死后脑脊液中的α-突触核蛋白水平在多系统萎缩中升高,并将其与其他α-突触核蛋白病、帕金森病和路易体痴呆区分开来。

Post mortem cerebrospinal fluid α-synuclein levels are raised in multiple system atrophy and distinguish this from the other α-synucleinopathies, Parkinson's disease and Dementia with Lewy bodies.

机构信息

Division of Biomedical and Life Sciences, Faculty of Health and Medicine, University of Lancaster, Lancaster, LA1 4AY, UK.

出版信息

Neurobiol Dis. 2012 Jan;45(1):188-95. doi: 10.1016/j.nbd.2011.08.003. Epub 2011 Aug 10.

Abstract

Differentiating clinically between Parkinson's disease (PD) and the atypical parkinsonian syndromes of Progressive supranuclear palsy (PSP), corticobasal syndrome (CBS) and multiple system atrophy (MSA) is challenging but crucial for patient management and recruitment into clinical trials. Because PD (and the related disorder Dementia with Lewy bodies (DLB)) and MSA are characterised by the deposition of aggregated forms of α-synuclein protein (α-syn) in the brain, whereas CBS and PSP are tauopathies, we have developed immunoassays to detect levels of total and oligomeric forms of α-syn, and phosphorylated and phosphorylated oligomeric forms of α-syn, within body fluids, in an attempt to find a biomarker that will differentiate between these disorders. Levels of these 4 different forms of α-syn were measured in post mortem samples of ventricular cerebrospinal fluid (CSF) obtained from 76 patients with PD, DLB, PSP or MSA, and in 20 healthy controls. Mean CSF levels of total and oligomeric α-syn, and phosphorylated α-syn, did not vary significantly between the diagnostic groups, whereas mean CSF levels of phosphorylated oligomeric α-syn did differ significantly (p<0.001) amongst the different diagnostic groups. Although all 4 measures of α-syn were higher in patients with MSA compared to all other diagnostic groups, these were only significantly raised (p<0.001) in MSA compared to all other diagnostic groups, for phosphorylated oligomeric forms of α-syn. This suggests that this particular assay may have utility in differentiating MSA from control subject and patients with other α-synucleinopathies. However, it does not appear to be of help in distinguishing patients with PD and DLB from those with PSP or from control subjects. Western blots show that the principal form of α-syn within CSF is phosphorylated, and the finding that the phosphorylated oligomeric α-syn immunoassay appears to be the most informative of the 4 assays would be consistent with this observation.

摘要

在临床中区分帕金森病 (PD) 和不典型帕金森综合征,如进行性核上性麻痹 (PSP)、皮质基底节变性 (CBS) 和多系统萎缩 (MSA),具有挑战性,但对于患者管理和临床试验招募至关重要。由于 PD(和相关疾病路易体痴呆 (DLB))和 MSA 的特征是大脑中聚集形式的α-突触核蛋白 (α-syn) 的沉积,而 CBS 和 PSP 是 tau 病,我们开发了免疫测定法来检测体液中总α-syn 和寡聚形式以及磷酸化和磷酸化寡聚形式的 α-syn 的水平,试图找到一种可以区分这些疾病的生物标志物。在 76 名 PD、DLB、PSP 或 MSA 患者和 20 名健康对照者死后获得的心室脑脊液 (CSF) 样本中测量了这 4 种不同形式的α-syn 的水平。在诊断组之间,总α-syn 和寡聚α-syn 的平均 CSF 水平没有显著差异,而磷酸化α-syn 的平均 CSF 水平差异显著(p<0.001)。尽管 MSA 患者的所有 4 种α-syn 测量值均高于所有其他诊断组,但与所有其他诊断组相比,仅在 MSA 患者中,磷酸化寡聚形式的α-syn 显著升高(p<0.001)。这表明该特定测定法可能有助于区分 MSA 与对照受试者和其他α-突触核蛋白病患者。然而,它似乎无助于区分 PD 和 DLB 患者与 PSP 患者或与对照受试者。Western blot 显示 CSF 中主要的α-syn 形式是磷酸化的,而磷酸化寡聚α-syn 免疫测定似乎是这 4 种测定中最具信息量的一种,这与这一观察结果一致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bd3/3657198/75f836d3b3ec/gr1.jpg

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