Petzold Axel, Plant Gordon T
Institute of Neurology, University College London (UCL), London WC1N 3BG, UK ; Department of Neurology, Vrije Universiteit Medisch Centrum (VUMC), Amsterdam, The Netherlands.
Mult Scler Int. 2012;2012:217802. doi: 10.1155/2012/217802. Epub 2012 Dec 17.
Background. Loss of visual function differs between immune-mediated optic neuropathies and is related to axonal loss in the optic nerve. This study investigated the diagnostic and prognostic value of a biomarker for neurodegeneration, the neurofilament heavy chain (NfH) in three immune-mediated optic neuropathies. Methods. A prospective, longitudinal study including patients with optic neuritis due to multiple sclerosis (MSON, n = 20), chronic relapsing inflammatory optic neuritis (CRION, n = 19), neuromyelitis optica (NMO, n = 9), and healthy controls (n = 28). Serum NfH-SMI35 levels were quantified by ELISA. Findings. Serum NfH-SMI35 levels were highest in patients with NMO (mean 0.79 ± 1.51 ng/mL) compared to patients with CRION (0.13 ± 0.16 ng/mL, P = 0.007), MSON (0.09 ± 0.09, P = 0.008), and healthy controls (0.01 ± 0.02 ng/mL, P = 0.001). High serum NfH-SMI35 levels were related to poor visual outcome. Conclusions. Blood NfH-SMI35 levels are of moderate diagnostic and more important prognostic value in immune-mediated optic neuropathies. We speculate that longitudinal blood NfH levels may help to identify particular disabling events in relapsing conditions.
背景。免疫介导的视神经病变之间视觉功能丧失情况不同，且与视神经轴突损失有关。本研究调查了神经退行性变生物标志物神经丝重链（NfH）在三种免疫介导的视神经病变中的诊断和预后价值。方法。一项前瞻性纵向研究，纳入了多发性硬化症所致视神经炎患者（MSON，n = 20）、慢性复发性炎性视神经炎患者（CRION，n = 19）、视神经脊髓炎患者（NMO，n = 9）以及健康对照者（n = 28）。通过酶联免疫吸附测定法（ELISA）对血清NfH-SMI35水平进行定量分析。结果。与CRION患者（0.13±0.16 ng/mL，P = 0.007）、MSON患者（0.09±0.09，P = 0.008）和健康对照者（0.01±0.02 ng/mL，P = 0.001）相比，NMO患者的血清NfH-SMI35水平最高（平均0.79±1.51 ng/mL）。血清NfH-SMI35水平高与视觉预后不良有关。结论。血液NfH-SMI35水平在免疫介导的视神经病变中具有中等诊断价值且更重要的是具有预后价值。我们推测纵向血液NfH水平可能有助于识别复发情况下特定的致残事件。
