The diagnostic value of NR2 antibodies level in patients with chronic cerebral ischemia

Introduction. Hypertension, diabetes mellitus, atherosclerosis, and other risk factors for cardiovascular disease (CVD) contribute to the development of cerebral hypoperfusion and neurotoxicity, leading to recurrent transient ischemic attacks and cerebral infarctions. These processes are accompanied by the release of the NR2 peptide into the bloodstream and the production of antibodies to it. The use of NR2 antibodies to identify and assess the severity of chronic cerebral ischemia (CCI) and the risk of stroke can improve the quality of care for patients with risk factors for CVD.

Aim of the study. To examine the NR2 antibody levels in patients with different CVD risk factors and CCI of varying severity.

Materials and methods. In 107 patients (mean age 60.1 ± 7.9 years, 62 women and 45 men), 1.5T magnetic resonance imaging in the T1, T2, and T2 FLAIR sequences was performed. White matter hyperintensity was assessed using the Fazekas scale, and the size of individual hyperintensity lesions was also estimated. Enzyme immunoassay was used to measure the serum level of NR2 antibodies.

Results. In patients with signs of CCI, serum NR2 antibody levels were significantly higher compared to the patients without cerebrovascular brain disease (p < 0.05). That trend was observed both in compensated cerebral ischemia (p = 0.005) and in decompensated cerebral ischemia (p = 0.001).

Conclusion. The study results indicate that elevated NR2 antibody levels (>2 ng/ml) can be considered a marker associated with the development and progression of cerebral ischemia in patients with risk factors for CVD. Further study of the NR2 peptide and NR2 antibodies in patients with CCI will help optimize the indications for magnetic resonance imaging and improve the interpretation of its results.