|
1
|
Gomez-Gaitan EA, Garcia-Ortega YE, Saldaña-Cruz AM, Contreras-Haro B, Gamez-Nava JI, Perez-Guerrero EE, Nava-Valdivia CA, Gallardo-Moya S, Martinez-Hernandez A, Gonzalez Lopez L, Rios-Gonzalez BE, Marquez-Pedroza J, Mendez-del Villar M, Esparza-Guerrero Y, Villagomez-Vega A, Macias Islas MA. Genetic Variant HLA-DRB1*0403 and Therapeutic Response to Disease-Modifying Therapies in Multiple Sclerosis: A Case-Control Study. Int J Mol Sci 2023; 24:14594. [PMID: 37834042 PMCID: PMC10572793 DOI: 10.3390/ijms241914594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/06/2023] [Accepted: 09/14/2023] [Indexed: 10/15/2023] Open
Abstract
Multiple sclerosis (MS) is a chronic and demyelinating disease with an autoimmune origin, which leads to neurodegeneration and progressive disability. Approximately 30 to 50% of patients do not respond optimally to disease-modifying therapies (DMTs), and therapeutic response may be influenced by genetic factors such as genetic variants. Therefore, our study aimed to investigate the association of the HLA-DRB1*0403 genetic variant and therapeutic response to DMTs in MS. We included 105 patients with MS diagnosis. No evidence of disease activity based on the absence of clinical relapse, disability progression or radiological activity (NEDA-3) was used to classify the therapeutic response. Patients were classified as follows: (a) controls: patients who achieved NEDA-3; (b) cases: patients who did not achieve NEDA-3. DNA was extracted from peripheral blood leukocytes. HLA-DRB1*0403 genetic variant was analyzed by quantitative polymerase chain reaction (qPCR) using TaqMan probes. NEDA-3 was achieved in 86.7% of MS patients treated with DMTs. Genotype frequencies were GG 50.5%, GA 34.3%, and AA 15.2%. No differences were observed in the genetic variant AA between patients who achieved NEDA-3 versus patients who did not achieve NEDA-3 (48.7% vs. 43.1%, p = 0.6). We concluded that in Mexican patients with MS, HLA-DRB1*0403 was not associated with the therapeutic response to DMTs.
Collapse
Affiliation(s)
- Esteban Alejandro Gomez-Gaitan
- Pharmacology Doctoral Program, Physiology Department, University Center for Health Sciences, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico; (E.A.G.-G.); (J.I.G.-N.); (S.G.-M.); (A.M.-H.); (L.G.L.); (Y.E.-G.)
| | - Yessica Eleanet Garcia-Ortega
- Neurology Department, Western National Medical Center, Mexican Social Security Institute, Guadalajara 44340, Jalisco, Mexico;
| | - Ana Miriam Saldaña-Cruz
- Institute of Experimental and Clinical Therapeutics, Physiology Department, University Center for Health Sciences, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico;
| | - Betsabe Contreras-Haro
- Department of Biomedical Sciences, Tonala University Center, University of Guadalajara, Tonala 45425, Jalisco, Mexico; (B.C.-H.); (M.M.-d.V.); (A.V.-V.)
- Biomedical Research Unit 02, Mexican Social Security Institute, Guadalajara 44340, Jalisco, Mexico
| | - Jorge Ivan Gamez-Nava
- Pharmacology Doctoral Program, Physiology Department, University Center for Health Sciences, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico; (E.A.G.-G.); (J.I.G.-N.); (S.G.-M.); (A.M.-H.); (L.G.L.); (Y.E.-G.)
- Institute of Experimental and Clinical Therapeutics, Physiology Department, University Center for Health Sciences, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico;
| | - Emilio Edsaul Perez-Guerrero
- Institute of Biomedical Sciences, Department of Genetics and Molecular Physiology, University Center for Health Sciences, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico;
| | - Cesar Arturo Nava-Valdivia
- Department of Microbiology and Pathology, University Center for Health Sciences, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico;
| | - Sergio Gallardo-Moya
- Pharmacology Doctoral Program, Physiology Department, University Center for Health Sciences, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico; (E.A.G.-G.); (J.I.G.-N.); (S.G.-M.); (A.M.-H.); (L.G.L.); (Y.E.-G.)
| | - Alejandra Martinez-Hernandez
- Pharmacology Doctoral Program, Physiology Department, University Center for Health Sciences, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico; (E.A.G.-G.); (J.I.G.-N.); (S.G.-M.); (A.M.-H.); (L.G.L.); (Y.E.-G.)
| | - Laura Gonzalez Lopez
- Pharmacology Doctoral Program, Physiology Department, University Center for Health Sciences, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico; (E.A.G.-G.); (J.I.G.-N.); (S.G.-M.); (A.M.-H.); (L.G.L.); (Y.E.-G.)
- Institute of Experimental and Clinical Therapeutics, Physiology Department, University Center for Health Sciences, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico;
| | | | - Jazmin Marquez-Pedroza
- Neurosciences Division, Western Biomedical Research Center, Mexican Social Security Institute, Guadalajara 44340, Jalisco, Mexico;
| | - Miriam Mendez-del Villar
- Department of Biomedical Sciences, Tonala University Center, University of Guadalajara, Tonala 45425, Jalisco, Mexico; (B.C.-H.); (M.M.-d.V.); (A.V.-V.)
| | - Yussef Esparza-Guerrero
- Pharmacology Doctoral Program, Physiology Department, University Center for Health Sciences, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico; (E.A.G.-G.); (J.I.G.-N.); (S.G.-M.); (A.M.-H.); (L.G.L.); (Y.E.-G.)
| | - Alejandra Villagomez-Vega
- Department of Biomedical Sciences, Tonala University Center, University of Guadalajara, Tonala 45425, Jalisco, Mexico; (B.C.-H.); (M.M.-d.V.); (A.V.-V.)
| | - Miguel Angel Macias Islas
- Neurosciences Departament, University Center for Health Sciences, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| |
Collapse
|
|
2
|
Ozakbas S, Piri Cinar B, Baba C, Kosehasanogullari G, Sclerosis Research Group M. Self-injectable DMTs in relapsing MS: NEDA assessment at 10 years in a real-world cohort. Acta Neurol Scand 2022; 145:557-564. [PMID: 35043388 DOI: 10.1111/ane.13582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 12/06/2021] [Accepted: 01/06/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is an immune-mediated disorder of the central nervous system. DMTs effectively reduce the annual relapse rate-thus reducing disease activity-and, to a lesser extent, some DMTs prevent disease progression in some people with MS. Monitoring the efficacy of DMTs with no evidence disease activity (NEDA) provides an objective perspective for evaluating treatment success. OBJECTIVE Our goal is to detect the prevalence of NEDA-3 in people with MS treated with self-injectable DMTs at two years and 10 years in a retrospective study. METHODS The treatment continuation rates and NEDA-3 parameters in the 2nd and 10th years were evaluated. RESULTS A total of 1032 patients diagnosed with RRMS were included in the study, and 613 patients (59.3%) continued with treatment after 10 years. In the first two years, NEDA-3 was detected in 321 patients (52.4%), and 112 of the 613 patients continued with self-injectable DMTs at the end of 10 years (18.3%). The rate of NEDA-3 in patients starting treatment over the age of 35 was 15.1% compared to that in the patient group starting treatment aged 34 or less at 20.2% (p = .004). CONCLUSION Our study includes the most comprehensive NEDA-3 data from real world evidence and supports the idea that NEDA-3 can be an effective early predictor of progression-free status at treatment follow-up of up to 10 years.
Collapse
Affiliation(s)
- Serkan Ozakbas
- Neurology Department Dokuz Eylul University Izmir Turkey
| | - Bilge Piri Cinar
- Neurology Department Zonguldak Bulent Ecevit University Zonguldak Turkey
| | - Cavid Baba
- Neurology Department Dokuz Eylul University Izmir Turkey
| | | | | |
Collapse
|
|
3
|
Zhou R, Li H, Yang H, Jiang F, Cai H, Li J, Chen S, Fang L, Yin J, Zeng Q. Serological markers exploration and real-world effectiveness and safety of teriflunomide in south Chinese patients with multiple sclerosis. Mult Scler Relat Disord 2021; 58:103446. [PMID: 34929454 DOI: 10.1016/j.msard.2021.103446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 11/23/2021] [Accepted: 12/01/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Since September 2012, when teriflunomide was approved as a disease-modifying treatment for relapsing multiple sclerosis, real-world observational studies on teriflunomide in Chinese patients are limited. METHODS We collected demographic characteristics and peripheral blood samples at different time points. Clinical symptoms, magnetic resonance imaging data, and concentrations of neurofilament light chains and multiple cytokines at different time points were compared to assess the efficacy. Moreover, the safety was assessed by blood routine, liver and kidney function, and a questionnaire to report adverse reactions. RESULTS Teriflunomide significantly reduced serum levels of neurofilament light chains and several inflammatory cytokines. After accepting teriflunomide treatment, many clinical symptoms improved, scores of the expanded disability status scale decreased from 2.0 to 1.75, and annualized relapse rates decreased from 1.45 to 0.31. 29 (80.56%) and 15 (78.95%) patients achieved the no evidence of disease activity-3 status after 6 months and 12 months treatment, respectively. Teriflunomide was associated with mild or moderate discomfort, and discontinuation rates due to adverse events were low. CONCLUSION Serum neurofilament light chain protein is sensitive to teriflunomide treatment, suggesting that it has the potential to be used as an indicator to assess the efficacy of teriflunomide. Teriflunomide can significantly reduce the concentrations of inflammatory cytokines, indicating that teriflunomide may regulate neuroinflammation through the inhibitory effect on a variety of immune cells and their cytokines. Teriflunomide can improve clinical symptoms and disease severity in MS patients in southern China, and patients have good compliance.
Collapse
Affiliation(s)
- Ran Zhou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Hongliang Li
- The First Affiliated Hospital, Hunan University of Chinese Medicine, Changsha, China
| | - Huan Yang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Fei Jiang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Haobing Cai
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Jing Li
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Si Chen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Liangjuan Fang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Jun Yin
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Qiuming Zeng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.
| |
Collapse
|