Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Department of Clinical Laboratory, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Acta Neurol Scand. 2018 May;137(5):515-522. doi: 10.1111/ane.12894. Epub 2018 Jan 7.
Cystatin C (CysC) is associated with many neurodegenerative disorders and autoimmune diseases, but its relationship with anti-N-Methyl-D-aspartate receptor (anti-NMDAR) encephalitis is unknown.
Serum levels of CysC were determined in 66 patients with anti-NMDAR encephalitis and 115 healthy controls. Of the 66 patients, 30 had a follow-up evaluation at 3 months after admission. Association of CysC with anti-NMDAR encephalitis and its clinical parameters were evaluated in the patients.
The serum levels of CysC were significantly lower in patients with anti-NMDAR encephalitis than in controls (0.70 ± 0.13 vs 0.83 ± 0.17 mg/mL, P < .001). Disease severity and disease duration were significantly associated with CysC levels. Furthermore, a follow-up evaluation revealed that after treatment anti-NMDAR encephalitis patients had significantly increased serum CysC levels (P < .001) and significantly decreased modified Rankin Scale (mRS) scores (P < .001) compared with before treatment. In addition, a significant negative correlation was observed between the change in CysC levels and the change in mRS scores (r = -.700, P < .001).
Our results show that the serum levels of CysC are associated with anti-NMDAR encephalitis and its clinical parameters and that the changes in CysC levels correlate with therapeutic effect. Therefore, our findings provide new insights into the association between serum CysC and anti-NMDAR encephalitis.
半胱氨酸蛋白酶抑制剂 C（CysC）与许多神经退行性疾病和自身免疫性疾病有关，但它与抗 N-甲基-D-天冬氨酸受体（抗 NMDAR）脑炎的关系尚不清楚。
测定了 66 例抗 NMDAR 脑炎患者和 115 例健康对照者的血清 CysC 水平。在 66 例患者中，有 30 例在入院后 3 个月进行了随访评估。评估了 CysC 与抗 NMDAR 脑炎及其临床参数的相关性。
抗 NMDAR 脑炎患者的血清 CysC 水平明显低于对照组（0.70±0.13 与 0.83±0.17mg/ml，P<0.001）。疾病严重程度和疾病持续时间与 CysC 水平显著相关。此外，随访评估显示，与治疗前相比，抗 NMDAR 脑炎患者治疗后血清 CysC 水平显著升高（P<0.001），改良 Rankin 量表（mRS）评分显著降低（P<0.001）。此外，CysC 水平的变化与 mRS 评分的变化呈显著负相关（r=-.700，P<0.001）。
我们的结果表明，血清 CysC 水平与抗 NMDAR 脑炎及其临床参数相关，CysC 水平的变化与治疗效果相关。因此，我们的发现为血清 CysC 与抗 NMDAR 脑炎之间的关系提供了新的见解。
