背景：神经炎症可能与多发性系统性萎缩（MSA）的发病机制有关。然而,MSA患者外周炎症和免疫特征的特异性改变尚不清楚.
目的：确定MSA患者的外周炎症和免疫特征及其作为促进临床诊断和监测疾病严重程度的生物标志物的潜在价值。
方法：这项横断面研究包括235、240和235例MSA患者，帕金森病（PD）患者，和健康对照（HCs），分别。在外周血中测量炎症和免疫参数，评估了组间的差异，并对聚类进行了分析。使用Spearman和偏相关分析评估MSA的参数与临床特征之间的关联。
结果：观察到显著差异，尤其是在单核细胞中，MSA患者与HCs之间的中性粒细胞与淋巴细胞比率（NLR）和中性粒细胞与淋巴细胞比率（MPV）（P<0.01）。单核细胞和尿酸（UA）水平在MSA和PD患者之间也存在显着差异（P<0.05）。NLR和MPV的组合区分MSA-P患者与HC(曲线下面积=0.824)。此外,补体成分C4和C3与自主症状的PD量表和Wexner量表的结果显着相关，而免疫球蛋白G（IgG）与统一多系统萎缩评定量表评分显着相关（P<0.05）。
结论：在MSA患者中，单核细胞,NLR和MPV可能作为潜在的诊断生物标志物，而MLR,C3、C4和IgG与疾病严重程度显著相关。©2023国际帕金森和运动障碍协会。
BACKGROUND: Neuroinflammation might contribute to the pathogenesis of multiple systemic atrophy (MSA). However, specific alterations in the peripheral inflammatory and immune profiles of patients with MSA remain unclear.
OBJECTIVE: To determine the peripheral inflammatory and immune profiles of patients with MSA and their potential value as biomarkers for facilitating clinical diagnosis and monitoring disease severity.
METHODS: This cross-sectional study included 235, 240, and 235 patients with MSA, patients with Parkinson\'s disease (PD), and healthy controls (HCs), respectively. Inflammatory and immune parameters were measured in peripheral blood, differences between groups were assessed, and clusters were analyzed. Associations between the parameters and clinical characteristics of MSA were assessed using Spearman and partial correlation analyses.
RESULTS: Significant differences were observed especially in monocytes, neutrophils-to-lymphocyte ratio (NLR) and neutrophils-to-lymphocyte ratio (MPV) between MSA patients and HCs (P < 0.01). Monocytes and uric acid (UA) levels were also significantly different between the MSA and PD patients (P < 0.05). The combination of NLR and MPV distinguished MSA-P patients from HCs (areas under the curve = 0.824). In addition, complement components C4 and C3 were significantly correlated with the Scale Outcomes in PD for Autonomic Symptoms and Wexner scale, whereas immunoglobulin G (IgG) was significantly correlated with scores of Unified Multiple System Atrophy Rating Scale (P < 0.05).
CONCLUSIONS: In MSA patients, monocytes, NLR and MPV might serve as potential diagnostic biomarkers, whereas MLR, C3, C4, and IgG significantly correlate with disease severity. © 2023 International Parkinson and Movement Disorder Society.
