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Differences in peripheral myelin antigen-specific T cell responses and T memory subsets in atypical versus typical
M Staudt1, J M Diederich1, C Meisel2
1Department of Neurology, Charité University Medicine, Charitéplatz 1, 10117, Berlin, Germany.
Insights
Atypical chronic inflammatory demyelinating polyneuropathy (CIDP) shows distinct T cell differences compared to typical CIDP. These findings highlight potential immunological markers for diagnosing atypical CIDP variants.
Area of Science:
- Immunology
- Neurology
- Cellular Biology
Background:
- Chronic inflammatory demyelinating polyneuropathy (CIDP) exhibits significant clinical heterogeneity.
- Typical CIDP cases respond better to therapy than atypical variants.
- Understanding immunological differences is crucial for differentiating CIDP subtypes.
Purpose of the Study:
- To investigate cellular immunological distinctions between typical and atypical CIDP.
- To compare immune responses in CIDP patients against healthy controls.
Main Methods:
- Evaluated 26 CIDP patients (9 typical, 17 atypical) and 28 healthy controls.
- Employed clinical and immunological assessments, including ELISPOT and FACS.
- Utilized Kruskal-Wallis test for statistical comparisons.
Main Results:
- Atypical CIDP patients displayed higher frequencies of CD4+ effector memory T cells (TEM) and CD4+ central memory T cells (TCM).
- Elevated T cell responses against peripheral myelin antigens (PMP-22, P2, P0, MBP peptides) were observed in atypical CIDP.
- Significantly increased T cell reactivity to P0 180-199 and MBP 82-100 peptides in atypical CIDP versus controls.
Conclusions:
- Atypical CIDP is characterized by distinct T cell responses and an altered CD4+ memory compartment.
- Peripheral myelin antigen-specific T cell responses are heightened in atypical CIDP.
- Further multi-center studies are needed to validate these findings and develop diagnostic immunological markers.
Background:
Chronic inflammatory demyelinating polyneuropathy (CIDP) is presented by a large heterogeneity of clinical phenotypes. Around 50% of patients suffer from typical CIDP and show better therapy response than atypical variants. The goal of our study was to search for cellular immunological differences in typical versus atypical CIDP in comparison to controls.
Methods:
We evaluated 26 (9 typical, 17 atypical) patients with mainly active-unstable CIDP using clinical and immunological examinations (enzyme-linked immunospot assay ELISPOT, fluorescence-activated cell sorting FACS) in comparison to 28 healthy, age-matched controls (HC). Typical or atypical CIDP measurements were compared with HC using Kruskal-Wallis test.
Results:
Atypical CIDP patients showed increased frequencies of T cell subsets, especially CD4+ effector memory T cells (TEM) and CD4+ central memory T cells (TCM) as well as a tendency of higher T cell responses against the peripheral myelin antigens of PMP-22, P2, P0 and MBP peptides compared to typical CIDP. Searching for novel auto-antigens, we found that T cell responses against P0 180-199 as well as MBP 82-100 were significantly elevated in atypical CIDP patients vs. HC.
Conclusions:
Our results indicate differences in underlying T cell responses between atypical and typical CIDP characterized by a higher peripheral myelin antigen-specific T cell responses as well as a specific altered CD4+ memory compartment in atypical CIDP. Larger multi-center studies study are warranted in order to characterize T cell auto-reactivity in atypical CIDP subgroups in order to establish immunological markers as a diagnostic tool.
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