METHODS: In this cross-sectional study, 4 patients with mesial temporal lobe epilepsy and 4 patients with PNES were selected from patients with history of recurrent seizures. Venous blood samples were obtained within 1 hour after seizure and serum proteomes as well as the extent of protein expression were analyzed.
RESULTS: 361 proteins were identified; of these, expression of 197 proteins had altered. 110 (55.9%) proteins were down-regulated and 87 (44.1%) were up-regulated in the PNES samples compared to ES samples. The mean pI for deregulated proteins with 1.5 to 3 fold changes were 6.69 ± 1.68 in proteins with increasing expression in ES group and 5.88 ± 1.39 in proteins with increasing expression in PNES group (p = 0.008). The median and interquartile range (IQR) of molecular weight changes in proteins with 1.5 to 3 fold changes were 64 (22.0-86.0) in proteins whose expression had increased in ES group and 39.5 (26.0-61.5) in proteins whose expression had increased in PNES cases (p = 0.05).
CONCLUSIONS: Several spots with differential expression were observed by comparing patients with ES against the PNES groups, which could be potential biomarkers of the disease. Damage to the blood-brain barrier is the most important difference between the two groups, thus identifying total protein changes offers a key to the future of differentiating ES and PNES patients.
方法:在这项横断面研究中,从有反复发作史的患者中选择4例颞叶内侧癫痫和4例PNES患者。在癫痫发作后1小时内获得静脉血样品,并分析血清蛋白质组以及蛋白质表达的程度。
结果:鉴定出361种蛋白质;其中,197种蛋白质的表达发生了改变。与ES样品相比,PNES样品中110(55.9%)蛋白质下调,87(44.1%)蛋白质上调。在ES组中表达增加的蛋白质中,具有1.5至3倍变化的去调节蛋白质的平均pi为6.69±1.68,在PNES组中表达增加的蛋白质中为5.88±1.39(p=0.008)。具有1.5至3倍变化的蛋白质的分子量变化的中位数和四分位数范围(IQR)在ES组中表达增加的蛋白质为64(22.0-86.0),在PNES病例中表达增加的蛋白质为39.5(26.0-61.5)。
结论:通过比较ES患者与PNES组,观察到一些差异表达的斑点,这可能是该疾病的潜在生物标志物。血脑屏障受损是两组之间最重要的区别,因此,识别总蛋白变化为区分ES和PNES患者提供了关键.