Neuroinfection and Neuroimmunology Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.
Neuroinfection and Neuroimmunology Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.
Clin Chim Acta. 2024 May 15;558:119669. doi: 10.1016/j.cca.2024.119669. Epub 2024 Apr 8.
Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an inflammatory demyelinating disorder of central nervous system (CNS). Tryptophan indole catabolites have been reported to associate with the inflammatory diseases of the CNS. However, the roles of tryptophan indole catabolites have been rarely elucidated in MOGAD.
This cross-sectional study enrolled forty MOGAD patients, twenty patients with other non-inflammatory neurological diseases (OND) and thirty-five healthy participants. Serum and cerebrospinal fluid (CSF) samples of MOGAD and OND subjects during clinical attacks, serum samples of healthy participants were obtained. The concentrations of tryptophan, indoleacetic acid (IAA), indoleacrylic acid (IA) and indole-3-carboxylic acid (I-3-CA) were measured using high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). The correlations between tryptophan indole catabolites and maintenance immunotherapy, disease duration, overall numbers of attacks, short-term outcome in MOGAD patients were investigated.
Levels of serum tryptophan, IAA, IA and CSF tryptophan in MOGAD patients were significantly decreased, while levels of serum I-3-CA and CSF IA were markedly increased compared with OND patients and healthy controls. Levels of serum tryptophan, CSF tryptophan and IA were significantly decreased in MOGAD patients who had received maintenance immunotherapy within 6 months before the attack. In MOGAD patients, serum and CSF tryptophan conversely correlated with disease duration and overall numbers of attacks, and serum IA negatively correlated with disease duration. Furthermore, serum tryptophan in MOGAD patients negatively correlated with the modified Rankin Scale (mRS) scores at 3 months.
This study manifested decreased serum tryptophan levels and serum tryptophan may be the potential marker to predict the short-term outcome in MOGAD patients.
髓鞘少突胶质细胞糖蛋白抗体相关疾病（MOGAD）是一种中枢神经系统（CNS）的炎症性脱髓鞘疾病。色氨酸吲哚代谢物已被报道与 CNS 的炎症性疾病有关。然而，色氨酸吲哚代谢物在 MOGAD 中的作用很少被阐明。
本横断面研究纳入了 40 名 MOGAD 患者、20 名其他非炎症性神经系统疾病（OND）患者和 35 名健康参与者。在临床发作期间，采集 MOGAD 和 OND 患者的血清和脑脊液（CSF）样本，采集健康参与者的血清样本。采用高效液相色谱-串联质谱（HPLC-MS/MS）测定色氨酸、吲哚乙酸（IAA）、吲哚丙烯酸（IA）和吲哚-3-羧酸（I-3-CA）的浓度。探讨色氨酸吲哚代谢物与 MOGAD 患者维持性免疫治疗、疾病持续时间、发作总数、短期转归的相关性。
MOGAD 患者血清色氨酸、IAA、IA 和 CSF 色氨酸水平显著降低，而血清 I-3-CA 和 CSF IA 水平显著升高，与 OND 患者和健康对照组相比。在发病前 6 个月内接受维持性免疫治疗的 MOGAD 患者中，血清色氨酸、CSF 色氨酸和 IA 水平显著降低。在 MOGAD 患者中，血清和 CSF 色氨酸与疾病持续时间和发作总数呈负相关，血清 IA 与疾病持续时间呈负相关。此外，MOGAD 患者血清色氨酸与 3 个月时改良 Rankin 量表（mRS）评分呈负相关。
本研究显示血清色氨酸水平降低，血清色氨酸可能是预测 MOGAD 患者短期转归的潜在标志物。
