Effect of Follicular T Helper and T Helper 17 Cells-Related Molecules on Disease Severity in Patients with Myasthenia Gravis.

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

European Neurology Pub Date : 2024-01-01 Epub Date: 2024-08-21 DOI:10.1159/000540794

Doruk Arslan, Zeynep Ergul-Ulger, Sibel Goksen, Gunes Esendagli, Sevim Erdem-Ozdamar, Ersin Tan, Can Ebru Bekircan-Kurt

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引用次数: 0

Abstract

Introduction: Contribution of T helper 1 and 2 cells-related cytokines to pathogenesis of myasthenia gravis (MG) is well known. Recently, the contribution of follicular T helper (Tfh) and T helper 17 cells-related molecules to the pathogenesis has gained importance. In this study, we aimed to evaluate the changes in Tfh- and Th17-related molecules before and after rescue therapy in patients with myasthenic crisis (cMG) and to reveal the molecular differences between stable MG and cMG patients.

Methods: Patients with stable generalized MG (gMG) and cMG were classified according to Myasthenia Gravis Foundation of America (MGFA) classification. Serum samples were collected from cMG patients both before and after rescue therapy (plasmapheresis or intravenous immunoglobulin [IVIg]). Serum levels of Tfh- and selected Th17-related molecules (IL-22, IL-17A, CXCL13, sPD-L1, sICOSLG, and sCD40L) were analyzed by commercial ELISA kits.

Results: Twelve cMG (6 for IVIg, 6 for plasmapheresis) and 10 gMG patients were included in the study. A decrease in serum sPD-L1 and CXCL13 levels was observed in cMG patients after treatment, regardless of the treatment modality (p < 0.05). In contrast, serum sICOSLG levels decreased only in patients treated with IVIg (p < 0.05) and serum IL-22 levels increased in patients receiving plasmapheresis (p < 0.05). cMG patients had higher serum IL-17A levels compared to stable patients (p < 0.001) and its level was positively correlated with disease severity (r = 0.678, p = 0.001).

Conclusion: Our results confirm the contribution of Tfh- and Th17-related cell pathways to MG pathogenesis. Both IVIg and plasmapheresis appear to be effective in reducing Tfh- and Th17-related cytokine/molecule levels in cMG patients. Increased serum IL-17A levels may contribute to disease severity.

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滤泡 T 辅助细胞和 T 辅助细胞 17 相关分子对重症肌无力患者病情严重程度的影响

导言：与 T 辅助细胞 1 和 2 相关的细胞因子对重症肌无力（MG）发病机制的作用已众所周知。最近，滤泡T辅助细胞（Tfh）和T辅助细胞17相关分子对发病机制的贡献也变得越来越重要。在这项研究中，我们旨在评估肌无力危象（cMG）患者在抢救治疗前后Tfh和Th17相关分子的变化，并揭示稳定型MG和肌无力危象患者之间的分子差异：方法：根据美国肌无力基金会（MGFA）的分类方法对稳定型全身性肌无力（gMG）和肌无力危象（cMG）患者进行分类。在抢救治疗（血浆置换术或IVIg）之前和之后采集cMG患者的血清样本。）采用商业ELISA试剂盒分析血清中Tfh和选定的Th17相关分子（IL-22、IL-17A、CXCL13、sPD-L1、sICOSLG和sCD40L）的水平：研究共纳入了 12 名 cMG（6 名接受了 IVIg 治疗，6 名接受了血浆置换术）和 10 名 gMG 患者。无论采用哪种治疗方式，cMG 患者治疗后血清 sPDL1 和 CXCL13 水平均有所下降（p<0.05）。相比之下，只有接受 IVIg 治疗的患者血清 sICOSLG 水平下降（p<0.05），接受血浆置换治疗的患者血清 IL22 水平上升（p<0.05）。与病情稳定的患者相比，cMG 患者血清 IL-17A 水平较高（p<0.001），且其水平与病情严重程度呈正相关（r=0.678，p=0.001）：我们的研究结果证实了Tfh和Th17相关细胞通路对MG发病机制的贡献。IVIg和血浆置换术似乎都能有效降低肌无力危象患者的Tfh和Th17相关细胞因子/分子水平。血清IL-17A水平的升高可能会导致疾病的严重程度。

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来源期刊

European Neurology 医学-临床神经学

CiteScore

4.40

自引率

4.20%

发文量

审稿时长

4-8 weeks

期刊介绍： ''European Neurology'' publishes original papers, reviews and letters to the editor. Papers presented in this journal cover clinical aspects of diseases of the nervous system and muscles, as well as their neuropathological, biochemical, and electrophysiological basis. New diagnostic probes, pharmacological and surgical treatments are evaluated from clinical evidence and basic investigative studies. The journal also features original works and reviews on the history of neurology.