Distribution Of Peripheral Immune Cells Associated With Severity And Prognosis Of Multiple Sclerosis

Objective:Through the combination of bioinformatics analysis and clinical case study,we analyzed and discussed whether the distribution and infiltration of peripheral blood immune cells in multiple sclerosis patients are related to the severity and prognosis of the disease.Methods:Download the gene expression matrix in the public database,analyze the differentially expressed genes through R software,and conduct GO enrichment analysis and KEGG enrichment analysis on the differentially expressed genes;The differentially expressed genes are produced by the protein-protein interaction network(PPI),and the pivotal genes in the process of multiple sclerosis disease are screened out through the algorithm.The gene expression is converted into the percentage of 22 kinds of immune cells through the"CIBERSORT package"in R language,and then the difference between the multiple sclerosis population and the healthy population is analyzed.We further collected the basic clinical baseline data of 60 patients with multiple sclerosis,including gender,age(years),course(months),length of stay,past history,clinical manifestations,magnetic resonance and visual evoked potential results,and laboratory examination results,The patients were evaluated with the expanded disability status scale(EDSS)score and the modified Rankin scale(m RS)to assess the severity and prognosis of the disease,and the relevant statistical analysis was carried out through statistical software.Results:1.The gene expression matrix was processed in batches by R software.The results showed that there were 206 gene expression differences between multiple sclerosis patients and the control group,which were identified as differentially expressed genes,of which 70 genes were up-regulated and 136 genes were down-regulated;2.By making PPI network diagram,the genes with relatively close connection among the differential genes were obtained.According to the degree of correlation,the top 20 genes were TP53,JUN,IL1B,MNDA,TNFAIP3,VEGFA,RANBP2,KRAS,IDH1,SNRPN,CDKN1A,PHF20,DUSP10,CDC20,TNFSF10,PDCD4,FGL2,MCL1,CCR2,IFNG;3.Bioinformatics analysis showed that there was a significant difference in the proportion of immune cells between the multiple sclerosis group and the control group.The proportion of B lymphocytes and mononuclear macrophages in the multiple sclerosis group increased compared with the control group,while the proportion of T lymphocytes and NK cells decreased compared with the control group;4.The clinical case study found that the peripheral blood of MS patients was mainly composed of neutrophils and lymphocytes,accounting for 64.19%and 26.5%respectively;CD4+and CD8+T cells account for 41.03%and 28.21%of lymphocytes,followed by B lymphocytes,accounting for about 14.65%.5.EDSS score was positively correlated with the percentage of monocytes and MLR of patients.There was a significant difference in the percentage of monocytes and T lymphocytes between patients with m RS>2 and patients with m RS≤2.Conclusion:1)Genes IL1B、MNDA、TNFA、VEGFA、CCR2、NLRP3 play an important role in the process of multiple sclerosis;2)Bioinformation analysis showed that the proportion of immune cells in patients with multiple sclerosis was different from that in healthy people.There were differences between the two groups in naive B cells,memory B cells,M2 macrophages,activated dendritic cells,inactive and activated mast cells,and eosinophils;3)Clinical studies suggest that the infiltration of immune cells in the peripheral blood of MS patients is mainly neutrophils and lymphocytes,while CD4~+and CD8~+T lymphocytes account for the most proportion in lymphocytes;4)The distribution of immune cells in peripheral blood is related to the severity and prognosis of multiple sclerosis;5)The peripheral blood immune cell typing and MLR may be used as important indicators to monitor the severity and prognosis of MS disease.