Department of Neurology, the Second Affiliated Hospital of Guangzhou Medical University, 250# Changgang East Road, Guangzhou 510260 Guangdong Province, China; Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Collaborative Innovation Center for Neurogenetics and Channelopathies, 250# Changgang East Road, Guangzhou 510260, Guangdong Province, China.
Department of Emergency, the Second Affiliated Hospital of GuangZhou Medical University, 250# Changgang east Road, GuangZhou, 510260 Guangdong Province, China.
Mult Scler Relat Disord. 2019 Apr;29:94-99. doi: 10.1016/j.msard.2019.01.036. Epub 2019 Jan 24.
Determination of glial fibrillary acidic protein (GFAP), aquaporin 4 (AQP4), and myelin oligodendrocyte glycoprotein (MOG) levels in cerebrospinal fluid (CSF), and astrocytic damage analysis in patients with GFAP astrocytopathy (GFAP-A) and other conditions.
GFAP, AQP4, and MOG levels in CSF were detected via enzyme-linked immunosorbent assays. Anti-GFAP, anti-AQP4, and anti-MOG IgGs were detected via indirect immunofluorescence assays.
In 32 GFAP-Astrocytopathy patients, CSF GFAP was significantly higher during acute exacerbation than it was in patients with MOG encephalomyelitis, multiple sclerosis, autoimmune encephalitis, and an "other inflammatory neurological disorders" group (all p < 0.0001). CSF GFAP levels were slightly higher in the GFAP-A group than in an anti-AQP4 IgG-positive neuromyelitis optica spectrum disorder group (p = 0.012). There were no significant differences between the CSF MOG and AQP4 levels in the GFAP-A group and those of other groups. CSF GFAP levels were significantly reduced after steroid treatment (p = 0.011). CSF GFAP levels differed significantly in GFAP-Astrocytopathy patients with and without encephalitis (p = 0.016). In GFAP-Astrocytopathy patients, CSF GFAP was correlated with Expanded Disability Status Scale (EDSS) score during attack (r = 0.545, p = 0.001). In follow-up examinations however, in GFAP-Astrocytopathy patients CSF GFAP level was not correlated with EDSS score 6 months later.
CSF GFAP level and pathological examination of GFAP-Astrocytopathy patients revealed astrocyte damage. CSF GFAP level was associated with steroid treatment at the acute stage, therefore CSF GFAP may be a sensitive biomarker with respect to the effects of therapy during the acute stage.
检测神经胶质纤维酸性蛋白（GFAP）、水通道蛋白 4（AQP4）和髓鞘少突胶质细胞糖蛋白（MOG）在脑脊液（CSF）中的水平，并分析 GFAP 星形细胞瘤病（GFAP-A）和其他疾病患者的星形胶质细胞损伤。
通过酶联免疫吸附试验检测 CSF 中的 GFAP、AQP4 和 MOG 水平。通过间接免疫荧光法检测抗-GFAP、抗-AQP4 和抗-MOG IgG。
在 32 名 GFAP-Astrocytopathy 患者中，急性加重期 CSF GFAP 明显高于 MOG 脑炎、多发性硬化症、自身免疫性脑炎和“其他炎症性神经障碍”组（均 p < 0.0001）。GFAP-A 组 CSF GFAP 水平略高于抗 AQP4 IgG 阳性视神经脊髓炎谱系障碍组（p = 0.012）。GFAP-A 组 CSF MOG 和 AQP4 水平与其他组无显著差异。激素治疗后 CSF GFAP 水平显著降低（p = 0.011）。GFAP-Astrocytopathy 患者有无脑炎时 CSF GFAP 水平差异有统计学意义（p = 0.016）。在 GFAP-Astrocytopathy 患者中，CSF GFAP 与攻击期间的扩展残疾状态量表（EDSS）评分呈显著相关（r = 0.545，p = 0.001）。然而，在随访检查中，GFAP-Astrocytopathy 患者的 CSF GFAP 水平与 6 个月后的 EDSS 评分无关。
CSF GFAP 水平和 GFAP-Astrocytopathy 患者的病理检查均显示星形胶质细胞损伤。CSF GFAP 水平与急性期的激素治疗有关，因此 CSF GFAP 可能是一种与急性期治疗效果相关的敏感生物标志物。
