Chulalongkorn Centre of Excellence on Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Eur Neurol. 2011;66(3):123-7. doi: 10.1159/000330538. Epub 2011 Aug 25.
Reduction in caeruloplasmin (Cp) levels is sometimes found in other sporadic movement disorders, not limited to Wilson's disease (WD). Serum levels of Cp, copper, iron and gamma-glutamyl transpeptidase were measured in 71 patients with various diagnoses of movement disorders, including Parkinson's disease (PD), atypical parkinsonian disorders, tardive dyskinesia, essential tremor, and idiopathic focal dystonia, and compared with those of 26 healthy age- and gender-matched controls. The mean Cp level in the patient group was 20.5 ± 4.2 mg/dl , lower than in controls (23.5 ± 7.2 mg/dl; p = 0.005). In subgroup analysis, mean Cp level of PD patients (19.6 ± 3.0 mg/dl) was lower than that of controls (p = 0.045). In a group analysis as neurodegenerative movement disorders (NDD), their mean Cp level was 19.9 ± 3.0 mg/dl, lower than that of controls (p = 0.019). Linear regression analysis indicated that the presence of NDD was the main factor associated with lower Cp levels. The finding of reduced serum Cp level in non-Wilsonian movement disorders and selective reduction in the neurodegenerative subgroup supports the notion that Cp might be associated with the cascade of neurotoxicity in NDD. The variation in Cp level in other non-WD conditions highlights the fact that Cp level is a poor screening test for WD in the absence of clear clinical suspicion.
血清铜蓝蛋白(Cp)水平降低在其他散发性运动障碍中也有发现,不仅限于威尔逊病(WD)。我们测量了 71 例各种运动障碍患者(包括帕金森病(PD)、非典型帕金森病、迟发性运动障碍、特发性震颤和特发性局灶性肌张力障碍)和 26 例年龄和性别匹配的健康对照者的血清 Cp、铜、铁和γ-谷氨酰转肽酶水平,并与对照组进行了比较。患者组的平均 Cp 水平为 20.5 ± 4.2 mg/dl,低于对照组(23.5 ± 7.2 mg/dl;p = 0.005)。在亚组分析中,PD 患者的平均 Cp 水平(19.6 ± 3.0 mg/dl)低于对照组(p = 0.045)。在神经退行性运动障碍(NDD)的组分析中,他们的平均 Cp 水平为 19.9 ± 3.0 mg/dl,低于对照组(p = 0.019)。线性回归分析表明,存在 NDD 是与 Cp 水平降低相关的主要因素。非 WD 运动障碍患者血清 Cp 水平降低,神经退行性亚组选择性降低的发现支持 Cp 可能与 NDD 中的神经毒性级联反应相关的观点。其他非 WD 情况下 Cp 水平的变化突出表明,在没有明确临床怀疑的情况下,Cp 水平是 WD 的一个较差的筛选试验。