Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
Clinical Neurochemistry Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy.
Parkinsonism Relat Disord. 2023 Jul;112:105480. doi: 10.1016/j.parkreldis.2023.105480. Epub 2023 Jun 4.
Peripheral inflammation has been recently associated to Parkinson disease (PD). However, how the peripheral inflammatory immune response could affect the clinical-pathological features of the disease is not fully understood. In this study, we assessed the peripheral immune profile of a well-characterized PD cohort, examining several correlations with CSF biomarkers of neurodegeneration and the main clinical parameters, aimed at better elucidating the complex dynamics of the brain-periphery interactions in PD.
The leukocyte populations counts (neutrophils, lymphocytes, monocytes, eosinophils, and basophils) and the neutrophil-to-lymphocyte ratio (NLR) were collected and compared in 61 PD patients and 60 sex/age matched controls (CTRLs). Immune parameters were correlated with CSF levels of total α-synuclein, amyloid-β-42, total and phosphorylated-tau and main motor and non-motor scores.
PD patients had lower lymphocyte and higher NLR counts compared to CTRLs. In PD patients, the lymphocyte count directly correlated with CSF α-synuclein levels, whereas NLR displayed an inverse correlation with the CSF amyloid-β42 levels. The lymphocyte count also negatively correlated with HY stage, while NLR positively with the disease duration.
This study provided in vivo evidence that, in PD, changes in leukocytes in the periphery, assessed as relative lymphopenia and NLR increase, reflect in central neurodegeneration-associated proteins modifications, especially in α-synuclein and amyloid-β pathways, and greater clinical burden.
外周炎症最近与帕金森病（PD）有关。然而，外周炎症免疫反应如何影响疾病的临床病理特征尚不完全清楚。在这项研究中，我们评估了一个特征明确的 PD 队列的外周免疫谱，检查了与 CSF 神经退行性生物标志物和主要临床参数的几个相关性，旨在更好地阐明 PD 中大脑-外周相互作用的复杂动态。
收集并比较了 61 名 PD 患者和 60 名性别/年龄匹配的对照组（CTRLs）的白细胞群计数（中性粒细胞、淋巴细胞、单核细胞、嗜酸性粒细胞和嗜碱性粒细胞）和中性粒细胞与淋巴细胞比值（NLR）。免疫参数与 CSF 中总α-突触核蛋白、淀粉样蛋白-β-42、总蛋白和磷酸化tau 以及主要运动和非运动评分相关。
与 CTRLs 相比，PD 患者的淋巴细胞计数较低，NLR 计数较高。在 PD 患者中，淋巴细胞计数与 CSF α-突触核蛋白水平直接相关，而 NLR 与 CSF 淀粉样蛋白-β42 水平呈负相关。淋巴细胞计数也与 HY 分期呈负相关，而 NLR 与疾病持续时间呈正相关。
这项研究提供了体内证据，表明在 PD 中，外周白细胞的变化，如相对淋巴细胞减少和 NLR 增加，反映了中枢神经退行性变相关蛋白的变化，尤其是在α-突触核蛋白和淀粉样蛋白-β途径，以及更大的临床负担。
