预测进展性多发性硬化症残疾恶化的血液生物标志物:一个跨国,个体参与者级别分析
Ahmed Abdelhak1, Franziska Bachhuber2, Kiarra Ning3
1Department of Neurology, University of California San Francisco (UCSF), San Francisco, California, USA Ahmed.Abdelhak@ucsf.edu.
Journal of neurology, neurosurgery, and psychiatry
|June 12, 2025
概括
状纤维酸蛋白 (GFAP) 预测在渐进的多发性硬化症 (MS) 中残疾恶化,特别是在次级渐进的MS (SPMS) 中. 神经纤维光链 (NfL) 预测只有在初级渐进性MS (PPMS) 中恶化.
科学领域:
- 神经科学是一个神经科学.
- 生物标志物 生物标志物
- 神经学 神经学
背景情况:
- 像状纤维酸蛋白 (GFAP) 和神经纤维光链 (NfL) 这样的生物信息标志物对于预测多发性硬化症 (MS) 确定的残疾恶化 (CDW) 至关重要.
- 有限的数据和差异存在于血清GFAP和NfL在渐进性MS (PMS) 的预后值.
- 这项研究利用国际个人参与者数据来澄清PMS患者血清GFAP和NfL的预后价值.
研究的目的:
- 确定血清GFAP和NfL的预后值,用于预测进展性多发性硬化症 (pwPMS) 患者的确诊残疾恶化 (CDW).
- 调查GFAP和NfL在初级渐进性MS (PPMS) 与次级渐进性MS (SPMS) 中的不同预测能力.
主要方法:
- 分析了来自国际BioMS-eu网络中心和合作队伍的个人参与者数据.
- 包括pwPMS与PPMS或SPMS,至少有一个GFAP值和三个后续EDSS分数.
- 考克斯回归模型评估了CDW年龄和性别调整的GFAP和NfL Z-score的预后值,控制共变量.
主要成果:
- 纳入了1058名参与者 (平均年龄为53岁,57%为女性),有7530次接触,平均随访时间为4.6年.
- 增加的GFAP Z-分数与~10%的CDW风险增加有关 (aHR 1.107,p=0.049),主要是由SPMS参与者驱动的 (aHR 1.242,p=0.004).
- 在PPMS参与者中,较高的NfL Z-score仅在PPMS参与者中预测了CDW (aHR为1.236,p=0.001).
结论:
- 血清GFAP是pwPMS中未来CDW的显著预后指标,在pwSPMS中观察到更强效应.
- 血清NfL仅在pwPPMS中证明了CDW的预测价值.
- 这些发现凸显了GFAP和NfL在不同的渐进性MS亚型中作为生物标志物的差异效用.
相关概念视频
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
110
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
110
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
64
Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
64