Alzheimer病脑脊液磷酸化神经丝及双螺旋丝免疫活性(英文)

Alzheimer's disease:phosphorylated neurofilament and paired helical filament immunoreactivities in CSF

目的 建立测定脑脊液 (CSF)中磷酸化神经丝 (PNF)和双螺旋丝 (PHF)免疫活性的检测方法 ,并探讨Alzheimer病 (AD)患者CSF中PNF和PHF免疫活性的变化及其临床意义。方法 采用单克隆抗体作探针 ,建立竞争抑制型酶联免疫吸附试验 (ELISA)检测AD的CSF中PNF和PHF的免疫活性 ,并与对照组即多发梗塞性痴呆 (MID)、其他神经疾病 (ODC)、精神分裂症 (SCH)和正常人 (NC)进行比较。结果 AD组CSF中PNF免疫活性与MID、NC、SCH组无显著性差异 (P >0 0 5 )。AD组CSF中PHF活性高于各对照组 (P <0 0 5 ) ,而其PNF/PHF比值低于各对照组 (P <0 0 0 1) ,有显著性意义。结论 单纯测定CSF中PNF免疫活性对AD的诊断和鉴别无意义 ;测定CSF中PHF免疫活性对AD的诊断和鉴别有一定的价值 ;PNF/PHF比值对AD的诊断和鉴别亦有相当价值 ;将测定CSF中的PHF活性与PNF/PHF比值相结合可提高AD的诊断正确率 ,有可能发展为有临床意义的实验室诊断试验。

Using monoclonal antibody (mAb) as probes, with purified phosphorylated neurofilaments(PNF) and paired helical filaments(PHF) as coated antigens (Ag) respectively, a competitive enzyme linked immunosorbent assay (ELISA) has been established for PNF and PHF immunoreactivities in the cerebrospinal fluid (CSF). Using the assay, we measured PNF and PHF immunoreactivties in CSF from 21 patients with Alzheimer's disease (AD), 17 with multi infarct dementia(MID), 33 with other neurological diseases control (ODC), 33 pateints with Schizophrenia (SCH), and 40 normal control (NC). It was found that the levels of PNF immunoreactivity measured in CSF were no difference in AD, MID, SCH, and NC groups(P>0.05). The levels of PHF immunoreactivity measured in CSF were significantly higher in AD than in control groups(P<0.05). In only a minority of instances were values for PHF levels the same in AD and control groups. The values of PNF/PHF ratio in CSF were significantly lower in the AD than in the control groups(P<0.001). This findings demonstrate that first there is no means in only detection of PNF immunoreactivity in CSF in relation to diagnosis and differentiation of the AD; second, there is considerable significance in detection of PHF immunoreactivity in CSF in relation to it, and thirdly, the value of PNF/PHF ratio is also considerable significance to diagnose and differentiate the AD; finally, the certainty of diagnosis for AD might be strengthened considerably while combining the levels of PHF immunoreactivity in CSF with the values of PNF/PHF ratio. It might be developed to be significantly the means of clinical diagnosis of the AD.