age and sex-matched patients with AD, “N” means normal), NDall (neurological disease), NDdem (demented neurological disease), NDnon (non-demented neurological disease).
[FIG. 3]
FIG. 3 illustrates the MS/MS spectrum of Marker A (SEQ ID NO: 2, NRX2B) obtained by using TOF/TOF mass spectrometer (Example 1)
[FIG. 4]
FIG. 4 illustrates the comparison between non-psychiatric disease subjects (ADN) and patients of psychiatric disease including sementia for THRB(R−) (A) and B) of FIG. 4) and THRB(R+) (C) and D) of FIG. 4) in serum. (Example 1)
[FIG. 5]
FIG. 5A) illustrates the each individual comparison between non-psychiatric disease subjects (ADN) and patients of cognitive impairment (MCI, AD) patient for THRB(R−) and THRB(R+) in serum. FIG. 5B) illustrates the ROC curve of the comparison of AD vs. NDdon for THRB(R−) in serum. (Example 1)
[FIG. 6]
FIG. 6 illustrates the comparison (A) and B) of FIG. 6) between non-psychiatric disease subjects (ADN) and patients of psychiatric disease including dementia for S264A in serum, and the comparison (C) and D) of FIG. 6) between non-psychiatric disease subjects (ADN) and patients of psychiatric disease including dementia for COPZ1 in serum. (Example 1)
[FIG. 7]
FIG. 7 illustrates the each individual comparison between non-psychiatric disease subjects (ADN) and patients of cognitive impairment (MCI, AD) patient for PARR2(S−) (A) of FIG. 7) and PARR2(S+) (B) of FIG. 7) in serum. (Example 1)
[FIG. 8]
FIG. 8 illustrates the comparison (A) and B) of FIG. 8) between non-psychiatric disease subjects (ADN) and patients of psychiatric disease including dementia for GELS in serum. (Example 1)
[FIG. 9]
FIG. 9 illustrates the comparison (A) and B) of FIG. 9) between non-psychiatric disease subjects (ADN) and patients of psychiatric disease including dementia for CLUS(N-term SDVP) in serum, and the comparison (C) and D) of FIG. 9) between non-psychiatric disease subjects (ADN) and patients of psychiatric disease including dementia for CLUS(N-term RFFT) in serum. (Example 1)
[FIG. 10]
FIG. 10 illustrates the comparison (A) and B) of FIG. 10) between non-psychiatric disease subjects (ADN) and patients of psychiatric disease including dementia for EIF3J in serum, and the comparison (C) of FIG. 10) between non-psychiatric disease subjects (ADN) and patients of cognitive impairment (MCI, AD) patient for LRC27 in serum. (Example 1)
[FIG. 11]
FIG. 11 illustrates the mass spectrum of NRX2B peptide that captured and detected by immunoMS method using NRX2B-specific antibody from the serum of AD and MCI patients. The right figure is the enlarged view of arrow parts in the left figure. Endogenous NRX2B peptide (solid arrows) and stable isotope labeled-NRX2B synthetic peptide NRX2B (dashed arrows) are shown for each peak in right figure. (Example 4)



DESCRIPTION OF EMBODIMENTS
The present invention is a method for determining the kind and the amount of intact protein and/or its partial peptide when test subject is suffering from cognitive impairment as well as for diagnosing whether test subject is suffering from cognitive impairment and, whether test subject is diagnosed to be suffering from psychiatric disease. A peptide is generally said to be a chemical entity, made by polymerizing a number of amino acids, of less than 10,000 in molecular weight or by polymerizing several to less than about 50 amino acid residues. While in the present invention a partial peptide of an intact protein can be used as a biomarker for detection of cognitive impairment, such partial peptide is defined as a peptide of less than 10,000 in molecular weight consisting of a part of the amino acid sequence of the intact protein. Such peptide may arise as a partial peptide during the expression by transcription followed by synthesis by translation before maturing into an intact protein or as a peptide produced by enzyme digestion in the body after the intact protein has been synthesized. It is possible that, when the body is in abnormal state suffering from such disease as cognitive impairment, the mechanism for protein synthesis and regulation is de-regulated. In other words, the present invention is also a method for determining if test subject is in normal state or is suffering from cognitive impairment by using the degree of protein synthesis and/or protein digestion as an indicator. The detection of cognitive impairment in the present invention means evaluation and differentiation, i.e., diagnosis of test subject as to whether the subject is suffering from cognitive impairment. The present invention can also include the evaluation of patient's risk of suffering from more serious cognitive impairment.
Specifically, in the method of the present invention, the examples of intact protein that can be used as a cognitive impairment include Neurexin-2-beta precursor consisting of amino acid sequence expressed by SEQ ID NO: 1, Prothrombin precursor consisting of amino acid sequence expressed by SEQ ID NO: 3, Pendrin consisting of amino acid sequence expressed by SEQ ID NO: 6, Coatomer subunit zeta-1 consisting of amino acid sequence expressed by SEQ ID NO: 8, Retinoic acid receptor responder protein 2 precursor consisting of amino acid sequence expressed by SEQ ID NO: 10, Gelsolin precursor consisting of amino acid sequence expressed by SEQ ID NO: 13, Clusterin precursor consisting of amino acid sequence expressed by SEQ ID NO: 15, Eukaryotic translation initiation factor 3 subunit J consisting of amino acid sequence expressed by SEQ ID NO: 18, and Leucine-rich repeat-containing protein 27 consisting of amino acid sequence expressed by SEQ ID NO: 20, and further, the peptide fragments that comprise of partial peptides of not less than 5 amino acid residues of these intact proteins can be used as same purpose.
Still further, an example of biomarkers for cognitive impairment of the present invention includes the partial peptides consisting of amino acid sequence expressed by SEQ ID NO: 2 of Neurexin-2-beta precursor-derived peptide NRX2B, SEQ ID NO: 4 of Prothrombin precursor-derived peptide THRB(R−), SEQ ID NO: 5 of Prothrombin precursor-derived peptide THRB(R+), SEQ ID NO: 7 of Pendrin-derived peptide S26A4, SEQ ID NO: 9 of Coatomer subunit zeta-1-derived peptide COPZ1, SEQ ID NO: 11 of Retinoic acid receptor responder protein 2 precursor-derived peptide RARR2(S−), SEQ ID NO: 12 of Retinoic acid receptor responder protein 2 precursor-derived peptide RARR2(S+), SEQ ID NO: 14 of Gelsolin precursor-derived peptide GELS, SEQ ID NO: 16 of Clusterin precursor-derived peptide CLUS(N-term SDVP), SEQ ID NO: 17 of Clusterin precursor-derived peptide CLUS(N-term RFFT), SEQ ID NO: 19 of Eukaryotic translation initiation factor 3 subunit J-derived peptide EIF3J, SEQ ID NO: 21 of Leucine-rich repeat-containing protein 27-derived peptide LRC27. In the present invention, proteins and peptides consisting of amino acid sequences derived from SEQ ID NO: 1 to 21 by deletion, exchange, and/or addition of one or a few amino acids can be used as biomarkers and are included in the present invention. “One or a few” herein means “one or three,” “one or two,” or “one.” Furthermore, the partial peptides that can be used as biomarkers in the present invention include those peptide fragments consisting of not less than 5 amino acid residues arising respectively from SEQ ID NO: 1 to 21. The basis for the limitation of peptide fragments consisting of not less than 5 amino acid residues is in the description below in Non-patent Document 2. The document reported that an antibody obtained by using the peptide IRGERA as immunogen, which was the C-terminus (130-135) of histone 113, recognized the peptide IKGERA derived by exchange of K for R and the peptide CGGGERA which was derived by deletion of IR followed by addition of CGG. This demonstrates that the immunogenicity (antigenicity) is recognized by a peptide of not less than 4 amino acid residues. In order to expand this finding to other peptides than the C-terminus of histone H3, the number of amino acid residue is defined as not less than 5 instead of 4 in the present invention. To make such a low molecular weight peptide as the subject of the present invention is important when the method of detection and differentiation uses immunological means including immunoblot, ELISA and immunoMS.
It is to be noted that there are cases where a sugar chain or sugar chains have been added to an intact protein or its partial peptide to form glycated entities. Proteins and partial peptides in glycated form can also be used as biomarkers for detection of cognitive impairment.
It is also to be noted that, in the present invention, biomarker can be quantified or its presence or absence can be determined qualitatively.
Two-dimensional electrophoresis (2-DE) or 2-dimensional chromatography (2-DC) can be used in the present invention to separate biomarkers in biological materials including serum. Known chromatographic methods can be selected from ion-exchange chromatography, reverse-phase chromatography and gel-filtration chromatography. It is also possible to make quantification with the SRM/MRM method in LC-MS/MS technology. Furthermore, the immunoMS method which these inventors have developed, where target protein or peptide is captured by beads (including magnetic ones) with antibody linked to the protein or peptide, eluted from the beads, and determined by mass spectrometry enables convenient determination of presence or absence or the amount of target protein, protein fragment or peptide without the use of 2-DE or chromatography.
It is possible with the use of the method disclosed in the present invention to evaluate at the stage of mild of cognitive dysfunction in test subject and therefore it can be useful in prophylactic medicine. Further, when psychotherapy and/or drug therapy is given to patients with cognitive impairment, it is reflected in the amount of proteins and partial peptides in biological materials such as serum if the progression of the disorder has been inhibited. Therefore, by measuring these proteins and partial peptides, it is possible to evaluate and determine therapeutic effect.
The kind and amount of a protein in biological materials can be determined by various methods. If target protein (including protein fragment and partial peptide) has been characterized and when an antibody (primary antibody) to it has already been obtained, the following methods can be used:
1. Immunoblot
This is one of the simplest methods. Test serum in a fixed amount (about 1 microliter) after stepwise dilution is dropped onto an appropriate membrane such as of nitrocellulose and dried in air. The membrane is treated with a blocking solution containing a protein such as BSA, washed, reacted with primary antibody, and washed. Thereafter, the membrane is reacted with labeled secondary antibody to detect the primary antibody. The membrane is washed and the label is visualized to measure its density.
2. Western Blotting
After separation with one-dimensional or two-dimensional electrophoresis involving isoelectric focussing or SDS-PAGE, proteins are transferred onto such an appropriate membrane as of nitrocellulose and their amounts are determined, as in above-mentioned immunoblot, using primary antibody and labeled secondary antibody.
3. ELISA
Antibody to protein or its partial peptide is fixed to such a plate as a chemically modified microtiter plate. Appropriate amounts of samples after stepwise dilution are applied to the plate and incubated. Proteins and peptides not captured are removed by washing. Next, the plate is incubated with secondary antibody labeled with fluorescent or chemiluminescent substance or enzyme. After addition of respective substrate, fluorescence, chemiluminescence or visible light due to enzyme reaction is measured for evaluation and judgement.
Additional examples of methods are illustrated below (see PTL 2) but the invention is not limited by these examples.
4. Methods that Use Microarray (Microchip)
A microarray is a general term for devices where solidified materials with affinity for target substances are arrayed on solid support (plate). In the present invention, antibodies or aptamers to proteins and partial peptides are arrayed. A sample of biological material is placed on the microarray for fixation of target proteins or partial peptides and the microarray is then incubated with secondary antibody labeled with fluorescent or chemiluminescent substance or enzyme. After addition of respective substrate, fluorescence, chemiluminescence or visible light due to enzyme reaction is measured.
5. Mass Spectrometry
In mass spectrometry, for example, antibody to a specified protein or partial peptide is attached to chemically modified microbeads or plate (protein chip). The microbeads could be magnetic beads. There are no requirements for the material of the plate. The antibody to be used could be (1) an antibody which recognizes the full length form of the specified protein only, (2) an antibody which recognizes a partial peptide only, (3) all of antibodies which recognizes both the specified protein and its partial peptide, or a combination of (1) and (2), (1) and (3), or (2) and (3). Samples after stepwise dilution with original solvent or buffer are added to the microbeads or plate carrying antibody or antibodies and incubated. Those proteins and partial peptides not captured are removed by washing. The protein or partial peptide captured by micorbeads or plate is eluted, and analyzed by mass spectrometry with MALDI-TOF-MS, SELDI-TOF-MS, etc. Measurements are made with respect to the mass and intensity of the peak due to the protein, protein fragment or partial peptide. Prior to the measurements a fixed amount of substance serving as the internal standard is added to the original biological material and the intensity of its peak is also measured. The concentration of the target in the original biological material can be calculated from the ratio of peak intensity of the target to the peak intensity of the internal standard. This is called immunoMS method. Further, it is possible to make quantification, after the sample is diluted with original solvent or buffer, or after part of proteins are removed, by separation with HPLC followed by mass spectrometry with electrospray ionization (ESI) method. Therein the SRM/MRM method can be utilized for absolute quantification with the use of an isotope-labeled internal standard peptide.
Furthermore, in addition to the above-mentioned methods, it is possible to analyze proteins and partial peptides by using 2-DE, surface plasmon resonance, etc.
The present invention includes the method to detect cognitive impairment from the presence or absence or amount of the above-mentioned biomarker after applying biological material obtained from test subject to 2-DE or surface plasmon resonance.
EXAMPLE 1
Discovery of a Marker Peptide for Detection of Cognitive Impairment Using Two-dimensional Liquid Chromatography (2D-LC)-MALDI TOF-MS
(1) Serum Samples.
Followings, the characters before the parenthesis are an abbreviation.
A sera obtained from 20 AD (Alzheimer's disease), 20 ADN (subjects not suffering from psychiatric disease and age and sex-matched patients with AD, “N” means normal), and 20 NDall (neurological disease) were used. NDall consists of 10 NDdem (demented neurological disease) and 10 NDnon (non-demented neurological disease). Furthermore, NDdem consists of dementia with Lewy body and frontotemporal dementia each consisting of 5 cases, and NDnon consists of schizophrenia and depression each consisting of 5 cases.
(2) Methods
After 475 μl of 0.1% trifluoroacetic acid (TFA) were added in each of 25 μl of sera, samples were boiled for 15 min at 100 degrees. Subsequently, in order to recover peptides of molecular weight of 10,000 or less, ultrafiltration were performed by using YM-10 filter unit (Millipore Corp.). Then the analysis using 2D-LC-MALDI TOF-MS were performed as follows. In other words, recovering samples were fractionated to 1,146 fractions per sample by using two-dimensional HPLC(SCX cation exchange column and C18 reverse-phase column). All fractionated samples were spotted on MALDI target plate for MALDI TOF/TOF mass spectrometer (ultraflex TOF/TOF, Bruker Daltonics), and matrix solution (alpha-cyano-hydroxycinnamic acid, CHCA) were mixed and crystallized, and the mass and the peak area of the mass were measured automatically in refraction mode by irradiating to crystallised sample by laser. Peak area was normalized with 250 fmole of per each well of bradykinin 1-7 fragment that was added into matrix solution in advance. In other words, the area value was calculated in 10,000 times of the value dividing the peak area in specific mass of sample by the peak area obtained from 250 fmole of bradykinin1-7 fragment. This area value is corresponding in 25 μl of sample serum. Detection of difference in abundance of peptides in serum between groups (called differential analysis) was performed using multi-group statistical analysis software DeView developed by us. Peptide that was observed to difference in abundance was directly determined amino acid sequence in MS/MS analysis by ultraflex TOF/TOF, and intact proteins or peptides of their origin were identified.
(3) Results
FIG. 1 shows the result that was obtained from serum of one case of AD patient that was applied to 2D-LC-MALDI TOF-MS. Sample was fractionated into 6 fractions by SCX cation exchange column in the first dimension, then each of fractions were fractionated into 191 fractions by C18 reverse-phase column. Mass spectra of 191 fractions were obtained by MALDI TOF-MS measuring. As the horizontal axis is the m/z and the vertical axis is the fractions of reverse-phase column chromatography, FIG. 1 was visualized by Deview software developed by present inventors. SCX 1 shows flow-through fractions, SCX 2 shows fractions eluted in 10% salt concentration, SCX 3 shows fractions eluted in 20% salt concentration, SCX 4 shows fractions eluted in 30% salt concentration, SCX 5 shows fractions eluted in 50% salt concentration, SCX 6 shows fractions eluted in 100% salt concentration. As seen in FIG. 1, many peptides in many sera are present in fractions of SCX 1, SCX 3, SCX 4, and SCX 5. Total numbers of peptides fractionated by 2D-LC and detected by MALDI TOF-MS were about 4,000.
As one example of the results of differential analysis, FIG. 2 shows the case of Marker A. Marker A, as shown later in FIG. 3, is Neurexin-2-beta precursor-derived peptide NRX2B. A) of FIG. 2 shows a comparison between ADN, MCI, AD. A) and B) shows the result of experiments carried out separately, ADN and AD were used the same samples in both experiments (ie, for ADN and AD, the measurement results would indicate the reproducibility.). In A) of FIG. 2, it was found that Marker A is increased in MCI and AD patients than ADN patient. In B) of FIG. 2, it was found that Marker A is increased in AD, NDall, NDdem, and NDnon patients than ADN patient. In particular, in comparison of AD and NDnon, AD was significantly higher than NDnon (t-test, p=0.035). From these results, it was found that Marker A was useful to distinguish between cognitive impairment (MCI, AD, NDdem) patient and non-demented neurological disease (NDnon).
From the results of A) and B) in FIG. 2, in order to evaluate the extent to which the Marker A is useful as biomarker, the analysis by receiver operating characteristic (ROC) curve was performed. C), D) and E) in FIG. 2 shows respectively the ROC curve of the comparison of MCI vs. ADN, AD vs. ADN, and AD vs. NDnon. If the area value (hereinafter referred to as the ROC value) of under the ROC curve is close to 1, the usefulness as biomarker of Marker A will be higher. In C), D), E) of FIG. 2, the typical values of sensitivity and specificity are the values of the point (open square in the figure) of the coordinate on ROC curve that the distance is minimized when a straight line was drawn to ROC curve from the point of 100% on y-axis. The value of cut-off giving this point becomes a useful threshold to distinguish between the different groups, and the values of sensitivity and specificity at that time (ie, above the typical values) becomes an indicator of the usefulness of biomarkers together with ROC values. In C) of FIG. 2, as typical values in MCI vs. ADN, the sensitivity was 90%, the specificity was 100%, and the ROC value was 0.99. In D) of FIG. 2, as typical values in AD vs. ADN, the sensitivity was 100%, the specificity was 100%, and the ROC value was 1. In E) of FIG. 2, it was comparing between AD vs. CCC, the sensitivity was 100%, the specificity was 50%, and the ROC value was 0.710. Thus, it was revealed that Marker A (NRX2B) was useful to distinguish MCI and AD with ADN. And also, it was revealed that Marker A was useful to distinguish AD with non-demented neurological disease (NDnon). In particular, since MCI is the state of previous stage of AD, Marker A (NRX2B) is considered to be a extremely useful marker to detect MCI for early diagnosis of potential subjects to migrate to AD.
FIG. 3, for Marker A, illustrates the results of MS/MS spectrum using ultraflex TOF/TOF. The signals that show y-ions and b-ions have enough appeared, and the amino acid sequence could be readily identified. Mascot search was performed on this result, and the protein of origin or the peptide (hereinafter referred to as intact proteins or peptides) is Neurexin-2-beta precursor, and the detected peptide was found that the sequence is RSGGNATLQVDSWP (SEQ ID NO: 2). NRX2B of entry name of Swiss-Prot against Neurexin-2-beta precursor will use as an abbreviation of the peptide name. Also as for other peptides that were detected, the entry names of Swiss-Prot will be used as abbreviations of the peptide names in the following descriptions.
Including the Marker A, the peptides that have difference in abundance between the groups in serum were measured MS/MS spectra using ultraflex TOF/TOF, and in addition to determining the amino acid sequence, the results identified intact proteins or peptides were shown below. For peptides other than Marker A, the signals that show y-ions and b-ions has enough appeared, and the amino acid sequence could be readily identified. The following amino acid sequence that shows a set of two sequences, the entire sequence of the first sequence shows the amino acid sequence of intact proteins or peptides. The peptide comprising of the underlined portion of the first sequence and the second sequence is peptide detected by 2D-LC-MALDI TOF-MS. 001 represents N-terminus. The peptide which has oxidation of methionine was indicated as (+Oxidation (M)) at the end of the amino acid sequence. For the protein with mutation of amino acid by gene mutation, applicable amino acid residue was expressed with (X).
(1) Neurexin-2-beta Precursor-derived Peptide NRX2B NRX2B shown as SEQ ID NO: 2 was not detected in ADN patient, and was detected in MCI, AD, NDall, NDdem, and NDnon patients. Furthermore, in comparison of AD and NDnon, AD shown higher value than NDnon, NRX2B was shown distinction ability (previously described in FIG. 2).
Intact Protein/Peptide









(SEQ ID NO: 1)



001 MPPGGSGPGG CPRRPPALAG PLPPPPPPPP PPLLPLLPLL


 



LLLLLGAAEG


 



051 ARVSSSLSTT HHVHHFHSKH GTVPIAINRM PFLTRGGHAG


 



TTYIFGKGGA


 



101 LITYTWPPND RPSTRMDRLA VGFSTHQRSA VLVRVDSASG


 



LGDYLQLHID


 



151 QGTVGVIFNV GTDDITIDEP NAIVSDGKYH VVRFTRSGGN


 



ATLQVDSWPV


 



201 NERYPAGNFD NERLAIARQR IPYRLGRVVD EWLLDKGRQL


 



TIFNSQAAIK


 



251 IGGRDQGRPF QGQVSGLYYN GLKVLALAAE SDPNVRTEGH


 



LRLVGEGPSV


 



301 LVASAECPSD DEDLEECEPS TGGELILPII TEDSLDPPPV


 



ATRSPFVPPP


 



351 PTFYPFLTGV GATQDTLPPP AARRPPSGGP CQAERDDSDC


 



EEPIEASGFA


 



401 SGEVFDSSLP PTDDEDFYTT FPLVTDRTTL LSPRKPAPRP


 



NLRTDGATGA


 



451 PGVLFAPSAP APNLPAGKMN HRDPLQPLLE NPPLGPGAPT


 



SFEPRRPPPL


 



501 RPGVTSAPGF PHLPTANPTG PGERGPPGAV EVIRESSSTT


 



GMVVGIVAAA


 



551 ALCILILLYA MYKYRNRDEG SYQVDQSRNY ISNSAQSNGA


 



VVKEKAPAAP


 



601 KTPSKAKKNK DKEYYV






Neurexin-2-beta Precursor-derived Peptide NRX2B








(SEQ ID NO: 2)


RSGGNATLQVDSWP






(2) Prothrombin Precursor-derived Peptide (THRB(R−))

Prothrombin precursor-derived peptides are two types, and (R−) means the peptide lacking of R (Arginine residue) of C-terminus. THRB(R−) shown as SEQ ID NO: 4 was detected specifically in ADN patient, and was detected extremely low value in MCI, AD, NDall, NDdem, NDnon patients. Diagrams of THRB(R−) and THRB(R+) showed side by side in FIG. 4 and FIG. 5. FIG. 4 shows scatter plot. FIG. 5A) shows that the appearance of THRB(R−) and THRB(R+) how is different in every individual of ADN, MCI and AD. In the same individual, THRB(R−) has appeared overwhelmingly in ADN, THRB(R+) has appeared overwhelmingly in MCI and AD. It can be said that both peptides are extremely useful markers determining MCI and ADN. FIG. 5B) shows ROC curve comparing AD and NDnon of THRB(R−). ROC value indicated a high value of 0.815. the value in AD was lower compared to NDnon. In other words, it has been found that THRB(R−) as well as NRX2B is useful marker to distinguish between patients of cognitive impairment (MCI, AD, NDdem) and patients of non-demented neurological disease (NDnon).
Intact Protein/Peptide









(SEQ ID NO: 3)



001 MAHVRGLQLP GCLALAALCS LVHSQHVFLA PQQARSLLQR


 



VRRANTFLEE


 



051 VRKGNLEREC VEETCSYEEA FEALESSTAT DVFWAKYTAC


 



ETARTPRDKL


 



101 AACLEGNCAE GLGTNYRGHV NITRSGIECQ LWRSRYPHKP


 



EINSTTHPGA


 



151 DLQENFCRNP DSSTTGPWCY TTDPTVRRQE CSIPVCGQDQ


 



VTVAMTPRSE


 



201 GSSVNLSPPL EQCVPDRGQQ YQGRLAVTTH GLPCLAWASA


 



QAKALSKHQD


 



251 FNSAVQLVEN FCRNPDGDEE GVWCYVAGKP GDFGYCDLNY


 



CEEAVEEETG


 



301 DGLDEDSDRA IEGRTATSEY QTFFNPRTFG SGEADCGLRP


 



LFEKKSLEDK


 



351 TERELLESYI DGRIVEGSDA EIGMSPWQVM LFRKSPQELL


 



CGASLISDRW


 



401 VLTAAHCLLY PPWDKNFTEN DLLVRIGKHS RTRYERNIEK


 



ISMLEKIYIH


 



451 PRYNWRENLD RDIALMKLKK PVAFSDYIHP VCLPDRETAA


 



SLLQAGYKGR


 



501 VTGWGNLKET WTANVGKGQP SVLQVVNLPI VERPVCKDST


 



RIRITDNMFC


 



551 AGYKPDEGKR GDACEGDSGG PFVMKSPFNN RWYQMGIVSW


 



GEGCDRDGKY


 



601 GFYTHVFRLK KWIQKVIDQF GE






Prothrombin Precursor-derived Peptide THRB(R−)








(SEQ ID NO: 4)


GLDEDSDRAIEG






(3) Prothrombin Precursor-derived Peptide (THRB(R+))

THRB(R+) shows as SEQ ID NO: 5 was not detected in ADN patient, and was detected in MCI, AD, NDall, NDdem, and NDnon patients (FIG. 4). (R+) means that the peptide having of R (Arginine residue) of C-terminus. For explanation, refer to (2) Prothrombin precursor-derived peptide (THRB(R−)).
Intact Protein/Peptide









(SEQ ID NO: 3)



001 MAHVRGLQLP GCLALAALCS LVHSQHVFLA PQQARSLLQR


 



VRRANTFLEE


 



051 VRKGNLEREC VEETCSYEEA FEALESSTAT DVFWAKYTAC


 



ETARTPRDKL


 



101 AACLEGNCAE GLGTNYRGHV NITRSGIECQ LWRSRYPHKP


 



EINSTTHPGA


 



151 DLQENFCRNP DSSTTGPWCY TTDPTVRRQE CSIPVCGQDQ


 



VTVAMTPRSE


 



201 GSSVNLSPPL EQCVPDRGQQ YQGRLAVTTH GLPCLAWASA


 



QAKALSKHQD


 



251 FNSAVQLVEN FCRNPDGDEE GVWCYVAGKP GDFGYCDLNY


 



CEEAVEEETG


 



301 DGLDEDSDRA IEGRTATSEY QTFFNPRTFG SGEADCGLRP


 



LFEKKSLEDK


 



351 TERELLESYI DGRIVEGSDA EIGMSPWQVM LFRKSPQELL


 



CGASLISDRW


 



401 VLTAAHCLLY PPWDKNFTEN DLLVRIGKHS RTRYERNIEK


 



ISMLEKIYIH


 



451 PRYNWRENLD RDIALMKLKK PVAFSDYIHP VCLPDRETAA


 



SLLQAGYKGR


 



501 VTGWGNLKET WTANVGKGQP SVLQVVNLPI VERPVCKDST


 



RIRITDNMFC


 



551 AGYKPDEGKR GDACEGDSGG PFVMKSPFNN RWYQMGIVSW


 



GEGCDRDGKY


 



601 GFYTHVFRLK KWIQKVIDQF GE






Prothrombin Precursor-derived Peptide THRB(R+)








(SEQ ID NO: 5)


GLDEDSDRAIEGR






(4) Pendrind-derived Peptide (S26A4)

S26A4 shows as SEQ ID NO: 7 was not detected in ADN patient, and was detected in MCI, AD, NDall, NDdem, and NDnon patients (FIG. 6).
Intact Protein/Peptide









(SEQ ID NO: 6)



001 MAAPGGRSEP PQLPEYSCSY MVSRPVYSEL AFQQQHERRL


 



QERKTLRES


 



051 AKCCSCSRKR AFGVLKTLVP ILEWLPKYRV KEWLLSDVIS


 



GVSTGLVATL


 



101 QGMAYALLAA VPVGYGLYSA FFPILTYFIF GTSRHISVGP


 



FPVVSLMVGS


 



151 VVLSMAPDEH FLVSSSNGTV LNTTMIDTAA RDTARVLIAS


 



ALTLLVGIIQ


 



201 LIFGGLQIGF IVRYLADPLV GGFTTAAAFQ VLVSQLKIVL


 



NVSTKNYNGV


 



251 LSIIYTLVEI FQNIGDTNLA DFTAGLLTIV VCMAVKELND


 



RFRHKIPVPI


 



301 PIEVIVTIIA TAISYGANLE KNYNAGIVKS IPRGFLPPEL


 



PPVSLFSEML


 



351 AASFSIAVVA YAIAVSVGKV YATKYDYTID GNQEFIAFGI


 



SNIFSGFFSC


 



401 FVATTALSRT AVQESTGGKT QVAGIISAAI VMIAILALGK


 



LLEPLQKSVL


 



451 AAVVIANLKG MFMQLCDIPR LWRQNKIDAV IWVFTCIVSI


 



ILGLDLGLLA


 



501 GLIFGLLTVV LRVQFPSWNG LGSIPSTDIY KSTKNYKNIE


 



EPQGVKILR


 



551 SSPIFYGNVD GFKKCIKSTV GFDAIRVYNK RLKALRKIQK


 



LIKSGQLRAT


 



601 KNGIISDAVS TNNAFEPDED IEDLEELDIP TKEIEIQVDW


 



NSELPVKVNV


 



651 PKVPIHSLVL DCGAISFLDV VGVRSLRVIV KEFQRIDVNV


 



YFASLQDYV


 



701 EKLEQCGFFD DNIRKDTFFL TVHDAILYLQ NQVKSQEGQG


 



SILETITLIQ


 



751 DCKDTLELIE TELTEEELDV QDEAMRTLAS






Pendrin-derived Peptide S26A4








(SEQ ID NO: 7)


LAGLIFGLLTVVLR






(5) Coatomer Subunit Zeta-1-derived Peptide (COPZ1)

COPZ1 shows as SEQ ID NO: 9 was shown low value in ADN patient, was shown high value in MCI, AD, and NDdem patients (FIG. 6).
Intact Protein/Peptide









(SEQ ID NO: 8)



001 MEALILEPSL YTVKAILILD NDGDRLFAKY YDDTYPSVKE


 



QKAFEKNIFN


 



051 KTHRTDSEIA LLEGLTVVYK SSIDLYFYVI GSSYENELML


 



MAVLNCLFDS


 



101 LSQMLRKNVE KRALLENMEG LFLAVDEIVD GGVILESDPQ


 



QVVHRVALRG


 



151 EDVPLTEQTV SQVLQSAKEQ IKWSLLR






Coatomer Subunit Zeta-1-derived Peptide COPZ1








(SEQ ID NO: 9)









AILILDNDGDRLFAKYYDD






(6) Retinoic Acid Receptor Responder Protein 2 Precursor-derived Peptide (RARR2(S−))

RARR2(S−) shows as SEQ ID NO: 11 was not detected in ADN patient, and was detected in AD and MCI patients (FIG. 7). Retinoic acid receptor responder protein 2 precursor-derived peptides are two types, and (S−) means the peptide lacking of S (Serine residue) of C-terminus.
Intact Protein/Peptide







(SEQ ID NO: 10)








001
MRRLLIPLAL WLGAVGVGVA ELTEAQRRGL QVALEEFHKH


 



PPVQWAFQET


 


051
SVESAVDTPF PAGIFVRLEF KLQQTSCRKR DWKKPECKVR


 



PNGRKRKCLA


 


101
CIKLGSEDKV LGRLVHCPIE TQVLREAEEH QETQCLRVQR


 



AGEDPHSFYF


 


151
PGQFAFSKAL PRS






Retinoic Acid Receptor Responder Protein 2 Precursor-derived Peptide RARR2(S−)










(SEQ ID NO: 11)



PHSFYFPGQFAFSKALPR






(7) Retinoic Acid Receptor Responder Protein 2 Precursor-derived Peptide (RARR2(S+))

RARR2(S+) shows as SEQ ID NO: 12 was not detected in ADN patient as well as RARR2(S−), and was detected in AD and MCI patients (FIG. 7). (S+) means that the peptide having of S (Serine residue) of C-terminus.
Intact Protein/Peptide







(SEQ ID NO: 10)








001
MRRLLIPLAL WLGAVGVGVA ELTEAQRRGL QVALEEFHKH


 



PPVQWAFQET


 


051
SVESAVDTPF PAGIFVRLEF KLQQTSCRKR DWKKPECKVR


 



PNGRKRKCLA


 


101
CIKLGSEDKV LGRLVHCPIE TQVLREAEEH QETQCLRVQR


 



AGEDPHSFYF


 


151
PGQFAFSKAL PRS






Retinoic Acid Receptor Responder Protein 2 Precursor-derived Peptide RARR2(S+)










(SEQ ID NO: 12)



PHSFYFPGQFAFSKALPRS






(8) Gelsolin Precursor-derived Peptide (Gels)

GELS shows as SEQ ID NO: 14 was shown low value in ADN patient, and was shown relatively high value in MCI and AD patients (FIG. 8).
Intact Protein/Peptide







(SEQ ID NO: 13)








001
MAPHRPAPAL LCALSLALCA LSLPVRAATA SRGASQAGAP


 



QGRVPEARPN


 


051
SMVVEHPEFL KAGKEPGLQI WRVEKFDLVP VPTNLYGDFF


 



TGDAYVILKT


 


101
VQLRNGNLQY DLHYWLGNEC SQDESGAAAI FTVQLDDYLN


 



GRAVQHREVQ


 


151
GFESATFLGY FKSGLKYKKG GVASGFKHVV PNEVVVQRLF


 



QVKGRRVVRA


 


201
TEVPVSWESF NNGDCFILDL GNNIHQWCGS NSNRYERLKA


 



TQVSKGIRDN


 


251
ERSGRARVHV SEEGTEPEAM LQVLGPKPAL PAGTEDTAKE


 



DAANRKLAKL


 


301
YKVSNGAGTM SVSLVADENP FAQGALKSED CFILDHGKDG


 



KIFVWKGKQA


 


351
NTEERKAALK TASDFITKMD YPKQTQVSVL PEGGETPLFK


 



QFFKNWRDPD


 


401
QTDGLGLSYL SSHIANVERV PFDAATLHTS TAMAAQHGMD


 



DDGTGQKQIW


 


451
RIEGSNKVPV DPATYGQFYG GDSYIILYNY RHGGRQGQII


 



YNWQGAQSTQ


 


501
DEVAASAILT AQLDEELGGT PVQSRVVQGK EPAHLMSLFG


 



GKPMIIYKGG


 


551
TSREGGQTAP ASTRLFQVRA NSAGATRAVE VLPKAGALNS


 



NDAFVLKTPS


 


601
AAYLWVGTGA SEAEKTGAQE LLRVLRAQPV QVAEGSEPDG


 



FWEALGGKAA


 


651
YRTSPRLKDK KMDAHPPRLF ACSNKIGRFV IEEVPGELMQ


 



EDLATDDVML


 


701
LDTWDQVFVW VGKDSQEEEK TEALTSAKRY IETDPANRDR


 



RTPITVVKQG


 


751
FEPPSFVGWF LGWDDDYWSV DPLDRAMAEL AA






Gelsolin Precursor-derived Peptide Gels










(SEQ ID NO: 14)



PVRAATASRGAS






(9) Clusterin Precursor-derived Peptide (CLUS(N-term SDVP))

CLUS(N-term SDVP) shows as SEQ ID NO: 16 was shown low value in ADN patient, and was shown relatively high value in MCI and AD patients (FIG. 9). Clusterin precursor-derived peptides are two types, and (N-termSDVP) means that the amino acid sequence of N-terminus in peptide is SDVP.
Intact Protein/Peptide







(SEQ ID NO: 15)








001
MMKTLLLFVG LLLTWESGQV LGDQTVSDNE LQEMSNQGSK


 



YVNKEIQNAV


 


051
NGVKQIKTLI EKTNEERKTL LSNLEEAKKK KEDALNETRE


 



SETKLKELPG


 


101
VCNETMMALW EECKPCLKQT CMKFYARVCR SGSGLVGRQL


 



EEFLNQSSPF


 


151
YFWMNGDRID SLLENDRQQT HMLDVMQDHF SRASSIIDEL


 



FQDRFFTREP


 


201
QDTYHYLPFS LPHRRPHFFF PKSRIVRSLM PFSPYEPLNF


 



HAMFQPFLEM


 


251
IHEAQQAMDI HFHSPAFQHP PTEFIREGDD DRTVCREIRH


 



NSTGCLRMKD


 


301
QCDKCREILS VDCSTNNPSQ AKLRRELDES LQVAERLTRK


 



YNELLKSYQW


 


351
KMLNTSSLLE QLNEQFNWVS RLANLTQGED QYYLRVTTVA


 



SHTSDSDVPS


 


401
GVTEVVVKLF DSDPITVTVP VEVSRKNPKF METVAEKALQ


 



EYRKKHREE






Clusterin Precursor-derived Peptide CLUS(N-term SDVP)










(SEQ ID NO: 16)



SDVPSGVTEVVVKLFDS






(10) Clusterin Precursor-derived Peptide (CLUS(N-term RFFT))

CLUS(N-term RFFT) shows as SEQ ID NO: 17 was detected in ADN patient, and was not completely detected in AD patient (FIG. 9). (N-term RFFT) means that the amino acid sequence of N-terminus in peptide is RFFT.
Intact Protein/Peptide







(SEQ ID NO: 15)








001
MMKTLLLFVG LLLTWESGQV LGDQTVSDNE LQEMSNQGSK


 



YVNKEIQNAV


 


051
NGVKQIKTLI EKTNEERKTL LSNLEEAKKK KEDALNETRE


 



SETKLKELPG


 


101
VCNETMMALW EECKPCLKQT CMKFYARVCR SGSGLVGRQL


 



EEFLNQSSPF


 


151
YFWMNGDRID SLLENDRQQT HMLDVMQDHF SRASSIIDEL


 



FQDRFFTREP


 


201
QDTYHYLPFS LPHRRPHFFF PKSRIVRSLM PFSPYEPLNF


 



HAMFQPFLEM


 


251
IHEAQQAMDI HFHSPAFQHP PTEFIREGDD DRTVCREIRH


 



NSTGCLRMKD


 


301
QCDKCREILS VDCSTNNPSQ AKLRRELDES LQVAERLTRK


 



YNELLKSYQW


 


351
KMLNTSSLLE QLNEQFNWVS RLANLTQGED QYYLRVTTVA


 



SHTSDSDVPS


 


401
GVTEVVVKLF DSDPITVTVP VEVSRKNPKF METVAEKALQ


 



EYRKKHREE






Clusterin Precursor-derived Peptide CLUS(N-term RFFT)










(SEQ ID NO: 17)



RFFTREPQDTYHYLPFSLPH






(11) Eukaryotic Translation Initiation Factor 3 Subunit J-derived Peptide (EIF3J)

EIF3J shows as SEQ ID NO: 19 was detected in ADN patient, and was not at all or almost detected in MCI, AD, NDall, NDdem, and NDnon patients (FIG. 10).
Intact Protein/Peptide







(SEQ ID NO: 18)








001
MAAAAAAAGD SDSWDADAFS VEDPVRKVGG GGTAGGDRWE


 



GEDEDEDVKD


 


051
NWDDDDDEKK EEAEVKPEVK ISEKKKIAEK IKEKERQQKK


 



RQEEIKKRLE


 


101
EPEEPKVLTP EEQLADKLRL KKLQEESDLE LAKETFGVNN


 



AVYGIDAMNP


 


151
SSRDDFTEFG KLLKDKITQY EKSLYYASFL EVLVRDVCIS


 



LEIDDLKKIT


 


201
NSLTVLCSEK QKQEKQSKAK KKKKGVVPGG GLKATMKDDL


 



ADYGGYDGGY


 


251
VQDYEDFM






Eukaryotic Translation Initiation Factor 3 Subunit J-derived Peptide EIF3J










(SEQ ID NO: 19)



GVVPGGGLKATMKDDLADYGGYDGG + Oxidation (M)






(12) Leucine-rich Repeat-containing Protein 27-derived Peptide (LRC27)

LRC27 shows as SEQ ID NO: 21 was detected in ADN patient, and was not completely detected in AD patient (FIG. 10).
Intact Protein/Peptide







(SEQ ID NO: 20)








001
MEGSSSYEVP SVAAADLEEG AGQTRSLPAT PSKDVHKGVG


 



GIIFSSSPIL


 


051
DLSESGLCRL EEVFRIPSLQ QLHLQRNALC VIPQDFFQLL


 



PNLTWLDLRY


 


101
NRIKALPSGI GAHQHLKTLL LERNPIKMLP VELGSVTTLK


 



ALNLRHCPLE


 


151
FPPQLVVQKG LVAIQRFLRM WAVEHSLPRN PTSQEAPPVR


 



EMTLRDLPSP


 


201
GLELSGDHAS NQGAVNAQDP EGAVMKEKAS FLPPVEKPDL


 



SELRKSADSS


 


251
ENWPSEEEIR RFWKLRQEIV EHVKADVLGD QLLTRELPPN


 



LKAALNIEKE


 


301
LPKPRHVFRR KTASSRSILP DLLSPYQMAI RAKRLEESRA


 



AALRELQEKQ


 


351
ALMEQQRREK RALQEWRERA QRMRKRKEEL SKLLPPRRSM


 



VASKIPSATD


 


401
LIDNRKVPLN PPGKMKPSKE KSPQASKEMS ALQERNLEEK


 



IKQHVLQMRE


 


451
QRRFHGQAPL EEMRKAAEDL EIATELQDEV LKLKLGLTLN


 



KDRRRAALTG


 


501
NLSLGLPAAQ PQNTFFNTKY GESGNVRRYQ






Leucine-rich Repeat-containing Protein 27-derived Peptide LRC27










(SEQ ID NO: 21)



SSPILDLSESGLCRLEEVFRIPS






There have been already quoted, but for the peptides of SEQ ID NO: 2 (NRX2B) to SEQ ID NO: 21 (LRC27), the scatter plots of comparison between ADN, MCI and AD patients, and the scatter plot of comparison between ADN, AD, NDall, NDdem and NDnon patients, and the p-value of t-test in each comparison were showed in FIG. 2, FIG. 4 and FIG. 6 through FIG. 10.
Table 1 shows the list of 12 marker peptides described above and their ROC values for comparison of MCI vs. ADN and AD vs. ADN.









TABLE 1







Marker peptides
MCI vs. ADN
AD vs. ADN












Swiss-Prot
Sequence
ROC
MCI
ROC
AD


Entry
No.
value
was
value
was















NRX2B
2
0.99
up
1
up


THRB (R−)
4
0.854
down
0.841
down


THRB (R+)
5
0.94
up
0.985
up


S26A4
7
0.925
up
0.95
up


COPZ1
9
0.786
up
0.767
up


RARR2 (S−)
11
0.885
up
0.914
up


RARR2 (S+)
12
0.95
up
0.919
up


GELS
14
0.716
up
0.762
up


CLUS
16
0.739
up
0.717
up


(N-term SDVP)


CLUS
17
0.675
down
0.75
down


(N-term RFFT)


EIF3J
19
0.748
down
0.775
down


LRC27
21
0.699
down
0.755
down









Table 1 shows the usefulness of each marker peptide in detection of cognitive impairment (MCI and AD). Using these marker peptides in singly or in combination, using or without using liquid chromatography and/or any other suitable separation methods, directly measuring the abundance in serum using other methods such as mass spectrometry or immunological methods or enzymatic methods, it is possible to distinguish between non-dementia and dementia in neurological disease and diagnose cognitive impairment like AD and MCI. The marker peptide that is not detected in ADN and is detected in MCI, AD, NDall, NDdem and NDnon patients, or vice versa, the marker peptide that is detected in ADN patient and is not detected in MCI, AD, NDall, NDdem and NDnon patients, are also useful for the detection of psychiatric diseases.
EXAMPLE 2
Example 2. Synthesis of a Marker Peptide, and Preparation of a Marker Peptide Specific Polyclonal Antibody
The antigenic peptide was synthesized to prepare the specific antibody that recognizes Neurexin-2-beta precursor-derived peptide NRX2B of SEQ ID NO: 2. The synthetic peptide for coupling to a carrier protein was added the cysteine residue (labeled as C or Cys) in C-terminus. The peptide that was combined with carrier protein (RSGGNATC-KLH, see below) was mixed with an adjuvant, and the mixture was immunized in rabbit. Total eight times immunizations is performed every 1-2 weeks, and the test blood collection performed twice every 4 weeks, and the antibody titers were measured by enzyme immunoassay (EIA). After three months from the start of the immunization, the whole blood was collected from rabbit and the antiserum was obtained, furthermore the purification of the specific antibody was performed using the peptide column that antigen peptide was bound as ligand.
The sequence of synthetic antigen peptide for preparation of peptide specific antibody is shown below.









(SEQ ID NO: 22)



RSGGNAT + Cys






EXAMPLE 3
Example 3. Preparation of Antibody-beads
(1) Method
(1-1) Preparation of Antibody, and Binding to Magnetic-beads
The antibody solution, 1 mg of the antibody (anti-NRX2B antibody, Rabbit IgG) that specifically recognizes the peptide of amino acid sequence expressed by SEQ ID NO: 22 was dissolved with 3 ml of 0.1 M MES. After washing 1 ml (10 mg beads) of the magnetic-beads (Magnosphere MS300/carboxyl, JSR Corporation) by using 0.1 M MES, the magnetic-beads were mixed with the antibody solution and were gently shaken for 30 min at room temperature.
(1-2) Cross-linking of Antibody and Magnetic-beads
400 μl of EDC solution (10 mg/ml 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride in 0.1M MES) was added in antibody-beads solution and was suspended gently for 3 hours to bind antibody with beads by covalent bond.
(1-3) Blocking
1 ml of 200 mM ethanolamine (pH8.0) was added to wash beads, and further 1 ml of 200 mM ethanolamine (pH8.0) was added and was shaken gently for 1 hours at room temperature to block amine groups.
(1-4) Washing
After removal of 200 mM 200 m M ethanolamine (pH8.0), the beads were washed three times by 1 ml of TBST solution (25 mM Tris-HCl (pH7.2) containing 0.15M NaCl and 0.05% Tween 20).
(1-5) Storage
After suspending the beads by adding with 1 ml of TBST solution, and stored at 4° C.
EXAMPLE 4
Example 4. The Proof by ImmunoMS Method that the Peak of m/z 1,488 in Patient Serum Detected by 2D-LC-MALDI-TOF-MS is NRX2B
(1) Methods
As the control for comparison, stable isotope-labeled NRX2B synthetic peptide (12C and 13C5 of V has been replaced by 15N and 14N) greater than mass of NRX2B was used. The mass difference between NRX2B and its stable isotope peptide is 6 u. Both the endogenous peptide and the stable isotope-labeled peptide are captured by anti-NRX2B antibody. 1 μl of 200 fmol/μl stable isotope-labeled NRX2B synthetic peptide was added in 25 μl of each of patient serum in AD and MCI, and incubated for 10 min at 4° C. Then, 475 μl of 0.1% trifluoroacetic acid (TFA) was added and boiled for 5 min at 100° C. After centrifugation for 15 min at 14,000×g, 500 μl of 100 mM Tris-HCl buffer (pH 7.5) containing 0.3 M NaCl and 0.2% n-octyl glycoside was added in supernatant as peptide solutions. 20 μl of anti-NRX2B antibody-beads created in Example 3 was added in the peptide solutions, and was shaken gently for 2 hours. Then, after standing for 1 min on the magnetic stand, the supernatant was removed. 1 ml of 50 mM Tris-HCl buffer (pH 7.5) (TBS) containing 0.15 M NaCl and 0.1% n-octyl glycoside was added, and was shaken gently for 10 min. After standing for 1 min on the magnetic stand, the supernatant was removed. In addition, after adding 500 μl of TBS, and standing for 1 min on the magnetic stand, the supernatant was removed. This procedure was repeated three times. Furthermore, after adding 500 μl of 50 mM ammonium carbonate, and standing for 1 min on the magnetic stand, the supernatant was removed. This procedure was repeated three times. 50 μl of 2-propanol: H2O: formic acid (4:4:1) solution was added, and was stood for 10 min, and then after standing for 1 min on the magnetic stand, the filtrate was recovered. This procedure was repeated twice. The filtrates were completely dried using vacuum centrifuge. Then, 20 μl of 0.095% TFA containing 5% acetonitrile was added and was re-dissolved by sonication. The peptides were concentrated using C18 pipette tip (PerfectPure C-18 Tip, Eppendorf), and were spotted on MALDI target plate (MTP Anchor ChipTM 600/384 plate, BRUKER DALTONICS) by eluting from C18 pipette tip, and then the peptides were analyzed using MALDI TOF mass spectrometer (AXIMA CFRplus, SHIMADZU).
(2) Results
FIG. 11 shows the result of the mass spectrum of NRX2B peptide detected from the patient serum in AD and MCI using the above method. FIG. 11A) shows the overall mass spectrum, and FIG. 11B) shows the enlarged view of the arrow parts in FIG. 11A). The signal indicated by dashed arrows in FIG. 11B) is stable isotope-labeled NRX2B synthetic peptide that was spiked, and the signal indicated by solid arrows is endogenous NRX2B peptide. The observed mass value was within the measurement error of the expected value. And also the mass difference between endogenous NRX2B peptide and its stable isotope-labeled peptide was 6 u. Therefore, it was demonstrated that the trapped peptide is NRX2B.
In this experiment, NRX2B which is the peptide marker was detected from serum by using immunoMS method that developed originally by present inventors, and it could be shown that it is possible to distinguish between AD and MCI patients from ADN. At the same time, in this experiment, it has also shown that the specific antibody against NRX2B is useful in detecting its peptide marker. In addition, it also shows that immunological detection method could be effective against the peptide or protein comprised in the amino acid sequence of NRX2B using the specific antibody against NRX2B. In addition, in this experiment, it was determined by using the specific antibodies that recognize one peptide marker, but the combination of biomarkers specific antibodies that recognize other peptides that were found in Example 1, is expected to further increase the accuracy of diagnosis of the pathosis.
[Industrial Applicability]
As cognitive impairment including mild cognitive impairment and Alzheimer disease and cognitive impairment and non-psychiatric disease can be detected by using the biomarkers disclosed in the present invention, the invention is applicable to the use in the field of medical diagnosis including that of diagnostic agents.

## Claims

1. An isolated Neurexin-2-beta precursor polypeptide consisting of the amino acid sequence SEQ ID NO: 1.

2. An isolated Neurexin-2-beta precursor-derived peptide NRX2B consisting of the amino acid sequence SEQ ID NO: 2.