血浆脂多糖结合蛋白反映帕金森病的风险和进展。

Plasma Lipopolysaccharide-Binding Protein Reflects Risk and Progression of Parkinson's Disease.

机构信息

Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.

Department of Neurology, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan.

出版信息

J Parkinsons Dis. 2021;11(3):1129-1139. doi: 10.3233/JPD-212574.

DOI:10.3233/JPD-212574

PMID:33720853

Abstract

BACKGROUND

Lipopolysaccharide-binding protein (LBP) presents bacterial endotoxin, lipopolysaccharides, to cellular surface pattern receptors for immune responses in the gut-brain axis of Parkinson's disease (PD).

OBJECTIVE

We investigated whether plasma LBP levels were associated with PD severity and progression.

METHODS

This study included 397 participants (248 PD patients and 149 controls). We measured participants' plasma levels of LBP and pro-inflammatory cytokines, including TNF-α, IL-6, andIL-17A. PD patients underwent motor and cognition evaluations at baseline and at a mean follow-up interval of 4.7±2.3 years. We assessed the progression of motor and cognition symptoms based on changes in the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III motor score and Mini-Mental State Examination (MMSE) score, respectively.

RESULTS

Plasma LBP levels were lower in PD patients than controls (9.08±2.91 vs. 10.10±3.00μg/ml, p < 0.01). A multiple logistic regression model with adjustment for age, sex, and plasma cytokine levels revealed that reduced plasma LBP levels were associated with increased PD risk (odds ratio 0.816, [95% CI 0.717-0.929], p = 0.002). Among PD patients, LBP levels were correlated with MDS-UPDRS part III motor score after adjustment for confounders (coefficient = 0.636, p = 0.017), but not with MMSE score. Adjusted Cox regression analysis showed that higher plasma LBP levels associated with faster motor progression (adjusted hazard ratio 1.084 [95% CI 1.011-1.163], p = 0.024) during follow-up.

CONCLUSION

Our results demonstrated that plasma LBP levels reflect risk, motor symptom severity and progression in patients with PD.

摘要

背景

脂多糖结合蛋白（LBP）将细菌内毒素脂多糖呈现给肠道-大脑轴中帕金森病（PD）的细胞表面模式受体，引发免疫反应。

目的

我们研究了血浆 LBP 水平是否与 PD 的严重程度和进展有关。

方法

本研究纳入了 397 名参与者（248 名 PD 患者和 149 名对照者）。我们测量了参与者的血浆 LBP 和促炎细胞因子水平，包括 TNF-α、IL-6 和 IL-17A。PD 患者在基线和平均 4.7±2.3 年的随访间隔内接受了运动和认知评估。我们根据运动障碍协会统一帕金森病评定量表（MDS-UPDRS）第三部分运动评分和简易精神状态检查（MMSE）评分的变化评估运动和认知症状的进展。

结果

PD 患者的血浆 LBP 水平低于对照组（9.08±2.91 与 10.10±3.00μg/ml，p<0.01）。在调整年龄、性别和血浆细胞因子水平后，多变量逻辑回归模型显示，降低的血浆 LBP 水平与增加的 PD 风险相关（比值比 0.816，[95%CI 0.717-0.929]，p=0.002）。在 PD 患者中，LBP 水平与调整混杂因素后的 MDS-UPDRS 第三部分运动评分相关（系数=0.636，p=0.017），但与 MMSE 评分无关。调整后的 Cox 回归分析显示，较高的血浆 LBP 水平与随访期间更快的运动进展相关（调整后的危险比 1.084[95%CI 1.011-1.163]，p=0.024）。