临床孤立综合征患者血清和脑脊液中脑源性与胶质细胞源性神经营养因子水平及其神经保护作用研究

摘要

目的 探讨多发性硬化(MS)的早期表现--临床孤立综合征(CIS)患者血清及脑脊液中脑源性神经营养因子(BDNF)、胶质细胞源性神经营养因子(GDNF)水平及其神经保护作用.方法 对27例CIS患者及21例对照者进行研究,CIS患者发作期进行扩展残疾状态量表(EDSS)评分、寡克隆带测定及MRI检查,液相芯片分析技术检测血清及脑脊液BDNF、GDNF浓度.结果 CIS患者发作期血清及脑脊液BDNF[分别为(5.981±0.995)和(0.178±0.008)μg/L]、GDNF浓度[分别为(0.039±0.007)和(0.082±0.011)μg/L]与对照组[血清:(4.374±0.501)、(0.042±0.007)μg/L;脑脊液:(0.152±0.011)、(0.065±0.013)μg/L]比较差异均无统计学意义(均P＞0.05);脑脊液BDNF与GDNF浓度呈正相关(r=0.777,P=0.000),血清BDNF与GDNF浓度无相关性(r=-0.375,P=0.126).血清及脑脊液BDNF、GDNF浓度与EDSS评分、血脑屏障指数、Delpech指数、Tourtellotte合成率及脑萎缩无明显相关性(P＞0.05).结论 CIS患者体内BDNF与GDNF水平相关,二者可能具有协同的神经保护作用.BDNF及GDNF与CIS患者血脑屏障破坏及中枢神经系统内IgG合成无关,与神经功能残疾及脑萎缩的关系仍需研究.%Objectives To investigate brain-derived neurotrophic factor (BDNF) and glial cell line-derived neurotrophic factor (GDNF) concentrations in serum and cerebral spinal fluid (CSF) in patients of clinically isolated syndrome (CIS). The first presentation of multiple sclerosis (MS) and the neuroprotective effects were observed.Methods Twenty-seven patients with CIS and twenty-one controls were investigated. The disability severity of CIS patients in attack period was assessed by the Expanded Disability Status Scale (EDSS). The oligoclonal band in ser um and CSF were detected and MRI scanning of brain, spinal cord or optic nerve was examined. BDNF and GDNF concentrations in serum and CSF were assessed by Liquid Assay. Results There were no significant differences of BDNF [ (5. 981 ±0.995 ) μg/L in serum and (0. 178 ±0.008) μg/L in CSF] and GDNF [ (0. 039 ±0.007) μg/L in serum and (0. 082 ±0.011 ) μg/L in CSF] concentrations in serum and CSF from patients with CIS on attack and that from controls ( P ＞ 0. 05 ). There was a positive correlation between BDNF and GDNF concentrations in CSF (r = 0. 777 ,P = 0. 000), but no correlation between BDNF and GDNF concentrations in serum (r = -0. 375, P =0. 126). There were no correlations of BDNF and GDNF concentrations in serum and CSF with EDSS, blood brain barrier index, Delpech index, Tourtellotte synthesis rate and brain atrophy (P ＞ 0. 05 ). Conclusions The level of BDNF in patients with CIS is correlated with that of GDNF, which may have a synergistic neurotrophic effect on CIS.BDNF and GDNF are not associated with the blood-brain barrier destruction and IgG synthesis in central nervous system. However, associations of BDNF and GDNF with functional disability and neuron atrophy in CIS patients still need further studies.