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[年龄相关性认知障碍和阿尔茨海默病中的全身炎症标志物]

[Systemic inflammatory markers in age-associated cognitive impairment and Alzheimer's disease].

作者信息

Kliushnik T P, Androsova L V, Mikhaylova N M, Kolykhalov I V, Zozulya S A, Dupin A M

机构信息

Mental Health Research Center, Moscow, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2017;117(7):74-79. doi: 10.17116/jnevro20171177174-79.

Abstract

AIM

To determine a complex of immune markers reflecting various links of multicomponent inflammatory reactions in amnestic type of mild cognitive impairment (aMCI) in comparison with Alzheimer's disease (AD).

MATERIAL AND METHODS

Sixty-seven patients with aMCI, aged 72 [63; 77] years, and 91 patients with Alzheimer's disease at the age of 74 [68; 79] years were examined. The aMCI was diagnosed according to the criteria of R.S. Petersen et al. (1999) and B. Dubois et al. (2014). The diagnosis of AD was established in accordance with the ICD-10 and NINCDS-ADRDA criteria. The degree of dementia severity was determined by clinical signs using the CDR (Clinical Dementia Rating) and the Mini Mental State Examination (MMSE) total score. The control group included 38 age- and sex-matched individuals. Immune and biochemical parameters were determined in blood plasma. The activity of LE and α1-PI was determined by spectrophotometric method. Concentrations of IL-6 and CRP were measured by enzyme immunoassay.

RESULTS

AD was characterized by the significant decrease in LE activity (p<0.0001) and increase in the activity/levels of α1-PI, CRP and IL-6 (p<0.001; p<0.05; p<0.01, respectively) compared to controls. CDR and MMSE scores were correlated with the LE activity (r=-0.38, r=0.31, p<0.05), i.e. cognitive decline was associated with decreased activity of LE. aMCI was characterized by the significant increase in the activity/level of α1-PI and IL-6 (p<0.0001; p<0.01). In 30% of patients with aMCI, a spectrum of inflammatory markers, typical for patients with AD, was determined.

CONCLUSION

Based on the results of comparative analysis of aMCI and AD, one can suggest that one third of patients with aMCI represents a group of ultra-high risk of AD. These patients need a dynamic follow-up with a regular assessment of the state of cognitive functions and possibly preventive therapy.

摘要

目的

确定一组免疫标志物,以反映遗忘型轻度认知障碍(aMCI)与阿尔茨海默病(AD)相比多成分炎症反应的不同环节。

材料与方法

对67例年龄为72[63;77]岁的aMCI患者和91例年龄为74[68;79]岁的阿尔茨海默病患者进行检查。aMCI根据R.S.彼得森等人(1999年)和B.杜波依斯等人(2014年)的标准进行诊断。AD的诊断依据ICD-10和NINCDS-ADRDA标准确定。痴呆严重程度通过临床体征使用临床痴呆评定量表(CDR)和简易精神状态检查表(MMSE)总分来确定。对照组包括38名年龄和性别匹配的个体。测定血浆中的免疫和生化参数。通过分光光度法测定LE和α1-抗胰蛋白酶(α1-PI)的活性。通过酶免疫测定法测量白细胞介素-6(IL-6)和C反应蛋白(CRP)的浓度。

结果

与对照组相比,AD的特征是LE活性显著降低(p<0.0001),α1-PI、CRP和IL-6的活性/水平升高(分别为p<0.001;p<0.05;p<0.01)。CDR和MMSE评分与LE活性相关(r=-0.38,r=0.31,p<0.05),即认知能力下降与LE活性降低有关。aMCI的特征是α1-PI和IL-6的活性/水平显著升高(p<0.0001;p<0.01)。在30%的aMCI患者中,确定了一系列AD患者典型的炎症标志物。

结论

基于对aMCI和AD的比较分析结果,可以认为三分之一的aMCI患者代表了AD的超高风险组。这些患者需要动态随访,定期评估认知功能状态,并可能进行预防性治疗。

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