| ObjectiveNeuromyelitis optica (NMO) and multiple sclerosis (MS) are inflammatory demyelinating diseases of central nervous system (CNS). The discovery of aquaporin-4antibody (AQP4-Ab), which appears specific for NMO, makes NMO distinguished from MS. Nowadays, lots of studies have confirmed that many inflammatory cytokines involve the early stages of NMO and MS. In this present study, with the detection of a inflammatory marker, the serum high sensitivity C-reactive protein (hs-CRP), in NMO and MS patients, we aim to explore the possibility of hs-CRP to be a biomaker of NMO and MS, and to investigate the correlation between serum hs-CRP level and clinical characteristics.MethodsThe serum hs-CRP levels were measured in50NMO patients,28MS patients,30myasthenia gravis (MG) patients and58healthy controls (HC). The disability severity in NMO and MS was assessed by the Expanded Disability Status Scale (EDSS). Magnetic resonance imaging (MRJ) was performed to assess the involved lesions. Serum AQP4-Ab was tested with a cell based immunofluorescence assay (CBA). The correlations between the serum hs-CRP levels and clinical features were analyed.Results1. The serum hs-CRP levels in acute NMO patients (2.2±2.7mg/L) were significantly higher than in patients in the stable phase(1.2±1.3mg/L)(P=0.009).2. The serum hs-CRP levels were significantly higher in MS patients in relapse (2.0±1.8mg/L), compared with those in remission (1.1±1.0mg/L)(P=0.001).3. The serum hs-CRP levels in acute NMO group were signigicantly higher than that in MG group (P=0.011), as well as that in HC (P=0.001). The serum hs-CRP levels in MS in relapse were signigicantly higher than that in MG group (P=0.002), as well as that in HC (P=0.001).There were no diffences between NMO and MS, the same as MG and HC(P>0.05). 4. The serum hs-CRP levels in the group of shorter remitting period (<10month) of NMO were significantly higher than the longer group (≥10month)(P=0.038).5. The serum hs-CRP levels were negatively correlated with the duration of remitting period (r=-0.445, P=0.038), but not correlated with age of onset, EDSS score, segments of spinal cord lesions, titer of AQP4-Ab in NMO (P>0.05).6. The serum hs-CRP levels in the MS group with higher EDSS (≥score3) were significantly higher than the lower group (<score3)(P=0.001).7. The serum hs-CRP levels of MS group were positively correlated with the EDSS (r=0.667, P=0.001), but not correlated with age of onset, duration of remitting period (P>0.05).Conclusions1. The serum hs-CRP levels in NMO and MS patients in relapse were significantly higher than those in remission. It suggests that hs-CRP may play a role in pathogenesis of NMO and MS. The serum hs-CRP shows potential to be a inflammatory indicator for monitoring of disease activity.2. The serum hs-CRP levels in NMO and MS patients in relapse were significantly higher than those in MG patients and HC, while there was no difference between MG and HC. MG is an antibody mediated autoimmune desease, without blood brain barrier (BBB) damage. The results above suggest that hs-CRP may be involved in the disruption of the BBB, as well as be one of inflammatory indicators at early stage of NMO and MS.3. In the acute NMO group, serum hs-CRP levels were negatively correlated with the duration of remitting period. We guess that the higher levels of serum hs-CRP levels may damage endothelial cells, resulting in relapse easily.4. The serum hs-CRP levels of MS in relapse were positively correlated with EDSS score. It suggests that serum hs-CRP levels maybe a biomark of severity or activity of MS.5. In a word, the serum hs-CRP in NMO and MS patients may be a biomaker representing the level of inflammation. Hs-CRP shows potential to be a inflammatory indicator for monitoring of disease activity and suggesting relapse. Probably, hs-CRP play as a trigger role in NMO and MS pathogenesis as well. Thus, monitoring and controlling the hs-CRP level timely may benefit the NMO and MS patients. |
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