The Relationship Between Plasma Prolactin Levels and Clinical Manifestations with Neuromyelitis Optica Spectrum Disorders

Overview

Journal Neurol Sci

Specialty Neurology

Date 2023 Aug 24

PMID 37620730

Authors

Hanchen Liu

Xianxing Zhang

Wei Chen

Yiwen Xu

Xiaoting Lin

Aiyu Lin

Affiliations

Soon will be listed here.

Abstract

Introduction: Systemic prolactin levels have been found to increase in 19 patients diagnosed with neuromyelitis optica spectrum disorders (NMOSD). However, the relationship between plasma prolactin levels and clinical manifestations in NMOSD patients remains unclear.

Methods: This cross-sectional study was conducted as part of a Registered Cohort Study of Inflammatory Demyelination Disease (NCT04386018). A total of 95 patients diagnosed with central nervous system demyelinating diseases and 43 healthy controls were recruited between May 2020 and February 2022 at the First Affiliated Hospital of Fujian Medical University. Plasma samples were collected from all participants and analyzed for prolactin levels using electrochemiluminescence immunoassay. The study aimed to investigate the correlation between plasma prolactin levels and clinical features in patients with central nervous system demyelinating diseases.

Results: Plasma prolactin levels in NMOSD patients were significantly higher than those in multiple sclerosis/myelin oligodendrocyte glycoprotein antibody-associated diseases patients and controls (p<0.05, respectively), and were found to be correlated with disease activity, sensory abnormalities, thoracic spinal cord lesions, and MR lesion enhancement (p<0.05). A total of 16.28% of NMOSD patients exhibited macroprolactinemia. However, there was no correlation found between macroprolactin levels and disease activity (p>0.05).

Conclusion: Prolactin may play a role in the pro-inflammatory regulation mechanism of NMOSD.

References

Bove R, Elsone L, Alvarez E, Borisow N, Cortez M, Mateen F . Female hormonal exposures and neuromyelitis optica symptom onset in a multicenter study. Neurol Neuroimmunol Neuroinflamm. 2017; 4(3):e339. PMC: 5366671. DOI: 10.1212/NXI.0000000000000339. View

Wingerchuk D, Banwell B, Bennett J, Cabre P, Carroll W, Chitnis T . International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2015; 85(2):177-89. PMC: 4515040. DOI: 10.1212/WNL.0000000000001729. View

Jarius S, Ruprecht K, Wildemann B, Kuempfel T, Ringelstein M, Geis C . Contrasting disease patterns in seropositive and seronegative neuromyelitis optica: A multicentre study of 175 patients. J Neuroinflammation. 2012; 9:14. PMC: 3283476. DOI: 10.1186/1742-2094-9-14. View

Banwell B, Marrie R . Increased relapse rate during pregnancy and postpartum in neuromyelitis optica. Neurology. 2017; 89(22):2220-2221. DOI: 10.1212/WNL.0000000000004721. View

Collongues N, Alves Do Rego C, Bourre B, Biotti D, Marignier R, Silva A . Pregnancy in Patients With AQP4-Ab, MOG-Ab, or Double-Negative Neuromyelitis Optica Disorder. Neurology. 2021; 96(15):e2006-e2015. DOI: 10.1212/WNL.0000000000011744. View

Klawiter E, Bove R, Elsone L, Alvarez E, Borisow N, Cortez M . High risk of postpartum relapses in neuromyelitis optica spectrum disorder. Neurology. 2017; 89(22):2238-2244. PMC: 5705247. DOI: 10.1212/WNL.0000000000004681. View

Langer-Gould A, Smith J, Albers K, Xiang A, Wu J, Kerezsi E . Pregnancy-related relapses and breastfeeding in a contemporary multiple sclerosis cohort. Neurology. 2020; 94(18):e1939-e1949. PMC: 7274922. DOI: 10.1212/WNL.0000000000009374. View

Borba V, Zandman-Goddard G, Shoenfeld Y . Prolactin and autoimmunity: The hormone as an inflammatory cytokine. Best Pract Res Clin Endocrinol Metab. 2019; 33(6):101324. DOI: 10.1016/j.beem.2019.101324. View

Vilar L, Vilar C, Lyra R, Freitas M . Pitfalls in the Diagnostic Evaluation of Hyperprolactinemia. Neuroendocrinology. 2019; 109(1):7-19. DOI: 10.1159/000499694. View

10.

Gregg C . Pregnancy, prolactin and white matter regeneration. J Neurol Sci. 2009; 285(1-2):22-7. DOI: 10.1016/j.jns.2009.06.040. View

11.

Cabrera-Reyes E, Limon-Morales O, Rivero-Segura N, Camacho-Arroyo I, Cerbon M . Prolactin function and putative expression in the brain. Endocrine. 2017; 57(2):199-213. DOI: 10.1007/s12020-017-1346-x. View

12.

Shelly S, Boaz M, Orbach H . Prolactin and autoimmunity. Autoimmun Rev. 2011; 11(6-7):A465-70. DOI: 10.1016/j.autrev.2011.11.009. View

13.

Turkoglu R, Giris M, Gencer M, Akcan U, Orcen A . Serum Prolactin Levels in Multiple Sclerosis, Neuromyelitis Optica, and Clinically Isolated Syndrome Patients. Noro Psikiyatr Ars. 2017; 53(4):353-356. PMC: 5353044. DOI: 10.5152/npa.2016.16979. View

14.

Jarius S, Paul F, Aktas O, Asgari N, Dale R, De Seze J . MOG encephalomyelitis: international recommendations on diagnosis and antibody testing. J Neuroinflammation. 2018; 15(1):134. PMC: 5932838. DOI: 10.1186/s12974-018-1144-2. View

15.

Lopez-Chiriboga A, Majed M, Fryer J, Dubey D, McKeon A, Flanagan E . Association of MOG-IgG Serostatus With Relapse After Acute Disseminated Encephalomyelitis and Proposed Diagnostic Criteria for MOG-IgG-Associated Disorders. JAMA Neurol. 2018; 75(11):1355-1363. PMC: 6248120. DOI: 10.1001/jamaneurol.2018.1814. View

16.

Banwell B, Bennett J, Marignier R, Kim H, Brilot F, Flanagan E . Diagnosis of myelin oligodendrocyte glycoprotein antibody-associated disease: International MOGAD Panel proposed criteria. Lancet Neurol. 2023; 22(3):268-282. DOI: 10.1016/S1474-4422(22)00431-8. View

17.

Kim Y, Hyun J, Woodhall M, Oh Y, Lee J, Jung J . Refining cell-based assay to detect MOG-IgG in patients with central nervous system inflammatory diseases. Mult Scler Relat Disord. 2020; 40:101939. DOI: 10.1016/j.msard.2020.101939. View

18.

Thompson A, Banwell B, Barkhof F, Carroll W, Coetzee T, Comi G . Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2017; 17(2):162-173. DOI: 10.1016/S1474-4422(17)30470-2. View

19.

Melmed S, Casanueva F, Hoffman A, Kleinberg D, Montori V, Schlechte J . Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011; 96(2):273-88. DOI: 10.1210/jc.2010-1692. View

20.

Kasum M, Pavicic-Baldani D, Stanic P, Oreskovic S, Saric J, Blajic J . Importance of macroprolactinemia in hyperprolactinemia. Eur J Obstet Gynecol Reprod Biol. 2014; 183:28-32. DOI: 10.1016/j.ejogrb.2014.10.013. View