Differential expression of CD11c by peripheral blood NK cells reflects temporal activity of multiple sclerosis

Multiple sclerosis (MS) is an autoimmune disease, showing a great degree of variance in temporal disease activity. We have recently demonstrated that peripheral blood NK cells biased for secreting IL-5 (NK2 bias)-are associated with the remission state of MS. In this study, we report that MS patients in remission differentially express CD11c on NK cell surface (operationally defined as CD11c(high) or CD11c(low)). When we compared CD11c(high) or CD11c(low) patients, the expression of IL-5 and GATA-3 in NK cells supposed to endow a disease-protective NK2 phenotype was observed in CD11c(low) but not in CD11c(high) patients. In contrast, the CD11c(high) group showed a higher expression of HLA-DR on NK cells. In vitro studies demonstrated that NK cell stimulatory cytokines such as IL-15 would up-regulate CD11c expression on NK cells. Given previous evidence showing an association between an increased level of proinflammatory cytokines and temporal disease activity in MS, we postulate that inflammatory signals may play a role in inducing the CD11c(high) NK cell phenotype. Follow-up of a new cohort of patients showed that 6 of 10 CD11c(high) MS patients developed a clinical relapse within 120 days after evaluation, whereas only 2 of 13 CD11c(low) developed exacerbated disease (p = 0.003). As such, a higher expression of CD11c on NK cells may reflect the temporal activity of MS as well as a loss of regulatory NK2 phenotype, which may allow us to use it as a potential biomarker to monitor the immunological status of MS patients.