多发性硬化症中的分子生物标志物与认知障碍：该领域现状、局限性及未来方向——一项系统综述与荟萃分析
Molecular biomarkers and cognitive impairment in multiple sclerosis: State of the field, limitations, and future direction - A systematic review and meta-analysis.
作者信息
Rademacher Tom-D, Meuth Sven G, Wiendl Heinz, Johnen Andreas, Landmeyer Nils C
机构信息
Department of Neurology, University Hospital Münster, Germany.
Department of Neurology, University Hospital Düsseldorf, Germany.
出版信息
Neurosci Biobehav Rev. 2023 Mar;146:105035. doi: 10.1016/j.neubiorev.2023.105035. Epub 2023 Jan 3.
OBJECTIVE
Multiple sclerosis (MS) is associated with cognitive impairment (CI) such as slowed information processing speed (IPS). Currently, no immunocellular or molecular markers have been established in cerebrospinal fluid and serum analysis as surrogate biomarkers with diagnostic or predictive value for the development of CI. This systematic review and meta-analysis aims to sum up the evidence regarding currently discussed markers for CI in MS.
METHODS
A literature search was conducted on molecular biomarkers of CI in MS, such as neurofilament light chain, chitinases, and vitamin D.
RESULTS
5543 publications were screened, of which 77 entered the systematic review. 13 studies were included in the meta-analysis. Neurofilament light chain (CSF: r = -0.294, p = 0.003; serum: r = -0.137, p = 0.001) and serum levels of vitamin D (r = 0.190, p = 0.014) were associated with IPS outcomes.
CONCLUSIONS
Neurofilament light chain and vitamin D are promising biomarkers to track impairments in IPS in MS. Further longitudinal research is needed to establish the use of molecular biomarkers to monitor cognitive decline.
目的
多发性硬化症（MS）与认知障碍（CI）相关，如信息处理速度（IPS）减慢。目前，在脑脊液和血清分析中尚未确立免疫细胞或分子标志物作为CI发生的具有诊断或预测价值的替代生物标志物。本系统评价和荟萃分析旨在总结关于MS中目前讨论的CI标志物的证据。
方法
对MS中CI的分子生物标志物进行文献检索，如神经丝轻链、几丁质酶和维生素D。
结果
筛选了5543篇出版物，其中77篇进入系统评价。13项研究纳入荟萃分析。神经丝轻链（脑脊液：r = -0.294，p = 0.003；血清：r = -0.137，p = 0.001）和血清维生素D水平（r = 0.190，p = 0.014）与IPS结果相关。
结论
神经丝轻链和维生素D是追踪MS中IPS损伤的有前景的生物标志物。需要进一步的纵向研究来确立分子生物标志物在监测认知衰退中的应用。
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