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Gaetani L, Bellomo G, Di Sabatino E, Sperandei S, Mancini A, Blennow K, Zetterberg H, Parnetti L, Di Filippo M. The Immune Signature of CSF in Multiple Sclerosis with and without Oligoclonal Bands: A Machine Learning Approach to Proximity Extension Assay Analysis. Int J Mol Sci 2023; 25:139. [PMID: 38203309 PMCID: PMC10778830 DOI: 10.3390/ijms25010139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/04/2023] [Accepted: 12/08/2023] [Indexed: 01/12/2024] Open
Abstract
Early diagnosis of multiple sclerosis (MS) relies on clinical evaluation, magnetic resonance imaging (MRI), and cerebrospinal fluid (CSF) analysis. Reliable biomarkers are needed to differentiate MS from other neurological conditions and to define the underlying pathogenesis. This study aimed to comprehensively profile immune activation biomarkers in the CSF of individuals with MS and explore distinct signatures between MS with and without oligoclonal bands (OCB). A total of 118 subjects, including relapsing-remitting MS with OCB (MS OCB+) (n = 58), without OCB (MS OCB-) (n = 24), and controls with other neurological diseases (OND) (n = 36), were included. CSF samples were analyzed by means of proximity extension assay (PEA) for quantifying 92 immune-related proteins. Neurofilament light chain (NfL), a marker of axonal damage, was also measured. Machine learning techniques were employed to identify biomarker panels differentiating MS with and without OCB from controls. Analyses were performed by splitting the cohort into a training and a validation set. CSF CD5 and IL-12B exhibited the highest discriminatory power in differentiating MS from controls. CSF MIP-1-alpha, CD5, CXCL10, CCL23 and CXCL9 were positively correlated with NfL. Multivariate models were developed to distinguish MS OCB+ and MS OCB- from controls. The model for MS OCB+ included IL-12B, CD5, CX3CL1, FGF-19, CST5, MCP-1 (91% sensitivity and 94% specificity in the training set, 81% sensitivity, and 94% specificity in the validation set). The model for MS OCB- included CX3CL1, CD5, NfL, CCL4 and OPG (87% sensitivity and 80% specificity in the training set, 56% sensitivity and 48% specificity in the validation set). Comprehensive immune profiling of CSF biomarkers in MS revealed distinct pathophysiological signatures associated with OCB status. The identified biomarker panels, enriched in T cell activation markers and immune mediators, hold promise for improved diagnostic accuracy and insights into MS pathogenesis.
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Affiliation(s)
- Lorenzo Gaetani
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (L.G.)
| | - Giovanni Bellomo
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (L.G.)
| | - Elena Di Sabatino
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (L.G.)
| | - Silvia Sperandei
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (L.G.)
| | - Andrea Mancini
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (L.G.)
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, 431 41 Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 431 41 Mölndal, Sweden
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, 431 41 Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 431 41 Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
- UK Dementia Research Institute at UCL, London WC1E 6BT, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong 518172, China
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53792, USA
| | - Lucilla Parnetti
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (L.G.)
| | - Massimiliano Di Filippo
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (L.G.)
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Toscano S, Chisari CG, Lo Fermo S, Gulino G, Zappia M, Patti F. A dynamic interpretation of κFLC index for the diagnosis of multiple sclerosis: a change of perspective. J Neurol 2023; 270:6010-6020. [PMID: 37639016 PMCID: PMC10632300 DOI: 10.1007/s00415-023-11952-3] [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: 07/07/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND Previous studies attempted to define the best threshold for κ free light chains (κFLC) index, confirming higher sensitivity (Se) but less specificity (Sp) compared with IgG oligoclonal bands (OCB) for the diagnosis of MS. OBJECTIVE To evaluate the diagnostic accuracy of different κFLC index intervals in a miscellaneous cohort of neurological patients, proposing a procedural flowchart for MS diagnosis. METHODS We analyzed data from 607 patients diagnosed with MS (179), CIS (116), other inflammatory (94) or non-inflammatory neurological diseases (218). Measures of diagnostic accuracy were reported for different potential thresholds of κFLC index, and for IgG OCB and IgG index. Binary logistic regression was to used to calculate the odds of being diagnosed with MS based on each increase of κFLC index. RESULTS CSF IgG OCB showed 72.2% Se (CI 95% 68.4-75.7) and 95.2% Sp (CI 95% 93.1-96.7) in discriminating between MS/CIS and controls, with an AUC of 0.84 (CI 95% 0.80-0.87). The highest diagnostic accuracy was reported for κFLC index cut-off of 5.0 (Se = 85.4%, Sp = 90.4%, AUC = 0.88), while a threshold of 11.0 exhibited higher Sp (95.5%, 95% CI 93.1-97.1) than IgG OCB. AUCs for all thresholds between 4.25 and 6.6 were not significantly different from each other, but were significantly higher than the AUC of IgG OCB (p < 0.05). The odds of being diagnosed with MS/CIS increased by 17.1% for each unit increase of κFLC index (OR = 1.17; 95% CI 1.12-1.23; p < 0.001). CONCLUSION κFLC index performed better than CSF IgG OCB in supporting the diagnosis of MS/CIS, with the advantage of being a cost-effective and quantitative analysis.
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Affiliation(s)
- Simona Toscano
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123, Catania, Italy
- Multiple Sclerosis Unit, University-Hospital G. Rodolico-San Marco, Via Santa Sofia 78, 95123, Catania, Italy
| | - Clara Grazia Chisari
- Multiple Sclerosis Unit, University-Hospital G. Rodolico-San Marco, Via Santa Sofia 78, 95123, Catania, Italy
- Department "GF Ingrassia", Section Neuroscience, University of Catania, Via Santa Sofia 87, 95123, Catania, Italy
| | - Salvatore Lo Fermo
- Multiple Sclerosis Unit, University-Hospital G. Rodolico-San Marco, Via Santa Sofia 78, 95123, Catania, Italy
- Department "GF Ingrassia", Section Neuroscience, University of Catania, Via Santa Sofia 87, 95123, Catania, Italy
| | - Giuseppa Gulino
- Central Laboratory, A.O.U. Policlinico-San Marco, Via Santa Sofia 78, 95123, Catania, Italy
| | - Mario Zappia
- Department "GF Ingrassia", Section Neuroscience, University of Catania, Via Santa Sofia 87, 95123, Catania, Italy
| | - Francesco Patti
- Multiple Sclerosis Unit, University-Hospital G. Rodolico-San Marco, Via Santa Sofia 78, 95123, Catania, Italy.
- Department "GF Ingrassia", Section Neuroscience, University of Catania, Via Santa Sofia 87, 95123, Catania, Italy.
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Tall P, Qamar MA, Batzu L, Leta V, Falup-Pecurariu C, Ray Chaudhuri K. Non-oral continuous drug delivery based therapies and sleep dysfunction in Parkinson's disease. J Neural Transm (Vienna) 2023; 130:1443-1449. [PMID: 37126118 PMCID: PMC10645607 DOI: 10.1007/s00702-023-02640-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 04/21/2023] [Indexed: 05/02/2023]
Abstract
Continuous drug delivery (CDD) has emerged as a feasible and pragmatic therapeutic option for dopamine replacement therapy in advanced Parkinson's disease (PD). CDD aims to mimic the physiological tonic dopamine release from striatal dopaminergic neurons and thus reduces the severity and duration of motor and non-motor fluctuations partly related to pulsatile levodopa stimulation. Non-motor symptoms and fluctuations are ubiquitous in PD and include sleep dysfunction, a problem that occurs in over 90% of PD patients across all stages, from prodromal to palliative. In this review, we discuss the currently available and in development non-oral dopaminergic CDD strategies with a focus on their efficacy in the treatment of the burdensome sleep dysfunction in PD.
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Affiliation(s)
- P Tall
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AB, UK.
- Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK.
| | - M A Qamar
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AB, UK.
- Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK.
| | - L Batzu
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AB, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
| | - V Leta
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AB, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
| | - C Falup-Pecurariu
- Faculty of Medicine, Transilvania University, Brasov, Romania
- Department of Neurology, County Clinic Hospital, Brasov, Romania
| | - K Ray Chaudhuri
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AB, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
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Xu T, Shi Y, Zheng G, Zhang G. Diagnostic Potential of Two Novel Biomarkers for Neuromyelitis Optica Spectrum Disorder and Multiple Sclerosis. Diagnostics (Basel) 2023; 13:diagnostics13091572. [PMID: 37174963 PMCID: PMC10178292 DOI: 10.3390/diagnostics13091572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/07/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Currently, no tests can definitively diagnose and distinguish neuromyelitis optica spectrum disorder (NMOSD) from multiple sclerosis (MS). METHODS Initially, cerebrospinal fluid (CSF) proteomics were employed to uncover the novel biomarkers that differentiate NMOSD from MS into cohorts of 10 MS and 10 NMOSD patients. Subsequently, screening biomarkers were validated using an enzyme-linked immunosorbent assay method and CSF and serum samples from 20 MS patients, 20 NMOSD patients, 20 non-inflammatory neurological controls, and 20 healthy controls. RESULTS In study cohort, insulin-like growth factor-binding protein 7 (IGFBP7) and lysosome-associated membrane glycoprotein 2 (LAMP2) were screened. In validation cohort, serum and CSF IGFBP7 not only exhibited higher levels in MS and NMOSD patients than controls, but also had greatest area under the curve (AUC, above or equal to 0.8) in MS and NMOSD diagnoses. Serum IGFBP7 (0.945) and CSF IGFBP7 (0.890) also had the greatest AUCs for predicting MS progression, while serum LAMP2 had a moderate curve (0.720). CONCLUSIONS IGFBP7 was superior in diagnosing MS and NMOSD, and IGFBP7 and serum LAMP2 performed exceptionally well in predicting the MS progression. These results offered reasons for further investigations into the functions of IGFBP7 and LAMP2 in MS and NMOSD.
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Affiliation(s)
- Ting Xu
- Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing 100070, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing 100070, China
| | - Yijun Shi
- Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing 100070, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing 100070, China
| | - Guanghui Zheng
- Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing 100070, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing 100070, China
| | - Guojun Zhang
- Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing 100070, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing 100070, China
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Higgins V, Beriault D, Mostafa A, Estey M, Agbor T, Ismail O, Parker ML. Variation in Processes and Reporting of Cerebrospinal Fluid Oligoclonal Banding and Associated Tests and Calculated Indices across Canadian Clinical Laboratories. Clin Biochem 2023; 116:105-112. [PMID: 37100108 DOI: 10.1016/j.clinbiochem.2023.04.006] [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: 12/20/2022] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 04/28/2023]
Abstract
OBJECTIVES Multiple sclerosis is diagnosed based on clinical and laboratory findings, including cerebrospinal fluid (CSF) oligoclonal banding (OCB) analysis. The lack of updated CSF OCB laboratory guidelines in Canada has likely led to variation in processes and reporting across clinical laboratories. As a first step to developing harmonized laboratory recommendations, we examined current CSF OCB processes, reporting, and interpretation across all Canadian clinical laboratories currently performing this test. DESIGN AND METHODS A survey of 39 questions was sent to clinical chemists at all 13 Canadian clinical laboratories performing CSF OCB analysis. The survey included questions regarding quality control processes, reporting practices for CSF gel electrophoresis pattern interpretation, and associated tests and calculated indices. RESULTS The survey response rate was 100%. Most (10/13) laboratories use ≥2 CSF-specific bands (2017 McDonald Criteria) as their CSF OCB positivity cut-off and only 2/13 report the number of bands with every report. Most (8/13 and 9/13) laboratories report an inflammatory response pattern and monoclonal gammopathy pattern, respectively. However, the process for reporting and/or confirming a monoclonal gammopathy varies widely. Variation was observed for reference intervals, units, and the panel of reported associated tests and calculated indices. The maximum acceptable time interval between paired CSF and serum collections varied from 24 hours to no limit. CONCLUSIONS Profound variation exists in processes, reporting, and interpretation of CSF OCB and associated tests and indices across Canadian clinical laboratories. Harmonization of CSF OCB analysis is required to ensure continuity and quality of patient care. Our detailed assessment of current practice variation highlights the need for clinical stakeholder engagement and further data analysis to support optimal interpretation and reporting practices, which will aid in developing harmonized laboratory recommendations.
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Affiliation(s)
- V Higgins
- DynaLIFE Medical Labs, Edmonton, AB, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada.
| | - D Beriault
- Department of Laboratory Medicine, St. Michael's Hospital, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada
| | - A Mostafa
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - M Estey
- DynaLIFE Medical Labs, Edmonton, AB, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - T Agbor
- DynaLIFE Medical Labs, Edmonton, AB, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - O Ismail
- DynaLIFE Medical Labs, Edmonton, AB, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - M L Parker
- DynaLIFE Medical Labs, Edmonton, AB, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
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Pezzini F, Pisani A, Mazziotti V, Marastoni D, Tamanti A, Borroni E, Magon S, Zinnhardt B, Magliozzi R, Calabrese M. Intrathecal versus Peripheral Inflammatory Protein Profile in MS Patients at Diagnosis: A Comprehensive Investigation on Serum and CSF. Int J Mol Sci 2023; 24:ijms24043768. [PMID: 36835179 PMCID: PMC9964553 DOI: 10.3390/ijms24043768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 02/16/2023] Open
Abstract
Intrathecal inflammation plays a key role in the pathogenesis of multiple sclerosis (MS). To better elucidate its relationship with peripheral inflammation, we investigated the correlation between cerebrospinal fluid (CSF) and serum levels of 61 inflammatory proteins. Paired CSF and serum samples were collected from 143 treatment-naïve MS patients at diagnosis. A customized panel of 61 inflammatory molecules was analyzed by a multiplex immunoassay. Correlations between serum and CSF expression levels for each molecule were performed by Spearman's method. The expression of sixteen CSF proteins correlated with their serum expression (p-value < 0.001): only five molecules (CXCL9, sTNFR2, IFNα2, Pentraxin-3, and TSLP) showed a Rho value >0.40, suggesting moderate CSF/serum correlation. No correlation between inflammatory serum patterns and Qalb was observed. Correlation analysis of serum expression levels of these sixteen proteins with clinical and MRI parameters pinpointed a subset of five molecules (CXCL9, sTNFR2, IFNα2, IFNβ, and TSLP) negatively correlating with spinal cord lesion volume. However, following FDR correction, only the correlation of CXCL9 remained significant. Our data support the hypothesis that the intrathecal inflammation in MS only partially associates with the peripheral one, except for the expression of some immunomodulators that might have a key role in the initial MS immune response.
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Affiliation(s)
- Francesco Pezzini
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, 37134 Verona, Italy
| | - Annalisa Pisani
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
| | - Valentina Mazziotti
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
| | - Damiano Marastoni
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
| | - Agnese Tamanti
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
| | - Edilio Borroni
- Roche Pharma Research & Early Development (pRED), Biomarkers & Translational Technologies (BTT), F. Hoffmann-La Roche Ltd., CH-4070 Basel, Switzerland
| | - Stefano Magon
- Roche Pharma Research & Early Development (pRED), Biomarkers & Translational Technologies (BTT), F. Hoffmann-La Roche Ltd., CH-4070 Basel, Switzerland
| | - Bastian Zinnhardt
- Roche Pharma Research & Early Development (pRED), Biomarkers & Translational Technologies (BTT), F. Hoffmann-La Roche Ltd., CH-4070 Basel, Switzerland
| | - Roberta Magliozzi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
- Correspondence: (R.M.); (M.C.)
| | - Massimiliano Calabrese
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
- Correspondence: (R.M.); (M.C.)
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Foesleitner O, Jäger LB, Schwarz D, Hayes J, Sam G, Wildemann B, Wick W, Bendszus M, Heiland S. Peripheral Nerve Involvement at First Diagnosis of Multiple Sclerosis: A Prospective MR Neurography Study. Invest Radiol 2023; 58:173-179. [PMID: 35976760 DOI: 10.1097/rli.0000000000000915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The aim of this study was to assess peripheral nerve involvement in patients with multiple sclerosis (MS) at first clinical presentation using quantitative magnetic resonance (MR) neurography in correlation with clinical, laboratory, electrophysiological, and central nervous MR imaging data. MATERIALS AND METHODS In this prospective monocentric study, 30 patients first diagnosed with MS according to the McDonald criteria (19 women; mean age, 32.4 ± 8.8 years) and 30 age- and sex-matched healthy volunteers were examined with high-resolution 3 T MR neurography using a dual-echo T2-relaxometry sequence covering the tibial and peroneal nerves from proximal thigh to distal calf. Magnetic resonance biomarkers of T2 relaxation time (T2 app ), proton spin density (PSD), and nerve cross-sectional area (CSA) were correlated with clinical symptoms, intrathecal immunoglobulin (Ig) synthesis, nerve conduction study, and lesion load on brain and spine MR imaging. The diagnostic accuracy of MR biomarkers was assessed using receiver-operating characteristic curves. RESULTS Diffuse nerve changes were detected along the tibial and peroneal nerves in MS patients, who showed decreased PSD ( P < 0.001), increased T2 app ( P < 0.001), and smaller tibial nerve CSA ( P < 0.001) compared with healthy subjects. Tibial PSD was identified as best parameter separating patients from controls (area under the curve = 0.876). Intrathecal IgG and IgM synthesis correlated with PSD values ( r = -0.44, P = 0.016, and r = -0.42, P = 0.022). Contrast-enhancement of brain or spine lesions was related to larger tibial and peroneal CSA ( P < 0.001, P = 0.033). Abnormal electrophysiology correlated with higher tibial and peroneal T2 app ( P < 0.001 and P = 0.033), lower tibial and peroneal PSD ( P = 0.018 and P = 0.002), and smaller peroneal CSA ( P < 0.001). CONCLUSIONS Quantitative MR neurography reveals peripheral nerve changes in patients with initial diagnosis of MS. Correlation of imaging findings with intrathecal immunoglobulin synthesis may indicate a primary coaffection of the peripheral nervous system in MS.
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Affiliation(s)
| | | | | | | | - Georges Sam
- Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Wolfgang Wick
- Neurology, Heidelberg University Hospital, Heidelberg, Germany
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Räuber S, Schroeter CB, Strippel C, Nelke C, Ruland T, Dik A, Golombeck KS, Regner-Nelke L, Paunovic M, Esser D, Münch C, Rosenow F, van Duijn M, Henes A, Ruck T, Amit I, Leypoldt F, Titulaer MJ, Wiendl H, Meuth SG, Meyer Zu Hörste G, Melzer N. Cerebrospinal fluid proteomics indicates immune dysregulation and neuronal dysfunction in antibody associated autoimmune encephalitis. J Autoimmun 2023; 135:102985. [PMID: 36621173 DOI: 10.1016/j.jaut.2022.102985] [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: 10/15/2022] [Accepted: 12/15/2022] [Indexed: 01/09/2023]
Abstract
Autoimmune Encephalitis (AE) spans a group of non-infectious inflammatory conditions of the central nervous system due to an imbalanced immune response. Aiming to elucidate the pathophysiological mechanisms of AE, we applied an unsupervised proteomic approach to analyze the cerebrospinal fluid (CSF) protein profile of AE patients with autoantibodies against N-methyl-d-aspartate receptor (NMDAR) (n = 9), leucine-rich glioma-inactivated protein 1 (LGI1) (n = 9), or glutamate decarboxylase 65 (GAD65) (n = 8) compared to 9 patients with relapsing-remitting multiple sclerosis as inflammatory controls, and 10 patients with somatic symptom disorder as non-inflammatory controls. We found a dysregulation of the complement system, a disbalance between pro-inflammatory and anti-inflammatory proteins on the one hand, and dysregulation of proteins involved in synaptic transmission, synaptogenesis, brain connectivity, and neurodegeneration on the other hand to a different extent in all AE subtypes compared to non-inflammatory controls. Furthermore, elevated levels of several proteases and reduction in protease inhibitors could be detected in all AE subtypes compared to non-inflammatory controls. Moreover, the different AE subtypes showed distinct protein profiles compared to each other and inflammatory controls which may facilitate future identification of disease-specific biomarkers. Overall, CSF proteomics provides insights into the complex pathophysiological mechanisms of AE, including immune dysregulation, neuronal dysfunction, neurodegeneration, and altered protease function.
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Affiliation(s)
- Saskia Räuber
- Department of Neurology with Institute of Translational Neurology, University of Münster, 48149, Münster, Germany; Department of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, 40225 Düsseldorf, Germany
| | - Christina B Schroeter
- Department of Neurology with Institute of Translational Neurology, University of Münster, 48149, Münster, Germany; Department of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, 40225 Düsseldorf, Germany
| | - Christine Strippel
- Department of Neurology with Institute of Translational Neurology, University of Münster, 48149, Münster, Germany
| | - Christopher Nelke
- Department of Neurology with Institute of Translational Neurology, University of Münster, 48149, Münster, Germany; Department of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, 40225 Düsseldorf, Germany
| | - Tillmann Ruland
- Department of Psychiatry, University of Münster, 48149, Münster, Germany; Department of Psychiatry, Maria Brunn Hospital, 48163, Münster, Germany
| | - Andre Dik
- Department of Neurology with Institute of Translational Neurology, University of Münster, 48149, Münster, Germany; Department of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, 40225 Düsseldorf, Germany
| | - Kristin S Golombeck
- Department of Neurology with Institute of Translational Neurology, University of Münster, 48149, Münster, Germany; Department of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, 40225 Düsseldorf, Germany
| | - Liesa Regner-Nelke
- Department of Neurology with Institute of Translational Neurology, University of Münster, 48149, Münster, Germany; Department of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, 40225 Düsseldorf, Germany
| | - Manuela Paunovic
- Department of Neurology, Erasmus MC University Medical Center, 3015 GD, Rotterdam, the Netherlands
| | - Daniela Esser
- Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, 24105, Kiel, Lübeck, Germany
| | - Christian Münch
- Institute of Biochemistry II, Goethe University Frankfurt, Faculty of Medicine, Theodor-Stern-Kai 7, Building 75, 60590, Frankfurt am Main, Germany; Frankfurt Cancer Institute, Frankfurt am Main, Germany; Cardio-Pulmonary Institute, Frankfurt am Main, Germany
| | - Felix Rosenow
- Epilepsy Center Frankfurt Rhine-Main, Center of Neurology and Neurosurgery, University Hospital Frankfurt, Goethe University Frankfurt, 60528 Frankfurt am Main, Germany; LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Martijn van Duijn
- Department of Neurology, Erasmus MC University Medical Center, 3015 GD, Rotterdam, the Netherlands
| | - Antonia Henes
- Department of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, 40225 Düsseldorf, Germany
| | - Tobias Ruck
- Department of Neurology with Institute of Translational Neurology, University of Münster, 48149, Münster, Germany; Department of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, 40225 Düsseldorf, Germany
| | - Ido Amit
- Department of Immunology, Weizmann Institute of Science, 7610001, Rehovot, Israel
| | - Frank Leypoldt
- Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, 24105, Kiel, Lübeck, Germany; Department of Neurology, Faculty of Medicine, Kiel University, 24105, Kiel, Germany
| | - Maarten J Titulaer
- Department of Neurology, Erasmus MC University Medical Center, 3015 GD, Rotterdam, the Netherlands
| | - Heinz Wiendl
- Department of Neurology with Institute of Translational Neurology, University of Münster, 48149, Münster, Germany
| | - Sven G Meuth
- Department of Neurology with Institute of Translational Neurology, University of Münster, 48149, Münster, Germany; Department of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, 40225 Düsseldorf, Germany
| | - Gerd Meyer Zu Hörste
- Department of Neurology with Institute of Translational Neurology, University of Münster, 48149, Münster, Germany
| | - Nico Melzer
- Department of Neurology with Institute of Translational Neurology, University of Münster, 48149, Münster, Germany; Department of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, 40225 Düsseldorf, Germany.
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A Comprehensive Exploration of the Transcriptomic Landscape in Multiple Sclerosis: A Systematic Review. Int J Mol Sci 2023; 24:ijms24021448. [PMID: 36674968 PMCID: PMC9862618 DOI: 10.3390/ijms24021448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/29/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
Multiple Sclerosis (MS) is, to date, an incurable disease of the nervous system characterized by demyelination. Several genetic mutations are associated with the disease but they are not able to explain all the diagnosticated cases. Thus, it is suggested that altered gene expression may play a role in human pathologies. In this review, we explored the role of the transcriptomic profile in MS to investigate the main altered biological processes and pathways involved in the disease. Herein, we focused our attention on RNA-seq methods that in recent years are producing a huge amount of data rapidly replacing microarrays, both with bulk and single-cells. The studies evidenced that different MS stages have specific molecular signatures and non-coding RNAs may play a key role in the disease. Sex-dependence was observed before and after treatments used to alleviate symptomatology activating different biological processes in a drug-dependent manner. New pathways, such as neddylation, were found deregulated in MS and inflammation was linked to neuron degeneration areas through spatial transcriptomics. It is evident that the use of RNA-seq in the study of complex pathologies, such as MS, is a valid strategy to shed light on new involved mechanisms.
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10
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Loonstra FC, de Ruiter LRJ, Koel-Simmelink MJA, Schoonheim MM, Strijbis EMM, Moraal B, Barkhof F, Uitdehaag BMJ, Teunissen C, Killestein J. Neuroaxonal and Glial Markers in Patients of the Same Age With Multiple Sclerosis. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2022; 10:10/2/e200078. [PMID: 36543540 PMCID: PMC9773420 DOI: 10.1212/nxi.0000000000200078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 11/01/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND OBJECTIVES The specificity of novel blood biomarkers for multiple sclerosis (MS)-related neurodegeneration is unclear because neurodegeneration also occurs during normal aging. To understand which aspects of neurodegeneration the serum biomarkers neurofilament light (sNfL), serum glial fibrillary acidic protein (sGFAP), and serum contactin-1 (sCNTN1) reflect, we here explore their cross-sectional association with disability outcome measures and MRI volumes in a unique cohort of people with MS (PwMS) of the same age. METHODS sNfL, sGFAP (both singe-molecule array technology) and sCNTN1 (Luminex) were measured in serum samples of 288 PwMS and 125 healthy controls (HCs) of the Project Y cohort, a population-based cross-sectional study of PwMS born in the Netherlands in 1966 and age-matched HC. RESULTS sNfL (9.83 pg/mL [interquartile range {IQR}: 7.8-12.0]) and sGFAP (63.7 pg/mL [IQR: 48.5-84.5]) were higher in PwMS compared with HC (sNfL: 8.8 pg/mL [IQR: 7.0-10.5]; sGFAP: 51.7 pg/mL [IQR: 40.1-68.3]) (p < 0.001), whereas contactin-1 (7,461.3 pg/mL [IQR: 5,951.8-9,488.6]) did not significantly differ between PwMS compared with HC (7,891.2 pg/mL [IQR: 6,120.0-10,265.8]) (p = 0.068). sNfL and sGFAP levels were 1.2-fold higher in secondary progressive patients (SPMS) compared with relapsing remitting patients (p = 0.009 and p = 0.043). Stratified by MS subtype, no relations were seen for CNTN1, whereas sNfL and sGFAP correlated with the Expanded Disability Status Scale (ρ = 0.43 and ρ = 0.39), Nine-Hole Peg Test, Timed 25-Foot Walk Test, and Symbol Digit Modalities Test (average ρ = 0.38) only in patients with SPMS. Parallel to these clinical findings, correlations were only found for sNfL and sGFAP with MRI volumes. The strongest correlations were observed between sNfL and thalamic volume (ρ = -0.52) and between sGFAP with deep gray matter volume (ρ = - 0.56) in primary progressive patients. DISCUSSION In our cohort of patients of the same age, we report consistent correlations of sNfL and sGFAP with a range of metrics, especially in progressive MS, whereas contactin-1 was not related to clinical or MRI measures. This demonstrates the potential of sNfL and sGFAP as complementary biomarkers of neurodegeneration, reflected by disability, in progressive MS.
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Affiliation(s)
- Floor C Loonstra
- From the MS Center Amsterdam (F.C.L., L.R.J.R., E.M.M.S., B.M.J.U., J.K.), Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; Neurochemistry Laboratory (M.J.A.K.-S., C.T.), Clinical Chemistry, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; MS Center Amsterdam (M.M.S.), Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; MS Center Amsterdam (B.M., F.B.), Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; andQueen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London, United Kingdom.
| | - Lodewijk R J de Ruiter
- From the MS Center Amsterdam (F.C.L., L.R.J.R., E.M.M.S., B.M.J.U., J.K.), Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; Neurochemistry Laboratory (M.J.A.K.-S., C.T.), Clinical Chemistry, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; MS Center Amsterdam (M.M.S.), Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; MS Center Amsterdam (B.M., F.B.), Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; andQueen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London, United Kingdom
| | - Marleen J A Koel-Simmelink
- From the MS Center Amsterdam (F.C.L., L.R.J.R., E.M.M.S., B.M.J.U., J.K.), Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; Neurochemistry Laboratory (M.J.A.K.-S., C.T.), Clinical Chemistry, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; MS Center Amsterdam (M.M.S.), Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; MS Center Amsterdam (B.M., F.B.), Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; andQueen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London, United Kingdom
| | - Menno M Schoonheim
- From the MS Center Amsterdam (F.C.L., L.R.J.R., E.M.M.S., B.M.J.U., J.K.), Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; Neurochemistry Laboratory (M.J.A.K.-S., C.T.), Clinical Chemistry, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; MS Center Amsterdam (M.M.S.), Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; MS Center Amsterdam (B.M., F.B.), Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; andQueen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London, United Kingdom
| | - Eva M M Strijbis
- From the MS Center Amsterdam (F.C.L., L.R.J.R., E.M.M.S., B.M.J.U., J.K.), Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; Neurochemistry Laboratory (M.J.A.K.-S., C.T.), Clinical Chemistry, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; MS Center Amsterdam (M.M.S.), Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; MS Center Amsterdam (B.M., F.B.), Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; andQueen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London, United Kingdom
| | - Bastiaan Moraal
- From the MS Center Amsterdam (F.C.L., L.R.J.R., E.M.M.S., B.M.J.U., J.K.), Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; Neurochemistry Laboratory (M.J.A.K.-S., C.T.), Clinical Chemistry, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; MS Center Amsterdam (M.M.S.), Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; MS Center Amsterdam (B.M., F.B.), Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; andQueen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London, United Kingdom
| | - Frederik Barkhof
- From the MS Center Amsterdam (F.C.L., L.R.J.R., E.M.M.S., B.M.J.U., J.K.), Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; Neurochemistry Laboratory (M.J.A.K.-S., C.T.), Clinical Chemistry, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; MS Center Amsterdam (M.M.S.), Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; MS Center Amsterdam (B.M., F.B.), Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; andQueen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London, United Kingdom
| | - Bernard M J Uitdehaag
- From the MS Center Amsterdam (F.C.L., L.R.J.R., E.M.M.S., B.M.J.U., J.K.), Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; Neurochemistry Laboratory (M.J.A.K.-S., C.T.), Clinical Chemistry, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; MS Center Amsterdam (M.M.S.), Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; MS Center Amsterdam (B.M., F.B.), Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; andQueen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London, United Kingdom
| | - Charlotte Teunissen
- From the MS Center Amsterdam (F.C.L., L.R.J.R., E.M.M.S., B.M.J.U., J.K.), Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; Neurochemistry Laboratory (M.J.A.K.-S., C.T.), Clinical Chemistry, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; MS Center Amsterdam (M.M.S.), Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; MS Center Amsterdam (B.M., F.B.), Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; andQueen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London, United Kingdom
| | - Joep Killestein
- From the MS Center Amsterdam (F.C.L., L.R.J.R., E.M.M.S., B.M.J.U., J.K.), Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; Neurochemistry Laboratory (M.J.A.K.-S., C.T.), Clinical Chemistry, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; MS Center Amsterdam (M.M.S.), Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; MS Center Amsterdam (B.M., F.B.), Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, The Netherlands; andQueen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London, United Kingdom
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Arneth B, Kraus J. The Use of Kappa Free Light Chains to Diagnose Multiple Sclerosis. Medicina (B Aires) 2022; 58:medicina58111512. [PMID: 36363469 PMCID: PMC9698214 DOI: 10.3390/medicina58111512] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/10/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022] Open
Abstract
Background: The positive implications of using free light chains in diagnosing multiple sclerosis have increasingly gained considerable interest in medical research and the scientific community. It is often presumed that free light chains, particularly kappa and lambda free light chains, are of practical use and are associated with a higher probability of obtaining positive results compared to oligoclonal bands. The primary purpose of the current paper was to conduct a systematic review to assess the up-to-date methods for diagnosing multiple sclerosis using kappa and lambda free light chains. Method: An organized literature search was performed across four electronic sources, including Google Scholar, Web of Science, Embase, and MEDLINE. The sources analyzed in this systematic review and meta-analysis comprise randomized clinical trials, prospective cohort studies, retrospective studies, controlled clinical trials, and systematic reviews. Results: The review contains 116 reports that includes 1204 participants. The final selection includes a vast array of preexisting literature concerning the study topic: 35 randomized clinical trials, 21 prospective cohort studies, 19 retrospective studies, 22 controlled clinical trials, and 13 systematic reviews. Discussion: The incorporated literature sources provided integral insights into the benefits of free light chain diagnostics for multiple sclerosis. It was also evident that the use of free light chains in the diagnosis of clinically isolated syndrome (CIS) and multiple sclerosis is relatively fast and inexpensive in comparison to other conventional state-of-the-art diagnostic methods, e.g., using oligoclonal bands (OCBs).
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Affiliation(s)
- Borros Arneth
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Justus Liebig University, Feulgenstr. 12, 35392 Giessen, Germany
- Correspondence:
| | - Jörg Kraus
- Department of Laboratory Medicine, Paracelsus Medical University and Salzburger Landeskliniken, Strubergasse 21, 5020 Salzburg, Austria
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Bergische Landstraße 2, 40629 Düsseldorf, Germany
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12
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Rival M, Thouvenot E, Du Trieu de Terdonck L, Laurent-Chabalier S, Demattei C, Uygunoglu U, Castelnovo G, Cohen M, Okuda DT, Kantarci OH, Pelletier D, Azevedo C, Marin P, Lehmann S, Siva A, Mura T, Lebrun-Frenay C. Neurofilament Light Chain Levels Are Predictive of Clinical Conversion in Radiologically Isolated Syndrome. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2022; 10:10/1/e200044. [PMID: 36280258 PMCID: PMC9621336 DOI: 10.1212/nxi.0000000000200044] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/29/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND AND OBJECTIVES To evaluate the predictive value of serum neurofilament light chain (sNfL) and CSF NfL (cNfL) in patients with radiologically isolated syndrome (RIS) for evidence of disease activity (EDA) and clinical conversion (CC). METHODS sNfL and cNfL were measured at RIS diagnosis by single-molecule array (Simoa). The risk of EDA and CC according to sNfL and cNfL was evaluated using the Kaplan-Meier analysis and multivariate Cox regression models including age, spinal cord (SC) or infratentorial lesions, oligoclonal bands, CSF chitinase 3-like protein 1, and CSF white blood cells. RESULTS Sixty-one patients with RIS were included. At diagnosis, sNfL and cNfL were correlated (Spearman r = 0.78, p < 0.001). During follow-up, 47 patients with RIS showed EDA and 36 patients showed CC (median time 12.6 months, 1-86). When compared with low levels, medium and high cNfL (>260 pg/mL) and sNfL (>5.0 pg/mL) levels were predictive of EDA (log rank, p < 0.01 and p = 0.02, respectively). Medium-high cNfL levels were predictive of CC (log rank, p < 0.01). In Cox regression models, cNfL and sNfL were independent factors of EDA, while SC lesions, cNfL, and sNfL were independent factors of CC. DISCUSSION cNfL >260 pg/mL and sNfL >5.0 pg/mL at diagnosis are independent predictive factors of EDA and CC in RIS. Although cNfL predicts disease activity better, sNfL is more accessible than cNfL and can be considered when a lumbar puncture is not performed. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that in people with radiologic isolated syndrome (RIS), initial serum and CSF NfL levels are associated with subsequent evidence of disease activity or clinical conversion.
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Affiliation(s)
- Manon Rival
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Eric Thouvenot
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France.
| | - Lucile Du Trieu de Terdonck
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Sabine Laurent-Chabalier
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Christophe Demattei
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Ugur Uygunoglu
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Giovanni Castelnovo
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Mikael Cohen
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Darin T Okuda
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Orhun H Kantarci
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Daniel Pelletier
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Christina Azevedo
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Philippe Marin
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Sylvain Lehmann
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Aksel Siva
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Thibault Mura
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
| | - Christine Lebrun-Frenay
- From the Department of Neurology (M.R., E.T., G.C.), Nîmes University Hospital Center, Univ. Montpellier; Functional Genomics Institute (M.R., E.T., L.D.T.T., P.M.), Univ. Montpellier, CNRS, INSERM; Department of Biostatistics (S.L.-C., C.D., T.M.), Clinical Epidemiology, Public Health and Innovation in Methdology (BESPIM), Nîmes University Hospital Center, Univ. Montpellier, France; Department of Neurology (U.U., A.S.), Cerrahpasa School of Medecine, University of Istanbul, Turkey; Centre de Ressources et Compétences Sclérose En Plaques (CRCSEP) (M.C., C.L.-F.), CHU de Nice, Hôpital Pasteur 2, Université Côte d'Azur, UR2CA-URRIS, France; UT Southwestern Medical Center (D.T.O.), Dallas, TX; Mayo Clinic (O.H.K.), Rochester, MN; University of South California (D.P., C.A.), Los Angeles; and LBPC-PPC (S.L.), Univ. Montpellier, CHU Montpellier, INM, INSERM, France
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13
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Ricken F, Can AD, Gräber S, Häusler M, Jahnen-Dechent W. Post-translational modifications glycosylation and phosphorylation of the major hepatic plasma protein fetuin-A are associated with CNS inflammation in children. PLoS One 2022; 17:e0268592. [PMID: 36206263 PMCID: PMC9544022 DOI: 10.1371/journal.pone.0268592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 09/24/2022] [Indexed: 12/03/2022] Open
Abstract
Fetuin-A is a liver derived plasma protein showing highest serum concentrations in utero, preterm infants, and neonates. Fetuin-A is also present in cerebrospinal fluid (CSF). The origin of CSF fetuin-A, blood-derived via the blood-CSF barrier or synthesized intrathecally, is presently unclear. Fetuin-A prevents ectopic calcification by stabilizing calcium and phosphate as colloidal calciprotein particles mediating their transport and clearance. Thus, fetuin-A plays a suppressive role in inflammation. Fetuin-A is a negative acute-phase protein under investigation as a biomarker for multiple sclerosis (MS). Here we studied the association of pediatric inflammatory CNS diseases with fetuin-A glycosylation and phosphorylation. Paired blood and CSF samples from 66 children were included in the study. Concentration measurements were performed using a commercial human fetuin-A/AHSG ELISA. Of 60 pairs, 23 pairs were analyzed by SDS-PAGE following glycosidase digestion with PNGase-F and Sialidase-AU. Phosphorylation was analyzed in 43 pairs by Phos-TagTM acrylamide electrophoresis following alkaline phosphatase digestion. Mean serum and CSF fetuin-A levels were 0.30 ± 0.06 mg/ml and 0.644 ± 0.55 μg/ml, respectively. This study showed that serum fetuin-A levels decreased in inflammation corroborating its role as a negative acute-phase protein. Blood-CSF barrier disruption was associated with elevated fetuin-A in CSF. A strong positive correlation was found between the CSF fetuin-A/serum fetuin-A quotient and the CSF albumin/serum albumin quotient, suggesting predominantly transport across the blood-CSF barrier rather than intrathecal fetuin-A synthesis. Sialidase digestion showed increased asialofetuin-A levels in serum and CSF samples from children with neuroinflammatory diseases. Desialylation enhanced hepatic fetuin-A clearance via the asialoglycoprotein receptor thus rapidly reducing serum levels during inflammation. Phosphorylation of fetuin-A was more abundant in serum samples than in CSF, suggesting that phosphorylation may regulate fetuin-A influx into the CNS. These results may help establish Fetuin-A as a potential biomarker for neuroinflammatory diseases.
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Affiliation(s)
- Frederik Ricken
- Division of Neuropediatrics and Social Pediatrics, Department of Pediatrics, RWTH Aachen University Hospital, Aachen, Germany
- Helmholtz Institute for Biomedical Engineering, Biointerface Laboratory, RWTH Aachen University Hospital, Aachen, Germany
| | - Ahu Damla Can
- Division of Neuropediatrics and Social Pediatrics, Department of Pediatrics, RWTH Aachen University Hospital, Aachen, Germany
- Helmholtz Institute for Biomedical Engineering, Biointerface Laboratory, RWTH Aachen University Hospital, Aachen, Germany
| | - Steffen Gräber
- Helmholtz Institute for Biomedical Engineering, Biointerface Laboratory, RWTH Aachen University Hospital, Aachen, Germany
| | - Martin Häusler
- Division of Neuropediatrics and Social Pediatrics, Department of Pediatrics, RWTH Aachen University Hospital, Aachen, Germany
| | - Willi Jahnen-Dechent
- Helmholtz Institute for Biomedical Engineering, Biointerface Laboratory, RWTH Aachen University Hospital, Aachen, Germany
- * E-mail:
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14
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Ashida S, Kondo T, Fujii C, Hamatani M, Mizuno T, Ochi H. Association of cerebrospinal inflammatory profile with radiological features in newly diagnosed treatment-naïve patients with multiple sclerosis. Front Neurol 2022; 13:1012857. [PMID: 36203996 PMCID: PMC9530286 DOI: 10.3389/fneur.2022.1012857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 09/01/2022] [Indexed: 12/05/2022] Open
Abstract
Objective Multiple sclerosis (MS) is an immune-mediated demyelinating disease of the central nervous system. Without reliable diagnostic biomarkers, the clinical and radiological heterogeneity of MS makes diagnosis difficult. Although magnetic resonance imaging (MRI) is a major diagnostic tool for MS, the association of MRI findings with the inflammatory profile in cerebrospinal fluid (CSF) has been insufficiently investigated. Therefore, we focused on CSF profile of MS patients and examined its association with MRI findings. Methods Concentrations of 26 cytokines and chemokines were determined in CSF of 28 treatment-naïve MS patients and 12 disease-control patients with aquaporin-4 antibody-seropositive neuromyelitis optica spectrum disorder (NMOSD). Results High levels of interleukin (IL)-6, IL-17A, B-cell activating factor (BAFF), a proliferation inducing ligand (APRIL), and CD40 ligand were correlated with the absence of at least one of the following three MRI findings in MS: an ovoid lesion, three or more periventricular lesions, and a nodular and/or ring-shaped contrast-enhancing lesion. The multivariate analysis revealed that elevated IL-17A was an independent predictor of absence of ovoid lesion and periventricular lesions less than three. MS patients were classified into a group with all three MRI findings (MS-full) and a group with less than three (MS-partial). The discriminant analysis model distinguished three groups: MS-full, MS-partial, and NMOSD, with 98% accuracy. Conclusion The CSF inflammatory profile was associated with radiological findings of treatment-naïve MS. This result indicates the possible utility of combined CSF and MRI profiling in identifying different MS phenotypes related to the heterogeneity of underlying immune processes.
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Affiliation(s)
- Shinji Ashida
- Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takayuki Kondo
- Department of Neurology, Kansai Medical University Medical Center, Osaka, Japan
| | - Chihiro Fujii
- Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Mio Hamatani
- Department of Neurology, Kansai Medical University Medical Center, Osaka, Japan
- Institute for the Advanced Study of Human Biology, Kyoto University, Kyoto, Japan
| | - Toshiki Mizuno
- Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hirofumi Ochi
- Department of Intractable Disease and Aging Science, Ehime University Graduate School of Medicine, Toon, Japan
- *Correspondence: Hirofumi Ochi
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15
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A Scoping Review on Body Fluid Biomarkers for Prognosis and Disease Activity in Patients with Multiple Sclerosis. J Pers Med 2022; 12:jpm12091430. [PMID: 36143216 PMCID: PMC9501898 DOI: 10.3390/jpm12091430] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/22/2022] [Accepted: 08/27/2022] [Indexed: 11/30/2022] Open
Abstract
Multiple sclerosis (MS) is a complex demyelinating disease of the central nervous system, presenting with different clinical forms, including clinically isolated syndrome (CIS), which is a first clinical episode suggestive of demyelination. Several molecules have been proposed as prognostic biomarkers in MS. We aimed to perform a scoping review of the potential use of prognostic biomarkers in MS clinical practice. We searched MEDLINE up to 25 November 2021 for review articles assessing body fluid biomarkers for prognostic purposes, including any type of biomarkers, cell types and tissues. Original articles were obtained to confirm and detail the data reported by the review authors. We evaluated the reliability of the biomarkers based on the sample size used by various studies. Fifty-two review articles were included. We identified 110 molecules proposed as prognostic biomarkers. Only six studies had an adequate sample size to explore the risk of conversion from CIS to MS. These confirm the role of oligoclonal bands, immunoglobulin free light chain and chitinase CHI3L1 in CSF and of serum vitamin D in the prediction of conversion from CIS to clinically definite MS. Other prognostic markers are not yet explored in adequately powered samples. Serum and CSF levels of neurofilaments represent a promising biomarker.
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16
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Lee S, Plavina T, Singh CM, Xiong K, Qiu X, Rudick RA, Calabresi PA, Stevenson L, Graham D, Raitcheva D, Green C, Matias M, Uzgiris AJ. Development of a Highly Sensitive Neurofilament Light Chain Assay on an Automated Immunoassay Platform. Front Neurol 2022; 13:935382. [PMID: 35959400 PMCID: PMC9359312 DOI: 10.3389/fneur.2022.935382] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/14/2022] [Indexed: 11/21/2022] Open
Abstract
Background Neurofilament light chain (NfL) is an axonal cytoskeletal protein that is released into the extracellular space following neuronal or axonal injury associated with neurological conditions such as multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), and other diseases. NfL is detectable in the cerebrospinal fluid (CSF) and blood. Numerous studies on MS have demonstrated that NfL is correlated with disease activity, predicts disease progression, and is reduced by treatment with MS disease-modifying drugs, making NfL an attractive candidate to supplement existing clinical and imaging measures in MS. However, for NfL to achieve its potential as a clinically useful biomarker for clinical decision-making or drug development, a standardized, practical, and widely accessible assay is needed. Our objective was to develop a novel NfL assay on an automated, globally available immunoassay platform and validate its performance. Methods A prototype NfL assay was first developed and evaluated on the ADVIA Centaur® XP immunoassay system from Siemens Healthineers. The lower limit of quantitation (LLoQ), within-lab precision, assay range, cross-reactivity with neurofilament medium and heavy chains, and effect of interfering substances were determined. NfL assay values in serum and CSF were compared with radiological and clinical disease activity measures in patients with MS and ALS, respectively. This assay was further optimized to utilize serum, plasma, and CSF sample types on the Atellica® IM system and transferred to Siemens' CLIA laboratory where it was analytically validated as a laboratory-developed test (LDT). Results In this study, an LLoQ of 1.85 pg/mL, within-lab precision <6%, and an assay range of up to 646 pg/mL were demonstrated with the serum prototype assay. Cross-reactivity of <0.7% with the neurofilament medium and heavy chains was observed. Serum and CSF NfL assay values were associated with radiological and clinical disease activity measures in patients with MS and ALS, respectively. The optimized version of the NfL assay demonstrated specimen equivalence with additional plasma tube types and was analytically validated as an LDT. Conclusion The analytical performance of the NfL assay fulfilled all acceptance criteria; therefore, we suggest that the assay is acceptable for use in both research and clinical practice settings to determine elevated NfL levels in patients.
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Affiliation(s)
- Stephen Lee
- Siemens Healthcare Laboratory, LLC, Berkeley, CA, United States
| | | | | | | | - Xiaolei Qiu
- Siemens Healthcare Laboratory, LLC, Berkeley, CA, United States
| | | | - Peter A. Calabresi
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Tan M, Xu Y, Gao Z, Yuan T, Liu Q, Yang R, Zhang B, Peng L. Recent Advances in Intelligent Wearable Medical Devices Integrating Biosensing and Drug Delivery. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022; 34:e2108491. [PMID: 35008128 DOI: 10.1002/adma.202108491] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/28/2021] [Indexed: 05/27/2023]
Abstract
The primary roles of precision medicine are to perform real-time examination, administer on-demand medication, and apply instruments continuously. However, most current therapeutic systems implement these processes separately, leading to treatment interruption and limited recovery in patients. Personalized healthcare and smart medical treatment have greatly promoted research on and development of biosensing and drug-delivery integrated systems, with intelligent wearable medical devices (IWMDs) as typical systems, which have received increasing attention because of their non-invasive and customizable nature. Here, the latest progress in research on IWMDs is reviewed, including their mechanisms of integrating biosensing and on-demand drug delivery. The current challenges and future development directions of IWMDs are also discussed.
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Affiliation(s)
- Minhong Tan
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, P. R. China
- School of Materials Science and Engineering, Zhejiang University, Hangzhou, 310027, P. R. China
| | - Yang Xu
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, P. R. China
| | - Ziqi Gao
- School of Mechanical Engineering, Zhejiang University, Hangzhou, 310027, P. R. China
| | - Tiejun Yuan
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, P. R. China
| | - Qingjun Liu
- College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, 310027, P. R. China
| | - Rusen Yang
- School of Advanced Materials and Nanotechnology, Xidian University, Xian, 710126, P. R. China
| | - Bin Zhang
- School of Mechanical Engineering, Zhejiang University, Hangzhou, 310027, P. R. China
| | - Lihua Peng
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, P. R. China
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, P. R. China
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18
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Beyrampour-Basmenj H, Pourhassan-Moghamddam M, Nakhjavani SA, Faraji N, Alivand M, Zarghami N, Talebi M, Rahmati M, Ebrahimi-Kalan A. Sensitive and convenient detection of miRNA-145 using a gold nanoparticle-HCR coupled system: computational and in vitro validations. IEEE Trans Nanobioscience 2022; PP:155-162. [PMID: 35533171 DOI: 10.1109/tnb.2022.3170530] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Multiple sclerosis (MS) remains a challenging disease that requires timely diagnosis. Therefore, an ultrasensitive optical biosensor based on hybridization chain reaction (HCR) was developed to detect microRNA-145 (miRNA-145) as an MS biomarker. To construct such a sensor, HCR occurred between specific hairpin probes, as MB1 contains a poly-cytosine nucleotide loop and MB2 has a poly-guanine nucleotide sticky end. By introducing miR-145 as a target sequence, long-range dsDNA polymers are formed. Then, positively charged gold nanoparticles (AuNPs) were incubated with the HCR product, which adsorbed onto the dsDNA polymers due to electrostatic adsorption. This resulted in the precipitation of the AuNPs. By incubating different concentrations of miR-145 with AuNPs, the changes in the UV-vis spectrum of the supernatant were analyzed. The proposed biosensor showed a great ability to detect miR-145 in a wide linear range from 1 pM-1 nM with an excellent detection limit (LOD) of 0.519 nM. Furthermore, the developed biosensor indicated considerable selectivity in discriminating between miR-145 and mismatched sequences. It shows high selectivity in differentiating targets. Interestingly, the proposed method was also able to detect miRNA-145 in the diluted serum samples. In conclusion, this sensing platform exhibits high selectivity and specificity for the detection of circulating microRNAs, which holds great promise for translation to routine clinical applications.
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19
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Update on Multiple Sclerosis Molecular Biomarkers to Monitor Treatment Effects. J Pers Med 2022; 12:jpm12040549. [PMID: 35455665 PMCID: PMC9024668 DOI: 10.3390/jpm12040549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 12/04/2022] Open
Abstract
Multiple sclerosis (MS) is an inflammatory and neurodegenerative disease of the central nervous system characterized by broad inter- and intraindividual heterogeneity. The relapse rate, disability progression, and lesion load assessed through MRI are used to detect disease activity and response to treatment. Although it is possible to standardize these characteristics in larger patient groups, so far, this has been difficult to achieve in individual patients. Easily detectable molecular biomarkers can be powerful tools, permitting a tailored therapy approach for MS patients. However, only a few molecular biomarkers have been routinely used in clinical practice as the validation process, and their transfer into clinical practice takes a long time. This review describes the characteristics of an ideal MS biomarker, the challenges of establishing new biomarkers, and promising molecular biomarkers from blood or CSF samples used to monitor MS treatment effects in clinical practice.
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20
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Salazar IL, Lourenço AST, Manadas B, Baldeiras I, Ferreira C, Teixeira AC, Mendes VM, Novo AM, Machado R, Batista S, Macário MDC, Grãos M, Sousa L, Saraiva MJ, Pais AACC, Duarte CB. Posttranslational modifications of proteins are key features in the identification of CSF biomarkers of multiple sclerosis. J Neuroinflammation 2022; 19:44. [PMID: 35135578 PMCID: PMC8822857 DOI: 10.1186/s12974-022-02404-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 01/26/2022] [Indexed: 12/27/2022] Open
Abstract
Background Multiple sclerosis is an inflammatory and degenerative disease of the central nervous system (CNS) characterized by demyelination and concomitant axonal loss. The lack of a single specific test, and the similarity to other inflammatory diseases of the central nervous system, makes it difficult to have a clear diagnosis of multiple sclerosis. Therefore, laboratory tests that allows a clear and definite diagnosis, as well as to predict the different clinical courses of the disease are of utmost importance. Herein, we compared the cerebrospinal fluid (CSF) proteome of patients with multiple sclerosis (in the relapse–remitting phase of the disease) and other diseases of the CNS (inflammatory and non-inflammatory) aiming at identifying reliable biomarkers of multiple sclerosis. Methods CSF samples from the discovery group were resolved by 2D-gel electrophoresis followed by identification of the protein spots by mass spectrometry. The results were analyzed using univariate (Student’s t test) and multivariate (Hierarchical Cluster Analysis, Principal Component Analysis, Linear Discriminant Analysis) statistical and numerical techniques, to identify a set of protein spots that were differentially expressed in CSF samples from patients with multiple sclerosis when compared with other two groups. Validation of the results was performed in samples from a different set of patients using quantitative (e.g., ELISA) and semi-quantitative (e.g., Western Blot) experimental approaches. Results Analysis of the 2D-gels showed 13 protein spots that were differentially expressed in the three groups of patients: Alpha-1-antichymotrypsin, Prostaglandin-H2-isomerase, Retinol binding protein 4, Transthyretin (TTR), Apolipoprotein E, Gelsolin, Angiotensinogen, Agrin, Serum albumin, Myosin-15, Apolipoprotein B-100 and EF-hand calcium-binding domain—containing protein. ELISA experiments allowed validating part of the results obtained in the proteomics analysis and showed that some of the alterations in the CSF proteome are also mirrored in serum samples from multiple sclerosis patients. CSF of multiple sclerosis patients was characterized by TTR oligomerization, thus highlighting the importance of analyzing posttranslational modifications of the proteome in the identification of novel biomarkers of the disease. Conclusions The model built based on the results obtained upon analysis of the 2D-gels and in the validation phase attained an accuracy of about 80% in distinguishing multiple sclerosis patients and the other two groups. Supplementary Information The online version contains supplementary material available at 10.1186/s12974-022-02404-2.
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Affiliation(s)
- Ivan L Salazar
- CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.,Institute for Interdisciplinary Research, University of Coimbra, Coimbra, Portugal
| | - Ana S T Lourenço
- CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.,Institute for Interdisciplinary Research, University of Coimbra, Coimbra, Portugal
| | - Bruno Manadas
- CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.,Institute for Interdisciplinary Research, University of Coimbra, Coimbra, Portugal
| | - Inês Baldeiras
- CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Cláudia Ferreira
- Coimbra Chemistry Centre, Department of Chemistry, University of Coimbra, Coimbra, Portugal
| | - Anabela Claro Teixeira
- Molecular Neurobiology Group, Instituto de Biologia Molecular e Celular (IBMC), Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal
| | - Vera M Mendes
- CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Ana Margarida Novo
- Neurology Department, CHUC-Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Rita Machado
- Neurology Department, CHUC-Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Sónia Batista
- CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.,Neurology Department, CHUC-Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Maria do Carmo Macário
- Neurology Department, CHUC-Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Mário Grãos
- CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.,Institute for Interdisciplinary Research, University of Coimbra, Coimbra, Portugal.,Biocant-Associação de Transferência de Tecnologia, Cantanhede, Portugal
| | - Lívia Sousa
- Neurology Department, CHUC-Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Maria João Saraiva
- Molecular Neurobiology Group, Instituto de Biologia Molecular e Celular (IBMC), Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal
| | - Alberto A C C Pais
- Coimbra Chemistry Centre, Department of Chemistry, University of Coimbra, Coimbra, Portugal
| | - Carlos B Duarte
- CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal. .,Department of Life Sciences, University of Coimbra, Coimbra, Portugal.
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21
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Iparraguirre L, Alberro A, Sepúlveda L, Osorio-Querejeta I, Moles L, Castillo-Triviño T, Hansen TB, Muñoz-Culla M, Otaegui D. RNA-Seq profiling of leukocytes reveals a sex-dependent global circular RNA upregulation in multiple sclerosis and 6 candidate biomarkers. Hum Mol Genet 2021; 29:3361-3372. [PMID: 33030201 DOI: 10.1093/hmg/ddaa219] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/30/2020] [Accepted: 10/02/2020] [Indexed: 12/31/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system, with higher prevalence in women, that leads to neurological disability. The disease course and clinical phenotype are highly variable, and therefore, biomarkers for the diagnosis, classification, monitoring of the disease and treatment assessment are needed. Studies have shown a dysregulation in the coding and non-coding RNAs and proposed some as biomarkers. However, still none of them have reached the clinical practice. Recently, circular RNAs (circRNAs) have emerged as new players in the transcriptome that hold a great potential as biomarkers in several diseases. Leukocytes from 30 MS patients and 20 healthy controls (HCs) were RNA-sequenced to study the linear and circular transcriptome. Differential expression analysis was performed by DESeq, and circRNA candidates were studied in a second cohort (70 MS and 46 HC) by RT-qPCR and in paired samples drawn during the relapse and remission phases (20 patients). Among the differentially expressed circRNAs, 96.1% are upregulated in patients compared with controls, but similar circRNA profiles are found between MS types. The same upregulation trend was observed in females but not in males or in the linear transcriptome. The upregulation of 6 circRNAs was validated, and a change in their expression was found between relapse and remission. The 6 circRNAs showed a good performance to discriminate patients from HC with a combined area under the curve of 0.852. There is global, specific and sex-dependent increase of circRNA expression in MS, and 6 circRNAs are proposed as potential biomarkers.
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Affiliation(s)
- Leire Iparraguirre
- Multiple Sclerosis Unit, Biodonostia Health Research Institute, San Sebastián 20014, Spain
| | - Ainhoa Alberro
- Multiple Sclerosis Unit, Biodonostia Health Research Institute, San Sebastián 20014, Spain
| | - Lucía Sepúlveda
- Multiple Sclerosis Unit, Biodonostia Health Research Institute, San Sebastián 20014, Spain
| | - Iñaki Osorio-Querejeta
- Multiple Sclerosis Unit, Biodonostia Health Research Institute, San Sebastián 20014, Spain
| | - Laura Moles
- Multiple Sclerosis Unit, Biodonostia Health Research Institute, San Sebastián 20014, Spain
| | - Tamara Castillo-Triviño
- Multiple Sclerosis Unit, Biodonostia Health Research Institute, San Sebastián 20014, Spain.,Spanish Network of Multiple Sclerosis (REEM), Barcelona 08028, Spain.,Neurology Department, Donostia University Hospital, San Sebastián 20014, Spain
| | - Thomas B Hansen
- Molecular Biology and Genetics Department, Aarhus University, Aarhus C 8000, Denmark
| | - Maider Muñoz-Culla
- Multiple Sclerosis Unit, Biodonostia Health Research Institute, San Sebastián 20014, Spain.,Spanish Network of Multiple Sclerosis (REEM), Barcelona 08028, Spain
| | - David Otaegui
- Multiple Sclerosis Unit, Biodonostia Health Research Institute, San Sebastián 20014, Spain.,Spanish Network of Multiple Sclerosis (REEM), Barcelona 08028, Spain
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22
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Mommaerts K, Willemse EAJ, Marchese M, Larue C, van der Flier WM, Betsou F, Teunissen CE. A Cystatin C Cleavage ELISA Assay as a Quality Control Tool for Determining Sub-Optimal Storage Conditions of Cerebrospinal Fluid Samples in Alzheimer's Disease Research. J Alzheimers Dis 2021; 83:1367-1377. [PMID: 34420976 PMCID: PMC8673510 DOI: 10.3233/jad-210741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background: An N-terminal octapeptide cleavage of the cystatin C protein was discovered by mass spectrometry when cerebrospinal fluid (CSF) was stored at –20°C for 3 months, which did not occur when CSF was stored at –80°C. Objective: The aim was to develop an immunoassay as quality assessment tool to detect this –20°C cleavage of cystatin C in CSF and support Alzheimer’s disease research. Methods: A specific monoclonal antibody and a double indirect sandwich ELISA were developed: one assay quantifies the octapeptide uncleaved protein specifically and the other quantifies the total cystatin C present in the biological fluid (both cleaved and uncleaved forms). The ratio of these concentrations was calculated to assess the extent of cleavage of cystatin C. The novel ELISA was validated and applied in a short-term (up to 4 weeks) and mid-term (up to one year) stability study of CSF stored at 4°C, –20°C, –80°C, and liquid nitrogen. Impact of freeze-thaw cycles, adsorption, and protease inhibitors were tested. Results: The ratio of truncated protein was modified following –20°C storage and seemed to reach a plateau after 6 months. The ratio was impacted neither by freeze-thaw cycles nor adsorption. The –20°C specific cleavage was found to be protease related. Conclusion: Using this novel double indirect sandwich ELISA, absolute levels of the total and uncleaved cystatin C and the ratio of truncated cystatin C can be measured. This assay is an easily applicable tool which can be used to confirm that CSF biospecimen are fit-for-purpose for Alzheimer’s disease research.
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Affiliation(s)
- Kathleen Mommaerts
- Biospecimen Research Group, Integrated Biobank of Luxembourg, Luxembourg Institute of Health, Luxembourg.,Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Luxembourg
| | - Eline A J Willemse
- Department of Clinical Chemistry, Neurochemistry Laboratory, Amsterdam Neuroscience, Amsterdam University Medical Center, VU University, Amsterdam, the Netherlands
| | - Monica Marchese
- Translational Biomarker Group, Integrated Biobank of Luxembourg, Luxembourg Institute of Health, Luxembourg
| | - Catherine Larue
- Integrated Biobank of Luxembourg, Luxembourg Institute of Health, Luxembourg
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam University Medical Center, VU University, Amsterdam, the Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam University Medical Center, VU Amsterdam, Amsterdam, the Netherlands
| | - Fay Betsou
- Integrated Biobank of Luxembourg, Luxembourg Institute of Health, Luxembourg
| | - Charlotte E Teunissen
- Department of Clinical Chemistry, Neurochemistry Laboratory, Amsterdam Neuroscience, Amsterdam University Medical Center, VU University, Amsterdam, the Netherlands
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23
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Szilasiová J, Rosenberger J, Fedičová M, Mikula P, Urban P, Gdovinová Z, Vitková M, Hanes J, Stevens E. Neurofilament Light Chain Levels Are Associated with Disease Activity Determined by No Evident Disease Activity in Multiple Sclerosis Patients. Eur Neurol 2021; 84:272-279. [PMID: 34034261 DOI: 10.1159/000515806] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/04/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION There is a need for blood biomarkers of disease activity in multiple sclerosis (MS). The aim of the study was to assess the relationship between plasma neurofilament light chain (pNfL) and disease activity as defined by the concept three-domain no evident disease activity (NEDA-3). METHODS Levels of pNfL (SIMOA) were examined in 159 MS patients and analyzed in relationship to NEDA-3 status (absence of relapse, disability score worsening, and brain magnetic resonance activity) during the last 12 months. The accuracy of the proposed model was evaluated by calculating the area under the receiver operating characteristics (ROC) curve. From the pNfL cutoff, we evaluated the NEDA-NfL status (no relapse, no Expanded Disability Status Scale [EDSS] worsening, and pNfL below the cutoff value). RESULTS Levels of pNfL were significantly higher in MS patients than in healthy controls (p < 0.001). From a total of 159 patients, 80 (50.3%) achieved NEDA-3 status, while 79 (49.7%) patients showed evident disease activity (EDA) status. pNfL were significantly lower in the NEDA-3 group than in the EDA group (pNfL mean 7.06 pg/mL [standard deviation (SD) 2.37] vs. pNfL mean 13.04 pg/mL [SD 7.07]) (p < 0.001). ROC analysis showed that pNfL predicts NEDA-3 status (sensitivity and specificity were 80.5 and 72.7%, respectively, p < 0.001), and NEDA-NfL predicts NEDA-3 status (sensitivity and specificity were 97.1 and 82.9%, respectively, p < 0.001). CONCLUSION The results show that pNfL levels are a useful biomarker of disease activity determined by NEDA status in patients with MS and could be an alternative to brain magnetic resonance investigation.
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Affiliation(s)
- Jarmila Szilasiová
- Department of Neurology, Pavol Jozef Šafárik University, Košice, Slovakia
| | - Jaroslav Rosenberger
- Department of Health Psychology and Methodology of Research, II. Internal clinic, Pavol Jozef Šafárik University, Košice, Slovakia.,Olomouc University Social Health Institute, University Palacky, Olomouc, Czechia
| | - Miriam Fedičová
- Department of Neurology, University Hospital L. Pasteur Košice, Košice, Slovakia
| | - Pavol Mikula
- Department of Social and Behavioral Medicine, Pavol Jozef Šafárik University, Košice, Slovakia
| | - Peter Urban
- Department of Medical and Clinical Biochemistry, Pavol Jozef Šafárik University, Košice, Slovakia
| | - Zuzana Gdovinová
- Department of Neurology, Pavol Jozef Šafárik University, Košice, Slovakia
| | - Marianna Vitková
- Department of Neurology, Pavol Jozef Šafárik University, Košice, Slovakia
| | - Jozef Hanes
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia.,AXON Neuroscience R&D Services SE, Bratislava, Slovakia
| | - Eva Stevens
- AXON Neuroscience R&D Services SE, Bratislava, Slovakia
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24
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Oveland E, Ahmad I, Lereim RR, Kroksveen AC, Barsnes H, Guldbrandsen A, Myhr KM, Bø L, Berven FS, Wergeland S. Cuprizone and EAE mouse frontal cortex proteomics revealed proteins altered in multiple sclerosis. Sci Rep 2021; 11:7174. [PMID: 33785790 PMCID: PMC8010076 DOI: 10.1038/s41598-021-86191-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 02/19/2021] [Indexed: 02/06/2023] Open
Abstract
Two pathophysiological different experimental models for multiple sclerosis were analyzed in parallel using quantitative proteomics in attempts to discover protein alterations applicable as diagnostic-, prognostic-, or treatment targets in human disease. The cuprizone model reflects de- and remyelination in multiple sclerosis, and the experimental autoimmune encephalomyelitis (EAE, MOG1-125) immune-mediated events. The frontal cortex, peripheral to severely inflicted areas in the CNS, was dissected and analyzed. The frontal cortex had previously not been characterized by proteomics at different disease stages, and novel protein alterations involved in protecting healthy tissue and assisting repair of inflicted areas might be discovered. Using TMT-labelling and mass spectrometry, 1871 of the proteins quantified overlapped between the two experimental models, and the fold change compared to controls was verified using label-free proteomics. Few similarities in frontal cortex between the two disease models were observed when regulated proteins and signaling pathways were compared. Legumain and C1Q complement proteins were among the most upregulated proteins in cuprizone and hemopexin in the EAE model. Immunohistochemistry showed that legumain expression in post-mortem multiple sclerosis brain tissue (n = 19) was significantly higher in the center and at the edge of white matter active and chronic active lesions. Legumain was associated with increased lesion activity and might be valuable as a drug target using specific inhibitors as already suggested for Parkinson's and Alzheimer's disease. Cerebrospinal fluid levels of legumain, C1q and hemopexin were not significantly different between multiple sclerosis patients, other neurological diseases, or healthy controls.
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Affiliation(s)
- Eystein Oveland
- Proteomics Unit, Department of Biomedicine, University of Bergen (PROBE), Bergen, Norway
| | - Intakhar Ahmad
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Neurology, Norwegian Multiple Sclerosis Competence Centre, Haukeland University Hospital, Jonas Lies vei 65, 5021, Bergen, Norway
| | - Ragnhild Reehorst Lereim
- Proteomics Unit, Department of Biomedicine, University of Bergen (PROBE), Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Ann Cathrine Kroksveen
- Proteomics Unit, Department of Biomedicine, University of Bergen (PROBE), Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Harald Barsnes
- Proteomics Unit, Department of Biomedicine, University of Bergen (PROBE), Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Astrid Guldbrandsen
- Proteomics Unit, Department of Biomedicine, University of Bergen (PROBE), Bergen, Norway
- Department of Neurology, Norwegian Multiple Sclerosis Competence Centre, Haukeland University Hospital, Jonas Lies vei 65, 5021, Bergen, Norway
- Computational Biology Unit, Department of Informatics, University of Bergen, Bergen, Norway
| | - Kjell-Morten Myhr
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Lars Bø
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Neurology, Norwegian Multiple Sclerosis Competence Centre, Haukeland University Hospital, Jonas Lies vei 65, 5021, Bergen, Norway
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Frode S Berven
- Proteomics Unit, Department of Biomedicine, University of Bergen (PROBE), Bergen, Norway
- Department of Neurology, Norwegian Multiple Sclerosis Competence Centre, Haukeland University Hospital, Jonas Lies vei 65, 5021, Bergen, Norway
| | - Stig Wergeland
- Department of Neurology, Norwegian Multiple Sclerosis Competence Centre, Haukeland University Hospital, Jonas Lies vei 65, 5021, Bergen, Norway.
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Bergen, Norway.
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25
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Guerrero JM, Aguirre FS, Mota ML, Carrillo A. Advances for the Development of In Vitro Immunosensors for Multiple Sclerosis Diagnosis. BIOCHIP JOURNAL 2021. [DOI: 10.1007/s13206-021-00018-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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26
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Zheng Y, Cai MT, Yang F, Zhou JP, Fang W, Shen CH, Zhang YX, Ding MP. IgG Index Revisited: Diagnostic Utility and Prognostic Value in Multiple Sclerosis. Front Immunol 2020; 11:1799. [PMID: 32973754 PMCID: PMC7468492 DOI: 10.3389/fimmu.2020.01799] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/06/2020] [Indexed: 12/22/2022] Open
Abstract
Objective: Early and accurate diagnosis of multiple sclerosis (MS) remains a clinical challenge. The main objective is to evaluate the diagnostic and prognostic value of the routinely performed immunoglobulin G (IgG) index for MS patients in the Asian population. Methods: A retrospective study was conducted among a cohort of clinically isolated syndrome (CIS) patients in China with known oligoclonal band (OCB) status and IgG index at baseline. We first evaluated the predictive value of IgG index for OCB status. Secondly, the diagnostic utility and prognostic value of IgG index alone were tested. Lastly, we incorporated IgG index into the 2017 McDonald criteria by replacing OCB with either “IgG index or OCB” (modified criteria 1), “IgG index and OCB” (modified criteria 2), or “IgG index” (modified criteria 3). The diagnostic utility of different criteria was calculated and compared. Results: In a CIS cohort in China (n = 105), IgG index > 0.7 forecasted OCB positivity (X2 = 22.90, P < 0.001). An elevated IgG index was highly prognostic of more clinical relapses [1-year adjusted odds ratio [OR] = 1.32, P = 0.015; 2-years adjusted OR = 1.69, P = 0.013] and Expanded Disability Status Scale worsening (1-year adjusted OR = 1.76, P = 0.040; 2-years adjusted OR = 1.85, P = 0.032). Under the 2017 McDonald criteria (Positive Likelihood Ratio = 1.54, Negative Likelihood Ratio = 0.56), an IgG index > 0.7 in CIS patients increased the likelihood of developing MS within 2 years, either when OCB status was unknown (Positive Likelihood Ratio = 2.11) or with OCB positivity (Positive Likelihood Ratio = 2.11) at baseline; An IgG index ≤ 0.7, along with a negative OCB, helped rule out the MS diagnosis (Negative Likelihood Ratio = 0.53). Conclusions: IgG index > 0.7 predicts OCB positivity at the initial attack of MS and is prognostic of early disease activity. IgG index serves as an easily-obtainable and accurate OCB surrogate for MS diagnosis in the Asian population.
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Affiliation(s)
- Yang Zheng
- Department of Neurology, School of Medicine, Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Meng-Ting Cai
- Department of Neurology, School of Medicine, Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Fan Yang
- Department of Neurology, School of Medicine, Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Ji-Ping Zhou
- Harvard University School of Public Health, Boston, MA, United States
| | - Wei Fang
- Department of Neurology, School of Medicine, Fourth Affiliated Hospital, Zhejiang University, Yiwu, China
| | - Chun-Hong Shen
- Department of Neurology, School of Medicine, Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Yin-Xi Zhang
- Department of Neurology, School of Medicine, Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Mei-Ping Ding
- Department of Neurology, School of Medicine, Second Affiliated Hospital, Zhejiang University, Hangzhou, China
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27
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Sol N, Leurs CE, Veld SGI', Strijbis EM, Vancura A, Schweiger MW, Teunissen CE, Mateen FJ, Tannous BA, Best MG, Würdinger T, Killestein J. Blood platelet RNA enables the detection of multiple sclerosis. Mult Scler J Exp Transl Clin 2020; 6:2055217320946784. [PMID: 32843989 PMCID: PMC7418262 DOI: 10.1177/2055217320946784] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/05/2020] [Accepted: 07/13/2020] [Indexed: 12/15/2022] Open
Abstract
Background In multiple sclerosis (MS), clinical assessment, MRI and cerebrospinal fluid are important in the diagnostic process. However, no blood biomarker has been confirmed as a useful tool in the diagnostic work-up. Objectives Blood platelets contain a rich spliced mRNA repertoire that can alter during megakaryocyte development but also during platelet formation and platelet circulation. In this proof of concept study, we evaluate the diagnostic potential of spliced blood platelet RNA for the detection of MS. Methods We isolated and sequenced platelet RNA of blood samples obtained from 57 MS patients and 66 age- and gender-matched healthy controls (HCs). 60% was used to develop a particle swarm-optimized (PSO) support vector machine classification algorithm. The remaining 40% served as an independent validation series. Results In total, 1249 RNAs with differential spliced junction expression levels were identified between platelets of MS patients as compared to HCs, including EPSTI1, IFI6, and RPS6KA3, in line with reported inflammatory signatures in the blood of MS patients. The RNAs were subsequently used as input for a MS classifier, capable of detecting MS with 80% accuracy in the independent validation series. Conclusions Spliced platelet RNA may enable the blood-based diagnosis of MS, warranting large-scale validation.
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Affiliation(s)
- Nik Sol
- Department of Neurology, Neuroscience Amsterdam, VUmc MS Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands.,Brain Tumor Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Cyra E Leurs
- Department of Neurology, Neuroscience Amsterdam, VUmc MS Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands
| | - Sjors Gjg In 't Veld
- Brain Tumor Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands.,Department of Neurosurgery, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Eva M Strijbis
- Department of Neurology, Neuroscience Amsterdam, VUmc MS Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands
| | - Adrienne Vancura
- Brain Tumor Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands.,Department of Neurosurgery, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Markus W Schweiger
- Brain Tumor Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands.,Department of Neurosurgery, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands.,Department of Neurology, Massachusetts General Hospital Harvard Medical School, Boston, MA, USA
| | - Charlotte E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands
| | - Farrah J Mateen
- Department of Neurology, Massachusetts General Hospital Harvard Medical School, Boston, MA, USA
| | - Bakhos A Tannous
- Department of Neurology, Massachusetts General Hospital Harvard Medical School, Boston, MA, USA
| | - Myron G Best
- Brain Tumor Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands.,Department of Neurosurgery, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands.,Department of Pathology, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Thomas Würdinger
- Brain Tumor Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands.,Department of Neurosurgery, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Joep Killestein
- Department of Neurology, Neuroscience Amsterdam, VUmc MS Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands
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28
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Abstract
Effective biomarkers for multiple sclerosis diagnosis, assessment of prognosis, and treatment responses, in particular those measurable in blood, are largely lacking. We have investigated a broad set of protein biomarkers in cerebrospinal fluid (CSF) and plasma using a highly sensitive proteomic immunoassay. Cases from two independent cohorts were compared with healthy controls and patients with other neurological diseases. We identified and replicated 10 cerebrospinal fluid proteins including IL-12B, CD5, MIP-1a, and CXCL9 which had a combined diagnostic efficacy similar to immunoglobulin G (IgG) index and neurofilament light chain (area under the curve [AUC] = 0.95). Two plasma proteins, OSM and HGF, were also associated with multiple sclerosis in comparison to healthy controls. Sensitivity and specificity of combined CSF and plasma markers for multiple sclerosis were 85.7% and 73.5%, respectively. In the discovery cohort, eotaxin-1 (CCL11) was associated with disease duration particularly in patients who had secondary progressive disease (P CSF < 4 × 10-5, P plasma < 4 × 10-5), and plasma CCL20 was associated with disease severity (P = 4 × 10-5), although both require further validation. Treatment with natalizumab and fingolimod showed different compartmental changes in protein levels of CSF and peripheral blood, respectively, including many disease-associated markers (e.g., IL12B, CD5) showing potential application for both diagnosing disease and monitoring treatment efficacy. We report a number of multiple sclerosis biomarkers in CSF and plasma for early disease detection and potential indicators for disease activity. Of particular importance is the set of markers discovered in blood, where validated biomarkers are lacking.
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29
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Meyer Zu Hörste G, Gross CC, Klotz L, Schwab N, Wiendl H. Next-Generation Neuroimmunology: New Technologies to Understand Central Nervous System Autoimmunity. Trends Immunol 2020; 41:341-354. [PMID: 32147112 DOI: 10.1016/j.it.2020.02.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 02/10/2020] [Accepted: 02/10/2020] [Indexed: 12/11/2022]
Abstract
Understanding neuroimmunological disorders is essential for developing new diagnostic and therapeutic strategies. Rodent models have provided valuable insights, but are sometimes equated with their human counterparts. Here, we summarize how novel technologies may enable an improved human-focused view of immune mechanisms. Recent studies have applied these new technologies to the brain parenchyma, its surrounding cerebrospinal fluid, and peripheral immune compartments. Therapeutic interventions have also facilitated translational understanding in a reverse way. However, with improved technology, access to patient samples remains a rate-limiting step in translational research. We anticipate that next-generation neuroimmunology is likely to integrate, in the immediate future, diverse technical tools for optimal diagnosis, prognosis, and treatment of neuroimmunological disorders.
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Affiliation(s)
- Gerd Meyer Zu Hörste
- Department of Neurology with Institute of Translational Neurology, University Hospital Münster, University of Münster, Münster, Germany
| | - Catharina C Gross
- Department of Neurology with Institute of Translational Neurology, University Hospital Münster, University of Münster, Münster, Germany
| | - Luisa Klotz
- Department of Neurology with Institute of Translational Neurology, University Hospital Münster, University of Münster, Münster, Germany
| | - Nicholas Schwab
- Department of Neurology with Institute of Translational Neurology, University Hospital Münster, University of Münster, Münster, Germany
| | - Heinz Wiendl
- Department of Neurology with Institute of Translational Neurology, University Hospital Münster, University of Münster, Münster, Germany.
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30
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Cortini A, Bembich S, Marson L, Cocco E, Edomi P. Identification of novel non-myelin biomarkers in multiple sclerosis using an improved phage-display approach. PLoS One 2019; 14:e0226162. [PMID: 31805175 PMCID: PMC6894809 DOI: 10.1371/journal.pone.0226162] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 11/20/2019] [Indexed: 12/17/2022] Open
Abstract
Although the etiology of multiple sclerosis is not yet understood, it is accepted that its pathogenesis involves both autoimmune and neurodegenerative processes, in which the role of autoreactive T-cells has been elucidated. Instead, the contribution of humoral response is still unclear, even if the presence of intrathecal antibodies and B-cells follicle-like structures in meninges of patients has been demonstrated. Several myelin and non-myelin antigens have been identified, but none has been validated as humoral biomarker. In particular autoantibodies against myelin proteins have been found also in healthy individuals, whereas non-myelin antigens have been implicated in neurodegenerative phase of the disease. To provide further putative autoantigens of multiple sclerosis, we investigated the antigen specificity of immunoglobulins present both in sera and in cerebrospinal fluid of patients using phage display technology in a new improved format. A human brain cDNA phage display library was constructed and enriched for open-read-frame fragments. This library was selected against pooled and purified immunoglobulins from cerebrospinal fluid and sera of multiple sclerosis patients. The antigen library was also screened against an antibody scFv library obtained from RNA of B cells purified from the cerebrospinal fluid of two relapsing remitting patients. From all biopanning a complex of 14 antigens were identified; in particular, one of these antigens, corresponding to DDX24 protein, was present in all selections. The ability of more frequently isolated antigens to discriminate between sera from patients with multiple sclerosis or other neurological diseases was investigated. The more promising novel candidate autoantigens were DDX24 and TCERG1. Both are implicated in RNA modification and regulation which can be altered in neurodegenerative processes. Therefore, we propose that they could be a marker of a particular disease activity state.
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Affiliation(s)
- Andrea Cortini
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Sara Bembich
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Lorena Marson
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Eleonora Cocco
- Multiple Sclerosis Center, University of Cagliari/ATS Sardegna, Cagliari, Italy
| | - Paolo Edomi
- Department of Life Sciences, University of Trieste, Trieste, Italy
- * E-mail:
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31
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Kuhle J, Plavina T, Barro C, Disanto G, Sangurdekar D, Singh CM, de Moor C, Engle B, Kieseier BC, Fisher E, Kappos L, Rudick RA, Goyal J. Neurofilament light levels are associated with long-term outcomes in multiple sclerosis. Mult Scler 2019; 26:1691-1699. [PMID: 31680621 PMCID: PMC7604552 DOI: 10.1177/1352458519885613] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Neurofilament light chain (NfL) is a promising marker of disease activity/treatment response in multiple sclerosis (MS), although its predictive value for long-term clinical outcomes remains unclear. Objective: We measured NfL from a phase 3 trial in relapsing-remitting MS and investigated its association with outcomes after 8 and 15 years. Methods: NfL concentrations were measured by single molecule array assay in cerebrospinal fluid (CSF) from MS patients (n = 235) in a 2-year randomized clinical trial (RCT) of intramuscular interferon β-1a, and in serum (n = 164) from the extension study. Results: Year 2 CSF and Year 3 serum NfL were associated with brain parenchymal fraction (BPF) change over 8 years (p < 0.0001, r = −0.46; p < 0.05. r = −0.36, respectively) and were predictive of reaching Expanded Disability Status Scale (EDSS) ⩾ 6.0 at Year 8 (odds ratio (OR) (upper vs lower tertile) = 3.4; 95% confidence interval (CI) = 1.2–9.9, p < 0.05; OR = 11.0, 95% CI = 2.0–114.6; p < 0.01, respectively). Serum NfL concentration (Year 4) was predictive of reaching EDSS score ⩾6.0 at 15 years (OR (upper vs lower tertile) = 4.9; 95% CI = 1.4–20.4; p < 0.05). NfL concentrations were complementary to 2-year BPF change in predicting long-term outcomes. Conclusion: Serum and CSF NfL concentrations were associated with long-term clinical outcomes in MS patients and are promising biomarkers for disease severity stratification supporting treatment decisions.
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Affiliation(s)
- Jens Kuhle
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | | | - Christian Barro
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Giulio Disanto
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland/Neurocenter of Southern Switzerland, Ospedale Civico, Lugano, Switzerland
| | | | | | | | | | | | | | - Ludwig Kappos
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
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32
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Bharucha T, Gangadharan B, Kumar A, de Lamballerie X, Newton PN, Winterberg M, Dubot-Pérès A, Zitzmann N. Mass spectrometry-based proteomic techniques to identify cerebrospinal fluid biomarkers for diagnosing suspected central nervous system infections. A systematic review. J Infect 2019; 79:407-418. [PMID: 31404562 PMCID: PMC6838782 DOI: 10.1016/j.jinf.2019.08.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/04/2019] [Accepted: 08/05/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Central nervous system (CNS) infections account for considerable death and disability every year. An urgent research priority is scaling up diagnostic capacity, and introduction of point-of-care tests. We set out to assess current evidence for the application of mass spectrometry (MS) peptide sequencing in identification of diagnostic biomarkers for CNS infections. METHODS We performed a systematic review (PROSPEROCRD42018104257) using PRISMA guidelines on use of MS to identify cerebrospinal fluid (CSF) biomarkers for diagnosing CNS infections. We searched PubMed, Embase, Web of Science, and Cochrane for articles published from 1 January 2000 to 1 February 2019, and contacted experts. Inclusion criteria involved primary research except case reports, on the diagnosis of infectious diseases except HIV, applying MS to human CSF samples, and English language. RESULTS 4,620 papers were identified, of which 11 were included, largely confined to pre-clinical biomarker discovery, and eight (73%) published in the last five years. 6 studies performed further work termed verification or validation. In 2 of these studies, it was possible to extract data on sensitivity and specificity of the biomarkers detected by ELISA, ranging from 89-94% and 58-92% respectively. CONCLUSIONS The findings demonstrate feasibility and potential of the methods in a variety of infectious diseases, but emphasise the need for strong interdisciplinary collaborations to ensure appropriate study design and biomarker validation.
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Affiliation(s)
- Tehmina Bharucha
- Institute of Glycobiology, Department of Biochemistry, South Parks Road, Oxford OX1 3RQ, United Kingdom; Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao Democratic People's Republic.
| | - Bevin Gangadharan
- Institute of Glycobiology, Department of Biochemistry, South Parks Road, Oxford OX1 3RQ, United Kingdom
| | - Abhinav Kumar
- Institute of Glycobiology, Department of Biochemistry, South Parks Road, Oxford OX1 3RQ, United Kingdom
| | - Xavier de Lamballerie
- Unité des Virus Émergents (UVE: Aix-Marseille Univ - IRD 190 - Inserm 1207 - IHU Méditerranée Infection), Marseille, France
| | - Paul N Newton
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao Democratic People's Republic; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom
| | - Markus Winterberg
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 3/F, 60th Anniversary Chalermprakiat Building, 420/6 Rajvithi Road, Bangkok 10400, Thailand
| | - Audrey Dubot-Pérès
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao Democratic People's Republic; Unité des Virus Émergents (UVE: Aix-Marseille Univ - IRD 190 - Inserm 1207 - IHU Méditerranée Infection), Marseille, France; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom
| | - Nicole Zitzmann
- Institute of Glycobiology, Department of Biochemistry, South Parks Road, Oxford OX1 3RQ, United Kingdom
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Silajdžić E, Björkqvist M. A Critical Evaluation of Wet Biomarkers for Huntington's Disease: Current Status and Ways Forward. J Huntingtons Dis 2019; 7:109-135. [PMID: 29614689 PMCID: PMC6004896 DOI: 10.3233/jhd-170273] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
There is an unmet clinical need for objective biomarkers to monitor disease progression and treatment response in Huntington's disease (HD). The aim of this review is, therefore, to provide practical advice for biomarker discovery and to summarise studies on biofluid markers for HD. A PubMed search was performed to review literature with regard to candidate saliva, urine, blood and cerebrospinal fluid biomarkers for HD. Information has been organised into tables to allow a pragmatic approach to the discussion of the evidence and generation of practical recommendations for future studies. Many of the markers published converge on metabolic and inflammatory pathways, although changes in other analytes representing antioxidant and growth factor pathways have also been found. The most promising markers reflect neuronal and glial degeneration, particularly neurofilament light chain. International collaboration to standardise assays and study protocols, as well as to recruit sufficiently large cohorts, will facilitate future biomarker discovery and development.
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Affiliation(s)
- Edina Silajdžić
- Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Maria Björkqvist
- Department of Experimental Medical Science, Brain Disease Biomarker Unit, Wallenberg Neuroscience Center, Lund University, Lund, Sweden
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Gajofatto A, Donisi V, Busch IM, Gobbin F, Butturini E, Calabrese M, Carcereri de Prati A, Cesari P, Del Piccolo L, Donadelli M, Fabene P, Fochi S, Gomez-Lira M, Magliozzi R, Malerba G, Mariotti R, Mariotto S, Milanese C, Romanelli MG, Sbarbati A, Schena F, Mazzi MA, Rimondini M. Biopsychosocial model of resilience in young adults with multiple sclerosis (BPS-ARMS): an observational study protocol exploring psychological reactions early after diagnosis. BMJ Open 2019; 9:e030469. [PMID: 31377712 PMCID: PMC6687017 DOI: 10.1136/bmjopen-2019-030469] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 07/06/2019] [Accepted: 07/12/2019] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Multiple sclerosis (MS), the most common neurological disease causing disability in young adults, is widely recognised as a major stress factor. Studies have shown that the first years after the diagnosis are distressing in terms of adjustment to the disease and that MS negatively affects patients' psychological well-being, quality of life (QoL) and social functioning. However, the links between disease-specific variables at diagnosis, resilience and psychological adjustment of patients with MS remain largely unexplored, especially in adolescents and young adults. This observational study aims to fill the gap of knowledge on biopsychosocial characteristics and resilience of young adults with MS to evaluate the relationship among these variables and to develop a biopsychosocial model of resilience. METHODS AND ANALYSIS Biological and clinical characteristics of young adults newly diagnosed with MS will be investigated by collecting clinical information, performing neurological examinations, MRI and analysing cerebrospinal fluid and blood biomarkers (eg, measures of inflammation), body composition, gut microbiota and movement/perceptual markers. Psychosocial characteristics (eg, psychological distress, coping strategies), QoL, psychological well-being and resilience will be assessed by self-report questionnaires. Comparative statistics (ie, analysis of variance or unpaired samples t-test, correlation and regression analyses) will be applied to evaluate the relationship among biological, psychological and social factors. The results are expected to allow a comprehensive understanding of the determinants of resilience in young patients with MS and to inform resilience interventions, tailored to young patients' specific needs, aiming to reduce the risk of maladaptive reactions to the disease and to improve psychological well-being and QoL. ETHICS AND DISSEMINATION The study has been approved by the Verona University Hospital Ethics Committee (approval number: 2029CESC). The findings will be disseminated through scientific publications in peer-reviewed journals, conference presentations, social media and specific websites. TRIAL REGISTRATION NUMBER ClinicalTrials.gov (NCT03825055).
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Affiliation(s)
- Alberto Gajofatto
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Valeria Donisi
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Isolde Martina Busch
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Francesca Gobbin
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Elena Butturini
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Massimiliano Calabrese
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Paola Cesari
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Lidia Del Piccolo
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Massimo Donadelli
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Paolo Fabene
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Stefania Fochi
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Macarena Gomez-Lira
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Roberta Magliozzi
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Giovanni Malerba
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Raffaella Mariotti
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sofia Mariotto
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Chiara Milanese
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Maria Grazia Romanelli
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Andrea Sbarbati
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Federico Schena
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Maria Angela Mazzi
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Michela Rimondini
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Malekzadeh A, Leurs C, van Wieringen W, Steenwijk MD, Schoonheim MM, Amann M, Naegelin Y, Kuhle J, Killestein J, Teunissen CE. Plasma proteome in multiple sclerosis disease progression. Ann Clin Transl Neurol 2019; 6:1582-1594. [PMID: 31364818 PMCID: PMC7651845 DOI: 10.1002/acn3.771] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 02/28/2019] [Accepted: 03/07/2019] [Indexed: 01/01/2023] Open
Abstract
Background The pathophysiology of multiple sclerosis disease progression remains undetermined. The aim of this study was to identify differences in plasma proteome during different stages of MS disease progression. Methods We used a multiplex aptamer proteomics platform (Somalogic) for sensitive detection of 1129 proteins in plasma. MS patients were selected and categorized based on baseline and a 4‐year follow‐up EDSS (delta EDSS) scores; relapse‐onset (RO) slow progression (n = 31), RO with rapid progression (n = 29), primary progressive (n = 30), and healthy controls (n = 20). The relation of baseline plasma protein levels with delta EDSS and different MRI progression parameters were assessed using linear regression models. Results Regression analyses of plasma proteins with delta EDSS showed six significant associations. Strong associations were found for the proteins LGLAS8 (P = 7.64 × 10−5, q = 0.06), CCL3 (P = 0.0001, q = 0.06), and RGMA (P = 0.0005, q = 0.09). In addition, associations of plasma proteins were found with percentage brain volume for C3 (P = 2,08 × 10−9, q = 1,70 × 10−6), FGF9 (P = 3,42 × 10−9, q = 1,70 × 10−6), and EHMT2 (P = 0.0007, q = 0.01). Most of the significant markers were associated with cell‐cell and cell‐extracellular matrix adhesion, immune system communication, immune system activation, and complement pathways. Conclusions Our results revealed eight novel biomarkers related to clinical and radiological progression in MS. These results indicate that changes in immune system, complement pathway and ECM remodeling proteins contribute to MS progression and may therefore be further explored for use in prognosis of MS.
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Affiliation(s)
- Arjan Malekzadeh
- Department of Clinical Chemistry, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Cyra Leurs
- Department of Neurology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Wessel van Wieringen
- Department of Mathematics, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Martijn D Steenwijk
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Menno M Schoonheim
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Michael Amann
- Division of Diagnostic and Interventional Neuroradiology, Department of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland.,Medical Image Analysis Center (MIAC AG), Basel, Switzerland
| | - Yvonne Naegelin
- Department of Biomedicine and Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Jens Kuhle
- Department of Biomedicine and Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Joep Killestein
- Department of Neurology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Department of Clinical Chemistry, Amsterdam University Medical Centre, Amsterdam, The Netherlands
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Paul A, Comabella M, Gandhi R. Biomarkers in Multiple Sclerosis. Cold Spring Harb Perspect Med 2019; 9:cshperspect.a029058. [PMID: 29500303 DOI: 10.1101/cshperspect.a029058] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Multiple sclerosis (MS) is a chronic neurodegenerative autoimmune disease with a complex clinical course characterized by inflammation, demyelination, and axonal degeneration. Diagnosis of MS most commonly includes finding lesions in at least two separate areas of the central nervous system (CNS), including the brain, spinal cord, and optic nerves. In recent years, there has been a remarkable increase in the number of available treatments for MS. An optimal treatment is usually based on a personalized approach determined by an individual patient's prognosis and treatment risks. Biomarkers that can predict disability progression, monitor ongoing disease activity, and assess treatment response are integral in making important decisions regarding MS treatment. This review describes MS biomarkers that are currently being used in clinical practice; it also reviews and consolidates published findings from clinically relevant potential MS biomarkers in recent years. The work also discusses the challenges of validating and application of biomarkers in MS clinical practice.
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Affiliation(s)
- Anu Paul
- Department of Neurology, Ann Romney Center for Neurological Diseases, Brigham and Women's Hospital, Boston, Massachusetts 02115
| | - Manuel Comabella
- Department of Neurology, MS Centre of Catalonia, Vall d'Hebron University Hospital, Barcelona 08035, Spain
| | - Roopali Gandhi
- Department of Neurology, Ann Romney Center for Neurological Diseases, Brigham and Women's Hospital, Boston, Massachusetts 02115
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37
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Bridel C, Eijlers AJC, van Wieringen WN, Koel-Simmelink M, Leurs CE, Schoonheim MM, Killestein J, Teunissen CE. No Plasmatic Proteomic Signature at Clinical Disease Onset Associated With 11 Year Clinical, Cognitive and MRI Outcomes in Relapsing-Remitting Multiple Sclerosis Patients. Front Mol Neurosci 2018; 11:371. [PMID: 30429773 PMCID: PMC6220078 DOI: 10.3389/fnmol.2018.00371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 09/18/2018] [Indexed: 01/06/2023] Open
Abstract
Background: The clinical course of relapsing-remitting multiple sclerosis (RRMS) is highly heterogeneous and prognostic biomarkers at time of diagnosis are lacking. Objective: We investigated the predictive value of the plasma proteome at time of diagnosis in RRMS patients. Methods: The plasma proteome was interrogated using a novel aptamer-based proteomics platform, which allows to measure the levels of a predefined set of 1310 proteins. Results: In 67 clinically and radiologically well characterized RRMS patients, we found no association between the plasma proteome at diagnosis and clinical, cognitive or MRI outcomes after 11 years. Conclusions: Proteomics studies on cerebrospinal fluid may be better suited to identify prognostic biomarkers in early RRMS.
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Affiliation(s)
- Claire Bridel
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands
| | - Anand J C Eijlers
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands
| | - Wessel N van Wieringen
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands and Department of Mathematics, VU University, Amsterdam, Netherlands
| | - Marleen Koel-Simmelink
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands
| | - Cyra E Leurs
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands
| | - Menno M Schoonheim
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands
| | - Joep Killestein
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands
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Abstract
Multiple sclerosis (MS) is the most common chronic inflammatory, demyelinating and neurodegenerative disease of the central nervous system in young adults. This disorder is a heterogeneous, multifactorial, immune-mediated disease that is influenced by both genetic and environmental factors. In most patients, reversible episodes of neurological dysfunction lasting several days or weeks characterize the initial stages of the disease (that is, clinically isolated syndrome and relapsing-remitting MS). Over time, irreversible clinical and cognitive deficits develop. A minority of patients have a progressive disease course from the onset. The pathological hallmark of MS is the formation of demyelinating lesions in the brain and spinal cord, which can be associated with neuro-axonal damage. Focal lesions are thought to be caused by the infiltration of immune cells, including T cells, B cells and myeloid cells, into the central nervous system parenchyma, with associated injury. MS is associated with a substantial burden on society owing to the high cost of the available treatments and poorer employment prospects and job retention for patients and their caregivers.
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Affiliation(s)
- Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. .,Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
| | - Amit Bar-Or
- Department of Neurology and Center for Neuroinflammation and Experimental Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Fredrik Piehl
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.,Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.,Neuroimmunology Unit, Center for Molecular Medicine, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden
| | - Paolo Preziosa
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.,Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Alessandra Solari
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Sandra Vukusic
- Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Fondation Eugène Devic EDMUS Contre la Sclérose en Plaques, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - Maria A Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.,Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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Relevance of KFLC quantification to differentiate clinically isolated syndrome from multiple sclerosis at clinical onset. Clin Neurol Neurosurg 2018; 174:220-229. [DOI: 10.1016/j.clineuro.2018.09.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 09/13/2018] [Accepted: 09/22/2018] [Indexed: 11/22/2022]
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40
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Abstract
The 1996 originally established multiple sclerosis (MS) subtypes, based solely on clinical impression and consensus, were revised in 2013 to review potential imaging and biological correlates and to reflect recently identified clinical aspects of MS. As a result, potential new disease phenotypes, radiologically isolated syndrome, and clinically isolated syndrome were considered along with the addition of two new descriptor subtypes: activity and progression applied to relapsing remitting and progressive MS phenotypes. In this way, the description of an individual patient's disease course is refined and provides temporal information about the ongoing disease process. There is still a lack of imaging and biological markers that would distinguish MS phenotypes and prognosticate the disease course on an individual patient's level, creating a pressing need for large collaborative research efforts in this field.
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Affiliation(s)
- Sylvia Klineova
- The CGD Center for Multiple Sclerosis, Icahn School of Medicine at Mount Sinai, New York, New York 10029
| | - Fred D Lublin
- The CGD Center for Multiple Sclerosis, Icahn School of Medicine at Mount Sinai, New York, New York 10029
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van Rossum JA, Killestein J, Villar LM, Riskind PN, Freedman MS, Teunissen C. gMS-Classifier1 does not predict disability progression in multiple sclerosis. Mult Scler 2018; 25:1010-1011. [PMID: 30168749 PMCID: PMC6545617 DOI: 10.1177/1352458518798048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Johannis A van Rossum
- 1 Department of Neurology, Amsterdam Neuroscience, MS Center Amsterdam, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Joep Killestein
- 1 Department of Neurology, Amsterdam Neuroscience, MS Center Amsterdam, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Luisa M Villar
- 2 Department of Neurology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Peter N Riskind
- 3 Memorial Multiple Sclerosis Center, Department of Neurology, UMass Memorial Medical Center, Worcester, MA, USA
| | - Mark S Freedman
- 4 Division of Neurology, Department of Medicine, University of Ottawa, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Charlotte Teunissen
- 5 Department of Clinical Chemistry, Amsterdam University Medical Centers, The Netherlands
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A simple and universal enzyme-free approach for the detection of multiple microRNAs using a single nanostructured enhancer of surface plasmon resonance imaging. Anal Bioanal Chem 2018; 411:1873-1885. [PMID: 30155701 DOI: 10.1007/s00216-018-1331-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 07/22/2018] [Accepted: 08/16/2018] [Indexed: 12/20/2022]
Abstract
Here we describe a simple approach for the simultaneous detection of multiple microRNAs (miRNAs) using a single nanostructured reagent as surface plasmon resonance imaging (SPRi) enhancer and without using enzymatic reactions, sequence specific enhancers or multiple enhancing steps as normally reported in similar studies. The strategy involves the preparation and optimisation of neutravidin-coated gold nanospheres (nGNSs) functionalised with a previously biotinylated antibody (Ab) against DNA/RNA hybrids. The Ab guarantees the recognition of any miRNA sequence adsorbed on a surface properly functionalised with different DNA probes; at the same time, gold nanoparticles permit to detect this interaction, thus producing enough SPRi signal even at a low ligand concentration. After a careful optimisation of the nanoenhancer and after its characterisation, the final assay allowed the simultaneous detection of four miRNAs with a limit of detection (LOD) of up to 0.5 pM (equal to 275 attomoles in 500 μL) by performing a single enhancing injection. The proposed strategy shows good signal specificity and permits to discriminate wild-type, single- and triple-mutated sequences much better than non-enhanced SPRi. Finally, the method works properly in complex samples (total RNA extracted from blood) as demonstrated by the detection of four miRNAs potentially related to multiple sclerosis used as case study. This proof-of-concept study confirms that the approach provides the possibility to detect a theoretically unlimited number of miRNAs using a simple protocol and an easily prepared enhancing reagent, and may further facilitate the development of affordable multiplexing miRNA screening for clinical purposes.
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43
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Hussein AA, Forouzanfar T, Bloemena E, de Visscher J, Brakenhoff RH, Leemans CR, Helder MN. A review of the most promising biomarkers for early diagnosis and prognosis prediction of tongue squamous cell carcinoma. Br J Cancer 2018; 119:724-736. [PMID: 30131545 PMCID: PMC6173763 DOI: 10.1038/s41416-018-0233-4] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 07/11/2018] [Accepted: 07/25/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND There is a great interest in developing biomarkers to enhance early detection and clinical management of tongue squamous cell carcinoma (TSCC). However, the developmental path towards a clinically valid biomarker remains extremely challenging. Ideally, the initial key step in moving a newly discovered biomarker towards clinical implementation is independent replication. Therefore, the focus of this review is on biomarkers that consistently showed clinical relevance in two or more publications. METHODS We searched PubMed database for relevant papers across different TSCC sample sources, i.e., body fluids (saliva, serum/plasma) and tissues. No restriction regarding the date of publication was applied except for immunohistochemistry (IHC); only studies published between 2010 and June 2017 were included. RESULTS The search strategy identified 1429 abstracts, of which 96 papers, examining 150 biomarkers, were eventually included. Of these papers, 66% were exploratory studies evaluating single or a panel of biomarkers in one publication. Ultimately, based on studies that had undergone validation for their clinical relevance in at least two independent studies, we identified 10 promising candidates, consisting of different types of molecules (IL-6, IL-8, and Prolactin in liquid samples; HIF-1α, SOX2, E-cadherin, vimentin, MALAT1, TP53, and NOTCH1 in tissue biopsies) CONCLUSIONS: Although more exploratory research is needed with newer methods to identify biomarkers for TSCC, rigorous validation of biomarkers that have already shown unbiased assessment in at least two publications should be considered a high priority. Further research on these promising biomarkers or their combination in multi-institutional studies, could provide new possibilities to develop a specific panel for early diagnosis, prognosis, and individualized treatments.
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Affiliation(s)
- Aisha A Hussein
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Academic Centre for Dentistry, VU University Medical Center, Amsterdam, The Netherlands
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Academic Centre for Dentistry, VU University Medical Center, Amsterdam, The Netherlands
| | - Elisabeth Bloemena
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Academic Centre for Dentistry, VU University Medical Center, Amsterdam, The Netherlands
| | - Jgam de Visscher
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Academic Centre for Dentistry, VU University Medical Center, Amsterdam, The Netherlands
| | - Ruud H Brakenhoff
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - C René Leemans
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Marco N Helder
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Academic Centre for Dentistry, VU University Medical Center, Amsterdam, The Netherlands.
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Gastaldi M, Zardini E, Leante R, Ruggieri M, Costa G, Cocco E, De Luca G, Cataldo I, Biagioli T, Ballerini C, Castellazzi M, Fainardi E, Pettini P, Zaffaroni M, Giunti D, Capello E, Bernardi G, Ciusani E, Giannotta C, Nobile-Orazio E, Bazzigaluppi E, Passerini G, Bedin R, Sola P, Brivio R, Cavaletti G, Sala A, Bertolotto A, Desina G, Leone MA, Mariotto S, Ferrari S, Paternoster A, Giavarina D, Lolli F, Franciotta D. Cerebrospinal fluid analysis and the determination of oligoclonal bands. Neurol Sci 2018; 38:217-224. [PMID: 29030765 DOI: 10.1007/s10072-017-3034-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This document presents the guidelines for the cerebrospinal fluid (CSF) analysis and the determination of oligoclonal bands (OCBs) as pivotal tests in neuroinflammatory pathologies of the central nervous system. The guidelines have been developed following a consensus process built on questionnaire-based surveys, internet contacts, and discussions at workshops of the sponsoring Italian Association of Neuroimmunology (AINI) congresses. Essential clinical information on the pathologies in which the CSF analysis is indicated, and, particularly, on those characterized by the presence of OCBs in the intrathecal compartment, indications and limits of CSF analysis and OCB determination, instructions for result interpretation, and agreed laboratory protocols (Appendix) are reported for the communicative community of neurologists and clinical pathologists.
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Affiliation(s)
- Matteo Gastaldi
- C. Mondino National Neurological Institute, University of Pavia, Pavia, Italy
| | - Elisabetta Zardini
- C. Mondino National Neurological Institute, University of Pavia, Pavia, Italy
| | | | | | | | | | | | | | | | - Clara Ballerini
- Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Florence, Italy
| | | | - Enrico Fainardi
- Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Florence, Italy
| | - Paola Pettini
- Ospedale di Gallarate ASST Valle Olona, Gallarate, Italy
| | | | - Debora Giunti
- Ospedale Policlinico San Martino IRCCS, University of Genova, Genoa, Italy
| | - Elisabetta Capello
- Ospedale Policlinico San Martino IRCCS, University of Genova, Genoa, Italy
| | | | | | | | | | | | | | - Roberta Bedin
- Ospedale Civile Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Patrizia Sola
- Ospedale Civile Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | | | - Guido Cavaletti
- Expersimental Neurology Unit, University of Milano-Bicocca, Monza, Italy
| | | | | | - Gaetano Desina
- IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy
| | - Maurizio A Leone
- IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy
| | - Sara Mariotto
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Sergio Ferrari
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | | | | | - Francesco Lolli
- Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Florence, Italy
| | - Diego Franciotta
- Laboratory of Neuroimmunology, C. Mondino National Neurological Institute, Via Mondino 2, 27100, Pavia, Italy.
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45
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DellaValle B, Manresa-Arraut A, Hasseldam H, Stensballe A, Rungby J, Larsen A, Hempel C. Detection of Glycan Shedding in the Blood: New Class of Multiple Sclerosis Biomarkers? Front Immunol 2018; 9:1254. [PMID: 29915593 PMCID: PMC5994890 DOI: 10.3389/fimmu.2018.01254] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/18/2018] [Indexed: 12/21/2022] Open
Abstract
Introduction Multiple sclerosis (MS) is a devastating autoimmune disease, afflicting people in the prime of their lives. Presently, after initial clinical presentation, there are no reliable markers for whether a patient will develop MS, or whether their prognosis will be aggressive or relapsing–remitting. Furthermore, many MS patients do not respond to treatment. Thus, markers for diagnosis, prognosis, and treatment-responsiveness are lacking for a disease, where a precision medicine approach would be valuable. The glycocalyx (GLX) is the carbohydrate-rich outer surface of the blood vessel wall and is the first interaction between the blood and the vessel. We hypothesized that cleavage of the GLX may be an early stage predictor of immune attack, blood–brain barrier (BBB) breakdown, and disease severity in MS. Methods Two experimental models of MS, experimental autoimmune encephalitis (EAE), were included in this study. EAE was induced in C57BL/6J mice and Lewis rats, which were monitored for weight loss and clinical presentation in comparison to healthy controls. Plasma samples were obtained longitudinally from mice until peak disease severity and at peak disease severity in rats. Soluble GLX-associated glycosaminoglycans (GAG) and proteoglycans (PG) were detected in plasma samples. Results All animals receiving EAE emulsion developed fulminant EAE (100% penetrance). Increased plasma levels of chondroitin sulfate were detected before the onset of clinical symptoms and remained elevated at peak disease severity. Hyaluronic acid was increased at the height of the disease, whereas heparan sulfate was transiently increased during early stages only. By contrast, syndecans 1, 3, and 4 were detected in EAE samples as well as healthy controls, with no significant differences between the two groups. Discussion In this study, we present data supporting the shedding of the GLX as a new class of biomarker for MS. In particular, soluble, sugar-based GLX components are associated with disease severity in two models of MS, molecules that would not be detected in proteomics-based screens of MS patient samples. Patient studies are presently underway.
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Affiliation(s)
- Brian DellaValle
- Department of Biomedicine/Pharmacology, Aarhus University, Aarhus, Denmark.,Department of Clinical Microbiology, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Alba Manresa-Arraut
- Department of Biomedical Sciences, Faculty of Health, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Hasseldam
- Department of Biomedical Sciences, Faculty of Health, University of Copenhagen, Copenhagen, Denmark
| | - Allan Stensballe
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Jørgen Rungby
- Department of Biomedicine/Pharmacology, Aarhus University, Aarhus, Denmark.,Department of Endocrinology, Bispebjerg Hospital Copenhagen, Copenhagen, Denmark
| | - Agnete Larsen
- Department of Biomedicine/Pharmacology, Aarhus University, Aarhus, Denmark
| | - Casper Hempel
- Department of Clinical Microbiology, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Micro- and Nanotechnology, Technical University of Denmark, Kongens Lyngby, Denmark
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Abreu CM, Soares-Dos-Reis R, Melo PN, Relvas JB, Guimarães J, Sá MJ, Cruz AP, Mendes Pinto I. Emerging Biosensing Technologies for Neuroinflammatory and Neurodegenerative Disease Diagnostics. Front Mol Neurosci 2018; 11:164. [PMID: 29867354 PMCID: PMC5964192 DOI: 10.3389/fnmol.2018.00164] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 04/30/2018] [Indexed: 01/02/2023] Open
Abstract
Neuroinflammation plays a critical role in the onset and progression of many neurological disorders, including Multiple Sclerosis, Alzheimer's and Parkinson's diseases. In these clinical conditions the underlying neuroinflammatory processes are significantly heterogeneous. Nevertheless, a common link is the chronic activation of innate immune responses and imbalanced secretion of pro and anti-inflammatory mediators. In light of this, the discovery of robust biomarkers is crucial for screening, early diagnosis, and monitoring of neurological diseases. However, the difficulty to investigate biochemical processes directly in the central nervous system (CNS) is challenging. In recent years, biomarkers of CNS inflammatory responses have been identified in different body fluids, such as blood, cerebrospinal fluid, and tears. In addition, progress in micro and nanotechnology has enabled the development of biosensing platforms capable of detecting in real-time, multiple biomarkers in clinically relevant samples. Biosensing technologies are approaching maturity where they will become deployed in community settings, at which point screening programs and personalized medicine will become a reality. In this multidisciplinary review, our goal is to highlight both clinical and recent technological advances toward the development of multiplex-based solutions for effective neuroinflammatory and neurodegenerative disease diagnostics and monitoring.
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Affiliation(s)
- Catarina M Abreu
- International Iberian Nanotechnology Laboratory, Braga, Portugal.,Medical School, Swansea University, Swansea, United Kingdom
| | - Ricardo Soares-Dos-Reis
- Neurology Department, Centro Hospitalar de São João, Porto, Portugal.,Department of Clinical Neurosciences and Mental Health, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Department of Biomedicine, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Pedro N Melo
- Graduate Programme in Areas of Basic and Applied Biology, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - João B Relvas
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Joana Guimarães
- Neurology Department, Centro Hospitalar de São João, Porto, Portugal.,Department of Clinical Neurosciences and Mental Health, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Center for Drug Discovery and Innovative Medicines (MedInUP), Universidade do Porto, Porto, Portugal
| | - Maria José Sá
- Neurology Department, Centro Hospitalar de São João, Porto, Portugal.,Energy, Environment and Health Research Unit (FP-ENAS), University Fernando Pessoa, Porto, Portugal.,Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal
| | - Andrea P Cruz
- International Iberian Nanotechnology Laboratory, Braga, Portugal
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47
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Guerrero-García JDJ, Godínez-Rubí M, Ortuño-Sahagún D. Multiple Sclerosis in Search for Biomarkers: Gender as a Variable in the Equation. ACTA ACUST UNITED AC 2018. [DOI: 10.3233/nib-170126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
| | - Marisol Godínez-Rubí
- Laboratorio de Investigación en Patología, Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Daniel Ortuño-Sahagún
- Laboratorio de Neuroinmunobiología Molecular, Instituto de Investigación en Ciencias Biomédicas (IICB), C.U.C.S., Universidad de Guadalajara, Guadalajara, Jalisco, México
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48
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Keane RW, Dietrich WD, de Rivero Vaccari JP. Inflammasome Proteins As Biomarkers of Multiple Sclerosis. Front Neurol 2018; 9:135. [PMID: 29615953 PMCID: PMC5868457 DOI: 10.3389/fneur.2018.00135] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 02/23/2018] [Indexed: 12/19/2022] Open
Abstract
Multiple sclerosis (MS) is an autoimmune disease that affects the brain and spinal cord. The inflammasome is a multiprotein complex that contributes to the innate immune response in animal models of MS as well as in patients with the disease. Important to the care of patients with MS is the need for biomarkers that can predict disease onset, disease exacerbation, as well as response to treatment. In this study, we analyzed serum samples from 32 patients with MS and 120 age-matched controls, and provide receiver operator characteristic (ROC) curves with associated confidence intervals following analyses of serum samples from patients with MS, most of which had the relapsing-remitting form of the disease, and from healthy unaffected donors, and determine the sensitivity and specificity of inflammasome proteins as biomarkers of MS. We report that caspase-1 (1.662 ± 0.6024 difference between means), apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC) (407.5 ± 35.79), and interleukin (IL)-18 (78.53 + 17.86) were elevated in the serum of MS patients when compared to controls. Interestingly, the levels of IL-1β (−0.5961 ± 0.265) were lower in the MS cohort. Importantly, the area under the curve (AUC) for ASC and caspase-1 were 0.9448 and 0.848, respectively. Taken together, these data suggest that ASC and caspase-1 could be potential candidate biomarkers for MS onset.
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Affiliation(s)
- Robert W Keane
- Department of Physiology and Biophysics, Miller School of Medicine, University of Miami, Miami, FL, United States.,InflamaCORE, LLC, Miami, FL, United States
| | - W Dalton Dietrich
- InflamaCORE, LLC, Miami, FL, United States.,Department of Neurological Surgery, The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Juan Pablo de Rivero Vaccari
- InflamaCORE, LLC, Miami, FL, United States.,Department of Neurological Surgery, The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, Miami, FL, United States
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49
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Teunissen CE, Otto M, Engelborghs S, Herukka SK, Lehmann S, Lewczuk P, Lleó A, Perret-Liaudet A, Tumani H, Turner MR, Verbeek MM, Wiltfang J, Zetterberg H, Parnetti L, Blennow K. White paper by the Society for CSF Analysis and Clinical Neurochemistry: Overcoming barriers in biomarker development and clinical translation. ALZHEIMERS RESEARCH & THERAPY 2018; 10:30. [PMID: 29544527 PMCID: PMC5855933 DOI: 10.1186/s13195-018-0359-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 02/20/2018] [Indexed: 12/27/2022]
Abstract
Body fluid biomarkers have great potential for different clinical purposes, including diagnosis, prognosis, patient stratification and treatment effect monitoring. This is exemplified by current use of several excellent biomarkers, such as the Alzheimer’s disease cerebrospinal fluid (CSF) biomarkers, anti-neuromyelitis optica antibodies and blood neurofilament light. We still, however, have a strong need for additional biomarkers and several gaps in their development and implementation should be filled. Examples of such gaps are i) limited knowledge of the causes of neurological diseases, and thus hypotheses about the best biomarkers to detect subclinical stages of these diseases; ii) the limited success translating discoveries obtained by e.g. initial mass spectrometry proteomic low-throughput studies into immunoassays for widespread clinical implementation; iii) lack of interaction among all stakeholders to optimise and adapt study designs throughout the biomarker development process to medical needs, which may change during the long period needed for biomarker development. The Society for CSF Analysis and Clinical Neurochemistry (established in 2015) has been founded as a concerted follow-up of large standardisation projects, including BIOMARKAPD and SOPHIA, and the BioMS-consortium. The main aims of the CSF society are to exchange high level international scientific experience, to facilitate the incorporation of CSF diagnostics into clinical practice and to give advice on inclusion of CSF analysis into clinical guidelines. The society has a broad scope, as its vision is that the gaps in development and implementation of biomarkers are shared among almost all neurological diseases and thus they can benefit from the activities of the society.
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Affiliation(s)
- Charlotte E Teunissen
- Neurochemistry Lab and Biobank, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Sebastiaan Engelborghs
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium.,Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium
| | - Sanna-Kaisa Herukka
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Sylvain Lehmann
- Université de Montpellier, University Hospital, INSERM U1183, Montpellier, France
| | - Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Erlangen, Germany.,Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany.,Department of Neurodegeneration Diagnostics, Medical University of Białystok, Białystok, Poland.,Department of Biochemical Diagnostics, University Hospital of Białystok, Białystok, Poland
| | - Alberto Lleó
- Memory Unit, Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Armand Perret-Liaudet
- Neurobiology Laboratory, Department of Biochemistry and Molecular Biology, Hospices Civils de Lyon, Lyon, France.,University of Lyon 1, CNRS UMR5292, INSERM U1028, BioRan, Lyon, France
| | - Hayrettin Tumani
- Department of Neurology, CSF Laboratory, MS Outpatient Unit, University Hospital of Ulm, Ulm, Germany.,Specialty Hospital of Neurology Dietenbronn, Acadamic Hospital of University of Ulm, Schwendi, Germany
| | - Martin R Turner
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Marcel M Verbeek
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Departments of Neurology and Laboratory Medicine, Radboud Alzheimer Centre, Nijmegen, The Netherlands
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August University, Goettingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany.,iBiMED, Medical Sciences Department, University of Aveiro, Aveiro, Portugal
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | - Lucilla Parnetti
- Center for Memory Disturbances, Lab of Clinical Neurochemistry, Section of Neurology, Department of Medicine, University of Perugia, Perugia, Italy
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
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50
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Shafit-Zagardo B, Gruber RC, DuBois JC. The role of TAM family receptors and ligands in the nervous system: From development to pathobiology. Pharmacol Ther 2018. [PMID: 29514053 DOI: 10.1016/j.pharmthera.2018.03.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Tyro3, Axl, and Mertk, referred to as the TAM family of receptor tyrosine kinases, are instrumental in maintaining cell survival and homeostasis in mammals. TAM receptors interact with multiple signaling molecules to regulate cell migration, survival, phagocytosis and clearance of metabolic products and cell debris called efferocytosis. The TAMs also function as rheostats to reduce the expression of proinflammatory molecules and prevent autoimmunity. All three TAM receptors are activated in a concentration-dependent manner by the vitamin K-dependent growth arrest-specific protein 6 (Gas6). Gas6 and the TAMs are abundantly expressed in the nervous system. Gas6, secreted by neurons and endothelial cells, is the sole ligand for Axl. ProteinS1 (ProS1), another vitamin K-dependent protein functions mainly as an anti-coagulant, and independent of this function can activate Tyro3 and Mertk, but not Axl. This review will focus on the role of the TAM receptors and their ligands in the nervous system. We highlight studies that explore the function of TAM signaling in myelination, the visual cortex, neural cancers, and multiple sclerosis (MS) using Gas6-/- and TAM mutant mice models.
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Affiliation(s)
- Bridget Shafit-Zagardo
- Albert Einstein College of Medicine, Department of Pathology, 1300 Morris Park Avenue, Bronx, NY 10461, United States.
| | - Ross C Gruber
- Sanofi, Neuroinflammation and MS Research, 49 New York Ave, Framingham, MA 01701, United States
| | - Juwen C DuBois
- Albert Einstein College of Medicine, Department of Pathology, 1300 Morris Park Avenue, Bronx, NY 10461, United States
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