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Plasma Homocysteine Level Is Associated with the Expanded Disability Status Scale in Neuromyelitis Optica Spectrum

Jie Liang1, Jia Liu1, Rong Fan1

  • 1Department of Neurology and Multiple Sclerosis Research Center, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.

Neuroimmunomodulation
|October 28, 2019
PubMed
Summary

Plasma homocysteine (Hcy) levels were investigated in neuromyelitis optica spectrum disorder (NMOSD). Elevated Hcy and erythrocyte sedimentation rate (ESR) were found in acute NMOSD patients with higher disability, suggesting a role in disease progression.

Keywords:
ComplementExpanded Disability Status ScaleHomocysteineNeuromyelitis optica spectrum disorder

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Area of Science:

  • Neurology
  • Immunology
  • Biochemistry

Background:

  • Plasma homocysteine (Hcy) levels are studied in multiple sclerosis (MS).
  • Associations between Hcy levels and inflammatory/immune/cerebrospinal fluid (CSF) markers in neuromyelitis optica spectrum disorder (NMOSD) are not well-established.
  • This study addresses the gap in understanding Hcy in NMOSD.

Purpose of the Study:

  • To investigate plasma Hcy levels in NMOSD patients.
  • To explore the relationship between Hcy levels and inflammatory, immune, and CSF parameters in NMOSD.
  • To determine if Hcy levels differ between acute and stable phases of NMOSD and correlate with disease severity.

Main Methods:

  • Collected data from 97 acute-phase and 39 stable-phase NMOSD patients.
  • Divided acute-phase patients based on Expanded Disability Status Scale (EDSS) score (cutoff ≥4).
  • Measured plasma Hcy, immunoglobulins (IgA, G, M), complement (C3, C4, CH50), C-reactive protein, erythrocyte sedimentation rate (ESR), and CSF parameters (white blood cells, total protein).

Main Results:

  • No significant difference in Hcy levels between acute and stable NMOSD phases.
  • Significantly higher Hcy and ESR levels in acute-phase NMOSD patients with EDSS ≥4.
  • Positive correlations found between EDSS and Hcy/ESR/1/aquaporin-4 antibody titer.
  • Negative correlation observed between Hcy levels and IgM in acute-phase NMOSD patients.

Conclusions:

  • Elevated plasma Hcy may play a role in the pathogenesis or progression of NMOSD.
  • Hcy and ESR are potential biomarkers for disease activity and severity in NMOSD.
  • Further research is warranted to elucidate the exact role of Hcy in NMOSD.