Journal
JOURNAL OF NEUROCHEMISTRY
Volume 159, Issue 5, Pages 923-930Publisher
WILEY
DOI: 10.1111/jnc.15497
Keywords
Anti-N-methyl-D-aspartate receptor encephalitis; GSDMD; inflammation; pyroptosis
Categories
Funding
- National Natural Science Foundation of China [82071343, 81701188]
- Natural Science Foundation of Guangdong Province [2021A1515010393, 2017A030313853]
- First Major Talent Project of the Third Affiliated Hospital of Sun Yat-Sen University [P02099]
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This study found that serum levels of GSDMD are elevated in patients with anti-NMDAR encephalitis and are associated with disease prognosis. After treatment, GSDMD levels decreased and clinical symptoms improved in patients, indicating a potential role of GSDMD in monitoring and predicting disease progression of anti-NMDAR encephalitis.
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disease of the central nervous system. Gasdermin D (GSDMD) is associated with autoimmune disorders and neuroinflammatory disorders, but its role in anti-NMDAR encephalitis is unclear. In this study, we measured serum levels of GSDMD in 42 patients with anti-NMDAR encephalitis and 25 healthy controls. Of the 42 patients, 17 had follow-up evaluation of GSDMD levels and modified Rankin scale (mRS) scores at 3 months. Association of GSDMD with anti-NMDAR encephalitis and its clinical parameters were evaluated. Serum GSDMD levels were significantly higher in patients with anti-NMDAR encephalitis than in healthy controls (p = 0.002, p(adjusted) = 0.009), especially in males (p = 0.001, p(adjusted) = 0.022). This was also evident in patients with severe impairment (mRS >3 vs mRS <= 3; p < 0.001). Serum GSDMD was associated with mRS before and after adjustment for age and gender (r = 0.440 and 0.430, p = 0.004 and 0.006, respectively) as well as serum CH50 (r = -0.419 and -0.426, p = 0.011 and 0.012, respectively). Furthermore, 3-month follow-up evaluation revealed that after treatment, anti-NMDAR encephalitis patients had significantly decreased serum GSDMD levels (p = 0.007) and significantly decreased mRS scores (p = 0.002) compared with before treatment. Furthermore, the changes in mRS scores were negatively associated with changes in GSDMD levels, although the associations were not significant (r = -0.222, p = 0.393). Our findings show that serum GSDMD levels are elevated in anti-NMDAR encephalitis and are associated with disease prognosis.
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