Chen Jinyu, Ding Yuewen, Zheng Dong, Wang Zhanhang, Pan Suyue, Ji Teng, Shen Hai-Ying, Wang Honghao
Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Department of Neurology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.
Front Neurol. 2018 Oct 12;9:727. doi: 10.3389/fneur.2018.00727. eCollection 2018.
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis predominantly affects children and young women; the disease can have a multistage presentation and exhibit a wide variety of neuropsychiatric features. This study aimed to investigate the profile of YKL-40 (Chitinase 3-like 1) in anti-NMDAR encephalitis patients and evaluate its association with modified Rankin Scale (mRS) scores and expression of inflammatory cytokines. A total of 66 patients were enrolled in this study, 33 with anti-NMDAR encephalitis, 13 with viral meningitis and 20 with non-inflammatory neurological disease. Patients were evaluated to determine mRS scores at disease onset and at the 3 month follow-up; cerebrospinal fluid (CSF) samples were collected in the meantime. CSF levels of YKL-40 and cytokines (TNF-α, IL-6, IL-10) were measured by enzyme-linked immunosorbent assay. CSF levels of YKL-40 and inflammatory cytokines (TNF-α, IL-6, IL-10) were all more highly elevated in patients with anti-NMDAR encephalitis at the acute stage of disease compared with the controls. Levels of CSF YKL-40 were correlated with levels of IL-6 both at disease onset and at the 3 month follow-up. Changes in YKL-40 levels were significantly correlated with improved mRS scores in patients with anti-NMDAR encephalitis. Our study suggests that CSF levels of YKL-40 in patients with anti-NMDAR encephalitis were increased and correlated with clinical mRS scores. This may be reflective of the underlying neuroinflammatory process. YKL-40 demonstrates potential as a possible biomarker for the prognosis of anti-NMDAR encephalitis.
抗N-甲基-D-天冬氨酸受体（NMDAR）脑炎主要影响儿童和年轻女性；该疾病可呈现多阶段表现，并具有多种多样的神经精神症状。本研究旨在调查抗NMDAR脑炎患者中YKL-40（几丁质酶3样蛋白1）的情况，并评估其与改良Rankin量表（mRS）评分及炎性细胞因子表达的相关性。本研究共纳入66例患者，其中33例患有抗NMDAR脑炎，13例患有病毒性脑膜炎，20例患有非炎性神经系统疾病。对患者进行评估以确定疾病发作时及3个月随访时的mRS评分；同时采集脑脊液（CSF）样本。采用酶联免疫吸附测定法测量CSF中YKL-40和细胞因子（TNF-α、IL-6、IL-10）的水平。与对照组相比，抗NMDAR脑炎患者在疾病急性期时CSF中YKL-40和炎性细胞因子（TNF-α、IL-6、IL-10）的水平均显著升高。在疾病发作时及3个月随访时，CSF中YKL-40的水平均与IL-6的水平相关。抗NMDAR脑炎患者中YKL-40水平的变化与mRS评分的改善显著相关。我们的研究表明，抗NMDAR脑炎患者CSF中YKL-40的水平升高，并与临床mRS评分相关。这可能反映了潜在的神经炎症过程。YKL-40显示出作为抗NMDAR脑炎预后潜在生物标志物的可能性。
