急性和慢性炎症性脱髓鞘性多神经病变患者脑脊液中神经元炎症相关生物标志物

IF 2.5 4区医学 Q3 IMMUNOLOGY

Journal of neuroimmunology Pub Date : 2025-09-11 DOI:10.1016/j.jneuroim.2025.578756

Ümit Atasever , Canan Akünal , Hayriye Soytürk

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引用次数: 0

摘要

免疫介导的多神经病变如急性和慢性炎症性脱髓鞘多神经病变是诊断和有效治疗的挑战。目的探讨与神经炎症相关的生物标志物在炎性脱髓鞘性多发性神经病中的诊断价值。方法回顾性分析2023年12月至2024年10月在BAİBÜ教研院神经内科就诊并行腰椎穿刺诊断的患者病历。分析20例AIDP患者、18例CIDP患者和15例假性脑瘤（PTC）患者作为不健康对照组的脑脊液样本及临床资料。结果AIDP组脑脊液中NfL、NfH、GFAP、SM、BDNF水平显著高于PTC组（p < 0.05）。与PTC组相比，CIDP组脑脊液NfL、GFAP和SM水平显著升高（p < 0.05），而CIDP组与PTC组脑脊液NfH和BDNF水平无显著差异。此外，AIDP组脑脊液中NfH和BDNF水平显著高于CIDP组（p < 0.05）。结论AIDP和CIDP患者脑脊液NfL、NfH和GFAP水平升高可能与继发性近端轴突损伤有关。此外，SM可以作为髓磷脂分解和重塑的指标，而BDNF的代偿作用可能支持髓鞘再生。综上所述，这五种生物标志物可能是AIDP和CIDP早期诊断和鉴别诊断的有希望的靶点。

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Neuronal inflammation-associated biomarkers in cerebrospinal fluid of patients with acute and chronic inflammatory demyelinating polyneuropathies

Background

Immune-mediated polyneuropathies such as acute and chronic inflammatory demyelinating polyneuropathy are challenging to diagnose and treat effectively.

Objective

To investigate the diagnostic value of certain biomarkers associated with neuronal inflammation in patients with inflammatory demyelinating polyneuropathy.

Methods

Medical records of patients who presented to the Neurology Clinic of BAİBÜ Education and Research Hospital between December 2023 and October 2024 and underwent lumbar puncture (LP) for diagnostic purposes were retrospectively reviewed. CSF samples and clinical data of 20 AIDP patients, 18 CIDP patients, and 15 patients with pseudotumor cerebri (PTC), included as the unhealthy control group, were analyzed.

Results

The CSF levels of NfL, NfH, GFAP, SM, and BDNF in the AIDP group were significantly higher than those in the PTC group (p < 0.05). In the CIDP group, CSF NfL, GFAP, and SM levels were significantly elevated compared to the PTC group (p < 0.05), while no significant difference was observed in CSF NfH and BDNF levels between the CIDP and PTC groups. Furthermore, the AIDP group had significantly higher levels of NfH and BDNF in CSF compared to the CIDP group (p < 0.05).

Conclusions

These findings suggest that in AIDP and CIDP patients, the elevation of CSF NfL, NfH, and GFAP levels may be associated with secondary proximal axonal damage. Additionally, SM could serve as an indicator of myelin breakdown and remodeling, while the compensatory effect of BDNF may support remyelination. In conclusion, these five biomarkers may represent promising targets for the early diagnosis and differential diagnosis of AIDP and CIDP.

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来源期刊

Journal of neuroimmunology 医学-免疫学

CiteScore

6.10

自引率

3.00%

发文量

154

审稿时长

37 days

期刊介绍： The Journal of Neuroimmunology affords a forum for the publication of works applying immunologic methodology to the furtherance of the neurological sciences. Studies on all branches of the neurosciences, particularly fundamental and applied neurobiology, neurology, neuropathology, neurochemistry, neurovirology, neuroendocrinology, neuromuscular research, neuropharmacology and psychology, which involve either immunologic methodology (e.g. immunocytochemistry) or fundamental immunology (e.g. antibody and lymphocyte assays), are considered for publication.