Correlations of serum AChE and IL-17 in patients with herpes simplex encephalitis with cognitive function impairment

doi:10.3969/j.issn.1673-8640.2023.08.003

Abstract

Abstract:

Objective To investigate the correlation between serum acetylcholinesterase（AChE） and interleukin（IL）-17 levels and cognitive function impairment in patients with herpes simplex encephalitis（HSE）. Methods A total of 159 HSE patients（HSE group） in Handan Central Hospital from March 2019 to March 2021 were enrolled. The patients were classified into cognitive impairment group（69 cases） and cognitive normal group（90 cases） according to whether cognitive function impairment occurred. According to the score of the mini-mental state examination（MMSE），the patients with cognitive function impairment were classified into mild group（23 cases，MMSE score 20-25），moderate group（30 cases，MMSE score 11-19） and severe group（16 cases，MMSE score ≤10）. A total of 65 healthy subjects were enrolled as control group. Serum AChE and IL-17 levels were determined. Pearson correlation analysis was used to evaluate the correlation of AChE and IL-17 with Montreal cognitive assessment（MoCA） scores and MMSE scores. Receiver operating characteristic（ROC） curves were used to analyze the efficacy of AChE and IL-17 in diagnosing cognitive function impairment in HSE patients. Results Serum AChE and IL-17 levels in HSE group were higher than those in control group（P<0.05）. The levels of serum AChE and IL-17 in cognitive impairment group were higher than those in cognitive normal group（P<0.05）. The levels of serum AChE and IL-17 in severe group were higher than those in moderate group and mild group（P<0.05），and the levels of serum AChE and IL-17 in moderate group were higher than those in mild group（P<0.05）. The levels of serum AChE and IL-17 were negatively correlated with MoCA score in cognitive impairment group（r values were -0.311 and -0.480，P<0.01），and they were negatively correlated with MMSE score（r values were -0.349 and -0.447，P<0.01）. The areas under curves（AUC） of serum AChE and IL-17 single and combined determinations for the diagnosis of cognitive function impairment in HSE patients were 0.689，0.724 and 0.893，respectively. Conclusions Serum AChE and IL-17 levels in HSE patients are correlated with cognitive function impairment and can be used to assess the severity of cognitive function impairment.

Key words: Acetylcholinesterase, Interleukin-17, Herpes simplex virus, Viral encephalitis, Cognitive function impairment

CLC Number:

R446.1

HE Long, WANG Sha, CHENG Liping, LIAO Ziwei, WANG Donghong. Correlations of serum AChE and IL-17 in patients with herpes simplex encephalitis with cognitive function impairment[J]. Laboratory Medicine, 2023, 38(8): 719-724.

Figures/Tables 6

References 22

[1]	PIRET J, BOIVIN G. Immunomodulatory strategies in herpes simplex virus encephalitis[J]. Clin Microbiol Rev, 2020, 33(2):e00105-e00119.
[2]	秦灵芝, 李玮, 王晓娟, 等. 计算机辅助认知训练对单纯疱疹病毒性脑炎患者认知功能的影响[J]. 中华物理医学与康复杂志, 2020, 42(4):328-331.
[3]	SHARMA K. Cholinesterase inhibitors as Alzheimer's therapeutics(review)[J]. Mol Med Rep, 2019, 20(2):1479-1487. DOI
[4]	TRENOVA A G, SLAVOV G S, DRAGANOVA-FILIPOVA M N, et al. Circulating levels of interleukin-17A,tumor necrosis factor-alpha,interleukin-18,interleukin-10,and cognitive performance of patients with relapsing-remitting multiple sclerosis[J]. Neurol Res, 2018, 40(3):153-159. DOI URL
[5]	余婕, 郭虎, 郑帼. 病毒性脑炎患儿的管理[J]. 中华实用儿科临床杂志, 2015, 30(23):1838-1840.
[6]	CARSON N, LEACH L, MURPHY K J. A re-examination of Montreal Cognitive Assessment(MoCA) cutoff scores[J]. Int J Geriatr Psychiatry, 2018, 33(2):379-388. DOI URL
[7]	LI H, JIA J, YANG Z. Mini-mental state examination in elderly Chinese:a population-based normative study[J]. J Alzheimers Dis, 2016, 53(2):487-496. DOI URL
[8]	张美燕, 王华丽, 李涛, 等. 精神科记忆门诊阿尔茨海默病患者的精神行为症状[J]. 中国心理卫生杂志, 2011, 25(4):259-264.
[9]	SHOAIB M, KRAUS J J, KHAN M T. Herpes simplex virus encephalitis:atypical presentation as a right middle cerebral artery stroke[J]. Cureus, 2018, 10(1):e2067.
[10]	秦灵芝, 李玮, 王晓娟, 等. 计算机辅助认知训练对单纯疱疹病毒性脑炎患者认知功能的影响[J]. 中华物理医学与康复杂志, 2020, 42(4):328-331.
[11]	ITZHAKI R F. Herpes simplex virus type 1 and Alzheimer's disease:possible mechanisms and signposts[J]. FASEB J, 2017, 31(8):3216-3226. DOI URL
[12]	DUARTE L F, FARÍAS M A, ÁLVAREZ D M, et al. Herpes simplex virus type 1 infection of the central nervous system:insights into proposed interrelationships with neurodegenerative disorders[J]. Front Cell Neurosci, 2019, 13:46.
[13]	FRUCHTER E, GOLDBERG S, FENCHEL D, et al. The impact of herpes simplex virus type 1 on cognitive impairments in young,healthy individuals-a historical prospective study[J]. Schizophr Res, 2015, 168(1-2):292-296. DOI URL
[14]	MOSS D E. Improving anti-neurodegenerative benefits of acetylcholinesterase inhibitors in Alzheimer's disease:are irreversible inhibitors the future?[J]. Int J Mol Sci, 2020, 21(10):3438. DOI URL
[15]	CAVALCANTE S F A, SIMAS A B C, BARCELLOS M C, et al. Acetylcholinesterase:the "hub" for neurodegenerative diseases and chemical weapons convention[J]. Biomolecules, 2020, 10(3):414. DOI URL
[16]	ZHANG Q, LI A, HE S, et al. Serum total cholinesterase activity on admission is associated with disease severity and outcome in patients with traumatic brain injury[J]. PLoS One, 2015, 10(6):e0129082. DOI URL
[17]	姜文佳. 骨关节炎患者血清1,25(OH)₂D₃、IL-17和IL-10水平的变化及临床意义[J]. 检验医学, 2019, 34(3):202-205.
[18]	BERNINK J H, OHNE Y, TEUNISSEN M B M, et al. c-Kit-positive ILC2s exhibit an ILC3-like signature that may contribute to IL-17-mediated pathologies[J]. Nat Immunol, 2019, 20(8):992-1003. DOI PMID
[19]	CHAMOUN M N, BLUMENTHAL A, SULLIVAN M J, et al. Bacterial pathogenesis and interleukin-17:interconnecting mechanisms of immune regulation,host genetics,and microbial virulence that influence severity of infection[J]. Crit Rev Microbiol, 2018, 44(4):465-486. DOI URL
[20]	GRYGORCZUK S, WIERZBISKA R, KONDRUSIK M, et al. The intrathecal expression and pathogenetic role of Th17 cytokines and CXCR2-binding chemokines in tick-borne encephalitis[J]. J Neuroinflammation, 2018, 15(1):115. DOI
[21]	SUN L, ZHANG H, WANG W, et al. Astragaloside Ⅳ exerts cognitive benefits and promotes hippocampal neurogenesis in stroke mice by downregulating interleukin-17 expression via Wnt pathway[J]. Front Pharmacol, 2020, 11:421. DOI URL
[22]	NI P, DONG H, WANG Y, et al. IL-17A contributes to perioperative neurocognitive disorders through blood-brain barrier disruption in aged mice[J]. J Neuroinflammation, 2018, 15(1):332. DOI

组别	例数	性别		年龄/岁	BMI/ （kg/m²）	文化程度/%				AChE/ （U/mL）	IL-17/ （pg/mL）
组别	例数	男/例	女/例	年龄/岁	BMI/ （kg/m²）	小学/ [例（%）]	初中/ [例（%）]	高中/ [例（%）]	大学/ [例（%）]	AChE/ （U/mL）	IL-17/ （pg/mL）
轻度组	23	13	10	45.02±7.51	23.76±0.75	2 （8.70）	5（21.74）	8（34.78）	8（34.78）	66.05±1.39	15.35±0.49
中度组	30	19	11	45.12±7.09	23.80±0.80	4 （13.33）	14（46.67）	9（30.00）	3（10.00）	68.64±3.06^*	17.09±1.63^*
重度组	16	10	6	45.22±7.18	24.16±0.71	3 （18.75）	9（56.25）	2（12.50）	2（12.50）	71.72±0.47^*#	19.29±0.06^*#
统计值		0.277		0.004	1.597	10.496				31.666	58.776
P值		0.871		0.996	0.211	0.105				<0.01	<0.01

组别	例数	性别		年龄/岁	BMI/ （kg/m²）	文化程度/%				AChE/ （U/mL）	IL-17/ （pg/mL）
组别	例数	男/例	女/例	年龄/岁	BMI/ （kg/m²）	小学/ [例（%）]	初中/ [例（%）]	高中/ [例（%）]	大学/ [例（%）]	AChE/ （U/mL）	IL-17/ （pg/mL）
轻度组	23	13	10	45.02±7.51	23.76±0.75	2 （8.70）	5（21.74）	8（34.78）	8（34.78）	66.05±1.39	15.35±0.49
中度组	30	19	11	45.12±7.09	23.80±0.80	4 （13.33）	14（46.67）	9（30.00）	3（10.00）	68.64±3.06^*	17.09±1.63^*
重度组	16	10	6	45.22±7.18	24.16±0.71	3 （18.75）	9（56.25）	2（12.50）	2（12.50）	71.72±0.47^*#	19.29±0.06^*#
统计值		0.277		0.004	1.597	10.496				31.666	58.776
P值		0.871		0.996	0.211	0.105				<0.01	<0.01

项目	AUC（95%CI^①）	最佳临界值	P值	敏感性/%	特异性/%	约登指数
AChE	0.689（0.611~0.760）	65.03 U/mL	<0.01	69.57	68.89	0.384 6
IL-17	0.724（0.648~0.792）	16.42 pg/mL	<0.01	73.91	72.22	0.461 3
联合检测模型	0.893（0.835~0.937）	0.51	<0.01	89.86	90.00	0.798 6

项目	AUC（95%CI^①）	最佳临界值	P值	敏感性/%	特异性/%	约登指数
AChE	0.689（0.611~0.760）	65.03 U/mL	<0.01	69.57	68.89	0.384 6
IL-17	0.724（0.648~0.792）	16.42 pg/mL	<0.01	73.91	72.22	0.461 3
联合检测模型	0.893（0.835~0.937）	0.51	<0.01	89.86	90.00	0.798 6