背景:许多生化,免疫学,神经精神改变与终末期肾病(ESRD)相关。神经元损伤生物标志物,如胶质纤维酸性蛋白(GFAP),神经丝轻链(NFL),S100钙结合蛋白B(S100B),离子化钙结合衔接分子-1(IBA1),和髓鞘碱性蛋白(MBP)是ESRD研究较少的生物标志物之一。
目的:我们检查了这些神经轴生物标志物之间的关联,炎症生物标志物,例如,C反应蛋白(CRP),白细胞介素(IL-6),IL-10和锌,铜,和ERSD引起的神经精神症状。
方法:ELISA技术用于测量70例ESRD患者的神经元损伤生物标志物的血清水平,和46个健康对照。
结果:ESRD患者抑郁评分较高,焦虑,疲劳,和生理症状比健康对照组。肾功能测试的异常和透析干预的数量与抑郁症的严重程度有关。焦虑,纤维疲劳和生理症状,外周炎症,Nestin,和NFL。神经元损伤生物标志物的血清水平(NFL,MBP,和nestin),CRP,白细胞介素(IL)-10升高,与对照组相比,ESRD患者的血清锌降低。神经元损伤的生物标志物NFL,Nestin,S100B和MBP与一个或多个神经精神症状域的严重程度相关。大约50%的神经精神症状的差异是由NFL解释的,Nestin,S00B,铜,和炎症指数。
结论:肾功能不全的严重程度和/或透析干预措施的数量可能会诱发外周炎症,因此,对中间丝蛋白的神经毒性,星形胶质细胞,还有血脑屏障,导致ESRD的神经精神症状。
Many biochemical, immunological, and neuropsychiatric changes are associated with end-stage renal disease (ESRD). Neuronal damage biomarkers such as glial fibrillary acidic protein (GFAP), neurofilament light chain (NFL), S100 calcium-binding protein B (S100B), ionized calcium-binding adaptor molecule-1 (IBA1), and myelin basic protein (MBP) are among the less-studied biomarkers of ESRD.
We examined the associations between these neuro-axis biomarkers, inflammatory biomarkers, e.g., C-reactive protein (CRP), interleukin (IL-6), IL-10, and zinc, copper, and neuropsychiatric symptoms due to ERSD.
ELISA techniques were used to measure serum levels of neuronal damage biomarkers in 70 ESRD patients, and 46 healthy controls.
ESRD patients have higher scores of depression, anxiety, fatigue, and physiosomatic symptoms than healthy controls. Aberrations in kidney function tests and the number of dialysis interventions are associated with the severity of depression, anxiety, fibro-fatigue and physiosomatic symptoms, peripheral inflammation, nestin, and NFL. Serum levels of neuronal damage biomarkers (NFL, MBP, and nestin), CRP, and interleukin (IL)-10 are elevated, and serum zinc is decreased in ESRD patients as compared with controls. The neuronal damage biomarkers NFL, nestin, S100B and MBP are associated with the severity of one or more neuropsychiatric symptom domains. Around 50 % of the variance in the neuropsychiatric symptoms is explained by NFL, nestin, S00B, copper, and an inflammatory index.
The severity of renal dysfunction and/or the number of dialysis interventions may induce peripheral inflammation and, consequently, neurotoxicity to intermediate filament proteins, astrocytes, and the blood-brain barrier, leading to the neuropsychiatric symptoms of ESRD.