Objective: Our aim is to clarify the correlations between peripheral immune activation and the prevalence as well as the disease severity of MSA.

Background: Alpha-synuclein is involved in the pathogenesis of multiple system atrophy (MSA) and can be regulated by peripheral immune activation.

Methods: A total of 312 patients with probable MSA and 312 age- and gender-matched healthy controls were included in this study. Their lymphocyte subsets and the levels of immunoglobulins IgG, IgM, and IgA were evaluated. The unified MSA rating scale (UMSARS) was used to assess the severity of MSA.

Results: The mean age of MSA patients was 58.9±8.5 years and the median disease duration was 2.5 years. The proportions of CD3+, CD4+ T lymphocytes and the ratio of CD4+ to CD8+were significantly increased, and IgG concentrations were significantly decreased in MSA patients compared with those in normal controls. There was no significant difference on lymphocyte subsets and the levels of immunoglobulins IgG, IgM, and IgA between MSA-C and MSA-P. Subjects with the lowest quartiles, the second quartiles and the third quartiles of CD3+, CD4+ T lymphocytes and the ratio of CD4+ to CD8+ had low prevalence of MSA compared with those with the highest quartiles of CD3+, CD4+ T lymphocytes and the ratio of CD4+ to CD8+. Subjects with the lowest quartiles of IgG showed high prevalence of MSA compared with those with the highest quartiles of IgG. No correlation was found between UMSARS and lymphocyte subsets as well as the levels of immunoglobulins IgG, IgM, and IgA.

Conclusions: Low proportions of CD3+, CD4+ T lymphocytes and the ratio of CD4+ to CD8+ decreased the prevalence of MSA in a Chinese population. However, peripheral immune activation did not associate with the disease severity of MSA.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/peripheral-immune-activation-was-associated-with-multiple-system-atrophy/