Movment Disorders:血清炎症标志物,和早期帕金森的非运动性症状进展相关

2022-05-25 Freeman MedSci原创

周围炎症可能与PD早期阶段NMS的演变有关

帕金森病(PD)患者会出现各种非运动症状(NMSs),包括神经精神、睡眠相关、自主神经和感觉症状。NMSs通常会随着PD的发展而变得普遍,尽管有些可能比典型的运动症状要早几年。 NMSs被认为是PD患者健康相关生活质量和功能障碍的一个重要组成部分。虽然NMSs的病理机制很复杂,而且了解不多,但中枢和自主神经系统中的多巴胺能和非多巴胺能的缺陷似乎是这些症状的基础。

 


图1: 论文封面图

越来越多的证据表明,神经炎症过程有助于PD的发生和发展。鉴于外周和中枢炎症之间存在相当大的双向交叉,外周血炎症标志物可能是评估PD免疫反应的一个可获得的有用工具。事实上,包括25项研究的荟萃分析表明PD患者的外周血细胞因子水平有所改变,据说其变化与运动症状的严重程度有关。 然而,外周血炎症标志物与PD中NMS的关系仍不清楚。

尽管以前的研究调查了血清或血浆免疫标志物与PD患者认知功能的关系,但其结果并不一致,因为既有积极的结果,也有消极的结果。这种矛盾的观察可能部分是由于横断面研究的设计。以前只有一项研究实施了纵向研究设计。此外,外周炎症对其他非运动方面的影响基本上是未知的。

藉此,韩国 Inha University College of Medicine的的Ryul Kim等人,分析了一项为期3年的纵向研究的数据,前瞻性地研究了血清炎症标志物谱与早期PD患者NMSs演变的关系。

他们纳入了45名早期PD患者和20名健康对照者。测量六种炎症标志物,包括白细胞介素(IL)-1β、IL-2、IL-6、IL-10、肿瘤坏死因子-α和高敏C反应蛋白。在基线和3年后,使用非运动症状量表、蒙特利尔认知评估和综合自律神经症状评分-31评估非运动症状。


图2:论文结果图


他们发现:主成分(PC)分析显示,与对照组相比,PD组中只有主要由IL-2和IL-6加载的PC3分数明显升高。PD组中较高的PC3分数与非运动症状量表总分和情绪/病症领域分数的快速进展有关。PC评分与蒙特利尔认知评估和综合自主神经症状评分-31分的变化没有明显的联系。

这个研究的重要意义在于发现了: 周围炎症可能与PD早期阶段NMS的演变有关,特别是情绪症状。


原文出处:
Kim R, Kim H, Shin JH, Lee CY, Jeon SH, Jeon B. Serum Inflammatory Markers and Progression of Nonmotor Symptoms in Early Parkinson’s Disease. Movement Disorders. Published online May 21, 2022:mds.29056. doi:10.1002/mds.29056

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    2022-10-06 anminleiryan
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早发性帕金森病临床变异性|疑难探究

发病年龄小于50岁的帕金森病被称为早发型帕金森病,发病年龄在21~50为青年型帕金森病,21岁以前发病的被称为少年型帕金森病。

帕金森病:想睡个好觉太难!

帕金森病(PD)患者昼夜节律的改变不仅会影响睡眠-觉醒周期调节,同样会对非运动症状造成影响。

论文解读|Huifang Shang教授团队最新研究揭示与帕金森病相关的PLXNA1基因的罕见变异

研究揭示了与神经系统疾病和帕金森综合症有关的PLXNA1基因罕见变异。

2024 NICE 诊断指南:帕金森病远程监测设备 [DG51]

英国国家卫生与临床优化研究所(NICE,National Institute for Health and Clinical Excellence) · 2024-01-25

2023 NICE 技术鉴定指南:左旋多巴/卡比多巴组合治疗伴有运动症状的晚期帕金森病[TA934]

英国国家卫生与临床优化研究所(NICE,National Institute for Health and Clinical Excellence) · 2023-11-29

帕金森病患者睡眠障碍评估与护理干预的最佳证据总结

浙江中医药大学护理学院 · 2023-08-10

早中期帕金森病患者运动管理的最佳证据总结

山东第一医科大学附属省立医院老年神经内科 · 2023-05-10