一项前瞻性可行性试验,旨在探索离体肢体灌注后神经毒性的新生物标志物。

IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Perfusion-Uk Pub Date : 2024-11-01 Epub Date: 2023-11-07 DOI:10.1177/02676591231213506
Anna Corderfeldt Keiller, Markus Axelsson, Gudrun Bragadottir, Kaj Blennow, Henrik Zetterberg, Roger Olofsson Bagge
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引用次数: 0

摘要

背景:孤立肢体灌注(ILP)是一种区域性癌症治疗方法,在孤立肢体进行高剂量化疗。主要副作用是局部毒性,偶尔会导致神经损伤。测量神经轴突生物标志物可能是预测此类并发症的一种方法。因此,该研究的主要目的是研究神经元生物标志物在ILP过程中是否可以在孤立的肢体中测量和改变。其次,如果术后局部毒性、敏感性和/或肌肉力量的改变与生物标志物水平相关。方法:将18例ILP患者纳入研究。使用超灵敏单分子阵列(Simoa)技术,在术前、ILP开始和结束时、第3天和第30天采集的血浆中测量胶质原纤维酸性蛋白(GFAP)、神经丝光(NfL)和tau浓度。患者在术前和术后由理疗师进行评估。结果:在ILP结束时,测量到的肢体NfL和tau水平显著高于相应的系统循环中的NfL;17 vs 6 ng/L,p<0.01,tau;1.8 vs 0.6 ng/L,p<0.01),并且在ILP终止时肢体水平显著增加(NfL:66±37%,p<0.001,tau;75±45%,p=0.001)。在第3天和第30天,系统测量显著增加的NfL和GFAP水平(NfL第3天:69±30%,p<.001;第30天:76±26%,p<.001;GFAP第3天:33±22%,p<0.002;第30天:33±23%,p≤.004)。最后,未发现区域毒性之间或术后肌肉或敏感性降低与生物标志物释放之间存在显著相关性。结论:在ILP过程中,NfL和tau水平显著升高。尽管有必要进行大规模研究,但在生物标志物释放与区域毒性或肌肉力量或敏感性下降之间没有观察到明显的相关性。
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A prospective feasibility trial exploring novel biomarkers for neurotoxicity after isolated limb perfusion.

Background: Isolated limb perfusion (ILP) is a regional cancer treatment in which high-dose chemotherapy is administered in an isolated extremity. The main side effect is regional toxicity, which occasionally leads to nerve damage. Measuring neuroaxonal biomarkers, might be a method predicting such complications. Therefore, the primary aim of the study is to investigate if neuronal biomarkers are measurable and alters in an isolated extremity during ILP. Secondly, if postoperative regional toxicity, alterations in sensitivity, and/or muscle strength are correlated to the biomarker levels.

Methods: Eighteen scheduled ILP-patients were included in the study. Glial fibrillary acidic protein (GFAP), neurofilament light (NfL), and tau concentrations were measured in plasma sampled preoperatively, at the start and end of the ILP, on days 3 and 30, using ultrasensitive Single molecule array (Simoa) technology. The patients were assessed by a physiotherapist pre- and postoperatively.

Results: At ILP end, significantly higher NfL and tau levels were measured in the extremity than in the corresponding systemic circulation (NfL; 17 vs 6 ng/L, p < .01, tau; 1.8 vs 0.6 ng/L, p < .01), and the extremity levels were significantly increased at ILP end (NfL; 66 ± 37%, p < .001, tau; 75 ± 45%, p = .001). On days 3 and 30, significantly increased NfL and GFAP levels were measured systemically (NfL day 3: 69 ± 30%, p < .001; day 30: 76 ± 26%, p < .001; GFAP day 3: 33 ± 22%, p < .002; day 30: 33 ± 23%, p ≤ .004). Finally, no significant correlations were found between regional toxicity or between postoperative muscle or sensitivity decrease and biomarker release.

Conclusion: During ILP, NfL and tau levels increased significantly. No obvious correlations were observed between biomarker release and regional toxicity or decreased muscle strength or sensitivity, although large-scale studies are warranted.

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来源期刊
Perfusion-Uk
Perfusion-Uk 医学-外周血管病
CiteScore
3.00
自引率
8.30%
发文量
203
审稿时长
6-12 weeks
期刊介绍: Perfusion is an ISI-ranked, peer-reviewed scholarly journal, which provides current information on all aspects of perfusion, oxygenation and biocompatibility and their use in modern cardiac surgery. The journal is at the forefront of international research and development and presents an appropriately multidisciplinary approach to perfusion science.
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