脑源性神经营养因子在轻度肝性脑病肝硬化患者炎症与记忆之间中介作用的性别差异

Sex differences in the mediating role of brain-derived neurotrophic factor between inflammation and memory in cirrhotic patients with minimal hepatic encephalopathy.

作者信息

Batallas Daniela, Gallego Juan José, Casanova-Ferrer Franc, López-Gramaje Adriá, Rivas-Diaz Pablo, Megías Javier, Escudero-García Desamparados, Durbán Lucía, Benlloch Salvador, Urios Amparo, Hidalgo Vanesa, Salvador Alicia, Montoliu Carmina

机构信息

Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, 46010, Valencia, Spain.

Fundación Investigación Hospital Clínico Universitario de Valencia. INCLIVA, 46010, Valencia, Spain.

出版信息

Brain Behav Immun Health. 2025 Apr 22;46:100998. doi: 10.1016/j.bbih.2025.100998. eCollection 2025 Jul.

Abstract

Minimal hepatic encephalopathy (MHE) affects attention, visuo-motor coordination, and visual perception, with mixed evidence on its impact on memory. Brain-derived neurotrophic factor (BDNF) is associated with memory dysfunction, and plays a crucial role in modulating neuroplasticity. This study investigates the mediating role of BDNF in the relationship between pro-inflammatory cytokines (IL-6, IL-15, IL-18), and declarative memory performance, and the moderating effects of sex. Sixty-eight cirrhotic patients and 22 healthy volunteers performed the Psychometric Hepatic Encephalopathy Score for MHE diagnosis and logical memory subtest (Wechsler Memory Scale-III). Moderated mediation analysis using bias-corrected bootstrapping and multiple regression was performed. Results showed that increased levels of IL-18 and IL-15 were significantly associated with lower BDNF levels ( = 0.03 and  = 0.02 respectively). However, no direct effect was observed between IL-18 and IL-15 and memory. The conditional effects of BDNF on memory were significant only for women with and without MHE, and lower BDNF levels were associated with lower memory performance (without MHE:  = 0.002; MHE:  = 0.001). Moreover, BDNF mediated indirectly the relationship between pro-inflammatory cytokines and memory. IL-18 and IL-15 impacted memory through reduced BDNF levels only in women with and without MHE, whereas IL-6 showed no significant effect on BDNF or memory across groups. These findings underscore the important role of BDNF in memory in cirrhotic patients, especially women with MHE, by mediating the IL-18 and IL-15 effects. The study highlights the role of IL-18 and IL-15 cytokines in neuroplasticity-related memory decline, positioning BDNF as a key biomarker for inflammation-associated cognitive impairment in this population.

摘要

轻微肝性脑病(MHE)会影响注意力、视觉运动协调能力和视觉感知,关于其对记忆的影响存在混杂的证据。脑源性神经营养因子(BDNF)与记忆功能障碍有关,并且在调节神经可塑性方面起着关键作用。本研究调查了BDNF在促炎细胞因子(IL-6、IL-15、IL-18)与陈述性记忆表现之间关系中的中介作用,以及性别的调节作用。68名肝硬化患者和22名健康志愿者进行了用于MHE诊断的心理测量肝性脑病评分和逻辑记忆子测试(韦氏记忆量表第三版)。使用偏差校正自抽样和多元回归进行了调节中介分析。结果显示,IL-18和IL-15水平升高分别与较低的BDNF水平显著相关(分别为 = 0.03和 = 0.02)。然而,未观察到IL-18和IL-15与记忆之间的直接效应。BDNF对记忆的条件效应仅在患有和未患有MHE的女性中显著,较低的BDNF水平与较低的记忆表现相关(未患MHE: = 0.002;患MHE: = 0.001)。此外,BDNF间接介导了促炎细胞因子与记忆之间的关系。IL-18和IL-15仅在患有和未患有MHE的女性中通过降低BDNF水平影响记忆,而IL-6在各组中对BDNF或记忆均无显著影响。这些发现强调了BDNF在肝硬化患者记忆中的重要作用,尤其是患有MHE的女性,通过介导IL-18和IL-15的作用。该研究突出了IL-18和IL-15细胞因子在与神经可塑性相关的记忆衰退中的作用,将BDNF定位为该人群炎症相关认知障碍的关键生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbfd/12060516/4b9d55fedc7b/ga1.jpg

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