The Correlation Of Serum YKL-40、CD40 With Multiple System Atrophy

Objective: Multiple system atrophy(MSA) is a neurodegenerative disease characterized by varying degrees of autonomic dysfunction, parkinsonian features and cerebellar ataxia. The pathological hallmark of MSA is widespread and abundant glial cytoplasmic inclusions(GCIs) composed of α-synuclein. The accumulation of α-synuclein is associated with the NF-κB transcription factor stress system, and the activation of NF-κB system plays an important role in the expression of YKL-40 and CD40. Our study aims to detect the difference of serum YKL-40 and CD40 between MSA patients and healthy people, and the correlation of serum YKL-40 and CD40 with onset age, duration and severity degrees in MSA.Methods: According to the 2008 diagnostic criteria of MSA revised by Gilman et al, there are 30 MSA patients(14 MSA-P, 16 MSA-C) included in this study. And 30 healthy subjects without neurological disorders, infections or tumor are described as healthy controls. With the Unified Multiple System Atrophy Rating Scale(UMSARS) Part II, we evaluate the clinical status of each MSA patient. The concentration of serum YKL-40 and CD40 are detected by Enzyme linked Immunosorbent Assay(ELISA). We analyze the levels of serum YKL-40 and CD40 in MSA patients and healthy controls, and its relationship with onset age, duration and UMSARS II score of MSA.Results: Serum YKL-40 concentration is significantly lower in MSA [38.32(11.74) ng/ml] than in healthy controls [44.74 ± 9.95 ng/ml, P = 0.002]. However, no significant correlation is observed between serum YKL-40 and onset age, duration or UMSARS II score in MSA. Receiver operating characteristic(ROC) curve analysis indicates that serum YKL-40 is lack of diagnostic utility in differentiation between MSA patients and healthy controls(A = 0.264). There is no significant difference in serum CD40 concentration between MSA patients [120.39(39.47) pg/ml] and healthy controls [116.12(35.85) pg/ml, P = 0.871].Conclusions: 1.There are two subtypes of MSA, namely MSA-P and MSA-C, respectively accounted for 47 % and 53%. The mean onset age of MSA is 59.43 ± 10.04, without gender differences. 2. There is no correlation with serum YKL-40 level and age, gender. For MSA, serum YKL-40 level is not significantly correlated with onset age, duration and UMSARS II score. 3. Serum YKL-40 concentration is significantly lower in MSA than in healthy controls. There is a speculation that the activation of NF-κB system impact on the YKL-40 expression. 4. Serum YKL-40 concentration is not a diagnostic biomarker for MSA. 5. There is no significant difference in serum CD40 concentration between MSA patients and healthy people.