Therapeutic Response and Possible Biomarkers in Acute Attacks of Neuromyelitis Optica Spectrum Disorders: A Prospective Observational Study

• DOI: 10.3389/fimmu.2021.720907
• Publication Date: 2021-08-04T04:47:11Z
• Authors: Jingqi Wang; Chunping Cui; Yaxin Lu; Yanyu Chang; Yuge Wang; Rui Li; Yilong Shan; Xiaobo Sun; Youming Long; Honghao Wang; Zhanhang Wang; Michael Lee; Shane He; Zhengqi Lu; Wei Qiu; Sha Tan
• Keywords: Interquartile range; Neuromyelitis Optica

Objective To explore the outcomes of NMOSD attacks and investigate serum biomarkers for prognosis severity. Method Patients with were prospectively observationally enrolled from January 2019 to December 2020 at four hospitals in Guangzhou, southern China. Data collected attack, discharge 1/3/6 months after acute treatment. Serum cytokine/chemokine neurofilament light chain (NfL) levels examined onset stage. Results One hundred patients included. The treatment comprised intravenous methylprednisolone pulse therapy alone (IVMP, 71%), IVMP combined apheresis (8%), immunoglobulin (18%) other therapies (3%). EDSS scores decreased significantly a medium 4 (interquartile range 3.0–5.5) attack 3.5 (3.0–4.5) discharge, (2.0–4.0) 1-month visit 3.0 3-month (p<0.01 all comparisons). remission rate was 38.0% 63.3% visit. Notably, relapse occurred 12.2% 74 by 6-month follow-up. Higher T helper cell 2 (Th2)-related cytokines, including interleukin (IL)-4, IL-10, IL-13, IL-1 receptor antagonist, predicted (OR=9.33, p=0.04). NfL correlated positively acute-phase (p<0.001, R = 0.487). Conclusions Outcomes generally moderate. A high level Th2-related cytokines visit, may serve as biomarker disease severity attack. Clinical Trial Registration https://clinicaltrials.gov/ct2/show/NCT04101058 , identifier NCT04101058.