Serum Levels of Aryl Hydrocarbon Receptor Plasma Agonist Activity Are Reduced in Patients With NMOSD and Correlate With Disease Activity
Bibliographic record
Abstract
BACKGROUND AND OBJECTIVES: Neuromyelitis optica spectrum disorders (NMOSDs) are severe autoimmune diseases characterized by recurrent CNS inflammation and high risk of persistent disability. Effective disease monitoring is essential for timely intervention and relapse prevention. While biomarkers such as soluble glial fibrillary acidic protein and neurofilament light chain indicate astrocytic and neuronal damage, additional markers are needed to improve disease monitoring and treatment strategies. The ligand-activated transcription factor aryl hydrocarbon receptor (AHR) is a key immune regulator in autoimmune diseases such as multiple sclerosis, where its ligands correlate with disease activity. Given overlapping immunologic pathways, AHR signaling may also influence NMOSD pathophysiology. In this context, this study examines serum levels of AHR ligand in NMOSD, assessing their regulation and association with disease activity. Elucidating the role of AHR signaling may pave the way to explore novel markers of disease activity and therapeutic intervention in NMOSD. METHODS: AHR agonistic activity was assessed in the serum of 102 patients with aquaporin-4 antibody-positive NMOSD across various stages of the disease. As control, serum samples from 36 patients with noninflammatory diseases were evaluated for AHR agonistic activity. In addition, we measured AHR activity longitudinally in 10 individuals at 3 distinct time points-during a quiescent phase preceding relapse, at relapse, and during a postrelapse quiescent phase-to evaluate the dynamic changes in AHR activity over time. RESULTS: Serum AHR agonistic activity was globally decreased in the NMOSD cohort compared with the control group. AHR agonistic activity was further reduced during or near relapses. Finally, we conducted longitudinal analyses on individual serum samples obtained from patients with NMOSD. Our findings reveal that AHR activity significantly decreases during the relapse phase compared with the quiescent phase, with a subsequent recovery after relapse. DISCUSSION: Serum AHR agonistic activity is reduced in patients with NMOSD compared with controls and further modulated in temporal vicinity to a relapse. Furthermore, our longitudinal analysis confirmed that AHR activity is markedly reduced during relapse, underscoring its dynamic modulation in relation to disease activity. AHR agonist activity might represent a potential tool to monitor disease activity and develop novel therapeutic strategies. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that serum levels of AHR agonistic activity are reduced in patients with NMOSD compared with noninflammatory controls, and that these levels are further modulated across different stages of the disease.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".