Biomarkers and genotypes in patients with Central nervous system infection caused by enterovirus.

Infectious diseases (London, England) Pub Date : 2024-09-01 Epub Date: 2024-05-17 DOI:10.1080/23744235.2024.2345712
Karolina Alsén, Marianela Patzi Churqui, Helene Norder, Karolina Rembeck, Henrik Zetterberg, Kaj Blennow, Fredrika Sahlgren, Anna Grahn
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Abstract

Purpose: Enteroviruses (EV) comprises many different types and are the most common cause of aseptic meningitis. How the virus affects the brain including potential differences between types are largely unknown. Measuring biomarkers in CSF is a tool to estimate brain damage caused by CNS infections.

Methods: A retrospective study was performed in samples from 38 patients with acute neurological manifestations and positive CSF-EV RNA (n = 37) or serum-IgM (n = 1). The EV in 17 samples were typed by sequencing. The biomarkers neurofilament light (NFL), glial fibrillary acidic protein (GFAP), S-100B protein, amyloid-β (Aβ) 40 and Aβ42, total-tau (T-tau) and phosphorylated tau (P-tau) were measured and compared with data derived from a control group (n = 19).

Results: There were no increased levels of GFAP (p ≤ 0.1) nor NFL (p ≤ 0.1) in the CSF of patients with EV meningitis (n = 38) compared with controls. However, we found decreased levels of Aβ42 (p < 0.001), Aβ40 (p < 0.001), T-tau (p ≥ 0.01), P-tau (p ≤ 0.001) and S-100B (p ≤ 0.001). E30 (n = 9) and CVB5 (n = 6) were the most frequent EV-types identified, but no differences in biomarker levels or other clinical parameters were found between the infecting virus type. Seven patients who were followed for longer than one month reported remaining cognitive impairment, although no correlations with biomarker concentrations were observed.

Conclusion: There are no indication of neuronal or astrocyte damage in patients with EV meningitis. Yet, decreased concentrations of Aβ40, Aβ42, P-tau and T-tau were shown, a finding of unknown importance. Cognitive impairment after acute disease occurs, but with only a limited number of patients analysed, no conclusion can be drawn concerning any association with biomarker levels or EV types.

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肠道病毒引起的中枢神经系统感染患者的生物标记物和基因型。
目的:肠道病毒(EV)有许多不同的类型,是无菌性脑膜炎最常见的病因。病毒如何影响大脑,包括不同类型之间可能存在的差异,这些问题在很大程度上尚属未知。测量脑脊液中的生物标志物是估计中枢神经系统感染造成的脑损伤的一种工具:方法:我们对 38 名有急性神经系统表现、CSF-EV RNA 阳性(37 人)或血清-IgM 阳性(1 人)的患者样本进行了回顾性研究。对 17 份样本中的 EV 进行了测序分型。对生物标志物神经丝光(NFL)、胶质纤维酸性蛋白(GFAP)、S-100B蛋白、淀粉样β(Aβ)40和Aβ42、总tau(T-tau)和磷酸化tau(P-tau)进行了测定,并与对照组(n = 19)的数据进行了比较:结果:与对照组相比,EV 脑膜炎患者(38 人)脑脊液中的 GFAP(p ≤ 0.1)和 NFL(p ≤ 0.1)水平均未升高。然而,我们发现 Aβ42(p p p ≥ 0.01)、P-tau(p ≤ 0.001)和 S-100B (p ≤ 0.001)水平降低。E30(n = 9)和CVB5(n = 6)是最常见的EV类型,但不同感染病毒类型的生物标志物水平或其他临床参数并无差异。随访超过一个月的七名患者报告仍存在认知障碍,但未观察到与生物标志物浓度的相关性:结论:EV 脑膜炎患者没有神经元或星形胶质细胞受损的迹象。然而,Aβ40、Aβ42、P-tau 和 T-tau 的浓度有所下降,这一发现的重要性尚不清楚。急性病后会出现认知障碍,但由于分析的患者人数有限,因此无法就生物标志物水平或 EV 类型之间的关联得出结论。
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