Correlations between Electrophysiological Parameters, Lymphocyte Distribution and Cytokine Levels in Patients with Chronic Demyelinating Inflammatory Polyneuropathy.

Edyta Dziadkowiak,Helena Moreira,Ewa Barg,Malgorzata Wieczorek,Magdalena Koszewicz,Slawomir Budrewicz

doi:10.3390/jpm11080766

Edyta Dziadkowiak, Helena Moreira + Show 4 more

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https://doi.org/10.3390/jpm11080766

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Journal: Journal of Personalized Medicine	Publication Date: Aug 4, 2021
Citations: 3	License type: CC BY 4.0

Affiliation: Wroclaw Medical University

Abstract

The goal of this study was to analyse, in relation to electrophysiological results, the distribution of lymphocyte subpopulations and the level of cytokines in patients with the typical form of chronic demyelinating inflammatory polyneuropathy (CIDP) before immunoglobulin treatment. The study group consisted of 60 patients (52 men, eight women), with a mean age 64.8 ± 11.2, who fulfilled the diagnostic criteria for the typical variant of CIDP, with (23 patients) and without (37 patients) diabetes mellitus. We analysed the results of the neurophysiological tests, and correlated them with the leukocyte subpopulations, and cytokine levels. In CIDP patients, IL-6, IL-2, IL-4 and TNF-α levels were significantly increased compared to the control group. Fifty patients had decreased levels of T CD8+ lymphocytes, and 51 patients had increased levels of CD4+ lymphocytes. An increased CD4+/CD8+ ratio was also found. Negative correlations were observed mainly between compound muscle action potential (CMAP) amplitudes and cytokine levels. The study enabled the conclusion that electrophysiological parameters in CIDP patients are closely related to the autoimmune process, but without any clear differences between patients with and without diabetes mellitus. Correlations found in the study indicated that axonal degeneration might be independent of the demyelinating process and might be caused by direct inflammatory infiltration.

Highlights

Inflammatory neuropathies include the group of heterogeneous disorders characterized by immune-mediated hematogenous leukocyte infiltration of peripheral nerves, nerve roots or both, causing demyelination or axonal degeneration or both
chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) may coexist with other systemic diseases such as diabetes mellitus (DM) and monoclonal gammopathy of uncertain significance (MGUS)
CIDP associated with diabetes mellitus (CIDP-DM) differs from the CIDP subtype without diabetes in terms of clinical symptoms, laboratory results, response to therapy, and prognosis

Summary

Introduction

Inflammatory neuropathies include the group of heterogeneous disorders characterized by immune-mediated hematogenous leukocyte infiltration of peripheral nerves, nerve roots or both, causing demyelination or axonal degeneration or both. Three dominant disease categories can be distinguished among inflammatory neuropathies: Guillain–Barré syndrome, chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and non-systemic vasculitic neuropathy (or peripheral nerve vasculitis) [2,3]. Another rare immune-mediated neuropathy is multifocal motor neuropathy (MMN), characterized by slowly progressive, asymmetric, detached paresis of mainly the upper extremities. CIDP may coexist with other systemic diseases such as diabetes mellitus (DM) and monoclonal gammopathy of uncertain significance (MGUS). Consumption of alcohol, tobacco usage, and dysbiosis seem to exert a strong influence on neuroinflammatory processes [9]

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