视网膜标记物和肌萎缩性侧索硬化症的分析:一项基于光学相干断层扫描的队列研究。

IF 15.8 1区 医学 Q1 Medicine
PLoS Medicine Pub Date : 2025-06-25 eCollection Date: 2025-06-01 DOI:10.1371/journal.pmed.1004545
Chunyang Pang, Yaojia Li, Wenhua Jiang, Haobo Xie, Wen Cao, Huan Yu, Zhiyang Lin, Yifan Cheng, Dongsheng Fan, Binbin Deng
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引用次数: 0

摘要

背景:生物标志物被广泛认为是治疗肌萎缩侧索硬化症(ALS)的关键突破。其中,视网膜标记物由于视网膜与大脑的紧密连接以及无创、便携的检测方法而具有前景。因此,使用光学相干断层扫描(OCT),我们研究了基线细胞水平视网膜特征与未来ALS风险之间的联系。方法和发现:来自UK Biobank的参与者接受了OCT扫描来评估视网膜层、黄斑和视盘参数。基线期(2006-2010年)之后两年开始了后续行动,在此期间,利用医疗和评估记录中的国际疾病分类(ICD)代码确定ALS病例。采用Cox比例风险模型检验视网膜标志物与ALS发病之间的关系。在14.11年的中位随访中,53,824名参与者中发生了70例ALS病例(发病率为10.58 / 100,000人年)。大多数参与者为白人(94.6%),44.8%为男性,中位年龄为58岁。在调整了人口统计学和影响视网膜的合共病后,光感受器层(PRL)厚度的标准差(SD)减少15.19µm与19%(95%置信区间[7,29];p = 0.002)增加ALS的风险,而视网膜色素上皮(RPE)厚度SD增加26.11µm对应20% (95% CI [7, 34];P = 0.002)。排除随访少于4年和6年的敏感性分析得出了一致的结果。亚组分析显示,这些发现在吸烟者中更为明显。本研究的主要局限性是其单时间点观察设计。结论:较薄的PRL和较厚的RPE可能预示着ALS的临床诊断,为早期诊断和了解疾病的发病机制提供了潜在的线索。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analysis of retinal markers and incident amyotrophic lateral sclerosis: An optical coherence tomography-based cohort study.

Background: Biomarkers are widely recognized as crucial breakthroughs in tackling amyotrophic lateral sclerosis (ALS). Among them, retina markers may hold promise due to the close retina-brain connection and non-invasive, portable detection methods. Thus, using optical coherence tomography (OCT), we investigated the link between baseline cell-level retinal features and future ALS risk.

Methods and findings: Participants from the UK Biobank underwent OCT scans to assess retinal layers, macula, and optic disc parameters. Follow-up commenced two years after the baseline period (2006-2010), during which ALS cases were identified using International Classification of Diseases (ICD) codes from medical and assessment records. Cox proportional hazards models were applied to examine the relationship between retinal markers and incident ALS. Over a median follow-up of 14.11 years, 70 ALS cases occurred among 53,824 participants (incidence 10.58 per 100,000 person-years). Most participants were White (94.6%), 44.8% male, with a median age of 58 years. After adjusting for demographics and comorbidities affecting the retina, a standard deviation (SD) decrease of 15.19 µm in photoreceptor layer (PRL) thickness was associated with a 19% (95% confidence interval [7, 29]; p = 0.002) increased risk of ALS, while a SD increase of 26.11 µm in retinal pigment epithelium (RPE) thickness corresponded to a 20% (95% CI [7, 34]; p = 0.002) higher risk. Sensitivity analyses excluding follow-ups of less than 4 and 6 years yielded consistent results. Subgroup analyses showed these findings were more pronounced in smokers. The main limitation of this study is its single time point observational design.

Conclusion: A thinner PRL and thicker RPE may precede the clinical diagnosis of ALS, offering potential clues for early diagnosis and insights into the disease's pathogenesis.

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来源期刊
PLoS Medicine
PLoS Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
17.60
自引率
0.60%
发文量
227
审稿时长
4-8 weeks
期刊介绍: PLOS Medicine is a prominent platform for discussing and researching global health challenges. The journal covers a wide range of topics, including biomedical, environmental, social, and political factors affecting health. It prioritizes articles that contribute to clinical practice, health policy, or a better understanding of pathophysiology, ultimately aiming to improve health outcomes across different settings. The journal is unwavering in its commitment to uphold the highest ethical standards in medical publishing. This includes actively managing and disclosing any conflicts of interest related to reporting, reviewing, and publishing. PLOS Medicine promotes transparency in the entire review and publication process. The journal also encourages data sharing and encourages the reuse of published work. Additionally, authors retain copyright for their work, and the publication is made accessible through Open Access with no restrictions on availability and dissemination. PLOS Medicine takes measures to avoid conflicts of interest associated with advertising drugs and medical devices or engaging in the exclusive sale of reprints.
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