Molecular evidence of aquaporin-4 dysregulation and neuroinflammatory stress underlying blood-brain barrier dysfunction in idiopathic intracranial hypertension: A case-control study.
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引用次数: 0
Abstract
Objective: To evaluate aquaporins (AQP), heat shock proteins (HSP), and CD146 (cluster of differentiation) as molecular markers of blood-brain barrier (BBB) disruption and neuroinflammation in idiopathic intracranial hypertension (IIH).
Background: Emerging evidence implicates BBB dysfunction and neuroinflammation, yet their mechanistic basis in IIH is unclear.
Methods: In this case-control study with cross-sectional exposure ascertainment, conducted in Postgraduate Institute of Medical Education and Research, Chandigarh, India, from March 2023 to September 2024, newly diagnosed patients with IIH and age- and sex-matched healthy individuals undergoing spinal anesthesia for non-neurological disease anesthesia controls (AC) and age- and sex-matched healthy controls (HC) were enrolled. Protein levels of AQPs and gene expression of HSPs and CD146 were quantified in blood and cerebrospinal fluid (CSF) and correlated with clinical features and severity.
Results: Patients with IIH were predominantly female (87%), with mean body mass index (BMI) 28.1 ± 5.2 kg/m2 and mean CSF opening pressure 27.4 ± 4.8 cm CSF. Patients with IIH demonstrated reduced AQP4CSF levels as compared to AC group (2.65 [2.09, 3.70] vs. 3.07 [1.65, 7.15], p = 0.016) and increased gene expression of HSP70Blood as compared to AC and HC (3.86 [1.02, 5.61] vs. 1.08 [0.78, 2.91] vs. 1.77 [0.43, 2.27], p = 0.002); increased gene expression of HSP60CSF as compared to AC (1.28 [0.37, 2.44] vs. 0.52 [0.23, 1.26], p = 0.038); and increased gene expression of CD146Blood as compared to AC and HC (1.27 [0.50, 4.29] vs. 0.53 [0.35, 1.36] vs. 0.91 [0.58, 1.70], p = 0.008). HSP70CSF, HSP60Blood, and CD146Blood corelated positively with Headache Impact Test-6 (HIT-6) and MIDAS scores (ρ = 0.41, p = 0.01; ρ = 0.34, p = 0.032; ρ = 0.35, p = 0.029, ρ = 0.35) indicating an association with disease severity.
Conclusion: The findings provide molecular evidence of BBB disruption and neuroinflammatory pathway involved in the pathophysiology of IIH.
期刊介绍：
Headache publishes original articles on all aspects of head and face pain including communications on clinical and basic research, diagnosis and management, epidemiology, genetics, and pathophysiology of primary and secondary headaches, cranial neuralgias, and pains referred to the head and face. Monthly issues feature case reports, short communications, review articles, letters to the editor, and news items regarding AHS plus medicolegal and socioeconomic aspects of head pain. This is the official journal of the American Headache Society.
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