抗 N-甲基-D-天冬氨酸受体脑炎中的淀粉样蛋白和 Tau 作为脑脊液生物标志物。

Amyloid and Tau as cerebrospinal fluid biomarkers in anti-N-Methyl-D-aspartate receptor encephalitis.

机构信息

Department of Blood Transfusion, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, 450053, Henan, China.

Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

Neurol Sci. 2024 Jul;45(7):3399-3410. doi: 10.1007/s10072-024-07341-x. Epub 2024 Jan 27.

DOI:10.1007/s10072-024-07341-x

PMID:38280087

Abstract

INTRODUCTION

Neuroinfection is associated with the deposition of amyloid-beta (Aβ) peptides, and subsequent decrease in cerebrospinal fluid (CSF) amyloid levels. However, whether autoimmune encephalitis involves extracellular deposition of Aβ peptides in the brain is unreported.

METHODS

We examined CSF amyloid and tau values in adults with anti-N-methyl-D-aspartate receptor encephalitis (NMDAR-E). Forty-two patients with NMDAR-E, 35 patients with viral and bacterial neuroinfections, and 16 controls were included. We measured CSF Aβ1-42 (cAβ1-42), Aβ1-40 (cAβ1-40), t-Tau (ct-Tau), and p-Tau181 (cp-Tau181) levels and assessed their efficacies regarding differential diagnosis and predicting prognosis.

RESULTS

NMDAR-E patients had lower cAβ1-42 levels; however, they were higher than those of patients with bacterial meningitis. ct-Tau levels in NMDAR-E patients were lower than those in patients with neuroinfections. No changes were observed in controls. cAβ1-42 and ct-Tau were combined as an excellent marker to distinguish NMDAR-E from neuroinfections. cAβ1-42 levels in NMDAR-E patients were positively correlated with Montreal Cognitive Assessment scores. We observed an inverse relationship between cAβ1-42 levels and modified Rankin Scale scores. Patients with poor outcomes exhibited low cAβ1-42 levels and high levels of several blood parameters. cAβ1-42 was the highest quality biomarker for assessing NMDAR-E prognosis. Correlations were found between cAβ1-42 and some inflammatory indicators.

CONCLUSION

cAβ1-42 was decreased in NMDAR-E patients. cAβ1-42 levels indicated NMDAR-E severity and acted as a biomarker for its prognosis. Combining cAβ1-42 and ct-Tau levels could serve as a novel differential diagnostic marker for NMDAR-E.

摘要

简介

神经感染与淀粉样β（Aβ）肽的沉积有关，随后脑脊液（CSF）中的 Aβ 水平下降。然而，自身免疫性脑炎是否涉及脑内 Aβ 肽的细胞外沉积尚未报道。

方法

我们检查了抗 N-甲基-D-天冬氨酸受体脑炎（NMDAR-E）成人的 CSF 中 Aβ 和 tau 值。共纳入 42 例 NMDAR-E 患者、35 例病毒和细菌神经感染患者和 16 例对照者。我们测量了 CSF Aβ1-42（cAβ1-42）、Aβ1-40（cAβ1-40）、t-Tau（ct-Tau）和 p-Tau181（cp-Tau181）水平，并评估了它们在鉴别诊断和预测预后方面的效果。

结果

NMDAR-E 患者的 cAβ1-42 水平较低；然而，其水平高于细菌性脑膜炎患者。NMDAR-E 患者的 ct-Tau 水平低于神经感染患者。对照组未发生变化。cAβ1-42 和 ct-Tau 联合作为鉴别 NMDAR-E 与神经感染的优秀标志物。NMDAR-E 患者的 cAβ1-42 水平与蒙特利尔认知评估分数呈正相关。我们观察到 cAβ1-42 水平与改良 Rankin 量表评分之间呈负相关。预后不良的患者的 cAβ1-42 水平较低，且多项血液参数水平较高。cAβ1-42 是评估 NMDAR-E 预后的最佳生物标志物。cAβ1-42 与一些炎症指标之间存在相关性。