Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Clin Chim Acta. 2013 Jun 5;421:181-3. doi: 10.1016/j.cca.2013.03.020. Epub 2013 Mar 25.
The current 2006 neuromyelitis optica (NMO) criteria is useful for diagnosing NMO, however this criteria seemed to be insufficient at early stage of NMO. Hence, the development of diagnostic marker besides anti-aquaporin 4 antibody at early stage of NMO may be required. Our main aim of this study is to test the usefulness of measuring cerebrospinal fluid (CSF) interleukin (IL)-6 and glial fibrillary acidic protein (GFAP) concentrations as early diagnostic markers during initial NMO attacks.
We investigated CSF IL-6 and GFAP concentrations in 13 NMO spectrum disorder (NMOSD) patients at initial attacks, 24 idiopathic central nervous system inflammatory disease patients (9 optic neuritis, 9 myelitis and 6 encephalitis) and 20 other non-inflammatory neurological disorders (ONNDs) patients, retrospectively.
The mean CSF IL-6 and GFAP concentrations during the initial NMOSD attack were 91.4 pg/ml and 369.3 ng/ml, respectively, and were significantly higher than in ONNDs, idiopathic optic neuritis and myelitis patients (P<0.01). The sensitivity of high CSF IL-6 during initial NMO attack was 76.9% and that of high CSF GFAP was 84.6%, respectively.
Our data suggests that CSF IL-6 and GFAP may be useful early diagnostic markers of NMOSD.
目前的 2006 年视神经脊髓炎（NMO）标准对 NMO 的诊断是有用的，但在 NMO 的早期阶段，该标准似乎不够充分。因此，可能需要在 NMO 的早期阶段除抗水通道蛋白 4 抗体之外开发其他诊断标志物。本研究的主要目的是测试测量脑脊液（CSF）白细胞介素（IL）-6 和神经胶质纤维酸性蛋白（GFAP）浓度作为 NMO 初始发作时早期诊断标志物的有用性。
我们回顾性地研究了 13 名 NMO 谱障碍（NMOSD）患者在初始发作时、24 名特发性中枢神经系统炎症性疾病患者（9 名视神经炎、9 名脊髓炎和 6 名脑炎）和 20 名其他非炎症性神经疾病（ONND）患者的 CSF IL-6 和 GFAP 浓度。
NMOSD 初始发作时 CSF IL-6 和 GFAP 浓度的平均值分别为 91.4pg/ml 和 369.3ng/ml，明显高于 ONND、特发性视神经炎和脊髓炎患者（P<0.01）。初始 NMO 发作时高 CSF IL-6 的灵敏度为 76.9%，高 CSF GFAP 的灵敏度为 84.6%。
我们的数据表明 CSF IL-6 和 GFAP 可能是 NMOSD 的有用早期诊断标志物。
