Kim Ryul, Kang Nyeonju, Byun Kyeongho, Park Kiwon, Jun Jin-Sun
Department of Neurology, Inha University Hospital, Inha University College of Medicine, Incheon, Korea (the Republic of).
Division of Sport Science, Incheon National University, Incheon, Korea (the Republic of).
J Neurol Neurosurg Psychiatry. 2023 Dec;94(12):1040-1046. doi: 10.1136/jnnp-2022-330394. Epub 2023 Jul 14.
To explore whether peripheral blood neutrophils and lymphocytes are associated with longitudinal motor and cognitive decline in patients with early Parkinson's disease (PD) and, to uncover the disease-specific mechanisms underlying these associations.
Data were obtained from the Parkinson's Progression Markers Initiative cohort. We included 376 patients with recently diagnosed, drug-naïve PD and 178 matched healthy controls. The patients underwent annual assessments, including the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part 3 test to measure motor function and the Montreal Cognitive Assessment (MoCA) to measure cognitive function, for up to 8 years of follow-up. Dopamine transporter (DAT) imaging was performed at baseline and the 1-year, 2-year and 4-year follow-up visits.
At baseline, patients with PD showed higher neutrophil and lower lymphocyte counts, resulting in a higher neutrophil-to-lymphocyte ratio (NLR) than that in healthy controls. Higher neutrophil counts were associated with a greater increase in MDS-UPDRS part 3 scores in patients with PD (estimate: 0.25, 95% CI: 0.12 to 0.37, p<0.001). Correspondingly, higher neutrophil levels were related to a greater reduction in DAT activity in the caudate (estimate: -0.007, 95% CI: -0.014 to -0.001, p=0.046) and putamen (estimate: -0.0039, 95% CI: -0.0077 to -0.0002, p=0.042). However, there were no significant effects of lymphocyte count and NLR on changes in the MDS-UPDRS part 3 and MoCA scores and striatal DAT uptake over time.
Among the blood biomarkers, only a higher neutrophil count was associated with faster motor progression along with accelerated nigrostriatal dopaminergic degeneration in patients with PD. The impact of neutrophils and lymphocytes on longitudinal cognitive changes remains unclear.
NCT01141023.
探讨外周血中性粒细胞和淋巴细胞是否与早期帕金森病（PD）患者的运动和认知功能纵向衰退相关，并揭示这些关联背后的疾病特异性机制。
数据来自帕金森病进展标志物倡议队列。我们纳入了376例新诊断的、未用药的PD患者和178例匹配的健康对照。患者接受了年度评估，包括用于测量运动功能的运动障碍协会统一帕金森病评定量表（MDS-UPDRS）第3部分测试和用于测量认知功能的蒙特利尔认知评估（MoCA），随访时间长达8年。在基线以及第1年、第2年和第4年随访时进行多巴胺转运体（DAT）成像。
在基线时，PD患者的中性粒细胞计数较高，淋巴细胞计数较低，导致中性粒细胞与淋巴细胞比值（NLR）高于健康对照。较高的中性粒细胞计数与PD患者MDS-UPDRS第3部分评分的更大增加相关（估计值：0.25，95%置信区间：0.12至0.37，p<0.001）。相应地，较高的中性粒细胞水平与尾状核中DAT活性的更大降低相关（估计值：-0.007，95%置信区间：-0.014至-0.001，p=0.046）以及壳核中DAT活性的更大降低相关（估计值：-0.00把0.0039改为-0.0039，95%置信区间：-0.0077至-0.0002，p=0.042）。然而，淋巴细胞计数和NLR对MDS-UPDRS第3部分和MoCA评分以及纹状体DAT摄取随时间的变化没有显著影响。
在血液生物标志物中，只有较高的中性粒细胞计数与PD患者更快的运动进展以及黑质纹状体多巴胺能变性加速相关。中性粒细胞和淋巴细胞对纵向认知变化的影响仍不清楚。
NCT01141023。
