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Objective: To explore association between blood-brain barrier (BBB) permeability and physical disability in patients with neuromyelitis optica spectrum disorders (NMOSD). Methods: Clinical data of 105 patients with NMOSD was retrospectively analyzed in Department of Neurology at Changhai Hospital, Second Military Medical University and Renji Hospital, Shanghai Jiao Tong University School of Medicine from June 2009 to June 2016. According to the difference between the expanded disability status scale (EDSS) scores when discharged from hospital and when admitted to hospital, NMOSD patients were divided into disability-reduction group and disability-exacerbation group, and their clinical characteristics were compared between the two groups, then association between BBB permeability and physical disability was analyzed. Results: Between the disabilityreduction group and the disability-exacerbation group, there was no significant difference in gender, age, disease duration, inducing factor, clinical symptoms, and medication (all P>0.05), and the abnormal rates of thoracic spinal cord in clinical examination were statistically different (P=0.023). There was no significant difference in biochemical data between the two groups (P>0.05), and a statistically significant difference was observed in the rate of cerebrospinal/serum albumin ratio (QALB) in the cerebrospinal fluid examination (P=0.042). The percentages of exacerbation of disability in the QALB normal and high groups were 27.60% (16/58) and 46.80% (22/47), respectively, and there was a statistically significant difference between the two groups (χ2=4.150, P=0.042). BBB permeability was positively correlated with physical disability (r=0.299, P=0.042). Conclusion: The higher the BBB permeability of NMOSD patients on admission is, the higher the degree of physical disability is. The difference in BBB permeability provides key clues to the investigation of the immunological mechanisms of physical disability in NMOSD patients.
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Objective· To explore association between blood-brain barrier (BBB) permeability and physical disability in patients with neuromyelitis optica spectrum disorders (NMOSD).Methods· Clinical data of 105 patients with NMOSD was retrospectively analyzed in Department of Neurology at Changhai Hospital,Second Military Medical University and Renji Hospital,Shanghai Jiao Tong University School of Medicine from June 2009 to June 2016.According to the difference between the expanded disability status scale (EDSS) scores when discharged from hospital and when admitted to hospital,NMOSD patients were divided into disability-reduction group and disability-exacerbation group,and their clinical characteristics were compared between the two groups,then association between BBB permeability and physical disability was analyzed.Results · Between the disabilityreduction group and the disability-exacerbation group,there was no significant difference in gender,age,disease duration,inducing factor,clinical symptoms,and medication (all P＞0.05),and the abnormal rates of thoracic spinal cord in clinical examination were statistically different (P=0.023).There was no significant difference in biochemical data between the two groups (P＞0.05),and a statistically significant difference was observed in the rate of cerebrospinal/serum albumin ratio (QALB) in the cerebrospinal fluid examination (P=0.042).The percentages of exacerbation of disability in the QALB normal and high groups were 27.60％ (16/58) and 46.80％ (22/47),respectively,and there was a statistically significant difference between the two groups (x2=4.150,P=0.042).BBB permeability was positively correlated with physical disability (r=0.299,P=0.042).Conclnsion · The higher the BBB permeability of NMOSD patients on admission is,the higher the degree of physical disability is.The difference in BBB permeability provides key clues to the investigation of the immunological mechanisms of physical disability in NMOSD patients.
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Objective · To explore the association between cerebrospinal fluid (CSF) protein level and peripheral nerve demyelination in patients with Guillain-Barré syndrome (GBS). Methods · Clinical and biochemical data of 86 patients with GBS were retrospectively analyzed. According to electromyograms examination of peripheral nerve, GBS patients were divided into group with demyelination and group with axonal degeneration, and their clinical and biochemical characteristics were compared between the two groups. The correlation between CSF protein level and peripheral nerve demyelination was assessed by Spearman's correlation analysis. Results · Between the group with demyelination and group with axonal degeneration,there was no significant difference in gender, age, Hughes score, respiratory infection, gastrointestinal infection, erythra, ganglioside sodium injection and immunoglobulin G (IgG) index (P>0.05). Significant higher level of CSF protein, CSF albumin/serum albumin, IgG, and 24 h IgG intrathecal synthesis rate were detected in group with demyelination than that of in group with axonal degeneration (P<0.01). CSF protein level was positively correlated with peripheral nerve demyelination (r=0.345, P=0.001). Conclusion · The incidence of peripheral nerve demyelination increased accompanied with CSF protein level, and analysis of CSF protein level may be helpful in investigating the immunologic mechanism of peripheral nerve demyelination in GBS patients.
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Objective To explore the association between the cholesterol level and disease relapse in patients with Neuromyelitis Optica Spectrum Disorders (NMOSD). Methods Clinical and biochemical data of 96 patients with NMOSD were retrospectively analyzed. According to disease relapses, NMOSD patients were divided into primary and relapse groups.Their clinical characteristics and cholesterol level were compared between the two groups.The correlation between cholesterol level and disease recurrence was analyzed by partial correlation adjusted for sex. Results Between the primary group and relapse group,there were statistically significant differences in gender(48.8% vs. 80%, P<0.05), cholesterol (CHO)(4.27±0.85 vs. 5.18±1.26)and low density lipoprotein cholesterol (LDL-C)level[2.37(0.90)vs. 3.00 (1.21)](P<0.001). There were no significant difference in age, upper respiratory infection, gastrointestinal tract, rate of higher cerebrospinal fluid protein, triglyceride (TG)and high density lipoprotein cholesterol(HDL-C)(P>0.05). The percentage of recurrent patients in CHO normal and higher groups were 43.55% and 82.35% respectively, which was statistically significant difference between the two groups ( x2=13.51, P<0.01); The rate of relapse of LDL-C normal and higher groups were 47.69% and 75% respectively, which was statistically significant difference between the two groups ( x2=7.58,P<0.01).After adjusting for sex,CHO level was positively correlated with disease relapse(r=0.346,P<0.01),and LDL-C level also was positively correlated with disease relapse(r=0.380,P<0.01). Conclusion High CHO and LDL-C level may be associated with disease relapse, which has some clinical guiding significance for controlling CHO level in NMOSD patients.
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Objective · To explore the association between cerebrospinal fluid (CSF) protein level and peripheral nerve demyelination in patients with Guillain-Barré syndrome (GBS). Methods · Clinical and biochemical data of 86 patients with GBS were retrospectively analyzed. According to electromyograms examination of peripheral nerve, GBS patients were divided into group with demyelination and group with axonal degeneration, and their clinical and biochemical characteristics were compared between the two groups. The correlation between CSF protein level and peripheral nerve demyelination was assessed by Spearman's correlation analysis. Results · Between the group with demyelination and group with axonal degeneration,there was no significant difference in gender, age, Hughes score, respiratory infection, gastrointestinal infection, erythra, ganglioside sodium injection and immunoglobulin G (IgG) index (P>0.05). Significant higher level of CSF protein, CSF albumin/serum albumin, IgG, and 24 h IgG intrathecal synthesis rate were detected in group with demyelination than that of in group with axonal degeneration (P<0.01). CSF protein level was positively correlated with peripheral nerve demyelination (r=0.345, P=0.001). Conclusion · The incidence of peripheral nerve demyelination increased accompanied with CSF protein level, and analysis of CSF protein level may be helpful in investigating the immunologic mechanism of peripheral nerve demyelination in GBS patients.
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Objectives To explore the correlation between the cerebrospinal fluid protein and facial paralysis in pa?tients with Guillain-Barre syndrome (GBS). Methods Clinical and biochemical data of 111 patients with GBS in depart?ment of neurology from January 2005 to September 2015 were retrospectively analyzed. According to facial paralysis, GBS patients were divided into the facial normal and paralysis groups. Their clinical and biochemical characteristics were compared between the two groups. According to level of cerebrospinal fluid protein, GBS patients were divided into cerebrospinal fluid protein normal, mild high and severe high groups. Incidences of facial paralysis were compared among these three groups. The correlation between the cerebrospinal fluid protein and facial paralysis was analyzed. Results There was no significant difference in gender, age, respiratory infection and other clinical symptoms (P>0.05), whereas there were statistically significant differences in cerebrospinal fluid protein, immunoglobulin G, and cerebrospinal fluid albumin/serum albumin ratio between the facial normal and paralysis groups (P<0.05). Among the three groups by differ?ent levels of cerebrospinal fluid protein, there were statistically significant differences in the incidence of facial paralysis (F=3.48,P=0.03). Cerebrospinal fluid protein was positively correlated with facial paralysis (r=0.288,P<0.01). Conclu? sions The incidence of facial paralysis is associated with the levels of cerebrospinal fluid protein. Thus, cerebrospinal flu?id protein may be helpful in monitoring of GBS patients with facial paralysis.
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This review briefly summarizes the relevant knowledge of psychoneuroimmunological basis for neuroimmunology, with particular emphasis on bidirectional neural-immune interactions. The immune system and the nervous system maintain extensive communication, including hardwiring of sympathetic and parasympathetic nerves to lymphoid organs. Immune system is modulated by various neurotransmitters such as acetylcholine, norepinephrine, substance P and histamine. Neuroendocrine hormones such as corticotrophin-releasing hormone(CRH) or substance P regulate cytokine balance. The immune system modulates brain activity including sleep and body temperature. Recent studies have revealed that psychological factors which influence immunity and immune-related disease may modulate brain-to -immune interaction. But, we still await the scientific research and evidences to prove whether or how behavioral or treatment intervention of stress can influence the development, progress or prevention of a specific disease.