Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
Department of Pathology and Microbiology, University of Montreal, Canada.
Am J Trop Med Hyg. 2024 Sep 10;111(5):1015-1019. doi: 10.4269/ajtmh.24-0325. Print 2024 Nov 6.
Solitary cysticercus granulomas (SCG), prevalent among Indian patients with new-onset seizures, either resolve completely or transform into calcified granulomas. This study aimed to identify serum proteins through liquid chromatography-tandem mass spectrometry that could predict calcification of SCGs in 20 patients with SCG with at least 6-months of follow-up. At a median follow-up of 14 months, the SCG had calcified (n = 5), resolved (n = 11), or persisted (n = 4). Two serum proteins, ECM1 and MST1, were present in significantly higher serum concentrations, and AZGP1 in significantly lower concentration in subjects with calcifying SCGs than in those with lesions that resolved or persisted. On multivariate analysis, only ECM1 (odds ratio: 1.7, 95% CI: 0-2.8) and MST1 (odds ratio: 3.3, 95% CI: 0-4.1) were independent predictors of calcification of SCG. Combining elevated levels of serum ECM1 and MST1 had a sensitivity of 100% and specificity of 100% in differentiating granulomas that calcified from those that resolved/persisted. Increased expression of serum ECM1 and MST1 in patients with SCG might predict calcification.
孤立性囊尾蚴肉芽肿 (SCG) 在印度新发性癫痫患者中较为常见,其要么完全消退,要么转变为钙化性肉芽肿。本研究旨在通过液相色谱-串联质谱鉴定出 20 例 SCG 患者在至少 6 个月随访中有钙化的患者的血清蛋白,这些患者均有 SCG。在中位随访 14 个月时,SCG 发生钙化 (n = 5)、消退 (n = 11) 或持续存在 (n = 4)。与病变消退或持续存在的患者相比,钙化性 SCG 患者的血清 ECM1 和 MST1 浓度显著升高,而 AZGP1 浓度显著降低。多变量分析显示,只有 ECM1(比值比:1.7,95%CI:0-2.8)和 MST1(比值比:3.3,95%CI:0-4.1)是 SCG 钙化的独立预测因子。联合检测血清 ECM1 和 MST1 水平升高,在区分钙化和消退/持续存在的肉芽肿方面具有 100%的敏感性和 100%的特异性。SCG 患者血清 ECM1 和 MST1 表达增加可能预示着钙化。