Centre de Recherche Des Cordeliers Inserm, UMR_1138, Physiopathology of Ocular Diseaic Innovationsses/Therapeut, Université de Paris, Université Sorbonne Paris Cité, 15 rue de l'Ecole de Médecine, 75006, Paris, France.
Université de Paris, Paris, France.
Sci Rep. 2020 Nov 19;10(1):20175. doi: 10.1038/s41598-020-77202-y.
No systemic biomarker of Central Serous Chorioretinopathy (CSCR) has been identified. Lipocalin 2 (LCN2 or NGAL), alone or complexed with MMP-9 (NGAL/MMP-9), is increased in several retinal disorders. Serum levels of LCN2 and NGAL/MMP-9 were measured in CSCR patients (n = 147) with chronic (n = 76) or acute/recurrent disease (n = 71) and in age- and sex-matched healthy controls (n = 130). Samples with CRP > 5 mg/L, creatinine > 100 µmol/L, and/or urea > 7.5 mmol/L were excluded. Serum LCN2 was lower in CSCR patients than controls (81.4 ± 48.7 vs 107.3 ± 44.5 ng/ml, p < 0.0001), and lower in acute/recurrent CSCR than controls (p < 0.001) and chronic CSCR (p = 0.006). Serum NGAL/MMP-9 was lower in CSCR patients than controls (47.2 ± 40.7 vs 74.1 ± 42.6, p < 0.0001), and lower in acute/recurrent CSCR than controls (p < 0.001) and chronic CSCR (p = 0.002). A ROC curve showed that for LCN2 serum levels, the 80-ng/ml cutoff value allows to discriminate acute/recurrent CSCR from controls with 80.3% sensitivity and 75.8% specificity, and for NGAL/MMP-9 serum levels, a 38-ng/ml cutoff value allows to discriminate acute/recurrent CSCR from controls with 69.6% sensitivity and 80.3% specificity. In both acute and chronic CSCR, low serum LCN2 and NGAL/MMP-9, provide a biological link between the two CSCR forms, and potential susceptibility to oxidative stress and innate immune dysregulation in CSCR.
目前尚未发现可用于诊断中心性浆液性脉络膜视网膜病变（CSCR）的系统性生物标志物。在多种视网膜疾病中，脂质运载蛋白 2（LCN2 或 NGAL）或与 MMP-9（NGAL/MMP-9）结合后其水平会升高。研究人员检测了 147 例 CSCR 患者（慢性疾病 76 例，急性/复发性疾病 71 例）和 130 名年龄和性别相匹配的健康对照者（对照组）的血清 LCN2 和 NGAL/MMP-9 水平。排除 CRP＞5mg/L、肌酐＞100μmol/L 和/或尿素＞7.5mmol/L 的样本。CSCR 患者的血清 LCN2 水平低于对照组（81.4±48.7 vs 107.3±44.5ng/ml，p＜0.0001），且急性/复发性 CSCR 患者的血清 LCN2 水平低于对照组（p＜0.001）和慢性 CSCR 患者（p=0.006）。CSCR 患者的血清 NGAL/MMP-9 水平低于对照组（47.2±40.7 vs 74.1±42.6，p＜0.0001），且急性/复发性 CSCR 患者的血清 NGAL/MMP-9 水平低于对照组（p＜0.001）和慢性 CSCR 患者（p=0.002）。ROC 曲线显示，血清 LCN2 水平的 80ng/ml 截断值可使急性/复发性 CSCR 患者与对照组之间的区分灵敏度达到 80.3%，特异性达到 75.8%，血清 NGAL/MMP-9 水平的 38ng/ml 截断值可使急性/复发性 CSCR 患者与对照组之间的区分灵敏度达到 69.6%，特异性达到 80.3%。在急性和慢性 CSCR 中，低水平的血清 LCN2 和 NGAL/MMP-9 为这两种 CSCR 形式之间提供了生物学联系，并提示 CSCR 患者可能存在氧化应激和固有免疫失调的易感性。
