Expression levels of serum claudin-5 and JKAP in patients with Parkinson's disease and their clinical significance

BIAN Na; LIU Qian; SUN Yangyuan

doi:10.3969/j.issn.1674-3806.2025.02.08

Abstract：Objective To explore the expression levels of serum claudin-5 and c-Jun N-terminal kinase activating protein(JKAP)in patients with Parkinson's disease(PD)and their clinical significance.Methods A total of 85 PD patients(PD group)admitted to the Department of Neurology of Bao Ji People's Hospital from January 2021 to July 2024 were selected.According to Hoehn-Yahr classification,the PD patients were divided into early stage PD group(grade 1-2.5,17 cases),middle stage PD group(grade 3,41 cases),and late stage PD group(grade 4-5,27 cases).Other 85 volunteers who underwent physical examination in Bao Ji People's Hospital during the same period were selected as the control group.The levels of claudin-5 and JKAP in serum were detected by using enzyme-linked immunosorbent assay.According to the scores of PD-Cognitive Rating Scale(PD-CRS),the PD patients were divided into normal cognitive group(＞80 points,28 cases),PD mild cognitive impairment(PD-MCI)group(74-80 points,37 cases)and PD dementia(PDD)group(＜74 points,20 cases).Among them,PD-MCI and PDD belonged to PD cognitive impairment.Spearman rank correlation was used to analyse the correlation of claudin-5 and JKAP levels with the PD patients'Hoehn-Yahr grades.Multivariate logistic regression was used to analyze the influencing factors of cognitive impairment in the PD patients.The efficacy of claudin-5 and JKAP levels for diagnosing cognitive impairment and PDD in the PD patients was analyzed by using receiver operating characteristic(ROC)curve.Results Compared with the control group,the PD group had higher level of claudin-5 and lower level of JKAP,and the differences were statistically significant(P＜0.05).The levels of claudin-5 in the early stage PD group,the middle stage PD group and the late stage PD group were increased in order,while the levels of JKAP in the early stage PD group,the middle stage PD group and the late stage PD group were decreased in order,and the differences were statistically significant(P＜0.05).The Hoehn-Yahr grade in the PD patients was positively correlated with the claudin-5 level(rs=0.810,P＜0.001),and the Hoehn-Yahr grade in the PD patients was negatively correlated with the JKAP level(rs=-0.823,P＜0.001).The disease courses of the normal cognitive group,the PD-MCI group and the PDD group were prolonged in order,and the claudin-5 levels of the normal cognitive group,the PD-MCI group and the PDD group were increased in order,and the JKAP levels of the normal cognitive group,the PD-MCI group and the PDD group were decreased in order,and the differences were statistically significant(P＜0.05).The results of multivariate logistic regression analysis showed that higher claudin-5 level was an independent risk factor for cognitive impairment in the PD patients(P＜0.05),and higher JKAP level was an independent protective factor for cognitive impairment in the PD patients(P＜0.05).The results of ROC curve analysis showed that the combination of claudin-5 and JKAP levels had higher diagnostic efficacy for cognitive impairment[AUC(95％CI)=0.894(0.808-0.950)]and PDD[AUC(95％CI)=0.901(0.793-0.964)]than the single indicator in the PD patients(P＜0.05).Conclusion The level of claudin-5 in the serum of PD patients is increased and the level of JKAP is decreased,which are related to the aggravation of the disease and cognitive impairment.The combined detection of the two indicators is helpful for the diagnosis of cognitive impairment in the PD patients.