Furukawa Soma, Fukami Yuki, Hanamatsu Hisatoshi, Yokota Ikuko, Furukawa Jun-Ichi, Hane Masaya, Kitajima Ken, Sato Chihiro, Hiraga Keita, Satake Yuki, Yagi Satoru, Koike Haruki, Katsuno Masahisa
Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Institute for Glyco-core Research (iGCORE), Nagoya University, Nagoya, Aichi, Japan.
Eur J Neurol. 2025 Jan;32(1):e70023. doi: 10.1111/ene.70023.
This study conducted a comprehensive glycan analysis of serum to determine how glycan biomarkers are associated with the pathophysiology of chronic inflammatory demyelinating polyneuropathy (CIDP) and the effects of its treatment.
We comparatively analyzed N- and O-glycans in the pretreatment serum of 27 treatment-naïve patients with typical CIDP and 20 age- and sex-matched healthy controls (HC) using mass spectrometry. We determined the association between clinical parameters and glycans. The serum glycan and neurofilament light-chain (NfL) levels were assessed at the baseline, and treatment response was defined according to the degree of improvement in the modified Rankin scale 12 weeks after the first dose of intravenous immunoglobulin (IVIg).
Compared with the HC, the CIDP group demonstrated significantly lower levels of serum total N-glycans (CIDP, median 973.3 [IQR 836.2-1131.3] pmol/μL; HC, 1125.0 [1005.0-1236.2] pmol/μL; p < 0.05), especially sialylated N-glycans (CIDP, 898.0 [752.2-1037.2] pmol/μL; HC, 1064.4 [942.7-1189.8] pmol/μL; p < 0.01). In contrast, the O-glycan levels did not differ significantly between the two groups. The treatment response was associated with low N-glycan levels, but not with the serum NfL levels. Low levels of sialylated N-glycans were associated with resistance to treatment over 12 weeks, with an area under the curve of 0.822 (p < 0.01).
Low levels of sialylated N-glycans could potentially serve as a novel biomarker, reflecting pathophysiology and therapeutic resistance in typical CIDP.
本研究对血清进行了全面的聚糖分析，以确定聚糖生物标志物如何与慢性炎症性脱髓鞘性多发性神经病（CIDP）的病理生理学及其治疗效果相关联。
我们使用质谱法对27例未经治疗的典型CIDP患者和20例年龄及性别匹配的健康对照（HC）的治疗前血清中的N-聚糖和O-聚糖进行了比较分析。我们确定了临床参数与聚糖之间的关联。在基线时评估血清聚糖和神经丝轻链（NfL）水平，并根据首次静脉注射免疫球蛋白（IVIg）12周后改良Rankin量表的改善程度定义治疗反应。
与HC相比，CIDP组的血清总N-聚糖水平显著降低（CIDP，中位数973.3[四分位间距836.2 - 1131.3]pmol/μL；HC，1125.0[1005.0 - 1236.2]pmol/μL；p < 0.05），尤其是唾液酸化N-聚糖（CIDP，898.0[752.2 - 1037.2]pmol/μL；HC，1064.4[942.7 - 1189.8]pmol/μL；p < 0.01）。相比之下，两组之间的O-聚糖水平没有显著差异。治疗反应与低N-聚糖水平相关，但与血清NfL水平无关。低水平的唾液酸化N-聚糖与12周以上的治疗抵抗相关，曲线下面积为0.822（p < 0.01）。
低水平的唾液酸化N-聚糖可能作为一种新型生物标志物，反映典型CIDP的病理生理学和治疗抵抗。
