Department of Neurology Tianjin First Center Hospital Tianjin Medical University Tianjin China.
Brain Behav. 2017 Feb 19;7(3):e00637. doi: 10.1002/brb3.637. eCollection 2017 Mar.
The aim of this study was to identify CSF and serum factors as biomarkers that may aid in distinguishing ALS patients from control subjects and predicting ALS progression as well as prognosis.
Serum and CSF samples from 105 patients with ALS and 56 control subjects were analyzed for 13 factors using ELISA. The revised ALS functional rating scale (ALSFRS-r) was used to evaluate the overall functional status of ALS patients, and we also followed up with ALS patients either by phone or with clinic visits for five years after enrollment in this study. Finally, we examined the correlations between factor levels and various clinical parameters and evaluated the predictive value for prognosis through a multivariate statistic model.
A total of eight factors were obviously elevated in CSF, and twelve markers were increased in serum. In the correlation analyses, there were trends toward higher bFGF, VEGF, MIP-1α levels in ALS with a longer disease duration and slower disease progression in both CSF and serum. Higher MCP-1 levels were associated with worse disease severity and faster progression, and the IFN-γ levels were positively associated with disease progression in either CSF or serum. Finally, a better prognosis was observed with higher levels bFGF in CSF and VEGF in CSF and serum; conversely, patients with higher levels of IFN-γ in the CSF had shorter overall survival.
We demonstrated that a factor profile of ALS patients is distinct from control subjects and may be useful in clinical practice and therapeutic trials.
本研究旨在确定 CSF 和血清中的因素作为生物标志物，以帮助区分 ALS 患者和对照受试者，并预测 ALS 的进展和预后。
使用 ELISA 分析了 105 例 ALS 患者和 56 例对照受试者的血清和 CSF 样本中的 13 种因素。使用修订后的 ALS 功能评定量表（ALSFRS-r）评估 ALS 患者的整体功能状态，我们还通过电话或临床随访对入组本研究后五年的 ALS 患者进行了随访。最后，我们检查了因子水平与各种临床参数之间的相关性，并通过多变量统计模型评估了对预后的预测价值。
CSF 中共有 8 种因子明显升高，血清中有 12 种标志物升高。在相关性分析中，CSF 和血清中 bFGF、VEGF、MIP-1α 水平随着疾病持续时间的延长和疾病进展速度的减慢而呈升高趋势。较高的 MCP-1 水平与更严重的疾病严重程度和更快的进展相关，而 IFN-γ 水平与 CSF 或血清中的疾病进展呈正相关。最后，CSF 中 bFGF 水平较高和 CSF 及血清中 VEGF 水平较高的患者预后较好；相反，CSF 中 IFN-γ 水平较高的患者总生存期较短。
我们证明了 ALS 患者的因子谱与对照受试者不同，可能在临床实践和治疗试验中有用。
