Lian Teng-Hong, Guo Peng, Zuo Li-Jun, Hu Yang, Yu Shu-Yang, Yu Qiu-Jin, Jin Zhao, Wang Rui-Dan, Li Li-Xia, Zhang Wei
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Internal Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Front Neurosci. 2019 Mar 27;13:255. doi: 10.3389/fnins.2019.00255. eCollection 2019.
Tremor is one of the most predominant symptoms of patients with Parkinson disease (PD), but the underlying mechanisms for tremor relating to iron and its metabolism-related proteins and the inflammatory factors in cerebrospinal fluid (CSF) and serum have not been fully elucidated. A total of 135 PD patients were divided into a tremor-dominant (PD-TD) group ( = 74) and a postural instability and gait difficulty-dominant (PD-PIGD) group ( = 39) based on the ratio of mean tremor score to the mean bradykinesia/rigid score of the Unified Parkinson's Disease Rating Scale (UPDRS) III. Age and sex-matched healthy controls were recruited ( = 35). Demographic variables were evaluated; iron and its metabolism-related proteins and the inflammatory mediators in both CSF and serum were measured in these groups. The relevance of iron metabolism, inflammation and PD-TD were analyzed. (1) The PD-TD group had significantly decreased L-ferritin, increased iron levels in CSF and increased ferritin levels in the serum compared with the PD-PIGD and control groups ( < 0.05). (2) The PD-TD group had significantly enhanced IL-6 levels in both CSF and serum compared with the PD-PIGD and control groups ( < 0.05). (3) In CSF, the IL-6 level was increased as the iron level was elevated in the PD-TD group ( = 0.308, = 0.022). In serum, the IL-6 level was increased as the ferritin level was elevated in the PD-TD group ( = 0.410, = 0.004). The interplay between disturbed iron metabolism and relevant inflammation might modulate clinical phenotypes of PD.
震颤是帕金森病（PD）患者最主要的症状之一，但与铁及其代谢相关蛋白以及脑脊液（CSF）和血清中的炎症因子相关的震颤潜在机制尚未完全阐明。根据统一帕金森病评定量表（UPDRS）III中平均震颤评分与平均运动迟缓/僵硬评分的比值，将135例PD患者分为震颤为主型（PD-TD）组（n = 74）和姿势不稳和步态障碍为主型（PD-PIGD）组（n = 39）。招募了年龄和性别匹配的健康对照者（n = 35）。评估人口统计学变量；测量这些组中CSF和血清中的铁及其代谢相关蛋白以及炎症介质。分析铁代谢、炎症与PD-TD之间的相关性。（1）与PD-PIGD组和对照组相比，PD-TD组的L-铁蛋白显著降低，CSF中铁水平升高，血清中铁蛋白水平升高（P < 0.05）。（2）与PD-PIGD组和对照组相比，PD-TD组CSF和血清中的IL-6水平均显著升高（P < 0.05）。（3）在CSF中，PD-TD组中IL-6水平随铁水平升高而升高（r = 0.308，P = 0.022）。在血清中，PD-TD组中IL-6水平随铁蛋白水平升高而升高（r = 0.410，P = 0.004）。铁代谢紊乱与相关炎症之间的相互作用可能会调节PD的临床表型。
