Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Immune Changes in ALS Bear Closer Observation

JAMA Neurol; ePub 2017 Sep 25; Murdock, et al

Changes in the immune system occur during amyotrophic lateral sclerosis (ALS) and may contribute to the pathologic features of ALS, a recent study found. In this longitudinal cohort study, leukocytes were isolated from peripheral blood samples from both controls and participants with ALS at the ALS Clinic of the University of Michigan, from June 18, 2014, through May 26, 2016. Follow-up visits occurred every 6 to 12 months. 35 controls (17 women [48.6%] and 18 men [51.4%]; mean [SD] age, 63.5 [9.9] years) and 119 participants with ALS (50 women [42.0%] and 69 men [68.0%]; mean [SD] age, 61.4 [11.5] years) were enrolled; 51 participants with ALS provided samples at multiple points. Researchers found:

  • Compared with controls, participants with ALS had increased mean counts (× 106/mL) of total leukocytes (4.57 vs 5.53), neutrophils (2.87 vs 3.80), CD16+ monocytes (0.03 vs 0.04), CD16− monocytes (0.25 vs 0.29), and natural killer cells (0.13 vs 0.18).
  • There was also an acute, transient increase in a population of CD11b+ myeloid cells expressing HLA-DR, CD11c, and CX3CR1.

Murdock BJ, Zhou T, Kaslan SR, Little EJ, Goutman SA, Feldman EL. Correlation of peripheral immunity with rapid amyotrophic lateral sclerosis progression. [Published online ahead of print September 25, 2017]. JAMA Neurol. doi:10.1001/jamaneurol.2017.2255.

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