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Camara-Lemarroy CR, Silva C, Metz LM, Cerchiaro G, Greenfield J, Dowlatabadi R, Vogel HJ, Lee CH, Giuliani F, Nakhaei-Nejad M, Li DKB, Traboulsee A, Yong VW. Multimodal peripheral fluid biomarker analysis in clinically isolated syndrome and early multiple sclerosis. Mult Scler Relat Disord 2021; 50:102809. [PMID: 33581614 DOI: 10.1016/j.msard.2021.102809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 01/06/2021] [Accepted: 01/31/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Increasing evidence suggests that various inflammatory, immunological and metabolic pathways are altered in the clinically isolated syndrome (CIS) of multiple sclerosis (MS). Moreover, recent diagnostic criteria have made possible the very early diagnosis of MS. We evaluated multiple fluid biomarkers in people with early MS and CIS. METHODS We measured blood levels of cytokines, matrix metalloproteinases (MMPs), serum metabolomics and immune cell immunophenotyping in participants in the Trial of Minocycline in a Clinically Isolated Syndrome of Multiple Sclerosis. RESULTS When compared with healthy controls, people with early MS/CIS had higher levels of eotaxin, MCP-3, IL-1 receptor antagonist, IL-1β, IL-9 and IP-10, as well as MMPs 1, 8 and 9. In metabolomics analysis, the alanine, aspartate and glutamate metabolism and the synthesis and degradation of ketone bodies pathways were altered compared to healthy controls. There were no differences in lymphocyte subpopulation numbers. Out of all these biomarkers, only MMP-1 was able to differentiate between early MS and CIS, and was found to correlate with lesion volume and gadolinium enhancing lesions on MRI. CONCLUSION The immunological and metabolic profile of CIS and early MS is remarkably similar, supporting that these are a continuum of a common underlying pathophysiological process.
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Affiliation(s)
- Carlos R Camara-Lemarroy
- Departments of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
| | - Claudia Silva
- Departments of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Luanne M Metz
- Departments of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Graziela Cerchiaro
- Departments of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jamie Greenfield
- Departments of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Reza Dowlatabadi
- Department of Biological Science, Bio-NMR-metabolomics Research center, University of Calgary, Calgary, Canada
| | - Hans J Vogel
- Department of Biological Science, Bio-NMR-metabolomics Research center, University of Calgary, Calgary, Canada
| | - Chieh-Hsin Lee
- Department of Medicine, University of Alberta, Alberta, Canada
| | | | | | - David K B Li
- Department of Medicine, University of British Columbia, Canada
| | | | - V Wee Yong
- Departments of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Grzegorski T, Losy J. What do we currently know about the clinically isolated syndrome suggestive of multiple sclerosis? An update. Rev Neurosci 2020; 31:335-349. [DOI: 10.1515/revneuro-2019-0084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 09/22/2019] [Indexed: 12/31/2022]
Abstract
AbstractMultiple sclerosis (MS) is a chronic, demyelinating, not fully understood disease of the central nervous system. The first demyelinating clinical episode is called clinically isolated syndrome (CIS) suggestive of MS. Although the most common manifestations of CIS are long tracts dysfunction and unilateral optic neuritis, it can also include isolated brainstem syndromes, cerebellar involvement, and polysymptomatic clinical image. Recently, the frequency of CIS diagnosis has decreased due to the more sensitive and less specific 2017 McDonald criteria compared with the revisions from 2010. Not all patients with CIS develop MS. The risk of conversion can be estimated based on many predictive factors including epidemiological, ethnical, clinical, biochemical, radiological, immunogenetic, and other markers. The management of CIS is nowadays widely discussed among clinicians and neuroscientists. To date, interferons, glatiramer acetate, teriflunomide, cladribine, and some other agents have been evaluated in randomized, placebo-controlled, double-blind studies relying on large groups of patients with the first demyelinating event. All of these drugs were shown to have beneficial effects in patients with CIS and might be used routinely in the future. The goal of this article is to explore the most relevant topics regarding CIS as well as to provide the most recent information in the field. The review presents CIS definition, classification, clinical image, predictive factors, and management. What is more, this is one of very few reviews summarizing the topic in the light of the 2017 McDonald criteria.
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Affiliation(s)
- Tomasz Grzegorski
- Department of Clinical Neuroimmunology, Chair of Neurology, Poznan University of Medical Sciences, 49 Przybyszewskiego Street, 60-355Poznan, Poland
| | - Jacek Losy
- Department of Clinical Neuroimmunology, Chair of Neurology, Poznan University of Medical Sciences, 49 Przybyszewskiego Street, 60-355Poznan, Poland
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Liu QC, Dong F, Pan JF, Zhuang ZH, Gao F, Liu GZ, Chen QQ, Chen S, Weng SH, Lin LQ, Chen JT, Chen M, Wang CD, Lin XH. Antibodies to Type IV Collagen Induce Type 1 Autoimmune Pancreatitis. Inflammation 2017; 39:592-600. [PMID: 26568263 DOI: 10.1007/s10753-015-0284-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Type 1 autoimmune pancreatitis (AIP) is prototypic autoantibody-mediated diseases. Sclerosis accompanied by fiber deposition is generally regarded as the primary lesion in the development of obliterative vasculitis. However, why collagens or their antibodies play a crucial role in the pathogenesis of AIP has not been demonstrated. This study was performed to investigate if anti-collagen type IV antibodies (ACIVAbs) are the key factor of fiber deposition and recruit leukocytes, resulting in obliterative vasculitis in pancreas. Enzyme-linked immunosorbent analyses (ELISA) were used to measure the expression of Col IV and ACIVAbs in serum of patients with and without AIP. In vitro, adhesion and proliferation were determined by human lymphocytes incubated with Col IV and ACIVAbs. In vivo, C57BL0/6 mice were immunized with IgG-ACIVAbs, followed by analysis of clinical phenotype. IgG-ACIVAbs were recognized by the serum specimens from 12 of 22 patients with type 1 AIP, 3 of 9 patients with Crohn's disease, and 2 of 18 patients with pancreatic cancer, but not in healthy controls and acute pancreatitis. In patient's biopsy, ACIVAb staining increased and co-localized with subepithelial IgG4 deposits along the capillary walls and surrounding nerve fibers. In vitro, recombinant IgG-ACIVAbs increased leukocyte adhesion and proliferation. What is more, AIP could be induced in mice by immunization with IgG-ACIVAbs into adult mice.
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Affiliation(s)
- Qi-cai Liu
- Department of Laboratory Medicine, the 1st Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China
| | - Feng Dong
- Department of Radiation Oncology, the 1st Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China
| | - Jian-feng Pan
- Department of Pharmacy, the 1st Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China
| | - Ze-hao Zhuang
- Department of Gastroenterology, the 1st Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China
| | - Feng Gao
- Department of Pathology, the 1st Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China
- Graduate Education College, Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China
| | - Guo-zhong Liu
- Department of Surgery, the 1st Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China
| | - Qing-quan Chen
- Medical Technology and Engineering College, Fujian Medical University, Fuzhou, 350005, China
| | - Shu Chen
- Department of Pharmaceutical Analysis, Fujian Medical University, Fuzhou, China
| | - Shao-huang Weng
- Department of Pharmaceutical Analysis, Fujian Medical University, Fuzhou, China
| | - Li-qing Lin
- Department of Pharmaceutical Analysis, Fujian Medical University, Fuzhou, China
| | - Jin-tong Chen
- Department of Gastroenterology, the 1st Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China
| | - Min Chen
- Department of Laboratory Medicine, Medical Technology and Engineering College, Fujian Medical University, 88 Jiaotong Road, 350004, Fuzhou, China.
| | - Cheng-dan Wang
- Department of Gastroenterology, the 1st Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China.
| | - Xin-hua Lin
- Department of Pharmaceutical Analysis, Fujian Medical University, Fuzhou, China.
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