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在为期一年的随访后,阿尔茨海默病患者认知能力快速下降者的干细胞因子血浆水平降低:Pythia 研究。

Stem cell factor plasma levels are decreased in Alzheimer's disease patients with fast cognitive decline after one-year follow-up period: the Pythia-study.

机构信息

Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany.

出版信息

J Alzheimers Dis. 2011;26(1):39-45. doi: 10.3233/JAD-2011-110008.

Abstract

Alzheimer's disease (AD) is the most common cause of cognitive decline in the elderly and is characterized by massive neuronal loss in the brain. Stem cell factor (SCF) is a hematopoietic growth factor that promotes neuroprotective effects and supports neurogenesis in the brain. Decreased SCF plasma levels have been described in AD patients. Whether SCF plasma levels are also associated with the rate of cognitive decline in AD patients has not been reported so far. In the present study, we demonstrate that SCF plasma levels are significantly decreased in AD patients with fast cognitive decline (decrease of Mini-Mental State Examination [MMSE] score > 4 after one year; n = 12) compared to AD patients with slow cognitive decline (decrease of MMSE score ≤ 4 after one year; n = 28) (fast versus slow cognitive decline: mean ± SD: 1051.1 ± 178.7 versus 1237.9 ± 274.2 pg/ml; p = 0.037). Moreover, SCF plasma levels correlated with the rate of cognitive decline after one year follow-up period (r = 0.315; p = 0.048). In a multiple linear regression analysis, independent predictors of the rate of cognitive decline in our study cohort were age, MMSE scores at baseline, SCF plasma levels, as well as brain-derived neurotrophic factor and activated glycoprotein (GP) IIb/IIIa. These results suggest that lower SCF plasma levels are associated with a higher rate of cognitive decline in AD patients. Thus, treatment strategies increasing SCF plasma levels could be useful for delaying the progression of AD. Further prospective studies are needed to elucidate the value of plasma SCF in a multimarker approach determining AD prognosis.

摘要

阿尔茨海默病(AD)是老年人认知能力下降的最常见原因,其特征是大脑中大量神经元丧失。干细胞因子(SCF)是一种造血生长因子,可促进神经保护作用并支持大脑中的神经发生。AD 患者的 SCF 血浆水平降低已有描述。目前为止,尚未报道 SCF 血浆水平是否也与 AD 患者认知能力下降的速度有关。在本研究中,我们证明与认知能力下降缓慢的 AD 患者(一年后 MMSE 评分下降≤4;n = 28)相比,认知能力快速下降的 AD 患者(一年后 MMSE 评分下降>4;n = 12)的 SCF 血浆水平显著降低(快速与缓慢认知下降:平均值±SD:1051.1 ± 178.7 与 1237.9 ± 274.2 pg/ml;p = 0.037)。此外,SCF 血浆水平与一年随访期间认知下降的速度相关(r = 0.315;p = 0.048)。在多元线性回归分析中,我们研究队列中认知能力下降速度的独立预测因子为年龄、基线时的 MMSE 评分、SCF 血浆水平以及脑源性神经营养因子和激活糖蛋白(GP)IIb/IIIa。这些结果表明,AD 患者 SCF 血浆水平较低与认知下降速度较快相关。因此,增加 SCF 血浆水平的治疗策略可能有助于延缓 AD 的进展。需要进一步的前瞻性研究来阐明在确定 AD 预后的多标志物方法中,血浆 SCF 的价值。

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