Measurement of CSF C_4d and panereadic neural thread protein for the early diagnosis of neurodogenerative disases

(1)测定11例进行性核上性麻痹(PSP)和11例帕金森病(PD)患者脑脊液中神经线蛋白(NTP)的浓度。(2)测定了6例PSP和14例PD患者血浆和脑脊液中C4D和循环免疫复合物(CIC)的水平。PSP组C4D脑脊液水平明显高于PD组。(3)测定27例肌萎缩侧索硬化症(ALS)和颈椎病(CS)患者的血浆和脑脊液C4D水平及CIC/Clq。ALS组脑脊液C4D水平显著高于CS组。ALS组的C4D指数也高于CS组。结果提示ALS患者中枢神经系统补体激活增强，其中一例ALS患者的免疫组织化学检查显示脊髓内有髓轴突和/或少突胶质细胞内有丰富的C4D沉积。脑脊液C4D或C4D指数升高可能与ALS的病理改变有关，并可作为鉴别ALS与CS的依据。(4)测定12例慢性特发性脱髓鞘多发性神经病和格林-巴利综合征患者血浆和脑脊液中C4D水平及CIC/Clq。8例颈椎病患者近端脱髓鞘患者的脑脊液C4D值均大于2SD。脑脊液C4D可能来源于鞘内合成和体循环。脑脊液中C4D水平可作为判断根部受累的敏感指标。

(1)Concentrations of neural thread protein (NTP) in cerebrospinal fluid (CSF) from 11 progressive supranuclear palsy (PSP) and 11 Parkinson's disease (PD) were measured. The mean levels did not differ between the groups, suggesting that NTP measurement is not useful for the differentiation of both diseases.(2)Plasma and CSF levels of C4d and the circulating immune complex (CIC) to Clq were measured in 6 PSP and 14 PD patients. The PSP group had significantly higher CSF levels od C4d than the PD group. CSF level of C4d may serve as a basis for differentiating PSP from PD.(3)Plasma and CSF levels of C4d and the CIC to Clq were measured in 27 patients with amyotrophic lateral sclerosis (ALS) and cervical spondylosis (CS). The ALS group had significantly higher CSF levels of C4d than the CS groups. Higher C4d index in the ALS group was also shown compared with CS groups. There results suggest that augmented complement activation in the central nervous system occurs in ALS.Postomortem immunohitochemical study from one of the ALS patient showed abundant C4d deposits in myelinated axons and/or oligodendrocytes in the spinal cord. Increased CSF levels of C4d or C4d index might correlate with such a pathological finding and serve as a basis for differentiating ALS from CS.(4)Plasma and cerebrospinal fluid (CSF) levels of C4d and the CIC to Clq were measured in 12 patients with chronic idiopathic demyelinating polyneuropathy and Guillain-Barre syndrome. CSF C4d values more than 2 SD from the mean of 8 cervical spongylosis cases were seen in the patients with proximal demyelination. The CSF C4d probably originated from both intrathecal synthesis and the systemic circulation. CSF levels of C4d may serve as a sensitive indicator for the involvement of the root area.