墨西哥患者的临床隔离综合征转化预测器到多发性硬化症:一项前性研究
Víctor Chavarria1, Guillermo Espinosa-Ramírez1, Julio Sotelo1
1Neuroimmunology Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
Archives of medical research
|July 10, 2023
概括
墨西哥患者从临床隔离综合征 (CIS) 转化为临床确定的多发性硬化症 (CDMS) 的预测因素包括运动症状,MRI病变和特定的疹病毒DNA. 较低的T和B细胞百分比也表明转化风险更高.
科学领域:
- 神经免疫学 神经免疫学
- 临床神经学 临床神经学
- 流行病学 流行病学
背景情况:
- 临床隔离综合征 (CIS) 是临床确定的多发性硬化症 (CDMS) 的初始表现.
- 在墨西哥混血人口中,CIS到CDMS转换预测指标的数据有限.
- 这项研究解决了理解墨西哥CIS发展的差距.
研究的目的:
- 在墨西哥患者中确定CIS转化为CDMS的免疫标志物,临床和临床前预测因素.
- 研究疹病毒DNA在疾病进展中的作用.
- 在墨西哥队列中确定MS发展的预后因素.
主要方法:
- 一个前性,单中心的队列研究,对273名新诊断的CIS患者在墨西哥 (2006-2010年).
- 在诊断时评估临床数据,免疫类型,血清细胞因子,抗髓抗体和疹病毒DNA.
- 使用2010年麦当劳标准进行十年的跟进,以确定转换到CDMS.
主要成果:
- 46%的CIS患者在10年内转换为CDMS.
- 运动症状,多焦点综合征和异常的体感官唤起潜能预测了转化.
- 至少有一个MRI病变的存在显著增加了转化风险 (RR 15.52).
- 在转化器中观察到低循环调节性T细胞,细胞毒性T细胞和B细胞.
- 脊髓流和血液中的1个DNA与CDMS转化相关.
结论:
- 运动症状,MRI病变和特定的疹病毒DNA是墨西哥患者CIS转化为CDMS的关键预测因素.
- 免疫类型的变化,包括T细胞和B细胞数量的减少,与疾病的进展有关.
- 这些发现为管理墨西哥人口中的CIS提供了关键的见解,并突出了潜在的治疗目标.
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