Study On Specific Markers Of Peripheral Serum In Adult Patients With Moyamoya Disease And Construction Of Risk Model

Background:Moyamoya disease(MMD)has a high morbidity and mortality rate,and there is still a lack of effective screening methods.We aims to explore the specific markers in peripheral blood of adult patients with moyamoya disease,such as VEGF(vascular endothelial growth factor),b FGF(basic fibroblast growth factor),TGF-beta(transforming growth factor beta),etc.,and to build a related risk model based on them,so as to provide some reference for the early screening,prevention and evaluation of moyamoya disease.Method:Retrospective analysis was performed on 20 patients(study group)who were diagnosed as MMD by DSA or MRA or CTA in the Department of Neurosurgery of the Second Affiliated Hospital of Nanchang University from June2019 to December 2019,and 15 healthy adults(control group)who were confirmed as having no obvious abnormalities in intracranial blood vessels by DSA or MRA or CTA in our hospital.At the same time,5ml of venous blood from the study group and the control group were collected for ELISA test to determine the plasma concentration of the above specific markers,so as to test the general characteristics of the above specific markers.Specific clinical data were collected,including gender,age,smoking history,drinking history,hypertension,unilateral and bilateral moyamoya disease,stage of moyamoya disease,etc.Patients included in the study were followed up.Prognosis of patients in the experimental group was evaluated based on improvement of ASL perfusion during follow-up.Finally,a risk model related to prognostic perfusion improvement was established by Lasso regression model based on the specific markers in patients’ plasma and the improvement of postoperative ASL perfusion and the improvement time.Results:In this study,HGF,IL-1β,TGFβ and SDF-1α were not significantly different between the moyamoya disease group and the healthy group.VEGF,PDGF-BB,HIF-1α,MMP-9,MMP-3,TIMP-1 and TIMP-2 were significantly different in both healthy people and patients with moyamoya disease and in different Suzuki grades.Although b FGF and IL-1β were not significantly different from the normal group,there were significant differences between different Suzuki grades.Enrichment analysis showed that the main occurrence and development of moyamoya disease was related to the growth and migration of vascular endothelium and the proliferation of smooth muscle.At the same time,HIF-1A,MMP-9,MMP-3,PDGF-BB and VEGF,five specific markers screened by Lasso regression model,can be divided into the good prognosis group and the poor prognosis group.The postoperative perfusion improvement rate of the good prognosis group is significantly higher than the poor prognosis group between the two groups.The improvement time was significantly shorter than that of the poor prognosis group.Finally,we found that the compensatory condition of posterior circulation was closely related to the improvement of postoperative perfusion,and patients with compensatory condition of posterior circulation usually had a better prognosis.Conclusions:In this study,we constructed a prognostic model with certain predictive function to reveal the expression,function and prognostic potential of these plasma specific markers in patients with moyamoya disease.These specific markers may become new biomarkers and therapeutic targets for the occurrence and development of moyamoya disease and can be used for early screening and postoperative evaluation.