Department of Medical Research, SRM Medical College Hospital, SRM Institute of Science and Technology, Chennai, India.
Department of Nephrology, SRM Medical College Hospital, SRM Institute of Science and Technology, Chennai, India.
J Clin Neurosci. 2019 Nov;69:38-42. doi: 10.1016/j.jocn.2019.08.073. Epub 2019 Aug 22.
Cognitive dysfunction potentially affecting up to 60% of CKD patients. GSK-3β plays a key role in the pathogenesis of AD and Cognitive dysfunction, contributing to Aβ production and Aβ-mediated neuronal death by phosphorylating tau inducing hyperphosphorylation in paired helical filaments. However, studies have shown that plasma p-Tau181 is more specific for AD and cognitive dysfunction. Anemia is a vital risk factor for cognitive dysfunction in CKD patients. EPO is usually to treat anemia in CKD and also improved in cognitive function. The aim of the study is to correlate between the impacts of rHuEPO therapy on platelet GSK3β expression, plasma Aβ total Tau, p-Tau 181 levels and neuropsychological assessments total scores in CKD patients with Cognitive dysfunction.
The subjects, 30 CKD without cognitive dysfunction and 30 CKD with cognitive dysfunction patients. To correlate abnormal proteins with neuropsychological tests scoring in CKD with cognitive dysfunction subjects after the six months rHuEPO therapy.
The p < 0.05 is considered as statistically significant. Pearson and Spearman correlation coefficient was used to determine the potential relationship between abnormal proteins with neuropsychological tests scoring in respective experimental groups.
The use of abnormal protein levels, preferably in association with neuropsychological assessment total scores, appears to be a potential tool that can improve the CKD with cognitive dysfunction diagnosis. In post rHuEPO treatment, the altered protein abnormalities and neuropsychological assessment scores were retrieved significantly compared to pre treatment determined the clinical usefulness of rHuEpo as supplemental therapeutic agent in cognitive dysfunction in CKD.
认知功能障碍可能影响多达 60%的慢性肾脏病患者。GSK-3β 在 AD 和认知功能障碍的发病机制中发挥关键作用，通过磷酸化 tau 导致 Aβ 产生和 Aβ 介导的神经元死亡，从而促进 tau 的过度磷酸化，形成双螺旋丝。然而，研究表明，血浆 p-Tau181 对 AD 和认知功能障碍更具特异性。贫血是慢性肾脏病患者认知功能障碍的重要危险因素。EPO 通常用于治疗慢性肾脏病患者的贫血，也可改善认知功能。本研究旨在探讨 rHuEPO 治疗对慢性肾脏病伴认知功能障碍患者血小板 GSK3β 表达、血浆 Aβ 总 Tau、p-Tau181 水平和神经心理学评估总分的影响。
研究对象为 30 名无认知功能障碍的慢性肾脏病患者和 30 名有认知功能障碍的慢性肾脏病患者。在 rHuEPO 治疗 6 个月后，将异常蛋白与有认知功能障碍的慢性肾脏病患者的神经心理学测试评分进行相关性分析。
p<0.05 被认为具有统计学意义。Pearson 和 Spearman 相关系数用于确定各自实验组中异常蛋白与神经心理学测试评分之间的潜在关系。
异常蛋白水平的使用，最好与神经心理学评估总分相结合，似乎是一种潜在的工具，可以改善慢性肾脏病伴认知功能障碍的诊断。与治疗前相比，rHuEPO 治疗后异常蛋白异常和神经心理学评估评分显著改善，表明 rHuEpo 作为慢性肾脏病认知功能障碍的辅助治疗药物具有临床应用价值。
