Increased Transferrin Sialylation Predicts Phenoconversion in Isolated REM Sleep Behavior Disorder.
Ranjani Ganapathy S1, Kateřina Levová2, Lenka Kotačková2
1Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
Summary
Lower serum transferrin sialylation, indicated by carbohydrate-deficient transferrin (CDT), is linked to neurodegeneration in Parkinson's disease (PD). In isolated rapid eye movement sleep behavior disorder (iRBD) patients, low CDT increases the risk of developing manifest PD.
Area of Science:
- Neuroscience
- Biochemistry
Background:
- Sialic acid-protein interactions are crucial for central nervous system immunity.
- Dysregulation in sialylation pathways may contribute to neurodegenerative processes.
Purpose of the Study:
- To investigate serum transferrin sialylation differences in prodromal and early Parkinson's disease (PD).
- To correlate sialylation patterns with substantia nigra degeneration and phenoconversion risk.
Main Methods:
- Serum transferrin sialylation (CDT) was measured using HPLC in PD patients, iRBD patients (prodromal synucleinopathy), and controls.
- Alcohol intake was adjusted for (CDTadj).
- Dopamine transporter SPECT (DaT-SPECT) and Cox regression were used to assess phenoconversion risk in iRBD patients.
Main Results:
- Median CDTadj was lower in PD patients compared to controls (P=0.001).
- iRBD patients with abnormal DaT-SPECT showed lower median CDTadj (P=0.005).
- Low CDTadj significantly increased phenoconversion risk in iRBD patients (HR 3.2, P=0.045), while abnormal DaT-SPECT yielded a higher risk (HR 15.8, P<0.001).
Conclusions:
- Reduced serum CDTadj is associated with substantia nigra degeneration in synucleinopathies.
- iRBD patients with lower CDTadj are more prone to developing manifest PD.
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