简单的血液检查可以预测多发性硬化症(MS)中的MRI疾病活动

2017-11-30 MedSci MedSci原创

一项监测多发性硬化症(MS)患者血液中神经蛋白的血液测试可能有助于预测疾病活动是否正在加剧。被称为神经丝轻链的神经蛋白是神经细胞的组分,当神经细胞死亡时可以在血流和脊髓液中检测到。挪威卑尔根卑尔根大学的研究作者Kristin N. Varhaug博士说:"由于MS在人与人之间差别很大,疾病的进展方式以及人们对治疗的反应如此不可预测,所以鉴定这样的生物标志物可以帮助我们做出预测,这将是非常有帮助的。


一项监测多发性硬化症(MS)患者血液中神经蛋白的血液测试可能有助于预测疾病活动是否正在加剧。

被称为神经丝轻链的神经蛋白是神经细胞的组分,当神经细胞死亡时可以在血液和脊髓液中检测到。

挪威卑尔根卑尔根大学的研究作者Kristin N. Varhaug博士说:“由于MS在人与人之间差别很大,疾病的进展方式以及人们对治疗的反应如此不可预测,所以鉴定这样的生物标志物可以帮助我们做出预测,这将是非常有帮助的。”

Varhaug博士补充说:“这些血液检查可以为核磁共振成像提供低成本的监测疾病活动的替代方法。对于那些害怕在封闭空间进行核磁共振扫描时需要的人来说,血液测试可能也是一个不错的选择。”

"我们监测与复发缓解型MS的人血轻链水平,发现这种神经蛋白水平较高时,人们有了新的疾病活动性和降低了他们的药物以减少症状发作的次数。"Varhaug博士说。

复发缓解型MS是一种以症状发作和缓解期为特征的疾病。在最初的六个月内,参与者没有接受疾病修饰治疗。在剩下的18个月里,他们都接受了干扰素- 1a的治疗,这可以减少多发性硬化症和多发性脑损伤的积累。

前九个月,参与者每月进行磁共振成像(MRI)扫描。然后他们在第一年和第二年再次进行核磁共振扫描。在研究开始时,在三个月和六个月,以及在第一年和第二年,还采集了血液样本。

研究人员发现,当MRI检测到新的T1和T2病变时,血液中的神经蛋白水平较高,这是由于MS引起的大脑损伤区域。新发T1病变的患者血液中的神经蛋白含量为37.3 pg / ml,而无新T1病变者为28pg / ml。在新病灶的发展过程中,神经蛋白水平增加了三个月。干扰素-β1a治疗开始时,神经蛋白水平也下降。

研究人员发现,一个人增加10微克/毫升会增加一个新的t1病变的风险增加48%,另一个新的T2病变的风险增加62%。

Varhaug博士说:"这种神经蛋白的血液检测可能是监测疾病活动和治疗效果的有效方法。"

这项研究的局限性包括:在常规的MS护理中,研究对象的MRI扫描频率要比正常人多。此外,虽然大多数患者在随访过程中出现新的病变,但并非所有患者都有复发。未来的研究可能需要考虑更长的随访时间。

该研究已发表在《Neurology: Neuroimmunology and Neuroinflammation, and the American Academy of Neurology》的在线期刊上。


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