| Objectives Neuromyelitis optica spectrum disorders(NMOSD)is a rare autoimmune disease associated with the serum aquaporin 4 antibody,which involves the central nervous system.The aim of this study is to compare the serum interleukin-36 levels in NMOSD patients and healthy controls,and to analyze the correlation between IL-36 level and other clinical indexes,and to explore the role and significance of IL-36 in the pathogenesis of NMOSD.Methods 31 patients with NMO in acute and remission phase as the experimental group,and selected 30 healthy volunteers as healthy control(HCs).Collecting samples and recording demographic information and clinical data ingluding disease onset age,annualized relapse rate,number of spinal cord segments invoved.Expanded Disability Status Scale(EDSS)was performed to evaluate the severity and degree of disability.The involved lesions in NMOSD was assessed by the magnetic resonance imaging(MRI).Serum IL-36 levels were measured using enzyme-linked immunosorbent assay(ELISA).The serum AQP-4 antibody was detected by Cell-based immunofluorescence assay(CBA).The correlation between IL-36 level and severity,relapse rate and other clinical indicators was analyzed.Results 1、Analysis of the results of serum IL-36αand its correlation(1)the level of serum IL-36αwas significantly higher in patients with NMOSDthan HCs.(100.45±95.35 vs 60.88±40.40 pg/ml,P=0.014).The level of serum IL-36α in the AQP-4 antibody positive group(125.11±100.53 pg/ml)was higher than that of the negative group(69.92±80.69 pg/ml),the difference was statistically significant(P=0.047).(2)The serum IL-36αlevels in the treated patients(125.76±119.15 pg/ml)was statistically higher than in the untreated patients(80.25±77.64 pg/ml P=0.046).(3)No correlation was found between serum IL-36αand the level of relapse,the number of spinal cord segments and the EDSS score of NMOSD patients.(r=-0.228,p=0.117;r=-0.005,p=0.977;R=-0.024,p=0.898).2、Analysis of the results of serum IL-36βand its correlation(1)The serum IL-36 β was significantly higher in patients with NMOSD than HCs(95.33±131.33 vs 33.95±51.36 pg/ml,P=0.017).The serum IL-36βin the AQP-4 antibody positive group(122.46±164.77pg/ml)was higher than that of the negative group(61.74±59.94 pg/ml),but it did not have statistical significance (P=0.116).(2)The serum IL-36βlevels in the treated patients(100.94±64.04 pg/ml)were higher than in the untreated patients(47.11±41.95 pg/ml),the difference was statistically significant(P=0.000).(3)No significant correlations between the serum IL-36αand annual recurrence rate,the number of segments of spinal cord involvement and the EDSS score in patients with NMOSD(r=-0.242 p=0.189,r=-0.164,p=0.377;r=-0.015,p=0.935).3、Analysis of the results of serum IL-36γand its correlation(1)the level of serum IL-36γwas significantly higher in patients with NMOSD than HCs(58.55 ± 108.51 vs14.81 ± 20.69 pg/ml,P=0.011).The serum IL-36 β in the AQP-4 antibody positive group(38.13±36.07pg/ml)was higher than the negative group(30.28±37.09 pg/ml),but it did not have statistical significance(P=0.468).(2)The serum IL-36γlevels in the treated patients(49.91±39.39 pg/ml)were higher than in the untreated patients(33.26±34.95 pg/ml),the difference was statistically significant(P=0.000).(3)The level of IL-36γwas positively correlated with the rate of annual recurrence(r=0.429 p=0.016).But no significant correlations between IL-36γlevels and the number of segments of spinal cord involvement and the EDSS score in patients with NMOSD(r=-0.036,p=0.847r=-0.076,p=0.685).Conclusions 1、The serum IL-36 α、 IL-36 β、 IL-36 γ levels in NMOSD patients were significantly higher than in HCs.It suggests that they may play a role in the clinical pathology of NMOSD and help to predict the activity of disease.2、After treated with immunomodulatory medicine,the serum IL-36 levels were lower than before.Monitoring serum IL-36 level may help to determine the therapeutic effect of the disease.3、The level of IL-36α,IL-36βand IL-36γin the positive group of AQP-4 antibody was higher than that in the negative group,but only the difference of IL-36 αwas statistically significant.It is presumed that IL-36αmay be involved in the immune response related to AQP-4 antibody and play an regulatory role.4、There is a positive correlation between IL-36γ and the rate of annual recurrence,suggesting that it may provide a new way to prevent the recurrence of patients. |
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