Immunological Detection Of Axonal Injury In Peripheral Neuropathy

The axonal injury of peripheral neuropathy is different from the demyelination damage, the cause may be related to infection, metabolism, drug toxicity. immune genetic reasons. The treatment of demyelinating peripheral neuropathy in recent years made great progress, but axonal injury of peripheral neuropathy is still faced with the difficulties of diagnosis. We mainly based on clinical manifestations, nerve electrophysiological diagnosis of axonal injury, there is no reliable laboratory indicator used to assist analysis. Neurofilament (NF) is a cytoskeletal proteins of neurons and axons which is an important biological marker, ganglioside is a group of acidic glycolipids distributed in neurons and axonal plasma membrane, GM1and GD1a antibody has been found in the serum of AMAN patients. The purpose of this study is to explore the immune markers of axonal injury of the peripheral neuropathy, and to explore its role in the prediction of the degree of axonal injury in peripheral neuropathy.This study consists of two parts. The first part is the measurement system building of axonal injury marker, including the ELISA detection system of NFH SMI-35protein, as well as the ELISA detection system of GM1, GD1a, GD1b antibody. The experimental data indicate that the detection system has good reproducibility, and can be used for the analysis of clinical samples. The second part is the ELISA detection of the samples, there are68cases of axonal neuropathy (18cases of motor axon,19cases of sensory axon,31cases of motor and sensory axon),23cases of demyelinating neuropathy,25cases of other neurological system diseases (OND),70cases of nervous system in normal control (NC) serum samples and part of the cerebrospinal fluid samples. we will observe NFH SMI-35protein concentration and GM1-IgG, GD1a-IgG,GD1b-IgG antibodies level to compare axonal peripheral neuropathy with the other groups.Results:(1)The detection of the standard sample, different concentrations and OD are related.(2)There are significant differences in the CSF level for NFH SMI-35protein between axonal group and the demyelinating group, the OND, NC group (P<0.001); There are significant differences in the serum level for NFH SMI-35protein between axonal group and the other three groups (P <0.001).(3)When QAlb>7. the NFH SMI-35level in CSF has association with that in serum (r=0.602,p=0.014). When QAlb<7. the NFH SMI-35level in CSF has no association with that in serum (r=0.157. P=0.354)(4) There are significant differences in the serum level for GD1a-IgG antibody between motor axonal group and the other five groups.(P<0.05).(5) There are significant differences in the serum level for GM1-IgG antibody between motor axonal group and the other five groups (P<0.05).(6) There are no significant difference in the serum level for GD1b-IgG antibody between sensory axonal group and the other five groups.(P>0.05).(7) The NFH SMI-35concentration in CSF has association with the median nerve, ulnar nerve CMAP amplitude (r=-0.492. P=0.004:r=-0.43. P=0.012); The NFH SMI-35concentration in serum has no association with the median nerve, ulnar nerve CMAP amplitude (P>0.05).(8) The GM1-IgG, GD1a-IgG antibody levels in serum have association with motor symptoms Hughes score (r=0.39, P=0.025; r=0.382, P=0.028).Conclusion:(1) The NFHSMI-35concentration in CSF predict the severity of axonal injury in peripheral neuropathy.(2) The NFH SMI-35concentration in CSF has negative association with the median nerve, ulnar nerve CMAP amplitude.(3) The GM1-IgG, GD1a-IgG antibody levels in serum have association with Hughes grade.(4) The GM1-IgG, GD1a-IgG antibody levels in serum predict the severity of motor axonal injury in peripheral neuropathy. The GD1b-IgG antibody cann’t predict axonal injury.(5) When the blood-brain barrier permeability changes. NFH SMI-35concentrations in CSF and serum related.