Objective: This study aimed to evaluate the peripheral immune profile in patients with Progressive Supranuclear Palsy (PSP) compared with patients with Parkinson’s disease (PD) and healthy controls (HCs).

Background: Evidence points to the involvement of peripheral inflammation in the pathogenesis of PSP and suggests that it is a common feature with PD. However, the peripheral immune profile in PSP remains unclear, as well as whether the inflammatory pathways differ significantly from those in PD. Studies on the leukocytes and subpopulations in PSP have shown controversial results. Interestingly, the neutrophil-to-lymphocyte ratio (NLR) in peripheral blood has been proven to be a well-established biomarker of systemic inflammation.

Method: We conducted a cross-sectional study including 120 patients with PSP, 127 patients with sporadic PD and 266 HCs. All subjects were examined for exclusion criteria that could influence the immune profile. Leukocytes subpopulations and the NLR were measured in peripheral blood. Multivariate lineal regression and post-hoc tests were applied to determine the differences among groups. Electronic databases were searched in November 2023 to perform a meta-analysis to clarify the peripheral immune profile in PSP.

Results: In our cohort, the NLR was significantly higher in both patients with PSP and PD compared with HCs (p<0,001). No significant differences were found in the NLR between PSP and PD (p=0.41). Patients with PSP had a significant higher neutrophil count compared with HCs (p<0,001). A higher neutrophil count was also found in patients with PD compared to HCs, but it did not reach statistical significance (p=0.06). Interestingly, while a significant lower lymphocyte count was found in patients with PD compared with HCs (p=0.001), the lymphocyte count did not differ between patients with PSP patients and HCs (p=0.97).

The metanalysis supported that a higher NLR and a higher neutrophil count were present in patients with PSP compared with HCs, without differences in the lymphocyte count.

Conclusion: Patients with PSP and PD show an increased peripheral inflammation and a higher NLR compared with HCs. However, different pathogenic inflammatory mechanisms are probably involved in PSP and PD, since in patients with PSP this altered peripheral immune profile is mainly driven by neutrophils. Understanding the role of neutrophils in PSP may allow for the development of targeted therapies.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/peripheral-immune-profile-and-neutrophil-to-lymphocyte-ratio-in-progressive-supranuclear-palsy/