The imbalance between Bregs, Tfh, and Tregs in patients with anti-N-methyl-D-aspartate receptor encephalitis

Abstract

Objective To detect the alteration of regulatory B cells (Bregs), follicular helper T cells (Tfh), and regulatory T cells (Tregs) frequencies in patients with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. Analyze their association with clinical severity and activity, and explore the effects of different immunotherapies on those immune cell subsets. Methods We enrolled 21 patients with anti-NMDAR encephalitis, 22 patients with neuromyelitis optica spectrum disorder (NMOSD), 14 patients with idiopathic intracranial hypertension (IIH), and 20 healthy controls (HC) in our study. The frequencies of various immune cell subsets were determined using flow cytometry. Results Compared to patients with IIH and HC, the frequencies of CD24hiCD38hi transitional B cells as well as Tregs were significantly lower while the frequency of Tfh was significantly higher in patients with anti-NMDAR encephalitis. The frequency of CD24hiCD38hi transitional B cells was significantly lower in the acute stage than in the recovery stage, and was negatively correlated with the modified Rankin scale (mRS) and the clinical assessment scale for autoimmune encephalitis (CASE). The frequency of CD24hiCD38hi transitional B cells at the last follow-up after rituximab (RTX) treatment was significantly higher than those treated with oral immunosuppressants or untreated. There was no clear difference between anti-NMDAR encephalitis and NMOSD in the above immune cell subsets. Conclusion We suggested that the frequencies of CD24hiCD38hi transitional B cells and Tregs were decreased while the frequency of Tfh was increased in patients with anti-NMDAR encephalitis. CD24hiCD38hi transitional B cells frequency may be a potential indicator to estimate the disease activity and severity.

B-cell targeted therapies in autoimmune encephalitis: mechanisms, clinical applications, and therapeutic potential

“…Blocking the interactions may also be a treatment strategy for AE. Li et al observed a significant decrease in the expression of regulatory B cells (Bregs) and regulatory T cells (Tregs) and an increase in T follicular helper cells (Tfh) in patients with NMDAR AE, indicating that Bregs may also be involved in AE pathogenesis (51). Bregs do not have a distinctive transcription factor and are characterized by the production of the inhibitory cytokine IL-10.…”

Effects of replacing dietary fishmeal with zymolytic black soldier fly larvae on the growth performance of the mud crab (scylla paramamosain) larvae

“…5 In related studies in the field of aquatic feeds, the use of plant protein sources like soybean meal, cottonseed meal, singlecelled algae and soybean protein concentrate can replace FM in some aquatic animal feeds to some extent and will not have negative effects on aquatic animals' growth, feed utilization, nutritional quality and immunity. [6][7][8][9] However, there are many problems with plant protein raw materials, for example, containing different kinds of antinutritional factors, high fiber content, amino acid imbalance, and its replacement of FM ratio above a certain level will affect the growth and health of aquatic animals to varying degrees, especially for carnivorous fish. 10,11 And the increased use of plant protein raw materials will lead to increased competition between feed production and human food supply.…”