Ma Jia, Zheng Zhidong, Sun Jiali, Wang Huabing, Cong Hengri, Wei Yuzhen, Ma Yuetao, Feng Kai, Yin Linlin, Zhang Xinghu
Department of Neuroinfection and Neuroimmunology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Beijing Shunyi Hospital, Beijing Shunyi Teaching Hospital of Capital Medical University, Beijing, China.
Front Neurol. 2024 Oct 9;15:1434139. doi: 10.3389/fneur.2024.1434139. eCollection 2024.
Encephalitis associated with antibodies against the -methyl--aspartate receptor (NMDAR) results in a distinctive neuro-psychiatric syndrome. It has been reported that the serum phenylalanine-tyrosine (Phe/Tyr) ratio increases during infection. However, the connection between phenylalanine-tyrosine metabolism and psychiatric symptoms remains unclear.
We enrolled 24 individuals with anti-NMDAR encephalitis and 18 individuals with non-inflammatory neurological diseases (OND). Chromatography was used to measure serum levels of phenylalanine and tyrosine. Serum and cerebrospinal fluid (CSF) TNF- levels were obtained from the clinical database. The modified Rankin Scale (mRS) score and Glasgow Coma Scale (GCS) score were recorded during the acute phase. The area under the curve (AUC) of the receiver operating characteristic curve was used to assess prediction efficacy.
In NMDAR patients, levels of serum Phe and the ratio of serum Phe/Tyr were higher compared to OND patients. The serum Phe/Tyr ratio was also elevated in NMDAR patients with psychiatric syndrome. Furthermore, serum Phe and Tyr levels were correlated with inflammatory indexes.
The serum Phe/Tyr ratio is elevated in NMDAR patients with psychiatric syndrome and is associated with severity. Therefore, the serum Phe/Tyr ratio may serve as a potential prognostic biomarker.
与抗 N-甲基-D-天冬氨酸受体（NMDAR）抗体相关的脑炎会导致一种独特的神经精神综合征。据报道，感染期间血清苯丙氨酸-酪氨酸（Phe/Tyr）比值会升高。然而，苯丙氨酸-酪氨酸代谢与精神症状之间的联系仍不清楚。
我们纳入了 24 例抗 NMDAR 脑炎患者和 18 例非炎性神经系统疾病（OND）患者。采用色谱法测量血清苯丙氨酸和酪氨酸水平。血清和脑脊液（CSF）肿瘤坏死因子-α（TNF-α）水平来自临床数据库。急性期记录改良 Rankin 量表（mRS）评分和格拉斯哥昏迷量表（GCS）评分。采用受试者操作特征曲线下面积（AUC）评估预测效能。
与 OND 患者相比，NMDAR 患者的血清苯丙氨酸水平及血清 Phe/Tyr 比值更高。有精神综合征的 NMDAR 患者血清 Phe/Tyr 比值也升高。此外，血清苯丙氨酸和酪氨酸水平与炎症指标相关。
有精神综合征的 NMDAR 患者血清 Phe/Tyr 比值升高且与病情严重程度相关。因此，血清 Phe/Tyr 比值可能是一种潜在的预后生物标志物。
