PDF(Pubmed)
Abstract：
The present study demonstrates, using human protein microarrays and plasma and cerebrospinal fluid samples obtained pre-surgically and simultaneously from 46 hip fracture repair patients, that CSF exhibits an extraordinarily complex IgG autoantibody profile composed of thousands of autoantibodies. We show that the pattern of expression levels of individual autoantibodies in CSF closely mimics that in the blood, regardless of age, gender or the presence or absence of disease, indicative of a blood-based origin for CSF autoantibodies. In addition, using five longitudinal serum samples obtained from one healthy individual over a span of nine years, we found that blood autoantibody profiles are remarkably stable over a long period of time, and that autoantibody profiles in both blood and CSF show features that are common among different individuals as well as individual-specific. Lastly, we demonstrate that an elevated CSF/plasma autoantibody ratio is more common in elderly hip fracture repair patients that experienced post-operative delirium than in non-delirium subjects, thus highlighting the crucial role that blood-brain and/or blood-CSF barrier compromise may play in the development of post-operative delirium.
摘要：
本研究表明，使用人的蛋白质微阵列和血浆和脑脊液样本获得的手术前和同时从46例髋部骨折修复患者，CSF表现出由数千种自身抗体组成的异常复杂的IgG自身抗体谱。我们表明，CSF中个体自身抗体的表达水平模式与血液中的表达水平非常相似，不管年龄,性别或疾病的存在或不存在，指示CSF自身抗体的血液来源。此外,使用从一个健康个体在9年内获得的五个纵向血清样本，我们发现血液自身抗体谱在很长一段时间内非常稳定，血液和CSF中的自身抗体谱显示出不同个体之间共有的特征以及个体特异性的特征。最后,我们证明，CSF/血浆自身抗体比值升高在经历术后谵妄的老年髋部骨折修复患者中比非谵妄患者更常见。因此强调了血脑和/或血脑脊液屏障受损在术后谵妄的发展中可能发挥的关键作用。
