快速眼动睡眠行为障碍和帕金森病患者血浆外泌体α-syn的变化

Change in plasma exosomeα-synuclein in patients with rapid eye movement sleep behavior disorder or Parkinson disease

目的定量分析血浆外泌体中α-突触核蛋白(α-synuclein,α-syn)含量在PD和iRBD中的差异,寻找可预测的生物学标志物。方法对20例iRBD患者、21例不伴RBD的PD患者(PD-nRBD)和20例年龄、性别匹配的正常健康人群(HC组),利用快动眼睡眠行为障碍量表-香港版(rapid-eye-movement sleep behavior disorder questionnaire hongkong,RBDQ-HK)评估所有受试者的夜间症状,利用统一帕金森病等级评分-运动部分(Unified Parkinsons Disease Rating Scale motor section,UPDRSⅢ)测评受试者的运动损害;采用酶联免疫吸附法测定血浆外泌体的α-syn含量,并分别分析3组血浆外泌体α-syn含量,及其与RBDQ-HK评分及UPDRSⅢ评分的相关性。结果iRBD组、PD-nRBD组、HC组的UPDRSⅢ评分具有统计学差异(P=0.0001),组间比较具有统计学差异(P<0.05);3组RBDQHK评分具有统计学差异(P=0.0001),iRBD组显著高于其他两组(P=0.0001)。iRBD组、PD-nRBD组血浆外泌体α-syn分别高于健康对照组(healthy control,HC)(P=0.001),iRBD组的血浆外泌体α-syn低于PD-nRBD组,但无组间差异(P>0.05)。iRBD组血浆外泌体α-syn与RBDQ-HK呈正相关(r=0.842,P=0.0001),PD-nRBD组血浆外泌体α-syn含量与UPDRS III得分、H-Y分期正相关(r=0.817,P=0.0001;r=0.592,P=0.005)。结论iRBD患者血浆外泌体存在α-syn,与PD-nRBD相似,且与PD-nRBD的运动评分和iRBD的夜间症状评分相关;血浆外泌体α-syn有望成为预测iRBD转化PD的早期生物学标志物。

Objective To quantitatively analyze the difference in the content of plasma exosomeα-synuclein(α-syn)between Parkinson disease(PD)and idiopathic rapid eye movement sleep behavior disorder(iRBD),and to identify predictable biological markers.Methods A total of 20 patients with iRBD(iRBD group),21 PD patients without RBD(PD-nRBD group),and 20 healthy controls matched for age and sex(HC group)were enrolled.Rapid-Eye-Movement Sleep Behavior Disorder Questionnaire-Hong Kong(RBDQ-HK)was used to evaluate the nocturnal symptoms of all subjects,and the motor section of Unified Parkinson Disease Rating ScaleⅢ(UPDRSⅢ)was used to evaluate motor impairment.ELISA was used to measure the content of plasma exosomeα-syn,and the three groups were analyzed in terms of the content of plasma exosomeα-syn and its correlation with RBDQ-HK score and UPDRSⅢscore.Results There was a significant difference in UPDRSⅢscore between the iRBD group,the PD-nRBD group,and the HC group(P=0.0001),with a significant difference between any two groups(P<0.05);there was also a significant difference in RBDQ-HK score between the three groups(P=0.0001),and the iRBD group had a significantly higher score than the other two groups(P=0.0001).The iRBD group and the PD-nRBD group had a significantly higher content of plasma exosomeα-syn than the HC group(P=0.001),and the iRBD group had a lower content of plasma exosomeα-syn than the PD-nRBD group(P>0.05).In the iRBD group,plasma exosomeα-syn was positively correlated with RBDQ-HK score(r=0.842,P=0.0001),and in the PD-nRBD group,plasma exosomeα-syn was positively correlated with UPDRSⅢscore(r=0.817,P=0.0001)and H-Y staging(r=0.592,P=0.005).Conclusion The presence of plasma exosomeα-syn is observed in iRBD patients,which is similar to that in PD-nRBD patients,and the content of plasma exosomeα-syn is associated with the motor score of PD-nRBD and the nocturnal symptom score of iRBD.Therefore,plasma exosomeα-syn is expected to become an early biomarker for predicting the conversion of iRBD to PD.