Affiliation:
1. Institute for Brain Disorders Beijing University of Chinese Medicine Beijing China
2. Department of Neurology, Dongzhimen Hospital Beijing University of Chinese Medicine Beijing China
3. Department of Neurology The Second Hospital of Hebei Medical University Shijiazhuang China
4. Key Laboratory of Neurology (Hebei Medical University) Ministry of Education Shijiazhuang China
5. Neurological Laboratory of Hebei Province Shijiazhuang China
Abstract
AbstractObjectiveNeuromyelitis optica spectrum disorder (NMOSD) is an autoimmune‐mediated disorder with aquaporin 4‐immunoglobulin G (AQP4‐IgG) in most settings. Soluble programmed death‐1 (sPD‐1) and soluble programmed death ligand 1 (sPD‐L1) play key roles in immunomodulation. We aim to assess the association of sPD‐1 and sPD‐L1 with cytokines and their clinical significance in AQP4‐IgG (+) NMOSD.MethodWe measured plasma sPD‐1, sPD‐L1, and 10 cytokines levels of 66 AQP4‐IgG (+) NMOSD patients, including 40 patients in attack (attack‐NMOSD) and 26 patients in remission (remission‐NMOSD) phases, and 28 healthy controls through ultrasensitive Simoa and SP‐X platform, respectively. We also performed >2 years (median) of follow‐up after testing and analyzed the relationship between the detection index and current and future clinical parameters.ResultPlasma sPD‐1 level discriminated attack‐NMOSD from remission‐NMOSD (AUC = 0.692, p = 0.009). sPD‐1 and sPD‐L1 levels positively correlated with IL‐6 (rsPD‐1 = 0.313; rsPD‐L1 = 0.508), IFN‐γ (rsPD‐1 = 0.331; rsPD‐L1 = 0.456), and TNF‐α (rsPD‐1 = 0.451; rsPD‐L1 = 0.531) expression, as well as clinical indicators, including the EDSS score (rsPD‐1 = 0.331; rsPD‐L1 = 0.402), number of attacks (rsPD‐1 = 0.431) and segments of spinal cord involvement (rsPD‐1 = 0.462; rsPD‐L1 = 0.508). The risk of relapse within 2 years after sampling was associated with higher sPD‐1/sPD‐L1 ratio in attack‐NMOSD (p = 0.022; Exp(B) = 1.589).InterpretationPlasma sPD‐1 and sPD‐L1 levels reflected current disease severity and activity, and predicted future relapses in AQP4‐IgG (+) NMOSD, suggesting that they hold the potential to guide timely and targeted treatment.
Funder
Natural Science Foundation of Beijing Municipality
National Natural Science Foundation of China
Subject
Neurology (clinical),General Neuroscience