Peripheral T-cell subset activation in NMDAR encephalitis: Insights into pathogenesis and biomarker potential for
Minjin Wang1, Jierui Wang2, Jianzhao Zhai3
1Department of Neurology, West China Hospital of Sichuan University, China; Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Background:
N-methyl-d-aspartate receptor encephalitis (NMDAR-E) is a severe autoimmune disorder characterized by neuropsychiatric symptoms and immune dysregulation ，involves T-cell dysregulation, but specific T-cell subset roles remain unclear. This study analyzed peripheral blood T-cell subsets as biomarkers for monitoring and severity prediction.
Methods:
Peripheral blood samples from 32 NMDAR-E patients, 31 antibody-mediated encephalitis, 26 viral encephalitis patients, and 23 healthy controls were analyzed using flow cytometry. Key markers of T-cell activation and co-stimulation were assessed. Clinical outcomes were correlated with immune profiles to develop a predictive model.
Results:
NMDAR-E patients showed elevated CD4+ T-cell activation, with increased CD28, CD38, and HLA-DR expression versus controls, indicating immune hyperactivation with compensatory regulation. The T-cell-based model predicted severe cases with high accuracy (AUC = 0.91).
Conclusion:
CD4+ T-cell activation is central to NMDAR-E pathogenesis, highlighting diagnostic/therapeutic potential. Future studies must validate the model in larger cohorts and address peripheral blood analysis limitations.
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