Elevated serum levels of the NLRP3 inflammasome are associated with the severity of anti-NMDAR encephalitis in children

作者全名："Yang, Jiaxin; Li, Yuhang; Luo, Hanyu; Ma, Jiannan; Zheng, Yaxin; Zhou, Lvli; Ding, Ran; Meng, Linxue; Zhang, Xiaofang; Jiang, Yan; Li, Xiujuan; Hong, Siqi; Jiang, Li"

作者地址："[Yang, Jiaxin; Li, Yuhang; Luo, Hanyu; Ma, Jiannan; Zheng, Yaxin; Zhou, Lvli; Ding, Ran; Meng, Linxue; Zhang, Xiaofang; Jiang, Yan; Li, Xiujuan; Hong, Siqi; Jiang, Li] Chongqing Med Univ, Childrens Hosp, Natl Clin Res Ctr Child Hlth & Disorders, Dept Neurol,Minist Educ,Key Lab Child Dev & Disor, Chongqing, Peoples R China; [Jiang, Li] Chongqing Med Univ, Dept Neurol, Childrens Hosp, 136 Zhongshan Er Rd, Chongqing 400014, Peoples R China"

通信作者："Jiang, L (通讯作者)，Chongqing Med Univ, Dept Neurol, Childrens Hosp, 136 Zhongshan Er Rd, Chongqing 400014, Peoples R China."

来源：CLINICA CHIMICA ACTA

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001097098600001

JCR分区：Q1

影响因子：5

年份：2023

卷号：551

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：anti-NMDAR encephalitis; NLRP3; Cytokine; modified Rankin Scale; Children

摘要："Background: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is the most common autoimmune encephalitis, mainly impacting young females and children. The involvement of the Nod-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome and related cytokines in pediatric individuals with this condition remains unclear.Methods: We collected information from 27 children who had anti-NMDAR encephalitis and 12 individuals with non-inflammatory neurological disorders as controls. We used an enzyme-linked immunosorbent assay (ELISA) to identify NLRP3 inflammasome, interleukin (IL)-113, and IL-18 expression in cerebrospinal fluid (CSF) and matching serum samples. The modified Rankin Scale (mRS) score was performed throughout the acute phase and at the 6-month follow-up to determine the severity of the disease. The area under the curve (AUC) of the receiver operating characteristic curve was utilized to calculate the prediction efficacy.Results: When compared to controls, individuals with anti-NMDAR encephalitis had significantly increased serum expression of the NLRP3 inflammasome (p < 0.001), IL-113 (p < 0.05), and IL-18 (p < 0.01). In the acute phase, mRS scores were correlated positively with serum levels of NLRP3 inflammasome (p = 0.008), IL-113 (p = 0.023), and IL-18 (p < 0.001). A positive connection was also found between serum levels of NLRP3 inflammasome and IL-113 (p = 0.005). Furthermore, the expression of IL-113 and IL-18 in serum correlated with the 6-month follow-up outcome. The AUC for NLRP3 inflammasome in distinguishing patients with severe neurologic impairments from those with moderate impairments was 0.808 (95 % CI: 0.645-0.972).Conclusion: In our investigation, children with anti-NMDAR encephalitis have more severe first clinical presentations when their serum concentrations of the NLRP3 inflammasome and related cytokines were higher. These findings provide a potential role for the NLRP3 inflammasome pathway in the pathogenesis of NMDAR encephalitis and provide a basis for targeted therapeutic interventions."

基金机构：National Clinical Medical Research Center Clinical General Program in China [NCRCCHD-2022-GP-11]

基金资助正文：This study was supported by the National Clinical Medical Research Center Clinical General Program in China (NCRCCHD-2022-GP-11) .