Ichikawa-Escamilla Eduardo, Espinosa-Cárdenas Raquel, Leyva-Hernández Jaquelin, Álvarez-Luquín Diana D, Arce-Sillas Asiel, Adalid-Peralta Laura
Laboratorio de Reprogramación Celular, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Av. Insurgentes Sur 3877, La Fama, Tlalpan, Ciudad de Mexico, 14269, México.
Neurol Sci. 2025 Jun 19. doi: 10.1007/s10072-025-08304-6.
The clinical stage of Parkinson's disease (PD) can be assessed using the Hoehn & Yahr (H&Y) and MDS-UPDRS scales. Both neuroinflammation and peripheral inflammation have been linked to advanced PD. This study aimed to investigate changes in the peripheral regulatory and proinflammatory immune response in PD patients and its relationship to advanced disease. Forty-six patients were classified by clinical stage according to H&Y as "mild," "moderate," and "severe." Twenty-two healthy subjects were included as controls. MDS-UPDRS, Beck, and Schwab & England scores were measured in patients and controls. Proinflammatory and regulatory cell populations were quantified by flow cytometry in each group. As expected, total MDS-UPDRS scores and MDS-UPDRS section scores increased significantly with disease severity. Interestingly, decreased counts of activated Tregs, functional Bregs, and IL-10-producing functional Bregs were found in PD patients compared to controls. Such decrease progresses in parallel with the disease in patients. In addition, the level of activated Tregs correlated positively with Schwab & England score. The levels of pro-inflammatory cells (Th2 IL-13 + , Th2 IL-4 + , and Th17 IL6 +) were decreased in patients compared to controls. However, the levels of IL-6 producing Th17 cells showed a significant positive correlation with MDS-UPDRS III score. These results suggest a relationship between the patient's peripheral immune response and developing advanced disease. Patients with higher levels of regulatory cells have a less progressive disease and a better quality of life than those with a peripheral pro-inflammatory profile. Thus, it is necessary to develop therapeutic strategies that contribute to the regulation of inflammation in PD.
帕金森病（PD）的临床分期可使用霍恩和雅尔（H&Y）量表以及运动障碍协会统一帕金森病评定量表（MDS-UPDRS）进行评估。神经炎症和外周炎症均与晚期PD有关。本研究旨在调查PD患者外周调节性和促炎性免疫反应的变化及其与疾病进展的关系。46例患者根据H&Y临床分期分为“轻度”、“中度”和“重度”。纳入22名健康受试者作为对照。对患者和对照测量MDS-UPDRS、贝克量表以及施瓦布和英格兰量表评分。通过流式细胞术对每组中的促炎性细胞群和调节性细胞群进行定量分析。正如预期的那样，MDS-UPDRS总分和MDS-UPDRS各部分得分随疾病严重程度显著增加。有趣的是，与对照组相比，PD患者中活化调节性T细胞（Tregs）、功能性调节性B细胞（Bregs）以及产生白细胞介素-10（IL-10）的功能性Bregs数量减少。在患者中，这种减少与疾病进展平行。此外，活化Tregs水平与施瓦布和英格兰量表评分呈正相关。与对照组相比，患者中促炎细胞（Th2 IL-13+、Th2 IL-4+和Th17 IL-6+）水平降低。然而，产生IL-6的Th17细胞水平与MDS-UPDRS III评分呈显著正相关。这些结果表明患者外周免疫反应与疾病进展之间存在关联。与具有外周促炎特征的患者相比，调节性细胞水平较高的患者疾病进展较慢且生活质量较好。因此，有必要制定有助于调节PD炎症的治疗策略。
