The Expression And Clinical Significance Of Progranulin In Multiple Sclerosis

Objective: To analyse the clinical,blood,cerebrospinal fluid's characterastics of Multiple sclerosis(MS),mainly discuss the expression of progranulin(PGRN)in the CSF from MS patients,and analyse the correlation between PGRN and the disease's activity of MS,the correlation between PGRN and the destruction of blood-brain barrier,as well as the correlation of clinical,blood,cerebrospinal fluid's characterastics in Multiple sclerosis.And finally we discuss whether PGRN can react MS patients' activity,and the probable pathogenesis of MS.Methods: we collected MS patients totally from 2013 to 2015 in Changhai Hospital,who were in accordance with the 2010 version of MS McDonald diagnostic criteria.Blood and cerebrospinal fluid samples and clinical,biochemical and imaging data were collected.Using enzyme linked immunoassay(ELISA)to detect the cerebrospinal fluid's PGRN content,analysis the differences of the PGRN levels in CSF among MS patients,other inflammatory neurological diseases and non inflammatory neurological diseases,and to compare the content of PGRN between the active and remission period of MS patients.Finally through the statistical methods of Pearson and Spearman correlation analysis research the relation among the PGRN levels in CSF of MS patients and the general situation,clinical manifestation,EDSS score,blood and cerebrospinal fluid biochemical and immunological index of MS patients.At last,analyse the correlation among PGRN,the disruption of Blood-brain barrier(BBB)and inflammatory immune response,in order to explore the pathogenesis of MS.Results: a total of 60 patients,including 33 cases of multiple sclerosis patients,15 patients with other inflammatory neurological diseases as positive control group,12 cases of non inflammatory neurological diseases as negative control group.33 cases of MS patients,12 cases of male,21 cases of female,mean age is 48.12 ± 16.38 years old,average age of onset is 46.61±15.59 years old.Duration rang from 10 days to 11 years.,4 months of median,interquartile 16.5 months,the cerebrospinal fluid' PGRN content of three groups respectively is 1.68±0.86 ng / ml,6.63±3.29 ng / ml,0.98±0.18ng/ml,PGRN levels among the three groups have statistical significance(P < 0.05).33 cases of patients with multiple sclerosis,divided into two groups according to active or remission period,the active group(n = 20)and remission period group(13 cases),respectivelypercentage was 60.61%(20 / 33)and 39.39%(13 / 33),the PGRN levels of active and remission period were 4.22 ± 1.20ng/ml,1.27 ± 0.27ng/ml,there was significantly statistical difference(F value =9.62,P < 0.01),The PGRN was positively correlated with multiple sclerosis' s activity(r = 0.633,P < 0.01).Finally,there is a positive correlation among the cerebrospinal fluid's PGRN levels in MS and EDSS score,cerebrospinal fluid leukocyte,protein in cerebrospinal fluid,cerebrospinal fluid albumin,QALB,cerebrospinal fluid IgG,24 hours intrathecal synthesis rate.Conclusion: the PGRN levels in CSF of MS patients was significantly higher than that in negative control group,and the levels of active stage was higher than that in remission stage,so PGRN maybe consider as a biomarker of MS's activity,which was used to monitor the condition of the disease.The positive correlation among the cerebrospinal fluid's PGRN levels in MS and EDSS score,cerebrospinal fluid leukocyte,protein in cerebrospinal fluid,cerebrospinal fluid albumin,QALB,cerebrospinal fluid IgG,24 hours intrathecal synthesis rate,is likely to be involved in the pathogenesis of MS.Further study of PGRN's role in the mechanism of MS,maybe open another door to the treatment of MS.In the future,a larger sample of clinical research and animal experiments are needed to explore these mechanisms.