p-tau217
p-tau217 is tau protein phosphorylated at threonine 217 and the most Alzheimer-specific plasma biomarker currently available. Concentrations rise early along the amyloid cascade, before cognitive symptoms emerge, and correlate tightly with amyloid-PET and tau-PET burden. In head-to-head comparisons plasma p-tau217 outperforms p-tau181, p-tau231 and several MRI-based markers for discriminating Alzheimer disease from other neurodegenerative disorders. Two-step workflows using plasma p-tau217 reduce the need for amyloid-PET or cerebrospinal fluid testing when triaging patients with cognitive impairment for anti-amyloid therapy. Pre-analytical handling, assay platform and reference ranges still vary across vendors. The first FDA-cleared blood test for Alzheimer disease (Fujirebio Lumipulse G pTau217/β-Amyloid 1-42 plasma ratio, May 2025) uses a plasma p-tau217 ratio; Roche received an EU CE mark for the Elecsys pTau217 plasma assay on 12 May 2026.
Sources
- Palmqvist S, Janelidze S, Quiroz YT, Zetterberg H, Lopera F, Stomrud E, et al.. (2020). Discriminative Accuracy of Plasma Phospho-tau217 for Alzheimer Disease vs Other Neurodegenerative Disorders. *JAMA*doi:10.1001/jama.2020.12134
- Janelidze S, Mattsson N, Palmqvist S, Smith R, Beach TG, Serrano GE, et al.. (2020). Plasma P-tau181 in Alzheimer's disease: relationship to other biomarkers, differential diagnosis, neuropathology and longitudinal progression to Alzheimer's dementia. *Nature Medicine*doi:10.1038/s41591-020-0755-1
- Mattsson-Carlgren N, Janelidze S, Palmqvist S, Cullen N, Svenningsson AL, Strandberg O, et al.. (2020). Longitudinal plasma p-tau217 is increased in early stages of Alzheimer's disease. *Brain*doi:10.1093/brain/awaa286
