| Background and objectiveNeuromyelitis optica spectrum disorders(NMOSD)is a demyelinating disease of the central nervous system that is different from multiple sclerosis(MS).It is characterized by severe optic neuritis or extensive longitudinal transverse spinal cord Inflammation,the two can also exist at the same time.The discovery of pathogenic serum anti-aquaporin 4(AQP-4)antibodies promoted the research of NMOSD.The International Panel for NMO diagnosis(IPND)proposed a NMSOD score based on AQP-4 antibodies.Layer diagnosis.However,studies have shown that transfer of anti-AQP-4 antibody alone cannot induce NMO pathological changes in experimental animals,and co-transfer of specific T cells can induce central nervous system inflammatory lesions,which indicates that T cells may be involved in the potential pathogenesis of NMOSD.Plays an important role.More and more immunological studies have reported that cytokines and chemokines play an important role in the pathogenesis of NMOSD,and indicate that NMOSD is a type 2 T helper cells(Th2)and Th17 related diseases.Interleukin-19(IL-19)is a member of the IL-10 family.It is a multifunctional cytokine,mainly composed of immune cells such as activated lymphocytes,macrophages and monocytes.secretion.Bacterial lipopolysaccharide(LPS)can stimulate the expression of IL-19 in these cells,and this effect is enhanced by the treatment of Th2 cytokines IL-4 and IL-13;in addition,IL-19 interacts with IL-20R1/IL-20R2 binds to activate signal transducer and activator of transcription(STAT)3 phosphorylation involved in Th17 cell differentiation.Therefore,the production of IL-19 is related to the response of Th2 and Th17 cells caused by inflammation.It implies a wide range of immune system influences from allergic diseases to autoimmune diseases.Interleukin 26(IL-26)also belongs to the IL-10 family,mainly derived from epithelial cells and immune cells,including alveolar macrophages,Thl and Th17 cells,NK cells and macrophage-like synovial cells.IL-26 is a Thl7-related cytokine.It is co-expressed with IL-22 in Th17 cells at high levels.It is affected by Th17 cell-related cytokines IL-1β,IL-23,and retinoic acid-related orphan receptors(retinoid-related receptors).orphan receptor(ROR)yt regulation,which sends signals through the heterodimeric receptor complex composed of IL-20R1 and IL-10R2 chains,and induces Janus kinase,signal transducer and transcription activator(Janus kinase-signal).transducer and activator of transcription,JAK-STAT)activates,leading to phosphorylation of STAT1 and STAT3.Both of them play an important role in various autoimmune diseases such as inflammatory bowel disease,rheumatoid arthritis,psoriasis,etc.,but their role in the occurrence and development of NMOSD is still unclear.Therefore,this study tested NMOSD patients Concentrations of IL-19 and IL-26 in serum and cerebrospinal fluid and analyze the correlation between the two and other clinical indicators,preliminary explore their role in different stages of NMOSD,in order to provide a further theoretical basis for the diagnosis and treatment of NMOSD.MethodsThis study is a case-control study.Collected 25 patients with neuromyelitis optica spectrum disease(6 males and 19 females)who attended the Department of Neurology of the First Affiliated Hospital of Zhengzhou University from September 2019 to December 2020,and collected blood from the cubital veins in the acute and remission phases.specimen.At the same time,12 cases of acute cerebrospinal fluid specimens were obtained during hospitalization.Record patient medical history data in detail,including name,gender,age,medical history,admission to the Hospital Expanded Disability Status Scale(EDSS)score,laboratory test results,imaging test results,neuroelectrophysiological test results,etc.Eighteen healthy volunteers who visited our hospital during the same period were selected as the control group,including 6 males and 12 women.In addition,8 cases of other non-inflammatory neurological diseases(other non-inflammatory neurological diseases)who visited our hospital during the same period were collected.The cerebrospinal fluid of patients with inflammatory neurological diseases(ONND)(including:primary headache,mental illness)was regarded as the ONND group.Use Enzyme-linked Immunosorbent Assay(ELISA)to detect the concentration of IL-19 and IL-26 in all samples,analyze the difference between the two in each group,and analyze the correlation with other clinical indicators.All data were analyzed using SPSS26.0 statistical software.Quantitative data are expressed as mean ± standard deviation;paired t test or two independent sample t test is used for comparison between normal distribution data groups;nonparametric test is used for non-normal distribution data comparison between groups;the correlation between two groups of quantitative data is used Pearson or Spearman correlation analysis;Chi-square test or Fisher’s exact probability method to compare the two groups of binary data;P<0.05 indicates that the difference is statistically significant.Results 1.Serum IL-19 level in the acute phase of NMOSD patients is 10.70±3.63pg/ml,the remission phase is 15.22±4.44pg/ml,and the control group is 7.68±2.18pg/ml.The level of IL-19 in the acute phase was higher than that of the healthy control group,and the difference was statistically significant(P=0.003);the level of IL-19 in the remission phase was higher than that of the healthy control group,and the difference was statistically significant(P<0.001);The level of IL-19 was higher than that in the acute phase,and the difference was statistically significant(P<0.001).2.Serum IL-26 level in NMOSD patients is 42.87±10.55pg/ml in acute phase,30.99±5.12pg/ml in remission phase,and 27.84±5.72pg/ml in control group.The level of IL-26 in the acute phase was higher than that in the remission period and the healthy control group,and the difference was statistically significant(P<0.001);the level of IL-26 in the remission period was slightly higher than that of the healthy control group,but the difference was not statistically significant(P=0.066);3.The level of serum IL-19 in the acute phase was negatively correlated with the patient’s EDSS score(r=0.601,P=0.001),There is no significant correlation with the length of spinal cord lesions(r=0.014,P=0.952).The level of serum IL-26 in the acute phase was not significantly correlated with the patient’s EDSS score and the length of spinal cord lesions(P>0.05).4.The levels of serum IL-19 and IL-26 in the acute phase have nothing to do with the status of serum AQP-4(P>0.05).5.The levels of serum IL-19 and IL-26 in the acute and remission phases are not correlated(P>0.1).6.The level of IL-19 in the cerebrospinal fluid in the acute phase was 31.59±3.84pg/ml,and that in the ONND group was 24.70±5.69pg/ml,which was higher in the acute phase than in the ONND group,and there was a statistical difference(P=0.017).The level of IL-26 in the cerebrospinal fluid was 78.54±17.74pg/ml,and it was 29.05±7.45pg/ml in the ONND group,which was higher in the acute phase than in the ONND group,and there was a statistical difference(P=0.001).Conclusion1.The level of serum IL-19 increased significantly in the remission period,suggesting that IL-19 mainly plays an anti-inflammatory effect in the remission period.The level of serum IL-19 in the acute phase is negatively correlated with the EDSS score,suggesting that IL-19 can also play a protective role in the acute phase and limit the severity of inflammation.It is expected to become a potential biological marker and therapeutic target.2.The levels of IL-26 in serum and cerebrospinal fluid both increase in the acute phase,suggesting that IL-26 mainly plays a role in the acute phase of the disease.However,it is not significantly related to the EDSS score and the length of the spinal cord segment involved.It is speculated that it has nothing to do with the severity of the disease,and may participate in the progression of the disease through other ways of regulating the inflammatory response. |
PDF Full Text Request