Integrated Blood Inflammatory Ratios and Cerebrospinal Fluid Blood‒Brain Barrier Dysfunction Predict Relapse Risk in Neuromyelitis Optica Spectrum Disorder - PubMed
2 hours ago
- #relapse prediction
- #neuromyelitis optica
- #inflammatory ratios
- Relapse drives irreversible disability in neuromyelitis optica spectrum disorder (NMOSD).
- Individualized relapse risk tools are limited despite AQP4-IgG's role in diagnosis.
- Study aimed to create a prognostic model using blood-brain barrier (BBB) dysfunction and systemic inflammation.
- 152 NMOSD patients were followed retrospectively for time to first relapse.
- Baseline data included neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and CSF BBB parameters.
- Higher BBB dysfunction and inflammation at baseline predicted relapse.
- Three models were compared: clinical, clinical-CSF, and integrated clinical-CSF-blood inflammatory.
- Integrated model showed best discrimination with AUC 0.850 and good calibration.
- Model predicted relapse risk even in AQP4-IgG seropositive patients, adding value beyond serostatus.
- Higher AQP4-IgG titers were linked to increased relapse risk in exploratory analyses.