The landscape of PBMCs in AQP4‐IgG seropositive NMOSD and MOGAD, assessed by high dimensional mass cytometry

Objectives Data on peripheral blood mononuclear cells (PBMCs) characteristics of aquaporin‐4 (AQP4)‐IgG seropositive neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody‐associated disease (MOGAD) are lacking. In this study, we describe the whole PBMCs landscape of the above diseases using cytometry by time‐of‐flight mass spectrometry (CyTOF). Methods The immune cell populations were phenotyped and clustered using CyTOF isolated from 27 AQP4‐IgG seropositive NMOSD, 11 MOGAD patients, and 15 healthy individuals. RNA sequencing was employed to identify critical genes. Fluorescence cytometry and qPCR analysis were applied to further validate the algorithm‐based results that were obtained. Results We identified an increased population of CD11b+ mononuclear phagocytes (MNPs) in patients with high expression of CCR2, whose abundance may correlate with brain inflammatory infiltration. Using fluorescence cytometry, we confirmed the CCR2+ monocyte subsets in a second cohort of patients. Moreover, there was a wavering of B, CD4+ T, and NKT cells between AQP4‐IgG seropositive NMOSD and MOGAD. Conclusions Our findings describe the whole landscape of PBMCs in two similar demyelinated diseases and suggest that, besides MNPs, T, NK and B, cells were all involved in the pathogenesis. The identified cell population may be used as a predictor for monitoring disease development or treatment responses. Our data systematically characterized the circulating PBMCs landscape of AQP4‐IgG seropositive NMOSD and MOGAD patients, revealed the profiles of periphery blood immune cells which may play potential roles in disease development or protection.