Esposito Antonio, Falco Fabrizia, Scalia Giulia, Gentile Laura, Spiezia Antonio Luca, Corsini Giuseppe, Manganiello Rosa, Eliano Martina, Lamagna Federica, Moccia Marcello, Petracca Maria, Lanzillo Roberta, Brescia Morra Vincenzo, Carotenuto Antonio
Multiple Sclerosis Clinical Care and Research Center, Department of Neuroscience, Reproductive Science, and Odontostomatology, Federico II University of Naples, Naples, Italy.
Laboratorio di Citometria Clinica e Sperimentale CEINGE-Biotecnologie Avanzate Franco Salvatore, Naples, Italy.
Eur J Neurol. 2025 Jan;32(1):e16536. doi: 10.1111/ene.16536. Epub 2024 Oct 30.
CD20 T lymphocytes are a subset of circulating T cells presenting the CD20 receptor, a molecular marker of B lineage. CD20 T lymphocytes are thought to play a pivotal role in multiple sclerosis (MS) pathology, especially at progressive stages. We aimed to investigate the correlation between CD20 T lymphocytes and neuropsychological features (i.e., cognition, depression, anxiety, fatigue, and sleep quality) in MS patients.
We enrolled 90 MS patients. Each patient underwent cognitive assessment (Brief International Cognitive Assessment for Multiple Sclerosis) and psychometric assessment (modified Fatigue Impact Scale, Beck Anxiety Inventory, Beck Depression Inventory, Pittsburgh Sleep Quality Index). Cognitive status was defined through the cerebral functional score.
Forty-four of 90 patients were relapsing-remitting (49%) and 46 were progressive patients (51%). Seventy patients (18.9%) showed CD20 T lymphocytes in peripheral blood with a mean level of 0.38 ± 1.2%. Patients with CD20 T lymphocytes were more likely to be at progressive phases (76.5% vs. 23.5%, p = 0.02) and showed a higher Expanded Disability Status Scale score (median [range] = 6.0 [1.5-7.5] vs. 3.5 [1-7.5], p = 0.001). Moreover, patients with CD20 T lymphocytes showed worse cognitive functioning (p = 0.004), higher global fatigue symptoms (p = 0.02), higher cognitive fatigue (p = 0.01), higher psychosocial fatigue (p = 0.005), and a trend toward worse sleep quality (p = 0.06).
The presence of CD20 T lymphocytes in the peripheral blood of MS patients was associated with worse neuropsychological functioning and progressive disease stages. Peripheral CD20 T lymphocytes could potentially serve as markers for both disease progression and development of fatigue in MS patients.
CD20⁺ T淋巴细胞是循环T细胞的一个亚群，表达CD20受体，这是B淋巴细胞系的一种分子标志物。CD20⁺ T淋巴细胞被认为在多发性硬化症（MS）病理过程中起关键作用，尤其是在疾病进展阶段。我们旨在研究MS患者中CD20⁺ T淋巴细胞与神经心理特征（即认知、抑郁、焦虑、疲劳和睡眠质量）之间的相关性。
我们纳入了90例MS患者。每位患者均接受了认知评估（简短国际多发性硬化症认知评估量表）和心理测量评估（改良疲劳影响量表、贝克焦虑量表、贝克抑郁量表、匹兹堡睡眠质量指数）。通过脑功能评分来定义认知状态。
90例患者中，44例为复发缓解型（49%），46例为进展型患者（51%）。70例患者（18.9%）外周血中存在CD20⁺ T淋巴细胞，平均水平为0.38±1.2%。存在CD20⁺ T淋巴细胞的患者更有可能处于疾病进展期（76.5% 对23.5%，p = 0.02），且扩展残疾状态量表评分更高（中位数[范围]=6.0[1.5 - 7.5]对3.5[1 - 7.5]，p = 0.001）。此外，存在CD20⁺ T淋巴细胞的患者表现出更差的认知功能（p = 0.004）、更高的总体疲劳症状（p = 0.02）、更高的认知疲劳（p = 0.01）、更高的社会心理疲劳（p = 0.005）以及睡眠质量变差的趋势（p = 0.06）。
MS患者外周血中CD20⁺ T淋巴细胞的存在与较差的神经心理功能及疾病进展阶段相关。外周血CD20⁺ T淋巴细胞可能潜在地作为MS患者疾病进展和疲劳发生的标志物。
