Moorfields Eye Hospital, London, United Kingdom.
J Neurol Sci. 2012 Jun 15;317(1-2):117-22. doi: 10.1016/j.jns.2012.02.012. Epub 2012 Mar 10.
Complement mediated autoimmunity against aquaporin-4 results in astrocytic damage in neuromyelitis optica (NMO). There is evidence for increased CSF glial fibrillary acidic protein (GFAP) and S100B levels in acute NMO. Here we tested whether the CSF finding also holds true for the diagnostic value of serum GFAP and S100B levels in NMO.
A multicentre study included 322 patients from London (n=160), Nijmegen (n=95), Pecs (n=44), and Lyon (n=24). Patients were classified into the following diagnostic categories: neurological control patients (n=45), MS optic neuritis (MSON, n=38), isolated optic neuritis (ION, n=11), relapsing isolated optic neuritis (RION, n=48), chronic relapsing isolated optic neuropathy (CRION, n=18), unclassified optic neuritis (UCON, n=39), NMO (n=77) and relapsing remitting multiple sclerosis (RRMS, n=47). Serum GFAP and S100B levels were quantified using ELISA.
Median serum GFAP but not S100B levels were significantly higher (p<0.0001, general linear model) in patients with NMO (4.83 pg/mL) if compared to MSON (1.5 pg/mL, p=0.0001), UCON (1.92 pg/mL, p<0.01), ION (0.0 ng/mL, p<0.05), RION (1.3 pg/mL, p<0.0001) and CRION (2.2 pg/mL, p=0.01). Serum GFAP levels in the control cohort (3.6 pg/mL) were not significantly different to NMO. There was no relationship between serum GFAP levels and any other clinical or demographic parameter. Serum S100B concentrations correlated with the number of relapses in MSON (R=0.83, p=0.005).
In contrast to the CSF, neither serum GFAP nor S100B levels were of major diagnostic value for the laboratory supported differential diagnosis between optic neuritis in the context of NMO and other optic neuropathies.
补体介导的针对水通道蛋白-4 的自身免疫反应导致视神经脊髓炎（NMO）中的星形胶质细胞损伤。有证据表明，急性 NMO 患者的脑脊液中神经胶质纤维酸性蛋白（GFAP）和 S100B 水平升高。在这里，我们测试了 CSF 中 GFAP 和 S100B 水平对 NMO 患者血清中 GFAP 和 S100B 水平的诊断价值是否也成立。
一项多中心研究纳入了来自伦敦（n=160）、奈梅亨（n=95）、佩奇（n=44）和里昂（n=24）的 322 名患者。患者被分为以下诊断类别：神经科对照组患者（n=45）、多发性硬化视神经炎（MSON，n=38）、孤立性视神经炎（ION，n=11）、复发性孤立性视神经炎（RION，n=48）、慢性复发性孤立性视神经病变（CRION，n=18）、未分类视神经炎（UCON，n=39）、NMO（n=77）和复发缓解型多发性硬化症（RRMS，n=47）。使用 ELISA 定量测定血清 GFAP 和 S100B 水平。
与 MSON（1.5pg/ml，p=0.0001）、UCON（1.92pg/ml，p<0.01）、ION（0.0ng/ml，p<0.05）、RION（1.3pg/ml，p<0.0001）和 CRION（2.2pg/ml，p=0.01）相比，NMO 患者的血清 GFAP 水平（中位数 4.83pg/ml）明显升高（p<0.0001，一般线性模型），而血清 S100B 水平无差异（p>0.05）。对照组患者的血清 GFAP 水平（3.6pg/ml）与 NMO 无显著差异。血清 GFAP 水平与任何其他临床或人口统计学参数均无相关性。MSON 患者的血清 S100B 浓度与复发次数相关（R=0.83，p=0.005）。
与 CSF 相比，血清 GFAP 和 S100B 水平对 NMO 相关视神经炎与其他视神经病变的实验室支持的鉴别诊断均无重要诊断价值。
