脑脊髓液 B 细胞激活因子水平作为神经结节病患者的新型生物标志物。

Cerebrospinal fluid B-cell activating factor levels as a novel biomarker in patients with neurosarcoidosis.

机构信息

Department of Neurology, Faculty of Medicine, Oita University, Oita, Japan.

出版信息

J Neurol Sci. 2023 Jun 15;449:120668. doi: 10.1016/j.jns.2023.120668. Epub 2023 May 3.

DOI:10.1016/j.jns.2023.120668

PMID:37148776

Abstract

OBJECTIVES

Neurosarcoidosis (NS) is a severe complication of sarcoidosis. Patients with NS often have poor outcomes. To improve both the quality of life and prognosis in patients with NS, accurate and reliable methods for early diagnosis and determining the efficacy of treatment are needed. This study aims to investigate B-cell-activating factor of the tumor necrosis factor family (BAFF) in cerebrospinal fluid (CSF) and elucidate the relationship between CSF BAFF levels and various parameters of NS.

METHODS

We studied 20 patients with NS and 14 control subjects. We measured CSF BAFF levels in all subjects and investigated the relationship with clinical findings, serum and CSF measures, and magnetic resonance imaging (MRI) findings.

RESULTS

CSF BAFF levels were significantly increased in patients with NS compared with controls (median 0.089 vs 0.04 ng/mL, p = 0.0005). CSF BAFF values were correlated with CSF findings-cell count, protein, angiotensin-converting enzyme, lysozyme, soluble interleukin-2 receptor, and immunoglobulin G-but not with serum parameters. CSF BAFF levels were especially higher in patients with abnormal intraparenchymal lesions of the brain and abnormal spinal MRI findings. CSF BAFF levels decreased significantly after immunosuppressive therapy.

CONCLUSION

CSF BAFF may aid the quantitative evaluation of NS and may serve as a biomarker for this disease.

摘要

目的

神经结节病（NS）是结节病的严重并发症。NS 患者的预后往往较差。为了提高 NS 患者的生活质量和预后，需要准确可靠的方法来进行早期诊断和评估治疗效果。本研究旨在探讨肿瘤坏死因子家族中的 B 细胞激活因子（BAFF）在脑脊液（CSF）中的水平，并阐明 CSF BAFF 水平与 NS 各种参数之间的关系。

方法

我们研究了 20 例 NS 患者和 14 例对照者。我们测量了所有受试者的 CSF BAFF 水平，并研究了其与临床发现、血清和 CSF 指标以及磁共振成像（MRI）结果之间的关系。

结果

与对照组相比，NS 患者的 CSF BAFF 水平显著升高（中位数 0.089 对 0.04ng/mL，p=0.0005）。CSF BAFF 值与 CSF 指标（细胞计数、蛋白、血管紧张素转换酶、溶菌酶、可溶性白细胞介素-2 受体和免疫球蛋白 G）相关，但与血清参数无关。CSF BAFF 水平在有脑实质内异常病变和异常脊髓 MRI 表现的患者中尤其升高。免疫抑制治疗后，CSF BAFF 水平显著下降。