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Protein biomarker signature in patients with spinal and bulbar muscular atrophy
Andrew T.N. Tebbenkamp, Spencer B. Huggett, Vittoria Lombardi, Luca Zampedri, Abdullah AlQahtani, Angela Kokkinis, Andrea Malaspina, Carlo Rinaldi, Christopher Grunseich, Pietro Fratta, Vissia Viglietta
Andrew T.N. Tebbenkamp, Spencer B. Huggett, Vittoria Lombardi, Luca Zampedri, Abdullah AlQahtani, Angela Kokkinis, Andrea Malaspina, Carlo Rinaldi, Christopher Grunseich, Pietro Fratta, Vissia Viglietta
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Research Article Muscle biology Neuroscience

Protein biomarker signature in patients with spinal and bulbar muscular atrophy

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Abstract

Spinal and bulbar muscular atrophy (SBMA) is a slowly progressing disease with limited sensitive biomarkers that support clinical research. We analyzed plasma and serum samples from patients with SBMA and matched healthy controls in multiple cohorts, identifying 40 highly reproducible SBMA-associated proteins out of nearly 3,000 measured. These proteins were robustly enriched in gene sets of skeletal muscle expression and processes related to mitochondria and calcium signaling. Many proteins outperformed currently used clinical laboratory tests (e.g., creatine kinase [CK]) in distinguishing patients from controls and in their correlations with clinical and functional traits in patients. Two of the 40 proteins, Ectodysplasin A2 receptor (EDA2R) and Repulsive guidance molecule A (RGMA), were found to be associated with decreased survival and body weight in a mouse model of SBMA. In summary, we identified what we believe to be a robust and novel set of fluid protein biomarkers in SBMA that are linked with relevant disease features in patients and in a mouse model of disease. Changes in these SBMA-associated proteins could be used as an early predictor of treatment effects in clinical trials.

Authors

Andrew T.N. Tebbenkamp, Spencer B. Huggett, Vittoria Lombardi, Luca Zampedri, Abdullah AlQahtani, Angela Kokkinis, Andrea Malaspina, Carlo Rinaldi, Christopher Grunseich, Pietro Fratta, Vissia Viglietta

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Figure 2

Discovery of protein biomarker signature in SBMA.

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Discovery of protein biomarker signature in SBMA.
(A) PCA of control and...
(A) PCA of control and patients with SBMA from the NIH cohort (n = 15 SBMA; n = 15 control). Differential abundance in protein expression was calculated using a linear regression framework, adjusting for age. (B) Volcano plot of all measured proteins from the NIH cohort. Proteins in red were increased, and proteins in blue were decreased. Proteins in green were not significantly different (Padj < 0.05 cut-off, dotted red line). Top proteins are labeled, and clinical labs measured in those patients are in bold and italicized. (C) PCA of samples from the UCL cohort (n = 19 SBMA; n = 12 control). (D) Volcano plot as described in B. (E) Correlation of proteins consistent across both cohorts; red indicates increased in both, blue indicates decreased in both, and green indicates inconsistent across cohorts. (F) Gene set enrichment analysis (GSEA) of SBMA proteomic associations showing the tissues and biological functions that were significantly enriched across cohorts.

Copyright © 2026 American Society for Clinical Investigation
ISSN 2379-3708

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