Associations of the cerebrospinal fluid lymphocyte population with a clinical presentation of tick-borne encephalitis.

Autor: Grygorczuk S; Department of the Infectious Diseases and Neuroinfections, Medical University in Białystok, ul. Żurawia 14, Białystok 15-540, Poland. Electronic address: grygorczuk.sambor@op.pl., Osada J; Department of Hematologic Diagnostics, Medical University in Białystok, ul. Jerzego Waszyngtona 15A, Białystok 15-269, Poland., Sulik A; Department of Pediatric Infectious Diseases, Medical University in Białystok, ul. Jerzego Waszyngtona 17, Białystok 15-274, Poland., Toczyłowski K; Department of Pediatric Infectious Diseases, Medical University in Białystok, ul. Jerzego Waszyngtona 17, Białystok 15-274, Poland., Dunaj-Małyszko J; Department of the Infectious Diseases and Neuroinfections, Medical University in Białystok, ul. Żurawia 14, Białystok 15-540, Poland., Czupryna P; Department of the Infectious Diseases and Neuroinfections, Medical University in Białystok, ul. Żurawia 14, Białystok 15-540, Poland., Adamczuk J; University Hospital in Białystok, ul. Żurawia 14, Białystok 15-540, Poland., Moniuszko-Malinowska A; Department of the Infectious Diseases and Neuroinfections, Medical University in Białystok, ul. Żurawia 14, Białystok 15-540, Poland.
Jazyk: angličtina
Zdroj: Ticks and tick-borne diseases [Ticks Tick Borne Dis] 2023 Sep; Vol. 14 (5), pp. 102204. Date of Electronic Publication: 2023 May 26.
DOI: 10.1016/j.ttbdis.2023.102204
Abstrakt: In tick-borne encephalitis (TBE), lymphocytes infiltrating central nervous system are indispensable for the infection control, but also potentially immunopathogenic. To clarify their roles, we have evaluated cerebrospinal fluid (CSF) count of the main lymphocyte populations (considered as a proxy of the brain parenchyma lymphocytic infiltrate) in TBE patients and analyzed if they associate with clinical presentation, blood-brain barrier disruption and intrathecal antibody synthesis. We have studied CSF from 96 adults with TBE (50 with meningitis, 40 with meningoencephalitis, 6 with meningoencephalomyelitis), 17 children and adolescents with TBE and 27 adults with non-TBE lymphocytic meningitis. Th CD3+CD4+, Tc CD3+CD8+, double positive T CD3+CD4+CD8+, B CD19+ and NK CD16+/56+ cells were counted cytometrically with a commercial fluorochrome-stained monoclonal antibody set. The associations between the counts and fractions of these cells and clinical parameters were analyzed with non-parametric tests, p<0.05 considered significant. The TBE patients had lower pleocytosis with similar proportions of the lymphocyte populations compared to non-TBE meningitis. The different lymphocyte populations correlated positively with one another, as well as with CSF albumin, IgG and IgM quotients. The higher pleocytosis and expansion of Th, Tc and B cells associated with a more severe disease and neurologic involvement: Th with encephalopathy, myelitis and weakly with cerebellar syndrome, Tc with myelitis and weakly with encephalopathy, B with myelitis and with at least moderately severe encephalopathy. The double-positive T lymphocytes associated with myelitis, but not with other forms of CNS involvement. The fraction of double positive T cells decreased in encephalopathy and the fraction of NK in patients with neurologic deficits. In children with TBE, Tc and B counts were increased at the expense of Th lymphocytes in comparison with adults. The concerted intrathecal immune response, involving the main lymphocyte populations, increases with the clinical severity of TBE, with no evidently protective or pathogenic elements distinguishable. However, the particular populations including B, Th and Tc cells associate with different, though overlapping, spectra of CNS manifestations, suggesting they may be specifically related to TBE manifesting as myelitis, encephalopathy and cerebellitis. The double-positive T and NK cells do not expand evidently with severity and may be most closely associated with the protective anti-TBEV response.
Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests regarding this manuscript.
(Copyright © 2023 The Author(s). Published by Elsevier GmbH.. All rights reserved.)
Databáze: MEDLINE
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