Plasma Homocysteine Level Is Associated with the Expanded Disability Status Scale in Neuromyelitis Optica Spectrum Disorder

Neuroimmunomodulation. 2019;26(5):258-264. doi: 10.1159/000503426. Epub 2019 Oct 25.

Abstract

Background and objective: Plasma homocysteine (Hcy) levels have been investigated among patients with multiple sclerosis (MS). However, the changes in Hcy levels and the association between Hcy levels and inflammatory/immune/cerebrospinal fluid (CSF) parameters in neuromyelitis optica spectrum disorder (NMOSD) patients have not been investigated yet.

Methods: Case data were collected from 97 acute-phase NMOSD patients and 39 stable-phase NMOSD patients. Patients in the acute phase were divided into 2 groups based on the EDSS score with cutoff equal to 4. Hcy levels, immunoglobulins (Ig) A, G, and M, complement 3 and 4, CH50, C-reactive protein, erythrocyte sedimentation rate (ESR), and CSF examination including white blood cells and total protein were determined.

Results: No significant differences in Hcy levels are observed between acute-phase and stable-phase NMOSD patients. Hcy and ESR levels were significantly higher in acute-phase NMOSD patients with EDSS score ≥4. Besides, EDSS is positively correlated with Hcy level, ESR, 1/aquaporin-4 titer and Hcy level is negatively correlated with IgM in acute-phase NMOSD patients.

Conclusion: Elevated plasma Hcy has the potential to affect the pathogenesis or progression of NMOSD.

Keywords: Complement; Expanded Disability Status Scale; Homocysteine; Neuromyelitis optica spectrum disorder.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aquaporin 4 / immunology
  • Autoantibodies / immunology
  • Blood Sedimentation
  • C-Reactive Protein / immunology
  • Cerebrospinal Fluid / cytology
  • Cerebrospinal Fluid Proteins / cerebrospinal fluid
  • Complement C3 / immunology
  • Complement C4 / immunology
  • Complement Hemolytic Activity Assay
  • Disease Progression
  • Female
  • Homocysteine / blood*
  • Humans
  • Immunoglobulin A / immunology
  • Immunoglobulin G / immunology
  • Immunoglobulin M / immunology
  • Leukocyte Count
  • Male
  • Middle Aged
  • Neuromyelitis Optica / blood*
  • Neuromyelitis Optica / cerebrospinal fluid
  • Neuromyelitis Optica / immunology
  • Neuromyelitis Optica / physiopathology*
  • Severity of Illness Index

Substances

  • Aquaporin 4
  • Autoantibodies
  • Cerebrospinal Fluid Proteins
  • Complement C3
  • Complement C4
  • Immunoglobulin A
  • Immunoglobulin G
  • Immunoglobulin M
  • Homocysteine
  • C-Reactive Protein