Zhongguo linchuang yanjiu (Dec 2022)
Correlation between serum AQP-4 antibody, inflammatory cytokines and recurrence of neuromyelitis optica in patients with chronic insomnia
Abstract
Objective To investigate the levels of serum aquaporin 4(AQP-4) antibodies and cytoinflammatory factors in patients with neuromyelitis optica(NMO) complicated with chronic insomnia and their correlation with the recurrence of NMO. Methods A total of 103 NMO patients diagnosed in the Department of Neurology of Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from February 2017 to June 2019 were selected for retrospective study. The patients were divided into insomnia group(n=54) and non-insomnia group(n=49) according to whether there was chronic insomnia. Serum AQP-4 antibody, interleukin(IL)-6, and IL-27 levels were detected in the two groups. The recurrence rate, number of spinal cord involved segments, and extended disability status score(EDSS) in the two groups were followed up for 2 years. Receiver operating characteristic curve(ROC) was used to calculate serum AQP-4 antibody, IL-6 and IL-27 levels to predict the diagnostic value of recurrence in NMO patients. Results The level of serum AQP-4 antibody and IL-6 in insomnia group was significantly higher than that in non-insomnia group(P＜0.05), and the level of IL-27 was significantly lower than that in non-insomnia group(P＜0.05). The relapse rate of NMO in the insomnia group was significantly higher than that in the non-insomnia group within 2 years(46.3% vs 20.4%, P＜0.05), and the number of involved segments of spinal cord and EDSS score in the relapse group were significantly higher than those in the non-insomnia group(P＜0.05). The area under the ROC curve(AUC) and 95%CI of serum AQP-4 antibody, IL-6 and IL-27 for predicting NMO recurrence were 0.867(0.738-0.984), 0.853(0.776-0.924) and 0.850(0.710-0.981), respectively. The annual non-recurrence rate of NMO2 was higher in patients with low AQP-4 antibody, low IL-6 and high IL-6 levels than in patients with high AQP-4 antibody, high IL-6 and low IL-27 levels(P＜0.05). Conclusion The recurrence of NMO is related to chronic insomnia, which may be related to the increase of serum AQP-4 antibody and IL-6 and the decrease of IL-27 caused by long-term chronic insomnia. Chronic insomnia has an important value in indicating the recurrence of NMO within 2 years.
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