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自然产生的抗淀粉样蛋白 β 自身抗体与阿尔茨海默病患者内侧颞叶萎缩的关系。

Association between naturally occurring anti-amyloid β autoantibodies and medial temporal lobe atrophy in Alzheimer's disease.

机构信息

Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Gifu, Japan.

Department of Informative Clinical Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.

出版信息

J Neurol Neurosurg Psychiatry. 2017 Feb;88(2):126-131. doi: 10.1136/jnnp-2016-313476. Epub 2016 Jun 21.

Abstract

BACKGROUND

Naturally occurring autoantibodies against amyloid β (Aβ) peptide exist in the serum and cerebrospinal fluid (CSF) of healthy individuals. Recently, it was reported that administration of intravenous immunoglobulin at the mild cognitive impairment (MCI) stage of Alzheimer's disease (AD) reduces brain atrophy.

OBJECTIVE

To examine the association between naturally occurring anti-Aβ autoantibodies and brain atrophy in patients with cognitive impairment.

METHODS

Serum and CSF levels of anti-Aβ autoantibodies and CSF biomarkers were evaluated in 68 patients with cognitive impairment, comprising 44 patients with AD, 19 patients with amnestic MCI and five patients with non-Alzheimer's dementia. The degree of brain atrophy was assessed using the voxel-based specific regional analysis system for AD, which targets the volume of interest (VOI) in medial temporal structures, including the whole hippocampus, entorhinal cortex and amygdala.

RESULTS

CSF levels of anti-Aβ autoantibodies were inversely correlated with the extent and severity of VOI atrophy, and the ratio of VOI/grey matter atrophy in patients with AD, but not in MCI or non-AD patients. Serum levels of anti-Aβ autoantibodies were not associated with these parameters in any of the patient groups.

CONCLUSIONS

These results indicate that CSF levels of naturally occurring anti-Aβ autoantibodies are inversely associated with the degree of the VOI atrophy in patients with AD. Although the mechanism is unclear, CSF levels of naturally occurring anti-Aβ autoantibodies may be implicated in the progression of atrophy of the whole hippocampus, entorhinal cortex and amygdala, in AD.

摘要

背景

在健康个体的血清和脑脊液(CSF)中存在针对淀粉样 β(Aβ)肽的天然自身抗体。最近有报道称,在阿尔茨海默病(AD)的轻度认知障碍(MCI)阶段给予静脉注射免疫球蛋白可减少脑萎缩。

目的

研究认知障碍患者中天然抗 Aβ 自身抗体与脑萎缩之间的关系。

方法

评估了 68 例认知障碍患者(包括 44 例 AD 患者、19 例遗忘型 MCI 患者和 5 例非阿尔茨海默病痴呆患者)的血清和 CSF 中抗 Aβ 自身抗体和 CSF 生物标志物水平。采用基于体素的 AD 特异性区域分析系统评估脑萎缩程度,该系统针对内侧颞叶结构(包括整个海马体、内嗅皮层和杏仁核)的感兴趣区(VOI)体积。

结果

CSF 中抗 Aβ 自身抗体的水平与 AD 患者的 VOI 萎缩程度、严重程度以及 VOI/灰质萎缩比率呈负相关,但在 MCI 或非 AD 患者中则没有相关性。在任何一组患者中,血清中抗 Aβ 自身抗体的水平均与这些参数无相关性。

结论

这些结果表明,AD 患者 CSF 中天然存在的抗 Aβ 自身抗体的水平与 VOI 萎缩的程度呈负相关。尽管机制尚不清楚,但 CSF 中天然存在的抗 Aβ 自身抗体可能与整个海马体、内嗅皮层和杏仁核萎缩的进展有关。

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