Journal
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
Volume 24, Issue 13, Pages -Publisher
MDPI
DOI: 10.3390/ijms241311196
Keywords
amyotrophic lateral sclerosis; QAlb; central nervous system barrier; C9orf72; blood-brain barrier; spinal cord barrier
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This study found that impairment of the central nervous system (CNS) barrier is present in amyotrophic lateral sclerosis (ALS) patients, indicating its potential significance in the disease. Elevated levels of QAlb were observed in a large cohort of patients, with a higher proportion in males compared to females. QAlb levels were associated with ALS functional rating scale-revised (ALSFRS-r) in male patients and were significantly associated with survival in male patients.
Central nervous system (CNS) barrier impairment has been reported in amyotrophic lateral sclerosis (ALS), highlighting its potential significance in the disease. In this context, we aim to shed light on its involvement in the disease, by determining albumin quotient (QAlb) at the time of diagnosis of ALS in a large cohort of patients. Patients from the university hospital of Tours (n = 307) were included in this monocentric, retrospective study. In total, 92 patients (30%) had elevated QAlb levels. This percentage was higher in males (43%) than in females (15%). Interestingly, QAlb was not associated with age of onset, age at sampling or diagnostic delay. However, we found an association with ALS functional rating scale-revised (ALSFRS-r) at diagnosis but this was significant only in males. The QAlb levels were not linked to the presence of a pathogenic mutation. Finally, we performed a multivariate survival analysis and found that QAlb was significantly associated with survival in male patients (HR = 2.3, 95% CI = 1.2-4.3, p = 0.009). A longitudinal evaluation of markers of barrier impairment, in combination with inflammatory biomarkers, could give insight into the involvement of CNS barrier impairment in the pathogenesis of the disease. The gender difference might guide the development of new drugs and help personalise the treatment of ALS.
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