Abstract

BackgroundDisruption of the blood–brain barrier (BBB) is an important pathophysiological process of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. A recent multi-center study showed that soluble (s) CD146 is a potential biomarker for monitoring early BBB damage and central nervous system inflammation, but little is known about sCD146 in anti-NMDAR encephalitis.MethodTwenty-three anti-NMDAR encephalitis patients and seventeen controls with non-inflammatory neurological diseases were recruited. sCD146 and inflammatory cytokines in cerebrospinal fluid (CSF) and serum were detected by ELISA. Modified Rankin scale (mRS) scores were used to assess the neurological status of each patient. A follow-up review was completed three months after discharge.ResultssCD146 levels in the CSF of patients with the acute stage anti-NMDAR encephalitis were significantly increased compared with controls and accompanied by increases in TNF-α, IL-6 and IL-10. CSF sCD146 was positively correlated with neuroinflammatory factors in the CSF and with mRS score. Three months after effective treatment, CSF sCD146 in patients was significantly decreased but remained significantly different compared with the controls.ConclusionOur data suggested that higher expression of CSF sCD146 correlated with more serious neurological damage. Therefore, levels of CSF sCD146 may represent a promising indicator for monitoring disease and optimizing clinical treatment decisions in the early stages of anti-NMDAR encephalitis.

Highlights

  • Anti-N-methyl-D-aspartate receptor encephalitis has gradually become recognized as an autoimmune disease targeting neuronal synapses

  • We found that soluble form of CD146 (sCD146) levels were markedly elevated in the cerebrospinal fluid (CSF) of antiNMDAR encephalitis patients

  • We found that the CSF sCD146 was significant increased in anti-NMDAR encephalitis patients with the acute stage, which were positively correlated with the levels of neuroinflammatory factors and mRS score

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Summary

Introduction

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis has gradually become recognized as an autoimmune disease targeting neuronal synapses. Based on a recent multi-center study in MS with large samples conducted by Wang et al [16], the results showed that compared with other soluble adhesion molecules, sCD146 may become a potential biomarker as it has high sensitivity and specificity for evaluating early BBB damage and CNS inflammation. We measured the levels of sCD146 in the CSF and serum of patients with anti-NMDAR encephalitis and assessed its potential clinical value in the diagnosis and treatment of this disease. Disruption of the blood–brain barrier (BBB) is an important pathophysiological process of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. A recent multi-center study showed that soluble (s) CD146 is a potential biomarker for monitoring early BBB damage and central nervous system inflammation, but little is known about sCD146 in anti-NMDAR encephalitis

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