Cerebrospinal fluid tau proteins in status epilepticus
Cerebrospinal fluid tau proteins in status epilepticus
复制标题
DOI：
10.1016/j.yebeh.2015.04.030
复制
发表时间：
2015-08-01
影响因子：
2.6
通讯作者：
Chiari, Annalisa
中科院分区：
文献类型：
--
作者：
Monti, Giulia;Tondelli, Manuela;Chiari, Annalisa
Tau蛋白是一种磷酸化的微管相关蛋白，主要定位于中枢神经系统（CNS）的神经元水平。脑脊液（CSF）中的Tau水平被认为是轴突和神经元损伤的指标。然而，迄今为止，没有研究专门评估了癫痫持续状态（SE）患者的CSF tau蛋白水平。我们在2007年至2014年期间在SE期间接受腰椎穿刺的SE患者中评估了这些已确定的神经元损伤生物标志物。排除了急性结构性脑损伤（包括CNS感染）导致的癫痫持续状态病例。收集临床、生物学、治疗和随访数据。根据抗癫痫药物（AED）的SE反应、残疾和癫痫结局对患者进行分组比较。28例患者被考虑用于分析（平均年龄56岁）：14例患者具有异常高的CSF t-tau水平，6例患者具有异常高的CSF p-tau水平，仅3例患者具有异常低的A β（1 - 42）水平。与AED控制癫痫发作的患者相比，发生难治性SE的患者的脑脊液t-tau值更高。脑脊液t-tau值与SE持续时间呈正相关，与未接受该治疗的患者相比，接受丙泊酚麻醉的患者的t-tau值更高。与CSF t-tau水平较低的患者相比，CSF t-tau水平较高的患者发生残疾（OR = 32.5，p = 0.004）和慢性癫痫（OR 12; p = 0.016）的风险较高。我们的研究结果表明，CSF中的t-tau水平可能被建议作为SE的严重程度和预后的生物标志物。需要前瞻性研究来评估丙泊酚对这种情况下tau病理学的影响。(C)2015 Elsevier Inc. All rights reserved.
Tau protein is a phosphaylated microtubule-associated protein, principally localized at neuronal level in the central nervous system (CNS). Tau levels in the cerebrospinal fluid (CSF) are considered to index both axonal and neuronal damage. To date, however, no study has specifically evaluated the CSF levels of tau proteins in patients with status epileptic-us (SE). We evaluated these established biomarkers of neuronal damage in patients with SE who received a lumbar puncture during SE between 2007 and 2014. Status epilepticus cases due to acute structural brain damage, including CNS infection, were excluded. Clinical, biological, therapeutic, and follow-up data were collected. Group comparison between patients stratified according to SE response to antiepileptic drugs (AEDs), disability, and epilepsy outcomes were performed. Twenty-eight patients were considered for the analyses (mean age 56 years): 14 patients had abnormally high CSF t-tau level, six patients had abnormally high CSF p-tau level, and only three patients had abnormally low A beta(1-42) level. Cerebrospinal fluid t-tau value was higher in patients who developed a refractory SE compared to patients with seizures controlled by AED. Cerebrospinal fluid t-tau values were positively correlated with SE duration and were higher in patients treated with propofol anesthesia compared to patients that had not received this treatment. Patients with higher CSF t-tau had higher risk of developing disability (OR = 32.5, p = 0.004) and chronic epilepsy (OR 12; p = 0.016) in comparison with patients with lower CSF t-tau level. Our results suggest that CSF t-tau level might be proposed as a biomarker of SE severity and prognosis. Prospective studies are needed to evaluate the effects of propofol on tau pathology in this setting. (C) 2015 Elsevier Inc. All rights reserved.