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Open Access 01-12-2023 | Systemic Lupus Erythematosus | Research

Supporting the differential diagnosis of connective tissue diseases with neurological involvement by blood and cerebrospinal fluid flow cytometry

Authors: Michael Heming, Louisa Müller-Miny, Leoni Rolfes, Andreas Schulte-Mecklenbeck, Tobias J. Brix, Julian Varghese, Marc Pawlitzki, Hermann Pavenstädt, Martin A. Kriegel, Catharina C. Gross, Heinz Wiendl, Gerd Meyer zu Hörste

Published in: Journal of Neuroinflammation | Issue 1/2023

Abstract

Objective

Neurological manifestations of autoimmune connective tissue diseases (CTD) are poorly understood and difficult to diagnose. We here aimed to address this shortcoming by studying immune cell compositions in CTD patients with and without neurological manifestation.

Methods

Using flow cytometry, we retrospectively investigated paired cerebrospinal fluid (CSF) and blood samples of 28 CTD patients without neurological manifestation, 38 CTD patients with neurological manifestation (N-CTD), 38 non-inflammatory controls, and 38 multiple sclerosis (MS) patients, a paradigmatic primary neuroinflammatory disease.

Results

We detected an expansion of plasma cells in the blood of both N-CTD and CTD compared to non-inflammatory controls and MS. Blood plasma cells alone distinguished the clinically similar entities N-CTD and MS with high discriminatory performance (AUC: 0.81). Classical blood monocytes indicated higher disease activity in systemic lupus erythematosus (SLE) patients. Surprisingly, immune cells in the CSF did not differ significantly between N-CTD and CTD, while CD4⁺ T cells and the CD4⁺/CD8⁺ ratio were elevated in the blood of N-CTD compared to CTD. Several B cell-associated parameters partially overlapped in the CSF in MS and N-CTD. We built a machine learning model that distinguished N-CTD from MS with high discriminatory power using either blood or CSF.

Conclusion

We here find that blood flow cytometry alone surprisingly suffices to distinguish CTD with neurological manifestations from clinically similar entities, suggesting that a rapid blood test could support clinicians in the differential diagnosis of N-CTD.

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Title: Supporting the differential diagnosis of connective tissue diseases with neurological involvement by blood and cerebrospinal fluid flow cytometry
Authors: Michael Heming
Louisa Müller-Miny
Leoni Rolfes
Andreas Schulte-Mecklenbeck
Tobias J. Brix
Julian Varghese
Marc Pawlitzki
Hermann Pavenstädt
Martin A. Kriegel
Catharina C. Gross
Heinz Wiendl
Gerd Meyer zu Hörste
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Systemic Lupus Erythematosus
Multiple Sclerosis
Published in: Journal of Neuroinflammation / Issue 1/2023
Electronic ISSN: 1742-2094
DOI: https://doi.org/10.1186/s12974-023-02733-w

2024 ASCO Annual Meeting

Springer Medicine

Supporting the differential diagnosis of connective tissue diseases with neurological involvement by blood and cerebrospinal fluid flow cytometry

Abstract

Objective

Methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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