房水中神经丝轻链作为青光眼神经退行性变的标志物
Neurofilament Light Chain in Aqueous Humor as a Marker of Neurodegeneration in Glaucoma.
作者信息
Lin Jonathan B, Pitts Kristen M, El Helwe Hani, Neeson Cameron, Hall Nathan E, Falah Henisk, Schultz Stephanie A, Wang Silas L, Lo Kristine, Song Christian, Margeta Milica A, Solá-Del Valle David
机构信息
Department of Ophthalmology, Harvard Medical School and Massachusetts Eye and Ear, Boston, MA, USA.
Department of Neurology, Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA.
出版信息
Clin Ophthalmol. 2023 Aug 2;17:2209-2217. doi: 10.2147/OPTH.S417664. eCollection 2023.
PURPOSE
Neurofilament light chain (NfL) is a neuronal cytoskeletal protein that has been identified as a marker of neurodegeneration in diseases of the central nervous system. In this study, we investigated whether NfL in the aqueous humor (AH) can serve as a marker of neurodegeneration in glaucoma in a racially diverse North American population.
DESIGN
Single-center, case-control study.
PARTICIPANTS
We enrolled patients with various types and stages of glaucoma undergoing planned ophthalmic surgery as part of their routine care and compared them with patients without glaucoma undergoing phacoemulsification for age-related cataract.
METHODS
We collected AH from 39 glaucoma patients and 10 patients without glaucoma. AH NfL was quantified using the Single-Molecule Array (Simoa) NF-light assay (Quanterix). Demographic information, such as age, body mass index, sex, and self-reported race, as well as clinical information, such as pre-operative intraocular pressure (IOP), maximum IOP, and number of pre-operative glaucoma medications, was obtained by reviewing the medical record.
MAIN OUTCOME MEASURES
Levels of AH NfL.
RESULTS
In a model controlling for age and body mass index (BMI), NfL was significantly elevated in AH from glaucoma patients (mean: 429 pg/mL; standard deviation [SD]: 1136 pg/mL) compared to AH from patients without glaucoma (mean: 3.1 pg/mL; SD: 1.9 pg/mg): P = 0.002. Higher AH NfL was associated with higher maximum IOP (R = 0.44, P = 0.005), higher pre-operative IOP (R = 0.46, P = 0.003), and more pre-operative glaucoma medications (R = 0.61, P < 0.001). There was no association between AH NfL and Humphrey visual field mean deviation (R = -0.20, P = 0.220), retinal nerve fiber layer thickness as measured with optical coherence tomography (R = 0.07, P = 0.694), or glaucoma stage (R = 0.015, P = 0.935).
CONCLUSION
Our findings suggest that AH NfL may have clinical utility as a marker of glaucomatous neurodegeneration.
目的
神经丝轻链（NfL）是一种神经元细胞骨架蛋白，已被确定为中枢神经系统疾病中神经退行性变的标志物。在本研究中，我们调查了北美不同种族人群房水中的NfL是否可作为青光眼神经退行性变的标志物。
设计
单中心病例对照研究。
参与者
我们纳入了因常规治疗而计划接受眼科手术的各种类型和阶段的青光眼患者，并将他们与因年龄相关性白内障接受超声乳化手术的非青光眼患者进行比较。
方法
我们收集了39例青光眼患者和10例非青光眼患者的房水。使用单分子阵列（Simoa）NF-light检测法（Quanterix）对房水中的NfL进行定量。通过查阅病历获取人口统计学信息，如年龄、体重指数、性别和自我报告的种族，以及临床信息，如术前眼压（IOP）、最高眼压和术前青光眼药物使用数量。
主要观察指标
房水中NfL的水平。
结果
在控制年龄和体重指数（BMI）的模型中，与非青光眼患者房水（平均值：3.1 pg/mL；标准差[SD]：1.9 pg/mg）相比，青光眼患者房水中的NfL显著升高（平均值：429 pg/mL；SD：1136 pg/mL）：P = 0.002。房水中较高的NfL与较高的最高眼压（R = 0.44，P = 0.005）、较高的术前眼压（R = 0.46，P = 0.003）以及更多的术前青光眼药物使用量相关（R = 0.61，P < 0.001）。房水中的NfL与Humphrey视野平均偏差（R = -0.20，P = 0.220）、光学相干断层扫描测量的视网膜神经纤维层厚度（R = 0.07，P = 0.694）或青光眼分期（R = 0.015，P = 0.935）之间均无关联。
结论
我们的研究结果表明，房水中的NfL可能作为青光眼神经退行性变的标志物具有临床应用价值。
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