YKL-40与视神经脊髓炎谱系障碍患者神经功能的相关性

Correlation between YKL-40 and neurological function in patients with neuromyelitis optica spectrum disorder

目的分析AQP-4阳性视神经脊髓炎谱系障碍(NMOSD)患者血清及脑脊液YKL-40水平及其与疾病严重程度的相关性。方法搜集2022-01-12郑州大学第一附属医院30例AQP-4阳性的视神经脊髓炎谱系障碍患者,并纳入24例年龄、性别相匹配的非炎症性神经系统疾病(ONND)患者及24名健康对照者。采用酶联免疫吸附试验测定YKL-40水平,并对所有患者进行扩展残疾状态量表(EDSS)评定。结果AQP-4阳性的视神经脊髓炎谱系障碍患者脑脊液YKL-40水平(314.3±42.9)μg/L,明显高于ONND患者(127.2±19.9)μg/L,P<0.001。MRI增强病变患者脑脊液YKL-40水平(324.7±43.7)μg/L,明显高于未出现MRI增强病变的患者(290±31.3)μg/L,P=0.041。视神经脊髓炎谱系障碍患者脑脊液YKL-40水平与EDSS得分呈正相关(r=0.372,P=0.043)。结论YKL-40可作为AQP-4阳性的视神经脊髓炎患者严重程度的生物标志物和治疗NMOSD的潜在靶点。

Objective To ana lyze the level of YKL-40 in serum and cerebrospinal fluid of patients with AQP-4 positive optic neuromyelitis and its relationship with the severity of the disease.Methods AQP-4 posi⁃tive optic neuromyelitis patients were collected who were treated at the First Affiliated Hospital of Zhengzhou University from January 2022 to December 2022.A total of 30 patients and 24 age-and sex-matched patients with non-inflammatory neurological diseases and healthy controls were included.The level of YKL-40 was mea⁃sured by enzyme-linked immunosorbent assay(ELISA).All patients were assessed by a neurological function as⁃sessment scale(EDSS).Results The level of YKL-40 in cerebrospinal fluid of patients with AQP-4 positive neuromyelitis optica spectrum disorder((314.3±42.9)μg/L)was significantly higher than that in ONND pa⁃tients((127.2±19.9)μg/L,P<0.001).The level of YKL-40 in cerebrospinal fluid of patients with MRI-en⁃hanced lesions was(324.7±43.7)μg/L,which was significantly higher than that of patients without MRI-en⁃hanced lesions((290±31.3)μg/L).The level of YKL-40 in cerebrospinal fluid was positively correlated with the score of EDSS in patients with neuromyelitis optica spectrum disorder(r=0.372,P=0.043).Conclusion YKL-40 can be used as a biomarker of the severity of AQP-4 positive neuromyelitis optica and a potential target for the tre atment of NMOSD.