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脑脊液生物标志物作为多发性硬化症严重程度的预测因素

Miguel Tolentino¹, Francesca Pace¹, Dana C Perantie¹

¹Department of Neurology, School of Medicine, Washington University in St. Louis, 660 South Euclid Avenue, St Louis, MO 63110, USA.

Multiple sclerosis and related disorders

|January 20, 2025

概括

脑脊液 (CSF) 标记物,如在骨髓细胞2 (sTREM2) 上表达的可溶性触发受体,神经丝重 (NFH) 和神经丝轻 (NFL) 预测多发性硬化症 (MS) 严重程度. 这些发现有助于识别高风险多发性硬化症患者,以便选择最佳的治疗方法.

科学领域:

神经学神经学
生物标志物发现发现
神经免疫学神经免疫学

背景情况:

在发病时预测多发性硬化症 (MS) 疾病严重程度对于指导可用的疾病修饰治疗 (DMT) 中的治疗选择至关重要.
早期识别高风险的MS患者可以优化使用高效,潜在的风险较高的疗法.

研究的目的:

调查在诊断前测量的可溶性脑脊液 (CSF) 生物标志物是否可以预测长期的MS疾病严重程度.
评估与神经炎症,微质活动和神经元/轴突损伤相关的特定CSF标记物的预测价值.

主要方法:

分析了42名复发性复发性多发性硬化症 (RRMS) 患者的脑脊髓样本,随访时间超过4年.
测量了包括CXCL13,sTREM2,MBP,NFL,NFH,INT-α和PVALB在内的生物标志物的CSF水平.
使用回归和斯皮尔曼相关性分析,与MS严重性评分 (MSSS) 和扩展残疾状况尺度 (EDSS) 相关联的生物标志物水平.

主要成果:

高水平的CSF神经丝重 (NFH),神经丝轻 (NFL) 和可溶性触发受体表达在骨髓细胞2 (sTREM2) 显著预测更糟糕的MS严重性得分 (MSSS).
腰部穿刺时的年龄较大也与MSSS的恶化有关.
NFL和NFH水平与sTREM2和CXCL13有积极的相关性.

结论:

CSF sTREM2,NFH和NFL是经过验证的MS疾病攻击性 (MSSS) 的预测指标.
这些发现凸显了微质活动和轴突损伤在MS进展中的早期参与.
该研究支持使用这些CSF生物标志物用于早期MS的预后评估.

关键词:

生物标志物:大脑脊髓液神经纤维纤维重链的重链.神经纤维光电链的链条可溶性TREM2可以溶解

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