神经损伤后血清神经丝轻链测量

IF 3.9 3区 医学 Q1 CLINICAL NEUROLOGY Journal of the Peripheral Nervous System Pub Date : 2023-06-22 DOI:10.1111/jns.12576
Matthew Wilcox, Melissa L. D. Rayner, Owein Guillemot-Legris, Isobel Platt, Hazel Brown, Tom Quick, James B. Phillips
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引用次数: 0

摘要

背景:周围神经损伤(PNIs)后的最佳功能恢复取决于早期识别和及时转诊到专科中心进行适当的手术干预。有助于早期发现PNI的技术将加快转诊率,并鼓励改善患者的预后。血清神经丝轻链(NfL)测量比许多用于神经损伤诊断的传统方法(如肌电图和/或磁共振成像评估)更便宜,更容易获取和解释,但尚未研究创伤性PNI后血清NfL水平的变化。这项临床前研究旨在确定血清NfL水平是否可以:(1)检测神经损伤的存在,(2)区分不同程度的神经损伤。方法采用大鼠坐骨神经压迫和腓总神经压迫作为神经损伤的对照动物模型。在损伤后1、3、7和21天,提取血清样本,使用SIMOA®NfL分析仪试剂盒进行分析。同时提取神经样本进行组织学分析。在损伤后定期测量静态坐骨指数(SSI)。结果坐骨神经和腓总神经损伤后1天血清NfL水平分别升高45倍和20倍。与腓总神经相比,坐骨神经的轴突损伤量增加了8倍(p < .001)。损伤后SSI测量显示,与普通腓骨挤压组相比,坐骨挤压组的功能下降更大。结论NfL血清检测是一种检测外伤性PNI并区分其严重程度的有效方法。这些发现的临床翻译可以为改善神经损伤患者的外科治疗提供有力的工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Serum neurofilament light chain measurements following nerve trauma

Background

Optimal functional recovery following peripheral nerve injuries (PNIs) is dependent upon early recognition and prompt referral to specialist centres for appropriate surgical intervention. Technologies which facilitate the early detection of PNI would allow faster referral rates and encourage improvements in patient outcomes. Serum Neurofilament light chain (NfL) measurements are cheaper to perform, easier to access and interpret than many conventional methods used for nerve injury diagnosis, such as electromyography and/or magnetic resonance imaging assessments, but changes in serum NfL levels following traumatic PNI have not been investigated. This pre-clinical study aimed to determine whether serum NfL levels can: (1) detect the presence of a nerve trauma and (2) delineate between different severities of nerve trauma.

Methods

A rat sciatic nerve crush and common peroneal nerve crush were implemented as controlled animal models of nerve injury. At 1-, 3-, 7- and 21-days post-injury, serum samples were retrieved for analysis using the SIMOA® NfL analyser kit. Nerve samples were also retrieved for histological analysis. Static sciatic index (SSI) was measured at regular time intervals following injury.

Results

Significant 45-fold and 20-fold increases in NfL serum levels were seen 1-day post-injury following sciatic and common peroneal nerve injury, respectively. This corresponded with an eightfold higher volume of axons injured in the sciatic compared to the common peroneal nerve (p < .001). SSI measurements post-injury revealed greater reduction in function in the sciatic crush group compared with the common peroneal crush group.

Conclusions

NfL serum measurements represent a promising method for detecting traumatic PNI and stratifying their severity. Clinical translation of these findings could provide a powerful tool to improve the surgical management of nerve-injured patients.

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来源期刊
CiteScore
6.10
自引率
7.90%
发文量
45
审稿时长
>12 weeks
期刊介绍: The Journal of the Peripheral Nervous System is the official journal of the Peripheral Nerve Society. Founded in 1996, it is the scientific journal of choice for clinicians, clinical scientists and basic neuroscientists interested in all aspects of biology and clinical research of peripheral nervous system disorders. The Journal of the Peripheral Nervous System is a peer-reviewed journal that publishes high quality articles on cell and molecular biology, genomics, neuropathic pain, clinical research, trials, and unique case reports on inherited and acquired peripheral neuropathies. Original articles are organized according to the topic in one of four specific areas: Mechanisms of Disease, Genetics, Clinical Research, and Clinical Trials. The journal also publishes regular review papers on hot topics and Special Issues on basic, clinical, or assembled research in the field of peripheral nervous system disorders. Authors interested in contributing a review-type article or a Special Issue should contact the Editorial Office to discuss the scope of the proposed article with the Editor-in-Chief.
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