Abstract

Utility and Application of Single and Bulk EV Analysis in Pediatric Neuroimmune Disorders

Setty Magaña, Assistant Professor of Neurology & Pediatrics, Nationwide Children's Hospital, The Ohio State University

Childhood acquired demyelinating syndromes (ADS) of the central nervous system (CNS) represent a spectrum of monophasic or recurrent inflammatory diseases. The incidence of ADS ranges from 06. To 1.66 per 100,000 children.  Neurologic symptoms resulting from active neuro-inflammation can range from mild sensory symptoms to coma and death. Distinguishing amongst the clinically overlapping but prognostically distinct ADS is challenging due to lack of readily available and robust disease-specific biomarkers—underscoring a tremendous unmet clinical and research need. The most common childhood ADS is multiple sclerosis.  Pediatric-onset multiple sclerosis (POMS) represents 3-10% of all MS cases. The cause is unknown, however there is a complex interplay between genetics and environmental factors.  The patho-mechanisms leading to inflammatory demyelinating CNS lesions appears similar in adult and POMS, however POMS patients have a more inflammatory course at disease onset, higher relapse rate, more cognitive impairment and prominent contrast-enhancing lesions which represent blood-brain-barrier breakdown. In this presentation, I will review our work on establishing an EV-omics pipeline for biomarker discovery and pathomechanistic insights into pediatric acquired demyelinating syndromes.