BACKGROUND The interplay between inflammation,immune dysregulation,and the onset of neurological disorders,including epilepsy,has become increasingly recognized.Interleukin(IL)-6,a pro-inflammatory cytokine,is suspect...BACKGROUND The interplay between inflammation,immune dysregulation,and the onset of neurological disorders,including epilepsy,has become increasingly recognized.Interleukin(IL)-6,a pro-inflammatory cytokine,is suspected to not only mediate traditional inflammatory pathways but also contribute to neuroinflammatory responses that could underpin neuropsychiatric symptoms and broader psychiatric disorders in epilepsy patients.The role of IL-6 receptor(IL6R)blockade presents an intriguing target for therapeutic intervention due to its potential to attenuate these processes.neuropsychiatric conditions due to neuroinflammation.METHODS Mendelian randomization(MR)analysis employing single nucleotide poly-morphisms(SNPs)in the vicinity of the IL6R gene(total individuals=408225)was used to evaluate the putative causal relationship between IL6R blockade and epilepsy(total cases/controls=12891/312803),focal epilepsy(cases/controls=7526/399290),and generalized epilepsy(cases/controls=1413/399287).SNP weights were determined by their effect on C-reactive protein(CRP)levels and integrated using inverse variance-weighted meta-analysis as surrogates for IL6R effects.To address potential outlier and pleiotropic influences,sensitivity analyses were conducted employing a variety of MR methods under different modeling assumptions.RESULTS The genetic simulation targeting IL6R blockade revealed a modest but significant reduction in overall epilepsy risk[inverse variance weighting:Odds ratio(OR):0.827;95%confidence interval(CI):0.685-1.000;P=0.05].Subtype analysis showed variability,with no significant effect observed in generalized,focal,or specific childhood and juvenile epilepsy forms.Beyond the primary inflammatory marker CRP,the findings also suggested potential non-inflammatory pathways mediated by IL-6 signaling contributing to the neurobiological landscape of epilepsy,hinting at possible links to neuroinflammation,psychiatric symptoms,and associated mental disorders.CONCLUSION The investigation underscored a tentative causal relationship between IL6R blockade and decreased epilepsy incidence,likely mediated via complex neuroinflammatory pathways.These results encouraged further in-depth studies involving larger cohorts and multifaceted psychiatric assessments to corroborate these findings and more thoroughly delineate the neuro-psychiatric implications of IL-6 signaling in epilepsy.The exploration of IL6R blockade could herald a novel therapeutic avenue not just for seizure management but also for addressing the broader psychiatric and cognitive disturbances often associated with epilepsy.展开更多
目的探讨微小RNA-370-3p(miR-370-3p)和低密度脂蛋白受体相关蛋白6(LRP6)对胎儿生长受限(FGR)孕妇的临床诊断价值。方法选取2020年6月—2022年6月期间产检并确诊为FGR的孕妇96例为观察组,另选取同期产检的健康孕妇96例作为对照组,记录...目的探讨微小RNA-370-3p(miR-370-3p)和低密度脂蛋白受体相关蛋白6(LRP6)对胎儿生长受限(FGR)孕妇的临床诊断价值。方法选取2020年6月—2022年6月期间产检并确诊为FGR的孕妇96例为观察组,另选取同期产检的健康孕妇96例作为对照组,记录两组分娩孕周、1 min Apgar评分、5 min Apgar评分、新生儿体重、胎盘质量,依据美国妇产科学院(ACOG)标准将观察组划分为FGR组、严重FGR组。qRT-PCR法检测血清miR-370-3p和LRP6 mRNA表达水平;血清miR-370-3p和LRP6 mRNA水平与分娩孕周、1 min Apgar评分、5 min Apgar评分、新生儿体重、胎盘质量的相关性采用Pearson法分析;miR-370-3p和LRP6 mRNA对FGR的诊断价值采用ROC曲线评估。结果两组孕妇年龄、分娩孕周、是否初产的比例差异有统计学意义(P<0.05);观察组miR-370-3p显著高于对照组,LRP6显著低于对照组(P<0.05);严重FGR组miR-370-3p显著高于FGR组,LRP6显著低于FGR组(P<0.05);对照组与观察组新生儿体重、1 min Apgar评分、5 min Apgar评分及胎盘质量之间差异有统计学意义(P<0.05);miR-370-3p与LRP6之间呈负相关(r=-0.692,P<0.05),miR-370-3p与分娩孕周、新生儿体重、1 min Apgar评分、5 min Apgar评分、胎盘质量均呈负相关(r=-0.401、-0.382、-0.425、-0.484、-0.504,均P<0.05),LRP6与分娩孕周、新生儿体重、1 min Apgar评分、5 min Apgar评分、胎盘质量均呈正相关(r=0.306、0.412、0.512、0.612、0.419,均P<0.05);ROC曲线显示,miR-370-3p对FGR诊断的AUC为0.877(95%CI:0.821~0.919),截断值为1.40,其敏感度、特异性分别为67.71%、93.75%;LRP6对FGR诊断的AUC为0.838(95%CI:0.778~0.887),截断值为0.83,其敏感度、特异性分别为84.37%、71.87%;二者联合对FGR诊断的AUC为0.923(95%CI:0.875~0.956),明显高于二者单独诊断(Z联合vs miR-370-3P=2.811、P=0.005;Z联合vs LRP6=3.372、P=0.001),其敏感度、特异性分别为85.42%、87.50%。结论FGR患者血清miR-370-3p高表达、LRP6低表达,二者联合对FGR具有一定诊断价值。展开更多
文摘BACKGROUND The interplay between inflammation,immune dysregulation,and the onset of neurological disorders,including epilepsy,has become increasingly recognized.Interleukin(IL)-6,a pro-inflammatory cytokine,is suspected to not only mediate traditional inflammatory pathways but also contribute to neuroinflammatory responses that could underpin neuropsychiatric symptoms and broader psychiatric disorders in epilepsy patients.The role of IL-6 receptor(IL6R)blockade presents an intriguing target for therapeutic intervention due to its potential to attenuate these processes.neuropsychiatric conditions due to neuroinflammation.METHODS Mendelian randomization(MR)analysis employing single nucleotide poly-morphisms(SNPs)in the vicinity of the IL6R gene(total individuals=408225)was used to evaluate the putative causal relationship between IL6R blockade and epilepsy(total cases/controls=12891/312803),focal epilepsy(cases/controls=7526/399290),and generalized epilepsy(cases/controls=1413/399287).SNP weights were determined by their effect on C-reactive protein(CRP)levels and integrated using inverse variance-weighted meta-analysis as surrogates for IL6R effects.To address potential outlier and pleiotropic influences,sensitivity analyses were conducted employing a variety of MR methods under different modeling assumptions.RESULTS The genetic simulation targeting IL6R blockade revealed a modest but significant reduction in overall epilepsy risk[inverse variance weighting:Odds ratio(OR):0.827;95%confidence interval(CI):0.685-1.000;P=0.05].Subtype analysis showed variability,with no significant effect observed in generalized,focal,or specific childhood and juvenile epilepsy forms.Beyond the primary inflammatory marker CRP,the findings also suggested potential non-inflammatory pathways mediated by IL-6 signaling contributing to the neurobiological landscape of epilepsy,hinting at possible links to neuroinflammation,psychiatric symptoms,and associated mental disorders.CONCLUSION The investigation underscored a tentative causal relationship between IL6R blockade and decreased epilepsy incidence,likely mediated via complex neuroinflammatory pathways.These results encouraged further in-depth studies involving larger cohorts and multifaceted psychiatric assessments to corroborate these findings and more thoroughly delineate the neuro-psychiatric implications of IL-6 signaling in epilepsy.The exploration of IL6R blockade could herald a novel therapeutic avenue not just for seizure management but also for addressing the broader psychiatric and cognitive disturbances often associated with epilepsy.
文摘目的探讨微小RNA-370-3p(miR-370-3p)和低密度脂蛋白受体相关蛋白6(LRP6)对胎儿生长受限(FGR)孕妇的临床诊断价值。方法选取2020年6月—2022年6月期间产检并确诊为FGR的孕妇96例为观察组,另选取同期产检的健康孕妇96例作为对照组,记录两组分娩孕周、1 min Apgar评分、5 min Apgar评分、新生儿体重、胎盘质量,依据美国妇产科学院(ACOG)标准将观察组划分为FGR组、严重FGR组。qRT-PCR法检测血清miR-370-3p和LRP6 mRNA表达水平;血清miR-370-3p和LRP6 mRNA水平与分娩孕周、1 min Apgar评分、5 min Apgar评分、新生儿体重、胎盘质量的相关性采用Pearson法分析;miR-370-3p和LRP6 mRNA对FGR的诊断价值采用ROC曲线评估。结果两组孕妇年龄、分娩孕周、是否初产的比例差异有统计学意义(P<0.05);观察组miR-370-3p显著高于对照组,LRP6显著低于对照组(P<0.05);严重FGR组miR-370-3p显著高于FGR组,LRP6显著低于FGR组(P<0.05);对照组与观察组新生儿体重、1 min Apgar评分、5 min Apgar评分及胎盘质量之间差异有统计学意义(P<0.05);miR-370-3p与LRP6之间呈负相关(r=-0.692,P<0.05),miR-370-3p与分娩孕周、新生儿体重、1 min Apgar评分、5 min Apgar评分、胎盘质量均呈负相关(r=-0.401、-0.382、-0.425、-0.484、-0.504,均P<0.05),LRP6与分娩孕周、新生儿体重、1 min Apgar评分、5 min Apgar评分、胎盘质量均呈正相关(r=0.306、0.412、0.512、0.612、0.419,均P<0.05);ROC曲线显示,miR-370-3p对FGR诊断的AUC为0.877(95%CI:0.821~0.919),截断值为1.40,其敏感度、特异性分别为67.71%、93.75%;LRP6对FGR诊断的AUC为0.838(95%CI:0.778~0.887),截断值为0.83,其敏感度、特异性分别为84.37%、71.87%;二者联合对FGR诊断的AUC为0.923(95%CI:0.875~0.956),明显高于二者单独诊断(Z联合vs miR-370-3P=2.811、P=0.005;Z联合vs LRP6=3.372、P=0.001),其敏感度、特异性分别为85.42%、87.50%。结论FGR患者血清miR-370-3p高表达、LRP6低表达,二者联合对FGR具有一定诊断价值。
