新兴的生物标志物可以预测吉-巴雷综合征的临床结果
Gautier Breville1, Egle Sukockiene1, Maria Isabel Vargas2,3
1Neurology Division, Neuroscience Department, University Hospitals of Geneva, Geneva, Switzerland.
Expert review of neurotherapeutics
|October 30, 2023
概括
识别患有严重吉兰-巴雷综合征 (GBS) 风险的患者至关重要. 生物标志物有助于预测结果,指导早期治疗,并改善这种免疫介导的神经病变的患者管理.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
背景情况:
- 吉兰-巴雷综合征 (GBS) 是一种免疫媒介的多基基隆性神经病变,临床结果不可预测.
- 识别患有长期残疾高风险的患者是一个重大的临床挑战.
研究的目的:
- 为GBS提供诊断和预后生物标志物的概述.
- 突出生物标志物在建立早期治疗策略和后续护理计划中的实用性.
主要方法:
- 对与GBS预后不佳相关的临床因素的审查.
- 对生物学,神经生理学和成像学标记的分析,这些标记表明了不利的结果.
- 检查神经纤维光链 (NfL) 的水平和比例.
主要成果:
- 预后不佳的临床预测因素包括晚年,腹前,快速衰弱进展,dysautonomia,以及特定的头骨/呼吸道肌肉衰弱.
- 不利的结局标志物包括高抗类胺抗体,血清/中枢神经液NfL增加,NfL中枢神经液/血清比率降低,低蛋白血症,特定神经传导研究结果和超声波神经扩大.
结论:
- 预后生物标志物对于预测短期死亡率,心肺呼吸系统支持的需要以及GBS的长期功能结果至关重要.
- 生物标志物可以指导治疗决策,并作为临床试验中监测治疗反应的终点.
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