Neuronal damage and neuroinflammation markers in patients with autoimmune encephalitis and multiple sclerosis
Inflammatory diseases of the central nervous system (CNS) are a diagnostic challenge to clinicians. Autoimmune encephalitis (AE) is an important diagnostic consideration in patients with CNS inflammatory disorders; despite of a wide range of neuropsychiatric symptoms it should be diagnosed as soon as possible and the patient transferred to the neurologist. We studied a group of AE patients (n = 24) as compared to multiple sclerosis (MS, n = 61) and control (n = 19) groups. Detailed clinical pictures of patients are presented. We focused on relevant cerebrospinal fluid (CSF) tests like protein levels, cytosis and oligoclonal bands, neuroinflammation indices (interleukin-6, soluble receptor of IL-6, neopterin, anti-ribosomal proteins antibodies) and markers of neurodegeneration (phosphorylated neurofilament heavy chain, pNfh). Elevated neopterin level was found in AE group as compared to the MS and control groups, while protein and pNfh were increased in both AE and MS groups. In the MS group, the cytosis and soluble receptor of IL-6 were higher as compared to the control group. Anti-ribosomal proteins antibodies were increased in a single patient with AE. High levels of protein were predictive of mortality in AE patients, while IL-6 and pNfh were elevated in severe AE patients. AE patients with paraneoplastic etiology demonstrated oligoclonal bands positivity. Taken together, our results suggest the neopterin as an additional marker of autoimmune brain inflammation. Though higher levels of protein, IL-6 and pNfh were found in patients with severe disease progression and death, prognostic values of these markers should be validated in larger cohorts of patients.
KeywordsAutoimmune encephalitis Multiple sclerosis Interleukin 6 Neopterin Neuroinflammation Neurodegeneration
acute disseminated encephalomyelitis
amyotrophic lateral sclerosis
ionotropic glutamate receptor
сentral nervous system
Kurtzke Expanded Disability Status Scale
glutamic acid decarboxylase
Leucine-rich glioma-inactivated 1
magnetic resonance imaging
neuromyelitisoptica spectrum disorders
phosphorylated neurofilament heavy chain
soluble Interleukin-6 Receptor
systemic lupus erythematosus
We thank all patients who participated in this study.
Partially supported by Russian Academy of Sciences, Program Fundamental Bases of Physiological Adaptation Technologies.
Compliance with ethical standards
Conflict of interest
No conflict of interest.
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