Zhao Xudong, Li Lei, Ma Xiuping, Li Yang, Gao Beibei, Luo Weifeng
Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China.
Department of General Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, Jiangsu Province, China.
J Neural Transm (Vienna). 2024 Jan;131(1):13-24. doi: 10.1007/s00702-023-02704-8. Epub 2023 Oct 20.
We aimed to explore the role of immune and inflammatory indicators in cognitive dysfunction and disease severity in patients with Parkinson's disease (PD). A total of 123 patients with Parkinson's disease were enrolled in the PD group and 49 healthy volunteers in the control group. The patients with PD were further divided into 2 subgroups by evaluating cognitive function using the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE): the normal cognitive function (PD-NCI) group and the mild cognitive impairment (PD-MCI) group. Moreover, the PD patients were also divided into 2 subgroups using the defined scale of the Hoehn and Yahr (H-Y) stage: the early-stage group and the middle- and late-stage group. Immune and inflammatory indicators, including serum Aβ, Tau, CD4, CD8, CD3, B lymphocytes cell, NK cell, Th17 cell, Treg cell, IL-6, IL-17, and TNF-α levels, were evaluated and analyzed to explore the potential correlation with the cognitive dysfunction and disease severity of PD. Among the 123 PD patients, 60 (48.8%) were diagnosed with mild cognitive impairment. Aβ, CD4, CD8, CD3, and Treg levels observed in the PD-NCI group were lower than the control group (P < 0.001), while higher than the PD-MCI group (P < 0.001). The levels of Tau, Th17, IL-6, IL-17, and TNF-α observed in the PD-NCI group were higher than the control group (P < 0.001), while lower than in the PD-MCI group (P < 0.01). Using the same method, the results of the early-stage group and the middle- and the late-stage group were the same as above. Logistic regression analysis and ROC curve estimation were performed and indicated that the variation of Tau, CD8, Treg, TNF-α levels was associated with cognitive decline in PD patients, and may serve as markers of PD onset. Furthermore, the variation of Aβ, IL-6, and TNF-α levels was found to correlate with the disease severity of PD. The immune and inflammatory-related indicators may represent an important factor in the pathogenesis of PD, cognitive dysfunction, and disease severity. The variation of Tau protein, CD8, Treg, and TNF-α levels are associated with the cognitive dysfunction of PD, which may be considered as onset markers. Moreover, the variation of Aβ, IL-6, and TNF-α levels can predict the progression of PD.
我们旨在探讨免疫和炎症指标在帕金森病（PD）患者认知功能障碍和疾病严重程度中的作用。PD组共纳入123例帕金森病患者，对照组纳入49名健康志愿者。通过蒙特利尔认知评估（MoCA）和简易精神状态检查表（MMSE）评估认知功能，将PD患者进一步分为2个亚组：认知功能正常（PD-NCI）组和轻度认知障碍（PD-MCI）组。此外，根据Hoehn和Yahr（H-Y）分期量表将PD患者也分为2个亚组：早期组和中晚期组。评估和分析免疫和炎症指标，包括血清Aβ、Tau、CD4、CD8、CD3、B淋巴细胞、NK细胞、Th17细胞、Treg细胞、IL-6、IL-17和TNF-α水平，以探讨其与PD患者认知功能障碍和疾病严重程度的潜在相关性。在123例PD患者中，60例（48.8%）被诊断为轻度认知障碍。PD-NCI组中观察到的Aβ、CD4、CD8、CD3和Treg水平低于对照组（P<0.001），但高于PD-MCI组（P<0.001）。PD-NCI组中观察到的Tau、Th17、IL-6、IL-17和TNF-α水平高于对照组（P<0.001），但低于PD-MCI组（P<0.01）。采用同样的方法，早期组和中晚期组的结果与上述相同。进行了逻辑回归分析和ROC曲线估计，结果表明Tau、CD8、Treg、TNF-α水平的变化与PD患者的认知衰退有关，可能作为PD发病的标志物。此外，发现Aβ、IL-6和TNF-α水平的变化与PD的疾病严重程度相关。免疫和炎症相关指标可能是PD发病机制、认知功能障碍和疾病严重程度的一个重要因素。Tau蛋白、CD8、Treg和TNF-α水平的变化与PD的认知功能障碍有关，可被视为发病标志物。此外，Aβ、IL-6和TNF-α水平的变化可预测PD的进展。
