Kuwonongeka kwa Maselo a Ubongo Kwapamwamba kwa Odwala a COVID-19 kuposa Odwala a Alzheimer's

Chofunika kwambiri, lipoti laposachedwa, lofalitsidwa pa intaneti Januware 13 mu Alzheimer's & Dementia: The Journal of the Alzheimer's Association, idachitika miyezi iwiri koyambirira kwa mliriwu (Marichi-Meyi 2020). Kutsimikiza kulikonse ngati odwala omwe ali ndi COVID-19 ali pachiwopsezo chowonjezereka cha matenda a Alzheimer's mtsogolo, kapena m'malo mwake achire pakapita nthawi, kuyenera kuyembekezera zotsatira zamaphunziro anthawi yayitali.

Motsogozedwa ndi ofufuza ku NYU Grossman School of Medicine, kafukufuku watsopanoyu adapeza milingo isanu ndi iwiri yakuwonongeka kwaubongo (neurodegeneration) mwa odwala a COVID-19 omwe ali ndi minyewa kuposa omwe alibe, komanso kuchuluka kwa odwala omwe adamwalira m'chipatala kuposa omwe alibe. mwa iwo otulutsidwa ndi kutumizidwa kwawo.

Kuwunika kwachiwiri kunapeza kuti kagawo kakang'ono ka zowonongeka mwa odwala omwe adagonekedwa m'chipatala ndi COVID-19, pakanthawi kochepa anali okwera kwambiri kuposa odwala omwe adapezeka ndi matenda a Alzheimer's, ndipo nthawi imodzi adakwera kuwirikiza kawiri. 

"Zomwe tapeza zikuwonetsa kuti odwala omwe agonekedwa m'chipatala chifukwa cha COVID-19, makamaka omwe ali ndi vuto la minyewa panthawi yomwe ali ndi vuto lalikulu, amatha kukhala ndi zolembera zovulala muubongo zomwe zimakhala zokwera kwambiri, kapena kuposa, zomwe zimawonedwa mwa odwala omwe ali ndi matenda a Alzheimer's," akuti wolemba wamkulu Jennifer A. Frontera, MD, pulofesa ku Dipatimenti ya Neurology ku NYU Langone Health. 

Kapangidwe / Tsatanetsatane                                                    

Kafukufuku wapano adazindikira odwala 251 omwe, ngakhale ali ndi zaka 71 zakubadwa pafupifupi, analibe mbiri kapena zizindikiro zakuchepa kwachidziwitso kapena dementia asanagoneke m'chipatala ku COVID-19. Odwalawa adagawika m'magulu omwe ali ndi komanso opanda zizindikiro zamanjenje panthawi yomwe ali ndi vuto la COVID-19, pomwe odwala adachira ndikutulutsidwa, kapena kufa.

Gulu lofufuzalo, ngati kuli kotheka, linafanizira zolembera m'gulu la COVID-19 ndi odwala a NYU Alzheimer's Disease Research Center (ADRC) Clinical Core cohort, kafukufuku wopitilira, wanthawi yayitali ku NYU Langone Health. Palibe m'modzi mwa odwala 161 owongolera awa (54 mwachidziwitso, 54 omwe anali ndi vuto la kuzindikira pang'ono, ndipo 53 omwe adapezeka ndi matenda a Alzheimer's) anali ndi COVID-19. Kuvulala muubongo kunayesedwa pogwiritsa ntchito ukadaulo wa single molecule array (SIMOA), yomwe imatha kuyang'anira kuchuluka kwa magazi a zolembera za neurodegeneration mu ma pickogram (gawo limodzi mwathililiyoni imodzi ya gramu) pa mililita imodzi ya magazi (pg/ml), pomwe matekinoloje akale sakanatha.

Zitatu mwazolemba zowerengera - ubiquitin carboxy-terminal hydrolase L1 (UCHL1), total tau, ptau181 - ndi miyeso yodziwika ya kufa kapena kulepheretsa ma neuroni, maselo omwe amalola njira za mitsempha kunyamula mauthenga. Miyezo ya neurofilament light chain (NFL) imawonjezeka ndi kuwonongeka kwa ma axon, zowonjezera za neuroni. Glial fibrillary acidic protein (GFAP) ndi muyeso wa kuwonongeka kwa ma cell a glial, omwe amathandizira ma neuron. Amyloid Beta 40 ndi 42 ndi mapuloteni omwe amadziwika kuti amamanga odwala matenda a Alzheimer's. Zotsatira za kafukufuku wam'mbuyomu zimanena kuti tau ndi phosphorylated-tau-181 (p-tau) ndizodziwikanso za matenda a Alzheimer's, koma gawo lawo mu matendawa likadali nkhani yotsutsana. 

Zolemba zamagazi m'gulu la odwala a COVID zidayezedwa mu seramu yamagazi (gawo lamadzi lomwe lapangidwa kuti litseke), pomwe zomwe zili mu kafukufuku wa Alzheimer's zidayezedwa mu plasma (gawo lamagazi lamadzimadzi lomwe limatsalira likatsekeredwa). Pazifukwa zaukadaulo, kusiyana kumatanthauza kuti magawo a NFL, GFAP, ndi UCHL1 atha kufananizidwa pakati pa gulu la COVID-19 ndi odwala mu kafukufuku wa Alzheimer's, koma tau yonse, ptau181, Amyloid beta 40, ndi amyloid beta 42 zitha kufananizidwa mkati. gulu la odwala COVID-19 (zizindikiro za neuro kapena ayi; kufa kapena kutulutsa).

Kupitilira apo, mulingo waukulu wa kuwonongeka kwa minyewa mwa odwala a COVID-19 unali toxic metabolic encephalopathy, kapena TME, yokhala ndi zisonyezo kuchokera ku chisokonezo mpaka chikomokere, komanso chifukwa chodwala kwambiri ndi poizoni wopangidwa ndi chitetezo chamthupi (sepsis), impso zimalephera (uremia) , ndipo kuperekedwa kwa okosijeni kumasokonekera (hypoxia). Mwachindunji, kuchuluka kwa kuchuluka kwa magawo asanu ndi awiri kwa odwala omwe ali m'chipatala omwe ali ndi TME poyerekeza ndi omwe alibe zizindikiro zaubongo (chithunzi cha 2 mu phunziroli) chinali 60.5 peresenti. Kwa zolembera zomwezo m'gulu la COVID-19, chiwonjezeko chapakati pakuyerekeza omwe atulutsidwa bwino m'chipatala ndi omwe adamwalira m'chipatala chinali 124 peresenti.

Zomwe zapezedwa zinachokera pakuyerekeza magawo a NFL, GFAP ndi UCHL1 mu seramu ya odwala a COVID-19 motsutsana ndi zolembera zomwezo mu plasma ya odwala omwe si a COVID Alzheimer's (chithunzi 3). NFL idakwera kwakanthawi kochepa 179 peresenti (73.2 motsutsana ndi 26.2 pg/ml) mwa odwala a COVID-19 kuposa odwala a Alzheimer's. GFAP inali yokwera ndi 65 peresenti (443.5 motsutsana ndi 275.1 pg/ml) mwa odwala a COVID-19 kuposa odwala a Alzheimer's, pomwe UCHL1 inali yokwera ndi 13 peresenti (43 motsutsana ndi 38.1 pg/ml).

"Kuvulala koopsa muubongo, komwe kumalumikizidwanso ndi kuchuluka kwa zolembera izi, sizitanthauza kuti wodwala ayamba kudwala matenda a Alzheimer's kapena dementia pambuyo pake, koma kumawonjezera ngozi," akutero wolemba wamkulu Thomas M. Wisniewski, MD, the Gerald J. ndi Dorothy R. Friedman Pulofesa mu Dipatimenti ya Neurology ndi mkulu wa Center for Cognitive Neurology ku NYU Langone. "Kaya ubale woterewu ulipo mwa iwo omwe apulumuka COVID-19 ndi funso lomwe tiyenera kuyankha mwachangu ndikuwunika odwalawa."

Pamodzi ndi Dr. Olemba a Frontera ndi Wisniewski, NYU Langone Health anali wolemba woyamba Allal Boutajangout, Arjun Masurkarm, Yulin Ge, Alok Vedvyas, Ludovic Debure, Andre Moreira, Ariane Lewis, Joshua Huang, Sujata Thawani, Laura Balcer, ndi Steven Galetta. Wolembanso anali Rebecca Betensky ku New York University School of Global Public Health. Kafukufukuyu adathandizidwa ndi thandizo lochokera ku National Institute on Aging COVID-19 administrative supplement 3P30AG066512-01.