目的:我们的目的是研究蜱传脑炎患者神经元和神经胶质细胞损伤的生物标志物与疾病严重程度之间的相关性。
方法:前瞻性纳入立陶宛和瑞典诊断的115例蜱传脑炎患者,住院后不久获得脑脊液(CSF)和血清样本。使用预定义的标准,病例被归类为轻度,中度或重度蜱传脑炎。此外,脊髓神经麻痹(脊髓炎)和/或颅神经病变的存在。脑细胞生物标志物胶质纤维酸性蛋白(GFAP)的浓度,YKL-40,S100B,神经颗粒素,在CSF中分析了神经丝光(NfL)和tau,此外,NFL,在血清中测量GFAP和S100B水平。采用Jonckheere-Terpstra检验对连续变量进行分组比较,采用Spearman偏相关检验对年龄进行校正。
结果:脑脊液和血清GFAP和NfL浓度与疾病严重程度相关,独立于年龄,神经麻痹的存在。标记神经颗粒素,检测CSF中的YKL-40、tau和S100B,血清中的S100B,但它们的浓度与疾病严重程度无关.
结论:CSF和血清中NfL和GFAP增加的神经元细胞损伤和星形胶质细胞活化与更严重的疾病有关,独立于年龄。CSF中的GFAP和NfL浓度增加以及血清中的NfL也指示脊髓和/或颅神经损伤。NfL和GFAP是tick传脑炎的有希望的预后生物标志物,未来的研究应该集中在确定这些生物标志物与长期后遗症之间的关联。
Our aim was to examine the correlation between biomarkers of neuronal and glial cell damage and severity of disease in patients with tick-borne encephalitis.
One hundred and fifteen patients with tick-borne encephalitis diagnosed in Lithuania and Sweden were prospectively included, and cerebrospinal fluid (CSF) and serum samples were obtained shortly after hospitalization. Using pre-defined criteria, cases were classified as mild, moderate or severe tick-borne encephalitis. Additionally, the presence of spinal nerve paralysis (myelitis) and/or cranial nerve affection were noted. Concentrations of the brain cell biomarkers glial fibrillary acidic protein (GFAP), YKL-40, S100B, neurogranin, neurofilament light (NfL) and tau were analysed in CSF and, in addition, NfL, GFAP and S100B levels were measured in serum. The Jonckheere-Terpstra test was used for group comparisons of continuous variables and Spearman\'s partial correlation test was used to adjust for age.
Cerebrospinal fluid and serum concentrations of GFAP and NfL correlated with disease severity, independent of age, and with the presence of nerve paralysis. The markers neurogranin, YKL-40, tau and S100B in CSF and S100B in serum were detected, but their concentrations did not correlate with disease severity.
Neuronal cell damage and astroglial cell activation with increased NfL and GFAP in CSF and serum were associated with a more severe disease, independent of age. Increased GFAP and NfL concentrations in CSF and NfL in serum were also indicative of spinal and/or cranial nerve damage. NfL and GFAP are promising prognostic biomarkers in tick-borne encephalitis, and future studies should focus on determining the association between these biomarkers and long-term sequelae.