B-cell related biomarkers associated with severity of the first demyelinating event of acute optic neuritis

Abstract

Background Optic neuritis (ON) is the most common cause of acute unilateral visual loss in young adults and frequently occurs as the presenting symptom of multiple sclerosis (MS). Recently, we reported activation of peripheral blood CD19 + B-cells in the early stage of ON. In the current study we aimed to identify peripheral blood B-cell molecular markers associated with ON severity and visual outcome. Methods Expression of B-cell related biomarkers were analysed in patients with the first clinical presentation of acute unilateral ON. Logarithm of the Minimum Angle of Resolution (LogMAR). visual acuity, Optical Coherence Tomography (OCT) imaging, Expanded Disability Status Scale (EDSS) visual score and visual evoked responses were evaluated at onset and visual acuity and EDSS visual score were repeated at 6 months post-ON. Results Thirty patients with acute unilateral ON, 77% female, mean age 33 ± 2.0 years, were enroled in the study. Expression of CD19, CD79A and CD20 B-cell markers significantly correlated with LogMAR visual acuity of the affected eye (r = 0.44, p = 0.01, r = 0.37, p = 0.01 and r = 0.36, p = 0.04, respectively). The marker levels were elevated between 1.5 and 2.2-folds in the group with worse visual acuity (LogMAR>1.0) at onset (CD79A:×1.5, p = 0.013; CD19:×2.25, p = 0.007; CD20:×1.5, p = 0.015) and not correlated with 6 month visual outcome. Conclusions Among patient with a first event of acute ON, expression of B-cell biomarkers correlated with the severity of the disease. These results could add information on the role of B-cell dysfunction in the early stages of ON.

Overview of diet and autoimmune demyelinating optic neuritis: a narrative review

“…Specifically, higher expression levels of these markers correlated with the severity of visual acuity deficits [69,70] . Interestingly, these markers largely did not differ between subjects irrespective of the extent of vision recovery [69] . In addition, naïve CD19 + CD24 + CD38 + B regulatory cells were higher in people experiencing ADON when compared with age-matched, healthy controls, although differences between the cohorts were not detected in the capacity of these cells to produce IL-10, a primary anti-inflammatory cytokine that suppresses pathogenic T cells through multiple mechanisms [71] .…”

“…B cells can present antigen to activate T cells during the earliest stages of ADON, and select B cell-related markers including CD19, CD20, and CD79A in peripheral blood mononuclear cells have been associated with first episodes of ADON. Specifically, higher expression levels of these markers correlated with the severity of visual acuity deficits [69,70] . Interestingly, these markers largely did not differ between subjects irrespective of the extent of vision recovery [69] .…”