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Blood\u2010based NMOSD severity and prognostic predictive immune\u2010 and inflammation\u2010related biomarkers are needed. We aimed to investigate the associations between plasma inflammatory biomarkers and relapse and attack severity in NMOSD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This two\u2010step, single\u2010center prospective cohort study included discovery and validation cohorts. We quantified 92 plasma inflammatory proteins by using Olink's proximity extension assay and identified differentially expressed proteins in the relapse group (relapse within 1\u2009year of follow\u2010up) and severe attack group. To define a new molecular prognostic model, we calculated the risk score of each patient based on the key protein signatures and validated the results in the validation cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The relapse prediction model, including FGF\u201023, DNER, GDNF, and SLAMF1, predicted the 1\u2010year relapse risk. The severe attack prediction model, including PD\u2010L1 and MCP\u20102, predicted the severe clinical attack risk. Both the relapse and severe attack prediction models demonstrated good discriminative ability and high accuracy in the validation cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our discovered biomarker signature and prediction models may complement current clinical risk stratification approaches. These inflammatory biomarkers could contribute to the discovery of therapeutic interventions and prevent NMOSD progression.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cns.14811","type":"journal-article","created":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T04:19:15Z","timestamp":1719202755000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Blood\u2010based inflammatory protein biomarker panel for the prediction of relapse and severity in patients with neuromyelitis optica spectrum disorder: A prospective cohort study"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-4667-4836","authenticated-orcid":false,"given":"Quanfeng","family":"Wei","sequence":"first","affiliation":[{"name":"Department of Neurology The First Hospital of China Medical University  Shenyang Liaoning 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