脑脊液和血清中α2-巨球蛋白水平的比值：急性播散性脑脊髓炎神经炎症的一种表现。

Ratio of Alpha 2-Macroglobulin Levels in Cerebrospinal Fluid and Serum: An Expression of Neuroinflammation in Acute Disseminated Encephalomyelitis.

机构信息

Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan.

出版信息

Pediatr Neurol. 2019 Sep;98:61-67. doi: 10.1016/j.pediatrneurol.2019.04.020. Epub 2019 May 11.

DOI:10.1016/j.pediatrneurol.2019.04.020

PMID:31248670

Abstract

BACKGROUND

Acute encephalitis and encephalopathy are life-threatening diseases in children. However, no laboratory examinations are performed for their early diagnosis and treatment. Alpha 2-macroglobulin (α2M) is a blood glycoprotein that increases during the early stages of inflammation. In the present study, we investigated the role of α2M levels in acute encephalitis and encephalopathy.

METHODS

We analyzed the cerebrospinal fluid and serum samples from patients with acute disseminated encephalomyelitis, infection-related acute encephalopathy, febrile status epilepticus, and febrile seizure simplex type. Samples were collected from the pediatric department of hospitals throughout the Fukushima Prefecture between January 1, 1999, and May 31, 2012.

RESULTS

α2M levels in the cerebrospinal fluid were 4.7 (3.8-8.4) μg/mL for acute disseminated encephalomyelitis, 2.1 (1.1-2.3) μg/mL for infection-related acute encephalopathy, 1.1 (0.9-6.4) μg/mL for febrile status epilepticus, and 1.0 (0.8-1.1) μg/mL for febrile seizure simplex type. α2M levels in patients with acute disseminated encephalomyelitis were significantly higher than those in patients with infection-related acute encephalopathy and febrile seizure simplex type (P = 0.019 and P = 0.002, respectively). The ratio of α2M level in the cerebrospinal fluid to that in the serum in patients with acute disseminated encephalomyelitis was significantly higher than the ratio in patients with febrile status epilepticus (P = 0.04). In patients with acute disseminated encephalomyelitis, α2M levels in the cerebrospinal fluid decreased with treatment.

CONCLUSIONS

Our results suggest that α2M levels in the cerebrospinal fluid reflect the neuroinflammatory status of patients with acute disseminated encephalomyelitis.

摘要

背景

急性脑炎和脑病是危及生命的儿童疾病。然而，目前还没有进行实验室检查来进行早期诊断和治疗。α2-巨球蛋白（α2M）是一种在炎症早期增加的血液糖蛋白。在本研究中，我们研究了 α2M 水平在急性脑炎和脑病中的作用。

方法

我们分析了来自急性播散性脑脊髓炎、感染相关急性脑病、热性惊厥性癫痫持续状态和单纯性热性惊厥患者的脑脊液和血清样本。样本采集自福岛县各医院儿科，时间为 1999 年 1 月 1 日至 2012 年 5 月 31 日。

结果

急性播散性脑脊髓炎患者脑脊液中 α2M 水平为 4.7（3.8-8.4）μg/mL，感染相关急性脑病患者为 2.1（1.1-2.3）μg/mL，热性惊厥性癫痫持续状态患者为 1.1（0.9-6.4）μg/mL，单纯性热性惊厥患者为 1.0（0.8-1.1）μg/mL。急性播散性脑脊髓炎患者脑脊液中 α2M 水平明显高于感染相关急性脑病和单纯性热性惊厥患者（P=0.019 和 P=0.002）。急性播散性脑脊髓炎患者脑脊液与血清中 α2M 水平比值明显高于热性惊厥性癫痫持续状态患者（P=0.04）。急性播散性脑脊髓炎患者脑脊液中 α2M 水平随治疗而降低。