Study of Clinical Immunological Electrophysiological Factors in Prognosis of Autoimmune Neurological Diseases

Abstract

Background newlineAutoimmune diseases of nervous system like Acute Inflammatory Demyelinating , Poly radiculopathy, Chronic Inflammatory Demyelinating Polyradiculopathy , Transverse Myelitis and Optic neuritis cause considerable morbidity and mortality. In this study we aim to elucidate the factors which influence their severity at presentation and response to immune therapy with steroids, Intravenous immunoglobulin therapy and plasmapheresis . newlineMethod newlineClinical data and serum cytokine levels of consecutive consenting patients who were admitted for the neurological conditions AIDP, CIDP, Transverse myelitis (Idiopathic of autoimmune etiology) and Optic neuritis in Chettinad Academy and Research Institute/Chettinad University of Tamil Nadu state in India between period 2017-2019 were studied . newlineResults newlineRelationship of cytokines to disease severity in polyradiculopathies newlineCytokine levels of patients with acute /chronic demyelinating poly radiculopathies are studied for their correlation with the severity of the disease as assessed by Hughes criteria. Patients who presented with severe debilitating disease (Hughes grade 4,5,6) had significantly higher levels of IL-17, IL-13 and Interferon gamma in serum at presentation when compared to patients with non debilitating illness ( Hughes grade 1,2,3). newline newlineComparison of effects of IVIg and Methyl prednisolone (Steroid) treatment on cytokine profile. newlineIVIG treatment reduced significantly TNF- alpha level and increased IL-6 levels in serum of most of the patients. The reduction in TNF- alpha levels due to IVIG ranged from 24 percentage to 99 percentage. There was no significant change in levels of any of the studied cytokines after methyl prednisolone treatment. newline newlineRelationship of Serum Cytokine profile to Steroid resistance in Demyelinating Neurological Illnesses newlineMost of the patients who were not responsive to steroid treatment were found to have significantly high levels of Interferon gamma, IL-17 and IL-13 levels in serum at presentation. newlineConclusion newline Serum cytokines levels may be a useful tool to prognosticate and predict response to treatment of patients with autoimmune neurological diseases . newline newline