Diagnostic significance of the determination of myelin basic protein in cerebrospinal fluid in HIV-associated neurological diseases.

К. Yu. Lуtvуn

doi:10.26641/2307-0404.2018.2.133941

Автор(и)

К. Yu. Lуtvуn

DOI:

https://doi.org/10.26641/2307-0404.2018.2.133941

Ключові слова:

HIV infection, HIV-associated neurological diseases, myelin basic protein, cerebrospinal fluid, ROC-analysis

Анотація

48 patients aged from 21 to 54 years, infected with human immunodeficiency virus (HIV) and presence of diseases of the central nervous system (CNS) were examined. CNS diseases included cerebral tuberculosis, viral encephalitis (caused by Epstein-Barr Virus (EBV), cytomegalovirus (CMV), herpes simplex virus (HSV)), encephalitis of unspecified etiology, cerebral toxoplasmosis, fungal meningitis. 29 (60.4%) of the patients were discharged from the hospital with a clinical improvement, and 19 (39.6%) of the patients died as a result of CNS disease. Significant differences in the content of the myelin basic protein (MBP) in the cerebrospinal fluid (CSF), depending on the outcome of the disease, were determined. The Median of MBP in deceased patients was 2.9 times higher than in the survived patients - 4.00 (1.90-7.70) ng/ml vs. 1.40 (0.99-2.00) ng/ml (p=0.002 U). An inverse correlation between the content of MBP in the CSF and the time from the determination of the HIV status to the manifestation of neurologic symptoms (rs=-0.30, p<0.05) was found. According to the results of the ROC analysis, the high risk of unfavorable course of HIV-associated CNS diseases is predicted when the concentration of MBP in the cerebrospinal fluid increases by more than 2 ng/ml (68.4% sensitivity, 75.9% specificity, 72.9% accuracy). The highest level of this protein was observed in patients with fungal lesions of the central nervous system (6.6 (1.9-7.8) ng/ml), and the lowest MBP level – in the group of patients with unspecified encephalitis (0.99 (0.9-1.1) ng/ml), which correlated to more favorable outcomes of the disease. The MBP in cerebrospinal fluid can be an important diagnostic and prognostic marker of HIV-associated neurological diseases.

Біографія автора

К. Yu. Lуtvуn

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine»
Department of Infectious Diseases
V. Vernadsky str., 9, Dnipro, 49044, Ukraine

Посилання

Yunkerov VI, Grigoryev SG, Rezvantsev MV. [Mathematic-statistical processing of medical research data]. SPb, vMedA, 2011;320. Russian.

Baron W, Hoekstra D. On the biogenesis of myelin membranes: sorting, trafficking and cell polarity. FEBS letters. 2010;584(9):1760-70.

Pritzker LB, Joshi S, Harauz G, Moscarello MA. Deimination of myelin basic protein. Effect of methylation of MBP on its deimination by peptidylarginine deiminase. Biochemistry. 2000;39(18):5382-8.

Del Valle L, Piña-Oviedo S. HIV disorders of the brain: pathology and pathogenesis. Front Biosci. 2006;11(1):718-32.

Corrêa DG, Zimmermann N, Doring TM, Wilner NV, Leite SC, Cabral RF, Gasparetto EL. Diffusion tensor MR imaging of white matter integrity in HIV-positive patients with planning deficit. Neuroradiology. 2015;57(5):475-82.

Wang R, Chen J, Zhou S, Li C, Yuan G, Xu W, Gong N. Enzyme-linked immunoadsorbent assays for myelin basic protein and antibodies to myelin basic protein in serum and CSF of patients with diseases of the nervous system. Hua xi yi ke da xue xue bao= Journal of West China University of Medical Sciences= Huaxi yike daxue xuebao, 1995;26(2):131-4.

Fitzner B, Hecker M, ZettlUK. Molecular biomarkers in cerebrospinal fluid of multiple sclerosis patients. Autoimmunity reviews. 2015;14(10):903-13.

Heaton RK, Clifford DB,Franklin DR, Woods SP, Ake C, Vaida F, & Rivera-Mindt M. HIV-associated neurocognitive disorders persist in the era of potent antiretroviral therapy CHARTER Study. Neurology. 2010;75(23):2087-96.

Ide T, Kamijo Y. Myelin basic protein in cerebrospinal fluid: a predictive marker of delayed encephalopathy from carbon monoxide poisoning. The American journal of emergency medicine. 2008;26(8):908-12.

Amor S, Puentes F, Baker D, Van Der Valk P. Inflammation in neurodegenerative diseases. Immunology. 2010;129(2):154-69.

Armstrong RC, Mierzwa AJ, Sullivan GM, Sanchez MA. Myelin and oligodendrocyte lineage cells in white matter pathology and plasticity after traumatic brain injury. Neuropharmacology. 2016;110:654-9.

Fitzner D, Schneider A, Kippert A, Möbius W, Willig KI, Hell SW, Simons M. Myelin basic protein‐dependent plasma membrane reorganization in the formation of myelin. The EMBO journal. 2006;25(21):5037-48.

Brouns R, De Vil B, Cras P, De Surgeloose D, Mariën P, De Deyn PP. Neurobiochemical markers of brain damage in cerebrospinal fluid of acute ischemic stroke patients. Clinical Chemistry. 2010;56(3):451-8.

Zou S, Fuss B, Fitting S, Hahn YK, Hauser KF, Knapp PE. Oligodendrocytes are targets of HIV-1 Tat: NMDA and AMPA receptor-mediated effects on survival and development. Journal of Neuroscience. 2015;35(32):11384-98.

Liu H, Xu E, Liu J, & Xiong H. Oligodendrocyte injury and pathogenesis of hiv-1-associated neurocognitive disorders. Brain sciences. 2016;6(3):23.

Chen Y, An H, Zhu H, Stone T, Smith JK, Hall C, Lin W. White matter abnormalities revealed by diffusion tensor imaging in non-demented and demented HIV+ patients. Neuroimage. 2009;47(4):1154-62.

Wohlschlaeger J, Wenger E, Mehraein P, Weis S. White matter changes in HIV-1 infected brains: a combined gross anatomical and ultrastructural morphometric investigation of the corpus callosum. Clinical neurology and neurosurgery. 2009;111(5):422-9.

Gongvatana A, Schweinsburg BC, Taylor MJ, Theilmann RJ, Letendre SL, Alhassoon OM, Frank LR. White matter tract injury and cognitive impairment in human immunodeficiency virus infected individuals. Journal of neurovirology. 2009;15(2):187-95.