Department of Clinical Laboratory, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
J Neuroimmunol. 2023 Nov 15;384:578221. doi: 10.1016/j.jneuroim.2023.578221. Epub 2023 Oct 16.
Uric acid (UA) is an important natural antioxidant and strong peroxynitrite scavenger, but little is known about central nervous system (CNS) levels of UA in patients with anti-N-methyl-d-aspartate receptor encephalitis (NMDARE).
Cerebrospinal fluid (CSF) and serum levels of UA were determined in 72 patients with anti-NMDARE and 111 controls with non-inflammatory neurological diseases (NINDs). Serum UA levels were also evaluated in 132 healthy controls (HCs). CSF neuron-specific enolase (NSE) and blood-brain barrier (BBB) index were evaluated in patients with anti-NMDARE. The association of CSF UA levels with anti-NMDARE and its clinical parameters were evaluated in the patients.
CSF UA levels were lower in patients with anti-NMDARE than in patients with NINDs, especially in patients with severe impairments (modified Rankin Scale [mRS] scores >3 vs. ≤ 3, p = 0.006). Furthermore, serum UA levels in patients with anti-NMDARE were significantly lower than in patients with NINDs and HCs. CSF UA levels were significantly associated with mRS scores, and serum UA levels in patients with anti-NMDARE. Furthermore, CSF/serum UA ratio was significantly associated with BBB index.
CSF UA levels associated with disease severity and serum UA levels in patients with anti-NMDARE. And CSF/serum UA ratio correlated with BBB index, indicating that CSF and serum UA levels change similarly with BBB permeability in anti-NMDARE patients.
尿酸（UA）是一种重要的天然抗氧化剂和强过氧亚硝酸盐清除剂，但人们对抗 N-甲基-D-天冬氨酸受体脑炎（NMDARE）患者中枢神经系统（CNS）中 UA 的水平知之甚少。
测定了 72 例 NMDARE 患者和 111 例非炎症性神经疾病（NIND）对照者的脑脊液（CSF）和血清 UA 水平。还评估了 132 例健康对照者（HCs）的血清 UA 水平。评估了 NMDARE 患者的 CSF 神经元特异性烯醇化酶（NSE）和血脑屏障（BBB）指数。评估了 CSF UA 水平与 NMDARE 及其临床参数的相关性。
与 NIND 患者相比，NMDARE 患者的 CSF UA 水平较低，尤其是在严重受损的患者中（改良 Rankin 量表评分>3 与≤3，p=0.006）。此外，NMDARE 患者的血清 UA 水平明显低于 NIND 患者和 HCs。CSF UA 水平与 mRS 评分显著相关，NMDARE 患者的血清 UA 水平也显著相关。此外，CSF/血清 UA 比值与 BBB 指数显著相关。
CSF UA 水平与疾病严重程度相关，NMDARE 患者的血清 UA 水平也相关。CSF/血清 UA 比值与 BBB 指数相关，表明 NMDARE 患者的 CSF 和血清 UA 水平与 BBB 通透性的变化相似。
