Department of Clinical Laboratory(,) The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
J Neuroimmunol. 2022 Aug 15;369:577900. doi: 10.1016/j.jneuroim.2022.577900. Epub 2022 May 27.
Cystatin C has neuroprotective and immunomodulatory effects on the central nervous system. However, the role of cerebrospinal fluid (CSF) cystatin C in anti-N-methyl-d-aspartate receptor encephalitis (anti-NMDARE) remains unknown.
In this study, CSF levels of cystatin C were determined in 73 patients with anti-NMDARE; 496 patients with other neurological diseases, comprising 108 with neuromyelitis optica, 77 with multiple sclerosis, 71 with schizophrenia, 68 with cryptococcus meningitis or meningoencephalitis, 43 with tuberculous meningitis or meningoencephalitis, 43 with bacterial meningitis or meningoencephalitis (BM), 35 with Guillain-Barré syndrome, 23 with spinal cord injury (SCI), 14 with amyotrophic lateral sclerosis (ALS), and 14 with idiopathic epilepsy; and 136 control patients with non-inflammatory diseases. The associations of CSF cystatin C with anti-NMDARE and its clinical parameters were evaluated.
CSF cystatin C levels were significantly lower in patients with anti-NMDARE than in patients with BM, SCI, and ALS, especially among those with poor functional status (modified Rankin Scale [mRS] ≥4). CSF cystatin C levels were also significantly lower in anti-NMDARE patients with poor functional status (mRS ≥4) than in those with good functional status (mRS <4). CSF cystatin C levels were significantly associated with mRS scores and CSF white blood cell counts in anti-NMDARE patients.
CSF levels of cystatin C are decreased in anti-NMDARE patients and negatively associated with disease severity.
半胱氨酸蛋白酶抑制剂 C 对中枢神经系统具有神经保护和免疫调节作用。然而，脑脊液（CSF）胱抑素 C 在抗 N-甲基-D-天冬氨酸受体脑炎（抗 NMDARE）中的作用尚不清楚。
本研究测定了 73 例抗 NMDARE 患者、496 例其他神经系统疾病患者（包括 108 例视神经脊髓炎、77 例多发性硬化症、71 例精神分裂症、68 例隐球菌性脑膜炎或脑膜脑炎、43 例结核性脑膜炎或脑膜脑炎、43 例细菌性脑膜炎或脑膜脑炎（BM）、35 例吉兰-巴雷综合征、23 例脊髓损伤（SCI）、14 例肌萎缩侧索硬化症（ALS）和 14 例特发性癫痫患者以及 136 例非炎症性疾病对照患者的 CSF 胱抑素 C 水平。评估了 CSF 胱抑素 C 与抗 NMDARE 及其临床参数的相关性。
与 BM、SCI 和 ALS 患者相比，抗 NMDARE 患者的 CSF 胱抑素 C 水平显著降低，尤其是功能状态较差（改良 Rankin 量表 [mRS]≥4）的患者。功能状态较差（mRS≥4）的抗 NMDARE 患者的 CSF 胱抑素 C 水平也显著低于功能状态较好（mRS<4）的患者。CSF 胱抑素 C 水平与抗 NMDARE 患者的 mRS 评分和 CSF 白细胞计数显著相关。
抗 NMDARE 患者的 CSF 胱抑素 C 水平降低，与疾病严重程度呈负相关。
