B淋巴细胞活化因子在视神经脊髓炎患者血清及脑脊液中的表达及意义

Investigation of B-cell activating factor in serum and cerebrospinal fluid of patients with neuromyelitis optica

目的探讨B淋巴细胞活化因子(BAFF)在视神经脊髓炎(NMO)患者血清及脑脊液中的表达情况及临床意义。方法收集44例NMO患者及38例多发性硬化(MS)患者的临床资料,患者均为急性复发期。30例健康人和15例非炎性神经系统疾病患者分别作为对照组,采用酶联免疫吸附测定(ELISA)方法检测血清及脑脊液中BAFF水平。结果 NMO组、MS组和对照组血清中BAFF水平分别为250.2±126.9、249.6±130.7和222.9±126.1 pg/ml,3组间两两比较,差异无统计学意义(P>0.05)。NMO组、MS组和对照组脑脊液中BAFF水平分别为525.8±230.0、298.4±141.9和141.4±76.2 pg/ml,3组间两两比较,NMO组和MS组脑脊液中BAFF水平较对照组明显增高,NMO组脑脊液中BAFF水平较MS组明显增高(P<0.05)。且NMO组、MS组脑脊液中BAFF水平与EDSS评分存在相关性,EDSS评分越高,其脑脊液中BAFF水平越高。但是NMO组脑脊液中BAFF水平与AQP4抗体滴度之间不具有相关性。结论脑脊液中BAFF水平可能是NMO和MS鉴别诊断的生物标记物,并在判定疾病严重程度方面具有重要价值。

Objective To study the expression of B-cell activating factor（BAFF） in the serum and cerebrospinal fluid of patients with neuromyelitis optica（NMO）. Methods Clinical data were collected from 44 patients with NMO and 38 patients with multiple sclerosis（MS）. Thirty healthy controls and 15 controls with noninflammatory neurological diseases were also recruited. The concentration of BAFF in the serum and cerebrospinal fluid were measured by enzyme-linked immunosorbent assay（ELISA）. Results The mean serum BAFF level was 250.2±126.9 pg/ml in NMO patients, 249.6±130.7 pg/ml in MS patients,and 222.9±126.1 pg/ml in the control subjects, showing no significant difference among the 3 groups（P〈0.05）. The mean BAFF level in the CSF was significantly higher in NMO patients than in MS patients（525.8±230.0 pg/ml vs 298.4±141.9 pg/ml, P〈0.05）,and higher in MS patients than in the control subjects（141.4±76.2 pg/ml, P〈0.05）. Both NMO and MS group showed a positive correlation between EDSS scores and CSF BAFF level. But in NMO patients, CSF BAFF level was not associated with AQP4-antibody titer. Conclusion BAFF in the CSF may be a useful biomarker for a differential diagnosis of NMO from MS and has an important value in evaluating the disease severity.