Li Pei, Wang Sujie, Zhang Ruili, Pei Jian, Chen Lili, Cao Yibin, Zhang Haoliang, Yang Guofeng
Department of Neurology, Tangshan Gongren Hospital, Tangshan, Hebei 063000, P.R. China.
Department of Neurology, Zunhua People's Hospital, Tangshan, Hebei 064200, P.R. China.
Exp Ther Med. 2018 Jun;15(6):5177-5182. doi: 10.3892/etm.2018.6117. Epub 2018 May 2.
The purpose of the present study was to screen for differentially expressed proteins in the cerebrospinal fluid (CSF) of patients with Guillain-Barré syndrome (GBS). The identification of differentially expressed protein can provide new targets for understanding the pathogenic mechanism, early clinical diagnosis, prognosis and for measuring the effectiveness of interventions. We enrolled 50 GBS patients and 50 meningitis patients (control group) to compare protein expression in CSF. The GBS cases included 28 cases of acute inflammatory demyelinating polyneuropathy (AIDP) and 22 cases of acute motor axonal neuropathy (AMAN). We then performed two-dimensional differential in-gel electrophoresis combined with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry to identify the differentially expressed proteins. The expression levels were validated by ELISA, and their accuracy, sensitivity, and specificity in GBS diagnosis were analyzed by the receiver operating characteristic curve. Three differentially expressed proteins were identified, including the upregulated haptoglobin (Hp) and heat shock protein 70 (Hsp70), and downregulated cystatin C. There were no significant differences between the AIDP and AMAN patients in the positive rates and quantitative expression levels of the three differentially expressed proteins. The accuracy of Hp in the diagnosis of GBS was 0.835, sensitivity was 86.7%, and specificity was 88.2%. The accuracy of cystatin C in the diagnosis of GBS was 0.827, sensitivity was 85.5%, and specificity was 89.7%. The accuracy of Hsp70 in the diagnosis of GBS was 0.841, its sensitivity was 87.8%, and its specificity was 92.3%. Hp and Hsp70 are significantly increased, and cystatin C is downregulated in CSF of GBS patients, which provides important biomarkers for early GBS diagnosis, although these proteins cannot distinguish AIDP and AMAN.
本研究的目的是筛选吉兰 - 巴雷综合征（GBS）患者脑脊液（CSF）中差异表达的蛋白质。鉴定差异表达的蛋白质可为理解发病机制、早期临床诊断、预后评估以及衡量干预措施的有效性提供新的靶点。我们纳入了50例GBS患者和50例脑膜炎患者（对照组）以比较脑脊液中的蛋白质表达。GBS病例包括28例急性炎症性脱髓鞘性多发性神经病（AIDP）和22例急性运动轴索性神经病（AMAN）。然后我们进行了二维差异凝胶电泳结合基质辅助激光解吸/电离飞行时间质谱来鉴定差异表达的蛋白质。通过酶联免疫吸附测定（ELISA）验证表达水平，并通过受试者工作特征曲线分析它们在GBS诊断中的准确性、敏感性和特异性。鉴定出三种差异表达的蛋白质，包括上调的触珠蛋白（Hp）和热休克蛋白70（Hsp70），以及下调的胱抑素C。三种差异表达蛋白质的阳性率和定量表达水平在AIDP和AMAN患者之间没有显著差异。Hp诊断GBS的准确性为0.835，敏感性为86.7%，特异性为88.2%。胱抑素C诊断GBS的准确性为0.827，敏感性为85.5%，特异性为89.7%。Hsp70诊断GBS的准确性为0.841，敏感性为87.8%，特异性为92.3%。GBS患者脑脊液中Hp和Hsp70显著升高，胱抑素C下调，这为GBS的早期诊断提供了重要的生物标志物，尽管这些蛋白质无法区分AIDP和AMAN。
