Immune system modifications in atypical parkinsonism related to autoimmunity - a case control study

Inflammation is known in atypical parkinsonism (AP), but the role of autoimmunity is unclear. This study evaluates immune system modifications suggesting autoimmunity in AP.

Included patients with AP diagnosed at Amrita Institute of Medical Sciences, Kochi (December 2018-May 2019), and age- and sex-matched controls. Fifteen immune parameters, including T regulatory cells, RORγt, and cytokines (IL-2, IL-4, IL-6, IL-10, IL-17A, IL-21, IL-22, IL-23, TNF, IFN-γ, GM-CSF, NF-κB, TGF-β), were assessed in peripheral blood (flow cytometry and ELISA).

Twenty-six cases (mean age 67.8 ± 7.5 years; 16 males) and 15 controls (mean age 68.1 ± 3.5 years; 10 males) studied. Diagnoses included progressive supranuclear palsy (n = 15), multiple system atrophy (n = 1), frontotemporal dementia with parkinsonism (n = 2), and unspecified AP (n = 8). AP cases had significantly higher RORγt (p = 0.041), IL-6 (p = 0.004), TNF (p = 0.020), IL-10 (p = 0.027), and IL-4 (p = 0.048).

Elevated RORγt and cytokines suggest immune dysregulation and possible autoimmune mechanisms in AP, warranting further investigation.