diagnostic ͉ MAPK ͉ Alzheimer's index ͉ PKC ͉ human fibroblasts R ecent evidence in human patients and animal models supports the hypothesis that early dysfunction in the brains of Alzheimer's disease (AD) patients involves inflammatory signaling pathways. For example, in several studies the cognitive impairment of AD patients increased with changes in two inflammatory signals: lower plasma TNF-␣ levels and higher levels of IL-1 (1-7). PKC-mediated ␣-secretase activation is responsible for TNF-␣ generation. Furthermore, deficits of PKC isozymes have been found in AD brain tissues (8) and skin fibroblasts (9-11), as have deficits of PKC-mediated phosphorylation of MAPK (12). Therefore, we investigated a molecular biomarker that assays both MAPK Erk1 and Erk2 phosphorylation in response to the inflammatory signaling molecule bradykinin (BK), which activates PKC pathways.The neurodegenerative processes responsible for AD may begin well before the disease can be detected by current clinical and͞or imaging diagnostic criteria. Therefore, a biological marker to predict or confirm AD would be invaluable for initiating early therapeutic regimens (13,14). Although definitive diagnosis of AD requires both clinically demonstrated dementia and amyloid plaques and tangles at autopsy, a molecular marker in peripheral tissue (e.g., skin, blood, and saliva) with high sensitivity and specificity, detectable soon after the onset of symptoms, could be important for enhancing the accuracy of clinical diagnosis and screening AD drug therapies.Recently, several studies have suggested that AD may indeed have systemic manifestations caused by molecular͞biophysical changes early in disease progression (15)(16)(17). AD skin fibroblast cell lines, for example, may offer a cellular environment in which the effects of AD-specific differences in amyloid  (A)(1-42) have altered signal transduction. Such studies have identified AD-specific changes in K ϩ channels that are also sensitive to A(1-42) interaction (15), changes in BK-mediated calcium mobilization via the IP 3 receptor (16), and changes in MAPK phosphor ylation (12). Still another report documented differences in A secretion from skin fibroblasts of family members with familial AD genes (17).BK is a potent inflammatory mediator that is produced in both brain and peripheral cells (e.g., skin fibroblasts) under pathophysiological conditions such as trauma, stroke, ischemia, and asthma. Via the G-protein-coupled B2 BK receptor (BK2bR), BK activates the phospholipase C͞phospholipid-Ca 2ϩ ͞PKC cascade that, in turn, interacts with the Ras͞Raf͞MAPK kinase͞ MAPK signaling pathway, ultimately causing Erk1͞2 phosphorylation (18). Erk1 and Erk2 were previously reported to be activated in response to A stimulation of the MAPK signaling pathways (19). Here, we introduce an Alzheimer's Erk1 and Erk2 index that differentially compares Erk1 and Erk2 phosphorylation induced by BK application within the media bathing human skin fibroblasts. The results, obtained by using both fibroblasts from ...