The possible role of Interleukin-6 as a regulator of insulin sensitivity in patients with neuromyelitis optica spectrum disorder

Maghbooli, Zhila; Moghadasi, Abdorreza Naser; Rezaeimanesh, Nasim; Omidifar, Abolfazl; Varzandi, Tarlan; Sahraian, Mohammad Ali

doi:10.1186/s12883-021-02198-5

Cited by 7 publications

(2 citation statements)

References 50 publications

(27 reference statements)

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“…TyG has recently been widely studied in the field of coronary heart disease, and it has also been found to be associated with poor prognosis in neurological diseases such as acute ischemic stroke and Alzheimer’s disease ( Lee et al, 2021 ; Gentreau et al, 2022 ). Although Maghbooli et al (2021) also found that high insulin resistance was a risk factor for NMOSD, our study did not find abnormal TyG in patients with NMOSD, which may suggest that the TyG index could not accurately represent the degree of insulin resistance in NMOSD.…”

Section: Discussioncontrasting

confidence: 86%

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Predictive role of blood-based indicators in neuromyelitis optica spectrum disorders

et al. 2023

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IntroductionThis study aimed to assess the predictive role of blood markers in neuromyelitis optica spectrum disorders (NMOSD).MethodsData from patients with NMOSD, multiple sclerosis (MS), and healthy individuals were retrospectively collected in a 1:1:1 ratio. The expanded disability status scale (EDSS) score was used to assess the severity of the NMOSD upon admission. Receiver operating characteristic (ROC) curve analysis was used to distinguish NMOSD patients from healthy individuals, and active NMOSD from remitting NMOSD patients. Binary logistic regression analysis was used to evaluate risk factors that could be used to predict disease recurrence. Finally, Wilcoxon signed-rank test or matched-sample t-test was used to analyze the differences between the indicators in the remission and active phases in the same NMOSD patient.ResultsAmong the 54 NMOSD patients, neutrophil count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) (platelet × NLR) were significantly higher than those of MS patients and healthy individuals and positively correlated with the EDSS score of NMOSD patients at admission. PLR can be used to simultaneously distinguish between NMOSD patients in the active and remission phase. Eleven (20.4%) of the 54 patients had recurrence within 12 months. We found that monocyte-to-lymphocyte ratio (MLR) (AUC = 0.76, cut-off value = 0.34) could effectively predict NMOSD recurrence. Binary logistic regression analysis showed that a higher MLR at first admission was the only risk factor for recurrence (p = 0.027; OR = 1.173; 95% CI = 1.018–1.351). In patients in the relapsing phase, no significant changes in monocyte and lymphocyte count was observed from the first admission, whereas patients in remission had significantly higher levels than when they were first admitted.ConclusionHigh PLR is a characteristic marker of active NMOSD, while high MLR is a risk factor for disease recurrence. These inexpensive indicators should be widely used in the diagnosis, prognosis, and judgment of treatment efficacy in NMOSD.

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Section: Discussioncontrasting

confidence: 86%

“…The triglyceride-glucose index (TyG) is widely used to assess insulin resistance ( Tahapary et al, 2022 ). A study by Maghbooli et al (2021) linked insulin resistance with NMOSD, indicating that higher insulin resistance is a risk factor for NMOSD. Therefore, we speculated that TyG would also be significantly implicated in NMOSD.…”

Section: Introductionmentioning

confidence: 99%

Predictive role of blood-based indicators in neuromyelitis optica spectrum disorders

et al. 2023

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Newly emerging type B insulin resistance (TBIR) during treatment with eculizumab for AQP4-IgG-positive neuromyelitis optica spectrum disorder (NMOSD): fatal outcome

Doubrovinskaja,

Korporal-Kuhnke,

Jarius

et al. 2023

J Neurol

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Background Aquaporin-4 immunoglobulin G (AQP4-IgG) antibody-positive neuromyelitis optica spectrum disorders (NMOSD) are frequently associated with other autoimmune disorders, including systemic lupus erythematosus (SLE). Eculizumab (ECU) is a highly effective long-term treatment for NMOSD. However, ECU is known to increase significantly the risk of infection with encapsulated bacteria and sepsis. Recently, increased insulin resistance (IR) in patients with NMOSD has been suggested. Type B IR (TBIR) is a rare autoimmune condition often accompanying or preceding SLE. TBIR has not yet been reported in NMOSD. Objective: To report an ECU-treated patient with AQP4-IgG-positive NMOSD who developed fatal septic complications after the emergence of TBIR. Methods: Description of the clinical course over a period of 8 years. Results: A female patient was diagnosed with NMOSD at the age of 16 years. A variety of disease-modifying drugs failed to achieve sufficient disease control, resulting in severe tetraparesis. Treatment with ECU was started 6 years after NMOSD diagnosis and stabilized the disease. The patient developed TBIR 8 months after initiation of ECU therapy. Following high-dose intravenous methylprednisolone therapy for a clinical relapse and three further courses of ECU, the patient was admitted with severe pneumonia caused by the encapsulated bacterium Klebsiella pneumoniae and hypoglycemia. Despite multimodal therapy, the patient died from sepsis-related multiorgan failure 18 months after initiation of ECU. Conclusions: TBIR should be considered as differential diagnosis in patients with NMOSD presenting with disturbed glucose metabolism, irrespective of the presence of SLE. More real-world data are needed on the risk/benefit ratio of ECU treatment in patients who have co-existing autoimmune comorbidities that may compromise immune function. Strategies to mitigate the risk of serious infection in patients treated with ECU are discussed.

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Interleukin-6 cytokine: An overview of the immune regulation, immune dysregulation, and therapeutic approach

Aliyu

Zohora

Anka

et al. 2022

International Immunopharmacology

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The possible role of Interleukin-6 as a regulator of insulin sensitivity in patients with neuromyelitis optica spectrum disorder

Cited by 7 publications

References 50 publications

Predictive role of blood-based indicators in neuromyelitis optica spectrum disorders

Predictive role of blood-based indicators in neuromyelitis optica spectrum disorders

Newly emerging type B insulin resistance (TBIR) during treatment with eculizumab for AQP4-IgG-positive neuromyelitis optica spectrum disorder (NMOSD): fatal outcome

Interleukin-6 cytokine: An overview of the immune regulation, immune dysregulation, and therapeutic approach

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