Division of Neurology, Department of Internal Medicine (IV), Osaka Medical and Pharmaceutical University, Osaka 569-1094, Japan.
Division of Rheumatology, Department of Internal Medicine (IV), Osaka Medical and Pharmaceutical University, Osaka 569-1094, Japan.
Int J Mol Sci. 2022 Nov 2;23(21):13374. doi: 10.3390/ijms232113374.
This study aimed to elucidate the pathomechanism of peripheral neuropathy (PN) in microscopic polyangiitis (MPA) and to identify biomarkers useful for diagnosis and severity assessment. Patients with MPA ( = 37) and other non-inflammatory neurological diseases (ONDs; = 12) were enrolled, and the peripheral nerves of all patients were evaluated using nerve conduction studies. We compared the clinical characteristics and 14 serum biomarker profiles among patients with MPA and PN, MPA without PN, and ONDs. Patients with MPA had a higher prevalence of motor neuropathy than patients with ONDs. Among the patients with MPA, those with motor neuropathy had significantly higher total Birmingham Vasculitis Activity Scores and serum levels of C-reactive protein (CRP), tissue inhibitor of metalloproteinase-1 (TIMP-1), and interleukin-6 than patients without motor neuropathy. Multivariable analyses adjusted for age, serum CRP level, and diabetes mellitus showed that high serum levels of TIMP-1 were independently related to a diagnosis of motor neuropathy in MPA. Additionally, there were significant negative correlations between the serum levels of TIMP-1 and compound muscle action potential amplitudes. Serum levels of TIMP-1 may be associated with the pathomechanism of motor neuropathy in MPA and could be a useful biomarker for diagnosing and evaluating the severity of motor neuropathy in MPA.
本研究旨在阐明显微镜下多血管炎(MPA)周围神经病(PN)的发病机制,并确定有助于诊断和严重程度评估的生物标志物。纳入了 37 例 MPA 患者和 12 例其他非炎症性神经系统疾病(OND)患者,并对所有患者的周围神经进行了神经传导研究。我们比较了 MPA 伴 PN、无 PN 和 OND 患者的临床特征和 14 种血清生物标志物谱。与 OND 患者相比,MPA 患者运动神经病的患病率更高。在 MPA 患者中,有运动神经病的患者的总伯明翰血管炎活动评分和 C 反应蛋白(CRP)、基质金属蛋白酶抑制剂-1(TIMP-1)和白细胞介素-6 的血清水平显著更高,而无运动神经病的患者则没有。经年龄、血清 CRP 水平和糖尿病校正的多变量分析表明,TIMP-1 血清水平升高与 MPA 运动神经病的诊断独立相关。此外,TIMP-1 血清水平与复合肌肉动作电位幅度之间存在显著负相关。TIMP-1 血清水平可能与 MPA 运动神经病的发病机制有关,可能是诊断和评估 MPA 运动神经病严重程度的有用生物标志物。