Postgraduate Program in Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
J Clin Immunol. 2013 Jan;33(1):179-89. doi: 10.1007/s10875-012-9780-2. Epub 2012 Sep 5.
Neuromyelitis optica (NMO), also known as Devic's disease, is an autoimmune, inflammatory disorder of the central nervous system (CNS) in which the immune system attacks myelin of the neurons located at the optic nerves and spinal cord, thus producing a simultaneous or sequential optic neuritis and myelitis. The objective of this study was evaluated the background T-cell function of patients suffering from neuromyelitis optica (NMO), an autoimmune disorder of the central nervous system. In our study, the in vitro T cell proliferation and the production of Th1 cytokines were significantly lower in cell cultures from NMO patients, as compared with healthy individuals. In contrast, a dominant Th17-like phenotype, associate with higher IL-23 and IL-6 production by LPS-activated monocytes, was observed among NMO patients. The release of IL-21 and IL-6 by polyclonally activated CD4+ T cells was directly correlated to neurological disability. In addition, the in vitro release of IL-21, IL-6 and IL-17 was significantly more resistant to glucocorticoid inhibition in NMO patients. In conclusion, the results indicate dominant Th17-related response in NMO patients that was directly proportional to neurological disability. Furthermore, our results can help to explain why NMO patients trend to be more refractory to corticoid treatment.
视神经脊髓炎（NMO），又称 Devic 病，是一种自身免疫性、中枢神经系统（CNS）炎症性疾病，其中免疫系统攻击位于视神经和脊髓的神经元髓鞘，从而产生同时或序贯性视神经炎和脊髓炎。本研究旨在评估患有视神经脊髓炎（NMO）的患者的背景 T 细胞功能，NMO 是一种中枢神经系统自身免疫性疾病。在我们的研究中，与健康个体相比，NMO 患者的体外 T 细胞增殖和 Th1 细胞因子的产生明显降低。相比之下，在 NMO 患者中观察到一种占主导地位的 Th17 样表型，与 LPS 激活的单核细胞产生更高的 IL-23 和 IL-6 相关。多克隆激活的 CD4+T 细胞释放的 IL-21 和 IL-6 与神经功能缺损直接相关。此外，体外 IL-21、IL-6 和 IL-17 的释放对 NMO 患者糖皮质激素抑制的抵抗力明显更强。总之，这些结果表明 NMO 患者存在占主导地位的 Th17 相关反应，与神经功能缺损直接相关。此外，我们的结果可以帮助解释为什么 NMO 患者倾向于对皮质激素治疗更有抵抗力。
