Study On The IL-10 Expression And Clinical Characteristics In Acute Stage Of Neuromyelitis Optica Disorders

Objective: Compare the differences of clinical features between the AQP4-IgG positive and AQP4-IgG negative groups in NMOSD patients,at the same time by comparing the IL-10 expression in the acute phase of NMOSD patients and healthy controls,find if there is a correlation IL-10 with the development and prognosis of NMOSD,to provide a new direction and new ideas for the pathogenesis and treatment strategies of NMOSD.Methods: acute stage patients diagnosed with NMOSD in the first and second affiliated hospitals of guangxi medical university during the period of solstice on September 1,2016 and January 31,2018 were collected.The diagnostic criteria were in line with the 2015 international NMOSD diagnostic group,and healthy subjects were collected as the control group.According to the test results of AQP4-IgG,NMOSD patients were divided into two sub-groups,the AQP4-IgG positive group and the AQP4-IgG negative group.General data,clinical manifestations,expanded disability status scale(EDSS),MRI of the brain and spinal cord,and the number and frequency of recurrence within 2years were collected,and then analyzed statistically.Meanwhile,the expressionlevel of IL-10 between the three groups was detected by ELISA method,and the correlation between the expression level of IL-10 and the severity and recurrence of NMOSD patients was analyzed.Results: 1.A total of 44 patients with NMOSD were collected,including 29 in the AQP4-IgG positive group and 15 in the AQP4-IgG negative group.The ratio of male and female in AQP4-IgG negative group was 1:6.5,and the age of onset was 30.27 13.66 years.There was no statistical difference in the ratio of male to female and the age of onset between the two subgroups.2.The first onset symptoms of the two subgroups of NMOSD were mainly optic neuritis or myelitis,and the number of cases of the six core symptoms of the first onset symptoms of AQP4-IgG positive group and AQP4-IgG negative group were counted,and no statistical difference was found in the first onset symptoms between the two subgroups(P=0.538).3.The first EDSS score of NMOSD patients was calculated,and it was found that the score of AQP4-IgG positive group was between 1.5 and 7 points,with a median of 3.5 points.The score of AQP4-IgG negative group was between 1.0 and 6 points,with a median of 2.0 points.The number of cases of spinal cord injury in the AQP4-IgG positive group was 23,including 17 cases of long segment transverse spinal cord injury(17/23).In the AQP4-IgG negative group,there were 12 cases of spinal cord injury,including 4 cases of long segment transverse spinal cord injury(4/12).Comparing the two subgroups,it was found that the proportion of long segment transverse injury in the AQP4-IgG positive group was significantly higher than that in the AQP4-IgG negative group,and the difference was statistically significant.4.According to the detection of the comprehensive index of autoimmune antibodies,there were 13 cases of AQP4-IgG positive combination with otherautoimmune antibody abnormalities(13/29),and 2 cases of AQP4-IgG negative combination with other autoimmune antibody abnormalities(2/15).Statistical analysis showed significant differences between the two groups(P=0.037).5.The IL-10 concentration was counted among the three groups,and the expression level of il-10 in the AQP4-IgG positive group was 9.436±8.490pg/ml.The AQP4-IgG negative group was 8.946±8.315pg/ml,and that in the healthy control group was 2.7±0.30pg/m.However,there was no significant difference between AQP4-IgG positive group and AQP4-IgG negative group.6.Correlation analysis was conducted between il-10 expression level of NMOSD patients and EDSS score and recurrence frequency,and negative correlation was found between il-10 expression level and EDSS score(R=-0.584,P=0.001).Conclusions: 1.There was no difference in the incidence sex ratio,age of onset,first onset symptoms and first onset EDSS score between the AQP4-IgG positive group and the AQP4-IgG negative group.However,the number of recurrence cases,the number of recurrence times,the number of patients with longitudinal spinal cord segment damage in MRI and the number of patients with other autoimmune antibodies in AQP4-IgG positive group were significantly higher than that in AQP4-IgG negative group,suggesting that AQP4-IgG and other autoimmune antibody positive groups are high-risk groups of NMOSD recurrence.2.The level of IL-10 in NMOSD patients was significantly higher than that in the healthy control group,and the expression level of IL-10 was moderately negatively correlated with EDSS score,suggesting that IL-10 may be involved in the pathogenesis of NMOSD and may play a protective role in it,but the mechanism remains unclear and needs further study.