Neurology: Cerebrospinal fluid biomarker, which can effectively predict autoimmune encephalitis

Although most associated with their cell surface receptor antibody immune encephalitis patients (antibody-mediated encephalitis, AME) receiving immunomodulatory therapy within two years returned to live independently, but at the NMDA receptor (NMDAR), In patients with leucine-rich glioma inactivated 1 (LGI1) and contactin-related protein 2 (CASPR2) antibody encephalitis, persistent deficits in memory and executive function appeared.

immunity

Obviously, this requires the development of objective measures to inform the recovering AME patients of the causes and contributing factors of the long-term injury.
In individuals with neurodegenerative dementia disease, cerebrospinal fluid biomarkers have been used powerfully for this purpose.

Increased levels of total tau and mucin-1 (VILIP-1) and neurofilament light chain (NfL) in cerebrospinal fluid, which are non-specific markers of neuron and nerve axis damage, respectively, predicting early symptoms of Alzheimer's The cognitive decline of patients with silent disease (AD) accelerates.

The chitinase-3 like protein (YKL-40)-a marker of astrocyte activation-can identify patients with symptomatic AD, HIV-related dementia, and refractory medsci.
cn/course/search.
do?w=%E7%99%AB%E7%97%AB">epilepsy .
In the CSF of patients with neurodegenerative diseases, there are also reports of increased levels of presynaptic protein (synaptosome-associated protein-25, SNAP-25) and postsynaptic protein (neugranulin, Ng), which indicates that the synapse Impaired integrity and impaired synapses are the pathogenesis of the disease.

medsci.
cn/course/search.
do?w=%E7%99%AB%E7%97%AB">epilepsy

In this way, Gregory Scott Day of Mayo Clinic in the United States and others, in order to determine whether these biomarkers inform the pathogenesis of AME, compared NMDAR and LGI1/CASPR2 antibody encephalitis patients and patients with similar age and gender with normal cognitive (CN) patients.
Tested CSF biomarkers for neuron and nerve axis damage, neuroinflammation, and synaptic dysfunction.

In the subset of AME patients with longitudinal data, we further consider whether CSF biomarkers are related to clinical measures of disease severity and outcome.

They measured neurons (total-tau) from the CSF of 45 patients diagnosed with NMDA receptors (n=34) or LGI1/CASPR-2 (n=11) AME and 39 cognitively normal people of similar age and gender.
, VILIP-1) and nerve axis injury (neurofilament light chain [NfL]), inflammation (YKL-40) and synaptic function (neurogranin, SNAP-25) biomarkers.

diagnosis

In patients who were followed longitudinally, the association between the biomarkers and the modified Rankin score was assessed (n=20).

They found that the biomarkers of nerve axis damage (NfL) and neuroinflammation (YKL-40) were increased when the AME cases occurred, while the markers of neuronal damage and synaptic function were stable (total-tau) or decreased (VILIP- 1.
SNAP-25, neurogranin).

The logarithmic conversion ratio of YKL-40/SNAP-25 can best distinguish cases from those with normal cognition (AUC=0.
99; 95%CI: 0.
97, >0.
99).

In prospective follow-up patients, younger age, lower VILIP-1 and SNAP-25, and higher log10 (YKL-40/SNAP-25) are related to higher disease severity (mRS).

Younger age, lower VILIP-1 and SNAP-25, higher log10 (YKL-40/SNAP-25), and higher disease severity (mRS).
Younger age, lower VILIP-1 and SNAP-25, higher log10 (YKL-40/SNAP-25), and higher disease severity (mRS).

Higher YKL-40) and neurogranin (ρ=0.
55; p=0.
03) at discharge were related to the modified Rankin score 12 months after discharge.

The important significance of this study is that despite the damage to the axons, the neuronal integrity of patients with AME is acutely maintained.
The low-level biomarkers of synaptic function may reflect the internalization of antibody-mediated cell surface receptors, and may represent an acutely related factor of antibody-mediated synaptic dysfunction, which may be the severity and outcome of the disease for reference.

Despite the damage to the axons, the neuronal integrity of patients with AME is acutely maintained.
Despite the damage to the axons, the neuronal integrity of patients with AME is acutely maintained.

Original source:

neurology.
org/content/early/2021/04/01/WNL.
0000000000011937" target="_blank" rel="noopener">Prospective Quantification of CSF Biomarkers in Antibody-Mediated Encephalitis
neurology.

org/content/early/2021/04/01/WNL.

neurology.
org/content/early/2021/04/01/WNL.
0000000000011937" target="_blank" rel="noopener">Quantification of Biomarkers in CSF Prospective Antibody-Mediated Encephalitis
neurology.
org/content/early/2021/04/01/WNL.
0000000000011937" target="_blank" rel="noopener">Gregory Scott Day, the Y Melanie Yarbrough, et Al.

neurology.
org/content/early/2021/04/01/WNL.
0000000000011937" target="_blank" rel="noopener">.
Neurology On Apr 2021, 10.
1212 / WNL.
0000000000011937; the DOI: 10.
1212 / WNL.
0000000000011937 in this message