RISULTATI E DISCUSSIONE
6.4 Livelli intrapiastrinici di BDNF
In figura (Illustrazione 22) riportiamo la retta di taratura ottenuta mediante il kit di determinazione del BDNF.
Illustrazione 22: Retta di calibrazione del dosaggio del BDNF.
I dati relativi al BDNF piastrinico sia nei controlli (C) che nei pazienti (HD) sono stati interpolati dalla retta di taratura e riportati come pg/ml di omogenato. Poiché l’omogenato era stato diluito 1:8 prima del dosaggio, i valori ottenuti sono stati poi tutti corretti per il fattore di diluizione.
82 CONTROLLI, BDNF pg/mg proteine tot. PAZIENTI, BDNF pg/mg proteine tot.
C1 2385,22 HD 1 3563,33 C2 1050,63 HD 2 4378,96 C3 2525,72 HD 3 3350,64 C4 1261,24 HD 4 3544,62 C5 2706,48 HD 5 3005,92 C6 2243,49 HD 6 2061,03 C7 3670,04 HD 7 3439,90 C8 2058,85 HD 8 3895,00 C9 4432,75 HD 9 2285,31 C10 1602,94 HD 10 2046,95 C11 1832,52 HD 11 3147,60 HD 12 2144,38 HD 13 2438,13
Tabella 6: Valori di BDNF intrapiastrinico nei controlli e nei pazienti.
Per una misura più accurata del BDNF contenuto all'interno delle piastrine, tali valori sono stati poi tutti rapportati alla quantità di proteine totali misurate nel sovranatante piastrinico, per normalizzare le concentrazioni in funzione della notevole variabilità del numero di piastrine tra campioni di soggetti diversi. Dai pg/ml di BDNF abbiamo quindi ottenuto i pg di BDNF/mg di proteine totali (Tabella 6).
Esprimendo i dati come pg/mg di proteine totali, le quantità medie di BDNF intrapiastrinico riscontrate nei pazienti sono risultate leggermente superiori (Media ± SEM: 3023 ± 212 pg/mg proteine) rispetto alle quantità medie ottenute nei controlli (2343 ± 302 pg/mg proteine). Questa differenza è risultata quasi significativa (t-test p = 0.072), indicando una tendenza verso livelli di BDNF intrapiastrinici più elevati nei pazienti con HD (Illustrazione 23).
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Illustrazione 23: Confronto tra BDNF intrapiastrinico nei controlli e nei pazienti
Infine, questo parametro non ha dato correlazioni significative con i tests psicocognitivi e di comportamento sociale (Pearson, p >0.05); i livelli piastrinici di BDNF non hanno correlato neanche con la scala UHDRS, con l’età, la scolarità e l’età di esordio della malattia (Pearson, p >0.05).
Una correlazione significativa e positiva è stata invece osservata tra i livelli di BDNF nelle piastrine dei pazienti e la durata della malattia (Illustrazione 24).
Illustrazione 24: Correlazione tra i livelli di BDNF nelle piastrine dei pazienti
e la durata della malattia
Infine, le correlazioni tra i 3 parametri valutati, binding del SERT
0 5 10 15 20 0 1000 2000 3000 4000 5000 r = 0.64; p=0.025
durata malattia (anni)
B D N F p ia s ti n ic o , p g /m g p ro te in e t o ta li
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piastrinico, livelli plasmatici di OT e il BDNF intrapistrinico non sono risultate significative, né esaminando i soggetti nella loro totalità, né separandoli nei due gruppi di confronto (p > 0.05).
CONCLUSIONI
I risultati clinici di questo studio hanno rivelato che i pazienti con HD mostrano una minore percezione emotiva e abilità al riconoscimento delle espressioni dei volti rispetto ai soggetti di controllo.
Per quanto riguarda i parametri biochimici presi in esame, i valori di densità ed affinità del SERT piastrinico sono risultati debolmente inferiori e maggiori, rispettivamente, nei pazienti rispetto ai controlli. I livelli di OT plasmatica prima e dopo la somministrazione dei tests psicosociali erano invece mediamente inferiori nei pazienti rispetto ai soggetti di controllo, mentre il BDNF intrapiastrinico risultava più elevato nei malati. L’insieme di questi dati potrebbe suggerire un diverso stato del SERT piastrinico, accompagnato da minor OT circolante e da un incrementato accumulo di BDNF all’interno delle piastrine, nella Corèa. Queste differenze non sono risultate tuttavia statisticamente significative, salvo il risultato molto vicino alla soglia di significatività relativo allo “storage” di BDNF piastrinico nei pazienti, impedendo quindi di trarre conclusioni definitive. La scarsa numerosità dei soggetti valutati e la variabilità interindividuale dei parametri biochimici misurati potrebbero aver influenzato l'esito dell'analisi statistica.
Sono risultate invece significative le correlazioni tra i parametri del SERT e dell'OT e le scale di valutazione neuropsicologiche: i valori più bassi di OT sono stati riscontrati nel plasma di pazienti con minori
85
abilità nel riconoscimento delle espressioni facciali negative, mentre l'affinità del SERT si riduceva al peggiorare delle capacità di riconoscimento di precise espressioni dei volti.
I livelli di BDNF accumulato nelle piastrine non erano invece correlati con nessun test neuropsicologico ma solo, in senso positivo, con la durata della malattia.
Riassumendo non possiamo del tutto escludere che 5-HT, OT e BDNF misurati a livello periferico possano avere una rilevanza di indicatori del quadro sintomatologico della patologia.
Lo studio necessita di ulteriori indagini incrementando il numero dei soggetti reclutati nelle diverse fasi di malattia, cercando anche di controllare tutti i fattori di variabilità individuale, nei limiti consentiti dalla rarità della Còrea.
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