The Study Of Level Change And Significance Of Resistin In Patients With Neuromyelitis Optica

Objectives Neuromyelitis optica(NMO)is a rare central nervous system(CNS)autoimmune inflammatory diseases,whose pathogenesis is caused by antibodies and the effect of a variety of inflammatory cells and factors.Resistin is an adipocytokine found in recent years and plays an important role in many inflammatory diseases.The study aimed to observe the role of resistin in NMO.Methods Fifty-six patients with NMO in acute phase and fifty-six healthy controls(HCs)were recruited.Besides,twelve non-inflammatory neurological disorders(ONNDs)were enrolled as disease control group.There is no statistical differences in age and gender between NMO patients and the other two groups.Collecting samples and recording demographic information and clinical data including body mass index(BMI),glucose(Glu),total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL),low density lipoprotein(LDL),high sensitive C reactive protein(hs-CRP),disease onset age,course of disease,annualized relapse rate(ARR),number of spinal cord segments involved and expanded disability status scale(EDSS).Cell-based immunofluorescence assay(CBA)was used to detect aquaporin-4 antibody(AQP4-Ab)in NMO patients.The levels of resistin in serum and CSF and the variation before and after high-dose corticosteroids therapy in NMO patients were explored by enzyme linked immunosorbent assay(ELISA).Categorical variables were assessed using a χ2 test.Differences between groups were analysed using a Student’s t-test when the data were normally distributed.If the data were non-normally distributed,Mann Whitney U tests were used to compare unpaired continuous measures.The effects of BMI,glucose,TC,TG,HDL and LDL were investigated by adding these variables to the analysis model as covariates.Differences between NMO subgroupswere analysed using a paired t-test.The relationships between variableswere analysed using Spearman correlation analysis.A P-value of <0.05 was considered significant for all statistical analyses.Results 1.44 patients in NMO group have seropositive AQP4-Ab,the positive rate is 78.6%;2.The concentration of serum resistin was significantly higher in patients with NMO than in HCs(7.6 ± 3.0 vs 4.1± 1.4 ng/ml,p < 0.001).In addition,serum high sensitive C reactive protein(hs-CRP)levels were also significantly increased in the NMO group(2.0±1.9 mg/l vs 0.8± 0.9 mg/l,p=0.017);3.The concentration of CSF resistin was significantly higher in patients with NMO than in ONNDs(0.25±0.23 vs 0.04 ±0.01 ng/ml,p = 0.001);4.A positive correlation was found between the resistin levels and hs-CRP in both serum and CSF in patients with NMO(r= 0.303,p = 0.023;r = 0.622,p = 0.003);5.No relationship was found in BMI and the concentration of TG between NMO patients and HCs(p > 0.05).Glu,TC,LDL and HDL had significant differences between NMO patients and HCs(5.3±0.8 vs 4.5±0.5mmol/l,p<0.001;5.0±1.1 vs 4.2±0.5mmol/l,p<0.001;3.1±0.9 vs 2.3±0.6 mmol/l,p<0.001;1.3±0.4 vs 1.5±0.4 mmol/l,p=0.025).But no significant differences were found in covariance analysis(p > 0.05);6.The serum resistin levels in NMO patients had positive correlation with ARR(r=0.354,p = 0.007)and no relationships were found between resistin levels and disease onset age,course of disease,number of spinal cord segments involved,EDSS and AQP4-Ab levels;7.There’s significant decrease of the serum resistin levels after high-dose corticosteroids therapy than before in sixteen patients with NMO.Conclusions 1.Resistin may participant in the pathogenesis and development of NMO and play a pro-inflammatory role;2.The significant increase of resistin in CSF of NMO patients indicates that the factor may play a role of inflammatory in CNS through passing broken BBB;3.The mechanism of resistin in inflammatory may have a certain correlation with hs-CRP;4.Serum resistin level has a certain prediction effect to the relapse of NMO but there’s no relationship between its level and disease severity;5.Resistin levels decreasing in remission phase of disease indicate that it may become one of the evaluation index of disease process and potential therapeutic target of NMO.