THE TREGS PHENOTYPE CHARACTERS FOR THE PROGRESSION MCI PATIENTS WITH OR WITHOUT INSOMNIA

Objective: ‌This study aimed to investigate the risk factors for rapidly progressive mild cognitive impairment (MCI) with or without insomnia.
Method: A total of 150 patients aged ≥65 years with MCI were followed up for two years. Based on cognitive assessment outcomes at the two-year mark, patients were categorized into two groups: progressive MCI (n=68) and non-progressive MCI (n=82). Additionally, patients were classified into an insomnia group (insomnia symptoms lasting >3 months) and a non-insomnia group. Regulatory T cells (Tregs) and other immune markers were measured, and differential changes in immune indicators between groups were analyzed.
Results: Of the 150 enrolled patients, 23 were classified into the insomnia group, and 127 were assigned to the non-insomnia group (N-insomnia). Significant differences were observed in the following immune markers between the insomnia and non-insomnia groups: CD3+CD4+/lymphocytes, TGF-β/Treg ratio, CD4+ T cells, and CD56+ cells (all P < 0.05). In MCI patients with insomnia, the Treg/CD4+ ratio and TGF-β/Treg ratio were negatively correlated with MCI progression, whereas in MCI patients without insomnia, PD-1+/Treg expression was positively correlated with MCI progression, and CD8+ T cells showed a negative correlation with disease progression.
Conclusion: This study demonstrates that insomnia significantly alters the immune profile in patients with MCI. More importantly, insomnia modifies the relationship between immune markers and MCI progression: in patients with insomnia, disease progression is associated with reduced Treg function, whereas in patients without insomnia, it is more prominently linked to Treg cell exhaustion and cytotoxic T cell activity.