The Clinical Significance Of Cerebrospinal Fluid And Plasma NGF,proNGF And P75NTR In Patients With Viral Encephalitis

Objective:To study the altered levels of nerve growth factor(NGF),precursor of nerve growth factor(pro NGF),and p75 neurotrophin receptor(p75NTR)in plasma and cerebrospinal fluid of patients with viral encephalitis and their clinical significance.Methods:A total of 84 patients with viral encephalitis admitted to the Department of Neurology of the Second Affiliated Hospital of Kunming Medical University from August 2021 to December 2022(VE group).Twenty patients who had been hospitalized during the same period and had excluded central nervous system infections,neurodegenerative diseases,autoimmune encephalitis,and cognitive impairment served as the control group.The levels of NGF/pro NGF and p75 NTR in cerebrospinal fluid and plasma of each group were measured by Enzyme Linked Immunosorbent Assay(ELISA),and the differences in levels between the groups were compared.Patients’ Montreal Cognitive Assessment(Mo CA)assessment,Electro-Encephalogram(EEG),and Magnetic Resonance Imaging(MRI)of the head were collected.And patients’ general Information and inflammatory indexes were collected : sex,age,peripheral blood interleukin-6(IL-6),C-reactive protein(CRP),lymphocytes,monocytes,serum albumin,and CSF cell count,CSF protein,immunoglobulin A(Ig A),Immunoglobulin G(Ig G),Immunoglobulin M(Ig M).According to the Mo CA scores,VE group were further divided into groups VE with cognitive impairment and VE without cognitive impairment.According to the EEG results,the VE group was divided into VE with mild EEG abnormality and moderate to severe abnormality groups.According to the MRI results,VE group was divided into VE with MRI lesions and without MRI lesions.Correlation of CSF,plasma levels of NGF/pro NGF,p75 NTR,CSF/peripheral blood inflammatory indexes with each factor and inflammatory index was analyzed between the groups.Results:1 Compared with the control group,CSF pro NGF and p75 NTR levels,and plasma pro NGF levels,were significantly higher in the VE group(P < 0.001).2 Pro NGF,p75 NTR levels of cerebrospinal fluid,and pro NGF levels of plasma were higher in the VE with cognitive impairment group than in the VE without cognitive impairment group.They were higher than the control group,with statistically significant differences between the three groups(P < 0.05).The levels of pro NGF and p75 NTR in cerebrospinal fluid,and the level of pro NGF in plasma were higher in the VE without MRI lesion group than VE with MRI lesion group.And all were higher than the control group.The difference between the three groups was statistically significant(P < 0.05).3 The number of CSF cells,CSF protein,CSF Ig G,CSF Ig A,CSF Ig M,and CSF protein/serum albumin ratio were higher in the VE group than in the control group,and the difference was statistically significant(P < 0.05).CSF pro NGF and CSF p75 NTR were positively correlated with CSF protein,CSF Ig G,CSF Ig A,CSF Ig M,and CSF protein/serum albumin(P < 0.05).CSF NGF was negatively correlated with cerebrospinal fluid cell count(P < 0.05).The peripheral blood leukocyte count and IL-6 were significantly higher in the VE group compared with the control group,and the difference was statistically significant(P < 0.05).Conclusions:1 pro NGF and p75 NTR are involved in the inflammatory response to VE,blood-brain barrier damage and play a negative regulatory role.Changes in pro NGF and p75 NTR levels can reflect the severity of neuroinflammation-related diseases.2 NGF/pro NGF levels,pro NGF-P75 NTR pathway has the potential to become a biomarker for further application in clinical diagnosis and therapy.