Expression And Clinical Significance Of Immune Cells And Related Cytokines In Demyelinating Diseases

Objective:To analyze the immune cells in the peripheral blood of patients with multiple sclerosis(MS),neuromyelitis optica spectrum diseases(NMOSD),and Guillain-Barre syndrome(GBS)The difference in expression and the expression and clinical significance of 12 cytokines in the serum of NMOSD patients,to evaluate the application value of immune cells and related cytokines in the diagnosis and differential diagnosis of immune demyelinating neurological diseases,and to provide the pathogenesis and early stage of this type of disease Provide theoretical basis for diagnosis and treatment.Methods:Enrolled 73 patients who were hospitalized and diagnosed in the Department of Neurology,Jiangxi Provincial People’s Hospital and the First Affiliated Hospital of Nanchang University from 2018 to 2020,including 21 MS patients,23NMOSD patients and 29 GBS patients,and selected them in Jiangxi during the same period The 40 healthy persons undergoing physical examination at the Provincial People’s Hospital served as the healthy control group(Health Control,HC).Flow cytometry was used to analyze the peripheral blood lymphocyte subsets(CD4~+T,CD8~+T,i NKT,NKT,γδT,B).,NK,Treg)percentage and cell count.Include 12NMOSD patients who were hospitalized and diagnosed in the Department of Neurology,Jiangxi Provincial People’s Hospital and the First Affiliated Hospital of Nanchang University from 2018 to 2020,and 15 healthy physical examination subjects matched with their age and gender,using multiple microsphere flow immunofluorescence luminescence Method to detect 12 cytokines(IL-5,IFN-α,IL-2,IL-6,IL-1β,IL-10,IFN-γ,IL-8,IL-17,IL-4.IL-12P70,TNF-α)levels.Use SPSS25.0to perform statistical processing on the data,and graph with Graphpad prism8.Analyze the differences in the expression of immune cells and cytokines in different diseases and their correlation with the severity of the disease.Results:1.Peripheral blood NKT cell count,γδT cell percentage and absolute count of MS patients were significantly higher than those of healthy people(P=0.014;P=0.020;P=0.013),B cell percentage and cell count were significantly higher than those of HC group High(P<0.001;P<0.001);the percentage and absolute count of NK cells were lower than those in the HC group(P=0.001;P=0.001).The disease course and EDSS score of MS patients were significantly positively correlated with the percentage of NK cells(r=0.588,P=0.005;r=0.606,P=0.004).2.The percentage of CD8+T in the peripheral blood of NMOSD patients was significantly higher than that of the HC group(P=0.035);the percentage and count of B cells were significantly higher than those of the HC group(P=0.001;P=0.045);the percentage and count of NK cells All were significantly lower than the HC group(P=0.007;P<0.001).There was no statistically significant difference in the expression of immune cells between positive and negative serum anti-AQP4 antibodies.There was no correlation between the course of disease and serum anti-AQP4 antibody titers in patients with NMOSD and the level of immune cells.The EDSS score was positively correlated with the percentage of CD4+T cells and the ratio of CD4+T/CD8+T(r=0.461,P=0.027;r=0.437,P=0.037).3.The percentage and count of B cells in the GBS group were significantly higher than those in the HC group(P=0.001;P=0.012);while the percentage and count of NK cells were significantly lower than those in the HC group(P=0.025;P=0.001).There was no significant difference in the expression levels of immune cells between mild and severe GBS patients.The Hughes score of GBS patients was positively correlated with the percentage of NK cells(r=0.394,P=0.034),and the course of the disease was negatively correlated with the percentage and count of B cells,and the count of Treg cells(r=-0.432,P=0.022;r=-0.442,P=0.016;r=-0.445,P=0.029).4.Peripheral blood NKT cell count andγδT cell percentage and count in NMOSD patients were lower than those in MS group(P=0.007;P=0.034;P=0.002).When the percentage ofγδT cells is less than 6.51%,the cell count is less than 47.50/μL,and the NKT cell count is less than 58.00/μL,NMOSD should be considered.5.The percentage and count ofγδT cells in MS patients were significantly higher than those in GBS patients(P=0.018;P=0.034).6.The expression of IL-5 and IL-10 in the serum of NMOSD patients was lower than that of healthy people(P=0.005;P=0.001),while the expressions of IL-6,IL-4,and IL-12P70 were significantly higher than those of healthy people(P=0.045;P=0.004;P<0.001).In addition,the expressions of IL-5 and IL-10,IL-4 and IL-12P70 in the serum of NMOSD patients were significantly positively correlated(r=0.866,P<0.001;r=0.999,P<0.001).Conclusion:This study suggests that T cells and their subgroups,B cells,and NK cells are all involved in the disease progression of MS,NMOSD,and GBS.γδT and NKT cells can be used as reference indicators for the differential diagnosis of MS and NMOSD or GBS.Compared with HC,the levels of IL-5 and IL-10 anti-inflammatory factors in the serum of NMOSD decreased significantly,while the expression levels of IL-6,IL-4,IL-12P70 pro-inflammatory factors increased significantly,and various pro-inflammatory factors There is a synergistic or mutual restriction relationship between factors and anti-inflammatory factors.Therefore,exploring the changes of relevant laboratory indicators in immune demyelinating neurological diseases will help us to monitor and predict the disease,so as to find new biomarkers to improve the effectiveness of treatment and improve patients The prognosis.