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[Preprint]. 2025 Jul 30:2025.07.30.25332433. [Version 1] doi: 10.1101/2025.07.30.25332433

Table 2.

Plasma protein biomarkers significantly associated with future onset of Parkinson’s disease

Protein HR (95% CI) p q Replication Cross-disease Prior evidence
2–28 years of follow-up
VAMP3 1.26 (1.16–1.36) 1.46E-08 1.07E-04 moderate
TPPP2 0.70 (0.61–0.80) 7.06E-08 3.15E-04 strong
HPGDS 0.73 (0.65–0.82) 8.59E-08 2.09E-04 strong AD
ALPLcap 1.25 (1.15–1.36) 1.30E-07 3.16E-04 strong
FCAR 1.34 (1.20–1.50) 3.48E-07 6.34E-04 suggestive Irmady et al., 202344
CERS5 1.23 (1.12–1.34) 5.64E-06 6.85E-03 suggestive ALS
MFAP5cap 0.73 (0.64–0.84) 1.14E-05 1.38E-02 strong
RSPO2 1.19 (1.10–1.29) 2.09E-05 2.10E-02 suggestive AD, ALS
CD3G 1.19 (1.10–1.29) 2.30E-05 2.10E-02 suggestive
GTF2A2cap 1.22 (1.11–1.34) 2.30E-05 2.40E-02 moderate
LTF 1.28 (1.14–1.43) 3.21E-05 2.34E-02 AD
NAMPTcap 1.28 (1.14–1.44) 4.51E-05 3.65E-02 ALS Santiago et al., 201645
OGFR 0.77 (0.68–0.87) 5.04E-05 3.67E-02 strong AD
FGF8 1.21 (1.10–1.33) 5.75E-05 3.46E-02 moderate
PSG6 1.25 (1.12–1.39) 6.17E-05 3.46E-02
ACAD8 1.18 (1.09–1.28) 7.05E-05 3.65E-02 strong AD
CRYGD 1.20 (1.10–1.32) 7.52E-05 3.65E-02
2–10 years of follow-up
TIMP1cap 0.72 (0.62–0.83) 4.52E-06 1.65E-02 moderate
IL11 1.30 (1.15–1.47) 2.04E-05 4.23E-02
TCL1A 0.71 (0.61–0.83) 2.23E-05 4.23E-02 strong Kedmi et al., 201146
10–20 years of follow-up
GUCA1Bcap 1.31 (1.18–1.45) 3.95E-07 1.44E-03
UBE2L3|UBBcap 1.29 (1.16–1.42) 6.08E-07 1.48E-03
DCAF12 1.24 (1.12–1.37) 2.63E-05 2.47E-02
GPC4cap 1.26 (1.13–1.40) 2.80E-05 3.33E-02 strong Tatenhorst et al., 202447
BECN1 1.26 (1.13–1.40) 2.92E-05 2.47E-02 Miki et al., 201848
HEPACAM2cap 1.25 (1.12–1.39) 3.05E-05 3.33E-02 suggestive
F13A1|F13Bcap 1.34 (1.17–1.54) 3.20E-05 3.33E-02
ABHD12 1.25 (1.12–1.38) 3.37E-05 2.47E-02 moderate
IRAG2 1.24 (1.12–1.37) 3.38E-05 2.47E-02 AD
TAFA4cap 1.25 (1.12–1.39) 5.93E-05 3.93E-02
GSTA3 1.23 (1.11–1.37) 6.08E-05 3.69E-02 strong AD
SPASTcap 1.24 (1.11–1.38) 7.94E-05 4.45E-02 AD, ALS
CUL4B 1.32 (1.15–1.51) 9.85E-05 4.22E-02 Yao et al., 202233
OSTF1 1.30 (1.14–1.49) 9.92E-05 4.22E-02
PYDC1 1.24 (1.11–1.38) 1.07E-04 4.22E-02 AD, ALS D. Torshizi et al., 202418
LCN2 1.30 (1.14–1.49) 1.10E-04 4.22E-02 strong Fan et al., 202430
OTX2 1.27 (1.13–1.44) 1.10E-04 4.22E-02 AD
MAGEA8 0.66 (0.54–0.82) 1.16E-04 4.22E-02
ZNF41 1.22 (1.10–1.35) 1.32E-04 4.57E-02
Men
RS1 1.42 (1.22–1.65) 4.34E-06 9.10E-03 AD
KRAScap 1.34 (1.17–1.53) 1.30E-05 1.89E-02 strong
LYZcap 1.37 (1.19–1.59) 2.06E-05 2.50E-02
GBA3cap 1.33 (1.16–1.52) 3.91E-05 3.17E-02 AD
GJA1 1.32 (1.16–1.50) 3.70E-05 3.37E-02 strong AD
AMN 1.40 (1.19–1.64) 5.07E-05 3.69E-02 moderate ALS Elango et al., 202331
Women
ITGA6 1.27 (1.14–1.42) 1.87E-05 4.29E-02 suggestive
CXCL11 0.69 (0.58–0.82) 2.34E-05 5.67E-02 moderate Hepp et al., 202332

This table presents all plasma proteins showing significant (false discovery rate [FDR]=0.05) association with incident Parkinson’s disease (PD) in Cox proportional hazard regressions in the EPIC4PD case-cohort stratified for center, sex (where non-sex-stratified) and 5-year age categories. Analyses were conducted for the entire follow-up period (2–28 years), as well as for proximal (2–10 years) and distal (10–20 years) time windows before disease onset or censoring, and additionally analyzed per sex stratum over the full follow-up. Strong evidence for replication: At least one nominally significant replication (for SomaScan in the same effect direction; for Olink, direction not required), and all additional SomaScan-based datasets showing effect estimates in the same direction. Moderate evidence for replication: Effects observed in the same direction in all (at least two) SomaScan datasets datasets, but non-significant results, or alternatively, one nominally significant SomaScan-based replication result (same direction), another SomaScan dataset showing the same and one showing an opposite direction. Suggestive evidence for replication: One nominally significant replication result (same direction for SomaScan, for Olink, direction not required) but heterogeneous effect directions among remaining datasets, or only two SomaScan datasets with consistent (but non-significant) effects. Cross-disease=at least nominally significant (uncorrected p<0.05) associations with instantaneous risk of Alzheimer’s disease (AD) and amyotrophic lateral sclerosis (ALS) based on EPIC4AD and EPIC4ALS, respectively. Prior evidence: publications describing differential protein and/or mRNA levels in blood in (always prevalent) PD patients compared to controls. Note that these were always in line with effect directions in EPIC4PD. HR=hazard ratio; CI=95% confidence interval; q=FDR-adjusted p-value (FDR=0.05). Bolded words for ‘cross-disease’ indicate significance at FDR=0.05. Note that from both outlier handling approaches, i.e., excluding outliers beyond 5 standard deviations from the log-mean or capping these outliers at the value of 5 standard deviations (indicated as “cap”), only the more significant result (smaller q) is shown. However, in all instances, at least nominally significant evidence was also observed for the alternative outlier removal method.