多发性硬化、视神经脊髓炎患者血清及脑脊液中脑源性神经营养因子与胶质细胞源性神经营养因子水平

目的 探讨多发性硬化(MS)、视神经脊髓炎(NMO)患者血清及脑脊液中脑源性神经营养因子(BDNF)、胶质细胞源性神经营养因子(GDNF)水平及其神经保护作用.方法 对62例MS、NMO患者及21例对照者进行研究,患者组复发期进行扩展残疾状态量表(EDSS)评分、MRI检查及寡克隆带测定,液相芯片分析技术检测血清及脑脊液BDNF、GDNF浓度.结果 MS、NMO患者复发期血清及脑脊液BDNF(μg/L,MS患者:5.616±0.650、0.186±0.012;NMO患者6.584±0.929、0.176±0.006)、GDNF浓度(μg/L,MS患者:0.039、0.080;NMO患者0.029、0.050)与对照组(μg/L,血清:4.374±0.501、0.040;脑脊液:0.152±0.011、0.065)比较差异无统计学意义;脑脊液BDNF与GDNF浓度水平呈正相关(r=0.756,P=0.000),血清BDNF与GDNF浓度水平呈负相关(r=-0.329,P=0.018).血清及脑脊液BDNF、GDNF浓度与EDSS评分、血脑屏障指数、Delpech指数及Tourtellotte合成率无明显相关性.有或无脑萎缩的MS、NMO患者血清及腩脊液BDNF、GDNF浓度差异无统计学意义.结论 MS、NMO患者体内BDNF与GDNF水平相关,二者可能具有协同的神经保护作用.BDNF及GDNF与NMO、MS患者血脑屏障破坏及中枢神经系统内IgG合成无关,与神经功能残疾及脑萎缩的关系仍需研究.

Investigation of brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor concentrations in serum and cerebrospinal fluid of patients with multiple sclerosis and neuromyelitis optica

Objective To investigate brain-derived neurotrophic factor (BDNF) and glial cell line-derived neurotrophic factor (GDNF) concentrations in serum and cerebrospinal fluid (CSF) in patients with multiple sclerosis (MS) and neuromyelitis optica (NMO),and their neuroprotective effects.Methods Sixty-two patients (49 patients were MS and 13 patients were NMO) and 21 controls were investigated in our studies.The disability severity in MS and NMO patients in their relapse period was assessed by the Expanded Disability Status Scale (EDSS).MRI scanning of brain,spinal cord or optic nerve was examined and the oligoclonal band in serum and CSF were detected.BDNF and GDNF concentrations in serum and CSF were assessed by Liquid Assay.Results There were no significant differences of BDNF (μg/L,5.616±0.650 in serum and 0.186±0.012 in CSF of MS patients;6.584±0.929 in serum and 0.176± 0.006 in CSF of NMO patients) and GDNF (μg/L,0.039 in serum and 0.080 in CSF of MS patients;0.029 in serum and 0.050 in CSF of NMO patients) concentrations in serum and CSF in patients with MS and NMO in relapse,compared with those in controls.There was a positive correlation between BDNF and GDNF concentrations in CSF (r=0.756,P=0.000),and a negative correlation between BDNF and GDNF concentrations in serum (r=-0.329,P=0.018).There were no correlations of BDNF and GDNF concentrations in serum and CSF with EDSS,blood brain barrier index,Delpech index and Tourtellotte synthesis rate.There were no significant differences of BDNF and GDNF concentration in serum and CSF between NMO/MS patients with and without atrophy.Conclusions The level of BDNF in patients with MS and NMO is correlated with that of GDNF,which may have a synergistic neurotrophic effect on MS and NMO.BDNF and GDNF are not associated with the blood-brain harrier destruction and lgG synthesis in central nervous system.However,associations of BDNF and GDNF with functional disability and neuron atrophy in NMO and MS patients still need further studies.