Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Clinical Research Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Neurol Sci. 2023 Jul;44(7):2465-2474. doi: 10.1007/s10072-023-06624-z. Epub 2023 Feb 13.
To detect the alteration of regulatory B cells (Bregs), follicular helper T cells (Tfh), and regulatory T cells (Tregs) frequencies in patients with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. Analyze their association with clinical severity and activity, and explore the effects of different immunotherapies on those immune cell subsets.
We enrolled 21 patients with anti-NMDAR encephalitis, 22 patients with neuromyelitis optica spectrum disorder (NMOSD), 14 patients with idiopathic intracranial hypertension (IIH), and 20 healthy controls (HC) in our study. The frequencies of various immune cell subsets were determined using flow cytometry.
Compared to patients with IIH and HC, the frequencies of CD24CD38 transitional B cells as well as Tregs were significantly lower while the frequency of Tfh was significantly higher in patients with anti-NMDAR encephalitis. The frequency of CD24CD38 transitional B cells was significantly lower in the acute stage than in the recovery stage, and was negatively correlated with the modified Rankin scale (mRS) and the clinical assessment scale for autoimmune encephalitis (CASE). The frequency of CD24CD38 transitional B cells at the last follow-up after rituximab (RTX) treatment was significantly higher than those treated with oral immunosuppressants or untreated. There was no clear difference between anti-NMDAR encephalitis and NMOSD in the above immune cell subsets.
We suggested that the frequencies of CD24CD38 transitional B cells and Tregs were decreased while the frequency of Tfh was increased in patients with anti-NMDAR encephalitis. CD24CD38 transitional B cells frequency may be a potential indicator to estimate the disease activity and severity.
检测抗 N-甲基-D-天冬氨酸受体（抗 NMDAR）脑炎患者调节性 B 细胞（Bregs）、滤泡辅助 T 细胞（Tfh）和调节性 T 细胞（Tregs）频率的变化。分析它们与临床严重程度和活动的关系，并探讨不同免疫疗法对这些免疫细胞亚群的影响。
我们纳入了 21 例抗 NMDAR 脑炎患者、22 例视神经脊髓炎谱系疾病（NMOSD）患者、14 例特发性颅内高压（IIH）患者和 20 名健康对照者（HC）进行研究。使用流式细胞术检测各种免疫细胞亚群的频率。
与 IIH 患者和 HC 相比，抗 NMDAR 脑炎患者的 CD24CD38 过渡 B 细胞以及 Tregs 的频率明显降低，而 Tfh 的频率明显升高。急性阶段的 CD24CD38 过渡 B 细胞频率明显低于恢复期，与改良 Rankin 量表（mRS）和自身免疫性脑炎临床评估量表（CASE）呈负相关。利妥昔单抗（RTX）治疗后最后一次随访时的 CD24CD38 过渡 B 细胞频率明显高于接受口服免疫抑制剂或未治疗的患者。在上述免疫细胞亚群中，抗 NMDAR 脑炎与 NMOSD 之间没有明显差异。
我们认为，抗 NMDAR 脑炎患者的 CD24CD38 过渡 B 细胞和 Tregs 频率降低，而 Tfh 频率升高。CD24CD38 过渡 B 细胞频率可能是评估疾病活动度和严重程度的潜在指标。
