Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu, China.
Department of Laboratory Medicine, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China.
Front Immunol. 2023 Jan 23;13:1064007. doi: 10.3389/fimmu.2022.1064007. eCollection 2022.
To summarize the cytokine/chemokine levels of anti-N-methyl-Daspartate receptor encephalitis (NMDAR-E) and explore the potential role of these molecules and immune cells in the pathogenic mechanism.
The PubMed, Cochrane Library, Embase, and Web of Science databases were searched for various articles that assessed the concentrations of cytokines/chemokines in the unstimulated cerebrospinal fluid (CSF) or serum of patients with NMDAR-E in this systematic review and meta-analysis. The standardized mean difference (SMD) and 95% confidence interval (CI) were calculated by Stata17.0.
A total of 19 articles were included in the systematic review from 260 candidate papers, and cytokine/chemokine levels reported in the CSF/serum were examined in each article. This meta-analysis included 17 eligible studies comprising 579 patients with NMDAR-E, 367 patients with noninflammatory neurological disorders, and 42 healthy controls from China, Spain, South Korea, Australia, Czechia, and Sweden. The results indicated that the levels of different cytokines interleukin (IL)-6, tumor necrosis factor (TNF)-α, IL-10, IL-13, IL-1β, IL-12, and IL-17 and chemokine C-X-C motif ligand (CXCL)10 in the CSF were significantly higher in NMDAR-E patients with a large effect size. In addition, B cell activating factor (BAFF), CXCL13, and interferon (IFN)-γ levels in the CSF were higher in NMDAR-E patients with a middle effect size. In contrast, levels of IL-2 and IL-4 in the CSF and CXCL13 and BAFF in the serum did not show a significant difference between cases and controls.
These analyses showed that the central immune response in NMDAR-E is a process that involves multiple immune cell interactions mediated by cytokines/chemokines, and T cells play an important role in the pathogenesis of immunity.
https://www.crd.york.ac.uk/PROSPERO/, identifier (CRD42022342485).
总结抗 N-甲基-D-天冬氨酸受体脑炎（NMDAR-E）的细胞因子/趋化因子水平，并探讨这些分子和免疫细胞在致病机制中的潜在作用。
本系统评价和荟萃分析检索了 PubMed、Cochrane 图书馆、Embase 和 Web of Science 数据库中评估 NMDAR-E 患者未刺激脑脊液（CSF）或血清中细胞因子/趋化因子浓度的各种文章。使用 Stata17.0 计算标准化均数差（SMD）和 95%置信区间（CI）。
从 260 篇候选论文中纳入了 19 篇系统评价文章，并在每篇文章中检查了 CSF/血清中细胞因子/趋化因子的水平。这项荟萃分析包括了来自中国、西班牙、韩国、澳大利亚、捷克和瑞典的 17 项合格研究，共纳入了 579 名 NMDAR-E 患者、367 名非炎症性神经疾病患者和 42 名健康对照。结果表明，NMDAR-E 患者 CSF 中不同细胞因子白细胞介素（IL）-6、肿瘤坏死因子（TNF）-α、IL-10、IL-13、IL-1β、IL-12 和 IL-17 以及趋化因子 C-X-C 基序配体（CXCL）10 的水平显著更高，且具有较大的效应量。此外，CSF 中 B 细胞激活因子（BAFF）、CXCL13 和干扰素（IFN）-γ水平也更高，且具有中等效应量。相比之下，CSF 中 IL-2 和 IL-4 以及血清中 CXCL13 和 BAFF 的水平在病例组和对照组之间没有显著差异。
这些分析表明，NMDAR-E 中的中枢免疫反应是一个涉及多种细胞因子/趋化因子介导的免疫细胞相互作用的过程，T 细胞在免疫发病机制中起着重要作用。
