Aim: Early biomarkers of phenoconversion to neurodegeneration are crucial to identify individuals at high risk. In patients with idiopathic REM sleep behavior disorder (iRBD), the strongest risk factor for neurodegeneration, CD4+ T cells exhibit a peculiar transcription factor pattern.Objective: To assess transcription factor mRNA levels in CD4+ T cells as predictive biomarkers of phenoconversion in iRBD patients.Methods: iRBD patients were followed prospectively. ROC curve analysis and Kaplan-Meier curves were used to assess the discrimination between converters and non-converters.Results: CD4+ T cells from converters had higher STAT1, and lower GATA3 and FOXP3 mRNA levels. Hazard ratio was 58.3 (95% CI: 6.2-547.1) for higher STAT1, 101.2 (95% CI: 16.8-609.4) for lower GATA3 and 15.7 (2.7-91.4) for lower FOXP3.Conclusion: STAT1, GATA3 and FOXP3 mRNA levels in CD4+ T cells are promising predictive biomarkers of phenoconversion in iRBD patients.
Keywords: CD4+ T lymphocytes; Parkinson's disease; biomarkers; gene expression; phenoconversion; transcription factors.
Idiopathic REM sleep behavior disorder (iRBD) can lead to neurodegeneration, and the early identification of patients at risk would be crucial. Our research now shows that mRNA levels of some transcription factors in CD4+ T cells may represent early biomarkers predicting phenoconversion to established neurodegenerative conditions on average up to 3.5 years earlier.