Astrocytic damage in glial fibrillary acidic protein astrocytopathy during initial attack
Astrocytic damage in glial fibrillary acidic protein astrocytopathy during initial attack
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胶质纤维酸性蛋白星形细胞病初次发作时星形细胞损伤
DOI：
10.1016/j.msard.2019.01.036
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发表时间：
2019
影响因子：
4
通讯作者：
Gao Cong
中科院分区：
文献类型：
--
作者：
Yang Xinguang;Huang Qingmei;Yang Huacai;Liu Si;Chen Baikeng;Liu Tianni;Yang Jie;Yao Haiyan;Lin Shaopeng;Chen Xiaohui;Zhuang Honghua;Long Youming;Gao Cong
目的检测脑脊液(CSF)中胶质纤维酸性蛋白(GFAP)、水通道蛋白4(AQP4)和髓鞘少突胶质细胞糖蛋白(MOG)的含量，并分析GFAP-A等疾病患者脑脊液中星形胶质细胞的损伤情况。结果32例胶质纤维酸性蛋白-星形细胞病急性加重期患者的脑脊液中胶质纤维酸性蛋白水平显著高于多发性硬化性脑脊髓炎、多发性硬化症、自身免疫性脑炎和其他炎症性神经疾病组(均为0.0001)。胶质纤维酸性蛋白-A组的脑脊液胶质纤维酸性蛋白水平略高于抗水通道蛋白4Ig G阳性视神经脊髓炎谱系障碍组(p= 0.012)。GFAP-A组脑脊液中MOG和AQP4水平与其他组比较差异无统计学意义。激素治疗后脑脊液中胶质纤维酸性蛋白水平显著降低(p= 0.011)。星形胶质细胞病伴与不伴脑炎患者的脑脊液中胶质纤维酸性蛋白水平差异有统计学意义(p= 0.016)。在星形胶质细胞病患者中，脑脊液胶质纤维酸性蛋白与发作期扩展残疾状态量表评分相关(r= 0.545，p= 0.001)。但在随诊中，GFAP-星形细胞病患者的脑脊液GFAP水平与6个月后的EDSS评分无相关性。结论GFAP-星形细胞病患者的脑脊液GFAP水平和病理检查均显示星形胶质细胞损伤。急性期脑脊液GFAP水平与激素治疗有关，因此，脑脊液GFAP可能是反映急性期疗效的敏感生物标志物。
ObjectiveDetermination of glial fibrillary acidic protein (GFAP), aquaporin 4 (AQP4), and myelin oligodendrocyte glycoprotein (MOG) levels in cerebrospinal fluid (CSF), and astrocytic damage analysis in patients with GFAP astrocytopathy (GFAP-A) and other conditions.MethodsGFAP, AQP4, and MOG levels in CSF were detected via enzyme-linked immunosorbent assays. Anti-GFAP, anti-AQP4, and anti-MOG IgGs were detected via indirect immunofluorescence assays.ResultsIn 32 GFAP-Astrocytopathy patients, CSF GFAP was significantly higher during acute exacerbation than it was in patients with MOG encephalomyelitis, multiple sclerosis, autoimmune encephalitis, and an “other inflammatory neurological disorders” group (allp< 0.0001). CSF GFAP levels were slightly higher in the GFAP-A group than in an anti-AQP4 IgG-positive neuromyelitis optica spectrum disorder group (p= 0.012). There were no significant differences between the CSF MOG and AQP4 levels in the GFAP-A group and those of other groups. CSF GFAP levels were significantly reduced after steroid treatment (p= 0.011). CSF GFAP levels differed significantly in GFAP-Astrocytopathy patients with and without encephalitis (p= 0.016). In GFAP-Astrocytopathy patients, CSF GFAP was correlated with Expanded Disability Status Scale (EDSS) score during attack (r= 0.545,p= 0.001). In follow-up examinations however, in GFAP-Astrocytopathy patients CSF GFAP level was not correlated with EDSS score 6 months later.ConclusionsCSF GFAP level and pathological examination of GFAP-Astrocytopathy patients revealed astrocyte damage. CSF GFAP level was associated with steroid treatment at the acute stage, therefore CSF GFAP may be a sensitive biomarker with respect to the effects of therapy during the acute stage.