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Abstract Details

Circulating B Cell Subsets and Cytokine Gene Expression Levels in Peripheral Blood and Skin Biopsy in Chronic Inflammatory Demyelinating Polyneuropathy
Autoimmune Neurology
P6 - Poster Session 6 (12:00 PM-1:00 PM)
15-004
The efficacy of intravenous immunoglobulin and plasma exchange in the treatment of chronic inflammatory demyelinating polyneuropathy(CIDP) suggests a pathogenetic contribution of humoral factors in CIDP. 
This study aimed to analyze peripheral B-cell homeostasis, IL6, IL10 and TNFA mRNA expression levels in peripheral mononuclear blood cells(PBMC) and in skin biopsy specimens among patients with typical,and atypical CIDP, also investigate their value as a biomarker.
Twenty-five typical CIDP, 18 MADSAM and 7 DADS-I patients were included.Twenty-five sex and age-matched healthy donors(HC) and 12 CMT1A cases served as disease controls.Peripheral B-cell populations were analyzed by flow cytometry.IL6, IL10 and TNFA mRNA expression levels in PBMC and in skin biopsy specimens were also evaluated by real-time polymerase chain reaction.Correlations between B-cell populations, cytokine gene expression levels and International Neuropathy Cause and Treatment(INCAT) disability score were evaluated. 
We detected significant reduction in total B-cells(p=0.0002), naive B-cells(p=0.0012) and plasma cells(p<0.0001) and elevation in switched memory B-cells (p=0.0004) in CIDP compared to HC.Plasma cell percentages were reduced in typical CIDP compared to atypical CIDP(p=0.0191). However, typical CIDP and atypical CIDP subjects both had reduced plasma cell percentages compared to control groups and other B-cell subtypes were similar among typical and atypical CIDP. CIDP cases had significantly higher TNFA gene expression levels in PBMC compared to HC(p=0.0191).There were no significant difference in IL6 and IL10 gene expression levels in PBMC between groups of CIDP and HC. IL6 and TNFA gene expression levels in skin biopsies were not different in CIDP subgroups and HC.

Altered B-cell homeostasis and TNFA gene expression levels in PBMC give an impression of chronic antigen exposure and overactivity in humoral immune system, and represent a typical signature in both typical and atypical CIDP as indicated above.Investigating the underlying mechanisms of changes in B-cell population will guide the development of novel treatment modalities in CIDP.

Authors/Disclosures
Ayse Nur Ozdag Acarli
PRESENTER
Ayse Nur Ozdag Acarli has nothing to disclose.
Vuslat Yilmaz Vuslat Yilmaz has nothing to disclose.
Nermin Sirin No disclosure on file
Arman Cakar Arman Cakar has nothing to disclose.
Aysun Soysal, MD (Bakirkoy Hospital Of Mental Disorders And Neuro) Dr. Soysal has nothing to disclose.
Fikret Aysal No disclosure on file
Hacer Durmus, MD (Department of Neurology, Istanbul Faculty of Medicine) Dr. Durmus has nothing to disclose.
Erdem Tuzun Erdem Tuzun has nothing to disclose.
Fatma Yesim Parman, MD (Istanbul Üniversitesi Tip Fakültesi) Dr. Parman has nothing to disclose.