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An interdependence between GAPVD1 gene polymorphism, expression level and response to interferon beta in patients with multiple sclerosis. J Neuroimmunol 2021; 353:577507. [PMID: 33548618 DOI: 10.1016/j.jneuroim.2021.577507] [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: 09/15/2020] [Revised: 01/02/2021] [Accepted: 01/27/2021] [Indexed: 11/21/2022]
Abstract
Interferon-β (IFN-β) is among the first drugs used for reducing the symptoms of multiple sclerosis (MS). Many studies show that the genetic predisposition of patients might modulate their response to IFN-β treatment. In this study GAPVD1 gene expression and the genotyping of rs2291858 variant were analysed in 100 responder and 100 non-responder patients with MS treated using IFN-β. Moreover, rs2291858 genotyping was performed for 200 patients with MS and 200 healthy controls. GAPVD1 expression was significantly increased in the responder patients than in non-responders and the distribution of rs2291858 polymorphism was significantly different between them. The GAPVD1 expression level in AA genotype of the responder group was higher than that in other genotypes of these two groups. The results show that the GAPVD1 expression level and rs2291858 genotype probably affect the response to IFN- β in patients with MS.
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Cakal B, Uygunoglu U, Saip S, Altintas A, Siva A, Badur S. BAb and MxA as functional biomarkers in routine clinical laboratories for the determination of anti-IFN-beta antibodies and their bioactivity levels in multiple sclerosis patients. J Immunoassay Immunochem 2014; 35:398-411. [PMID: 24547871 DOI: 10.1080/15321819.2014.885447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
In MS patients under IFNβ treatment to seek alternative treatments timely is important that anti-IFNβ antibodies and/or in vivo biologic activity loss detection in these. The most common diagnostic markers used for this purpose are BAb, Nab, and MxA. In this article, we aimed to establish the availability and feasibility of the correlation between BAb and MxA gene expression (mRNA) levels using evaluation of responses to IFNβ treatment for MS patients with a routine laboratory follow-up strategy in a major Turkish MS center. Bab seropositivity was determined in blood samples of 218 MS patients treated with different IFNβ preparations and MxA mRNA levels were measured in 128 patients among the total population. BAb seropositivity ratios to im INF-β 1a, scINF-β 1a, and sc INF-β 1b were 21.4%, 28.6%, and 70.4%, respectively (total 40%), and total loss of bioactivity (MxA mRNA) were 9.3%, 9.5%, and 11.6%, respectively (total 10.2%). The correlation between high BAb titers and low MxA mRNA levels was highly significant (P = 0.00003). Our data indicate that there is a good correlation between especially high BAbs levels and diminished MxA mRNA levels.
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Affiliation(s)
- Bulent Cakal
- a Department of Microbiology and Clinical Microbiology, Istanbul Medical Faculty , Istanbul University , Istanbul , Turkey
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Hegen H, Millonig A, Bertolotto A, Comabella M, Giovanonni G, Guger M, Hoelzl M, Khalil M, Killestein J, Lindberg R, Malucchi S, Mehling M, Montalban X, Polman CH, Rudzki D, Schautzer F, Sellebjerg F, Sørensen PS, Deisenhammer F. Early detection of neutralizing antibodies to interferon-beta in multiple sclerosis patients: binding antibodies predict neutralizing antibody development. Mult Scler 2013; 20:577-87. [PMID: 24009164 DOI: 10.1177/1352458513503597] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Neutralizing antibodies (NAb) affect efficacy of interferon-beta (IFN-b) treatment in multiple sclerosis (MS) patients. NAbs evolve in up to 44% of treated patients, usually between 6-18 months on therapy. OBJECTIVES To investigate whether early binding antibody (BAb) titers or different IFN-b biomarkers predict NAb evolution. METHODS We included patients with MS or clinically isolated syndrome (CIS) receiving de novo IFN-b treatment in this prospective European multicenter study. Blood samples were collected at baseline, before and after the first IFN-b administration, and again after 3, 12 and 24 months on that therapy; for determination of NAbs, BAbs, gene expression of MxA and protein concentrations of MMP-9, TIMP-1, sTRAIL, CXCL-10 and CCL-2. RESULTS We found that 22 of 164 (13.4%) patients developed NAbs during a median time of 23.8 months on IFN-b treatment. Of these patients, 78.9% were BAb-positive after 3 months. BAb titers ≥ 1:2400 predicted NAb evolution with a sensitivity of 74.7% and a specificity of 98.5%. Cross-sectionally, MxA levels were significantly diminished in the BAb/NAb-positive samples; similarly, CXCL-10 and sTRAIL concentrations in BAb/NAb-positive and BAb-positive/NAb-negative samples, respectively, were also diminished compared to BAb/NAb-negative samples. CONCLUSIONS BAb titers reliably predict NAbs. CXCL-10 is a promising sensitive biomarker for IFN-b response and its abrogation by anti-IFN-b antibodies.
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Affiliation(s)
- H Hegen
- Department of Neurology, Innsbruck Medical University, Austria
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Abstract
The development of neutralizing antibodies (NAbs) is a major problem in multiple sclerosis (MS) patients treated with interferon-beta (IFN-ß). Whereas binding antibodies (BAbs) can be demonstrated in the vast majority of patients, only a smaller proportion of patients develop NAbs. The principle in NAb in vitro assays is the utilization of cultured cell lines that are responsive to IFN-ß. The cytopathic effect (CPE) assay measures the capacity of NAbs to neutralize IFN- ß's protective effect on cells challenged with virus and the MxA induction assay measures the ability of NAbs to reduce the IFN-ß-induced expression of MxA, either at the mRNA or the protein level. A titer of >20 neutralizing units/ml traditionally defines NAb posi-tivity. NAbs in high titers completely abrogate the in vivo response to IFN-ß, whereas the effect of low and intermediate titers is unpredictable. As clinically important NAbs appear only after 9-18 months IFN- ß0 therapy, short-term studies of two years or less are unsuitable for evaluation of clinical NAb effects. All long-term trials of three years or more concordantly show evidence of a detrimental effect of NAbs on relapses, disease activity on MRI, or on disease progression. Persistent high titers of NAbs indicate an abrogation of the biological response and, hence, absence of therapeutic efficacy, and this observation should lead to a change of therapy. As low and medium titers are ambiguous treatment decisions in patients with low NAb titres should be guided by determination of in vivo mRNA MxA induction and clinical disease activity.
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Affiliation(s)
- Per Soelberg Sorensen
- Danish Multiple Sclerosis Research Center Department of Neurology 2082, Copenhagen University Hospital Rigshospitalet, DK-2100 Copenhagen, Denmark.
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van Beers MMC, Jiskoot W, Schellekens H. On the role of aggregates in the immunogenicity of recombinant human interferon beta in patients with multiple sclerosis. J Interferon Cytokine Res 2011; 30:767-75. [PMID: 20874254 DOI: 10.1089/jir.2010.0086] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Like many other therapeutic proteins, recombinant human interferon beta (rhIFN-β) elicits undesirable immune responses. rhIFN-β-treated multiple sclerosis patients may form binding antibodies and neutralizing antibodies (NAbs), with the latter being responsible for inhibition of the therapeutic effect of the protein. The incidence of binding antibodies and NAbs against rhIFN-β as well as the titer and persistence of NAbs differ among the marketed products. The proportion of patients forming antibodies against rhIFN-β-1b is higher than that against rhIFN-β-1a, which is likely explained by the differences in protein structure and aggregation behavior between the 2 types of rhIFN-β. Here, we summarize the different factors influencing the immunogenicity of rhIFN-β in patients with multiple sclerosis and discuss the role played by rhIFN-β aggregates.
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Affiliation(s)
- Miranda M C van Beers
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands
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Bojar M, Zajac M, Meluzínova E, Houžvičková E, Libertinová J, Lišková P, Mat'oška V, Nyč O, Mináriková M. Treatment with azathioprine and cyclic methylprednisolone has little or no effect on bioactivity in anti-interferon beta antibody-positive patients with multiple sclerosis. Mult Scler 2010; 16:1529-30; author reply 1531-2. [DOI: 10.1177/1352458510382248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- M Bojar
- Department of Neurology, Charles University Prague 2nd Medical School, University Hospital Motol, Prague, Czech Republic,
| | - M Zajac
- Institute of Clinical Microbiology, Charles University Prague 2nd Medical School, University Hospital Motol, Prague, Czech Republic
| | - E Meluzínova
- Department of Neurology, Charles University Prague 2nd Medical School, University Hospital Motol, Prague, Czech Republic
| | - E Houžvičková
- Department of Neurology, Charles University Prague 2nd Medical School, University Hospital Motol, Prague, Czech Republic
| | - J Libertinová
- Department of Neurology, Charles University Prague 2nd Medical School, University Hospital Motol, Prague, Czech Republic
| | - P Lišková
- Department of Neurology, Charles University Prague 2nd Medical School, University Hospital Motol, Prague, Czech Republic
| | - V Mat'oška
- Laboratory of Molecular Diagnostics, Hospital Na Homolce, Prague, Czech Republic
| | - O Nyč
- Institute of Clinical Microbiology, Charles University Prague 2nd Medical School, University Hospital Motol, Prague, Czech Republic
| | - M Mináriková
- Department of Neurology, Charles University Prague 2nd Medical School, University Hospital Motol, Prague, Czech Republic
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Zaffaroni M, Marino F, Bombelli R, Rasini E, Monti M, Ferrari M, Ghezzi A, Comi G, Lecchini S, Cosentino M. Therapy with interferon-beta modulates endogenous catecholamines in lymphocytes of patients with multiple sclerosis. Exp Neurol 2008; 214:315-21. [PMID: 18824168 DOI: 10.1016/j.expneurol.2008.08.015] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2008] [Revised: 08/14/2008] [Accepted: 08/29/2008] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To investigate the endogenous dopaminergic/adrenergic system of lymphocytes in multiple sclerosis (MS) patients during treatment with interferon (IFN)-beta. METHODS Patients with relapsing-remitting MS undergoing IFN-beta treatment were prospectively studied during the first year of treatment. Circulating lymphocytes were obtained at baseline and after 1, 3, 6 and 12 months of treatment and assayed for catecholamine (CA) production and mRNA expression of tyrosine hydroxylase (TH, the rate-limiting enzyme in the synthesis of CA), beta(2)-adrenoceptors (AR) and D2, D3 and D5 dopaminergic receptors (DR). RESULTS In cells from patients treated with IFN-beta for 12 months the production of CA hugely increased and was less sensitive to IFN-gamma-induced inhibition. Expression of mRNA for TH, beta(2)-AR and DRD5 was already enhanced after 1 month and further increased up to 6-12 months of treatment. On the contrary, DRD2 mRNA progressively decreased and DRD3 mRNA did not significantly change over the whole study period. CONCLUSIONS In MS patients IFN-beta treatment enhances the ability of lymphocytes to produce CA, and induces extensive modifications of both beta(2)-AR and DR-operated pathways. The clinical relevance of these effects deserves consideration.
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Affiliation(s)
- Mauro Zaffaroni
- Multiple Sclerosis Center, Hospital S. Antonio Abate, Gallarate, VA, Italy
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Gneiss C, Brugger M, Millonig A, Fogdell-Hahn A, Rudzki D, Hillert J, Berger T, Reindl M, Deisenhammer F. Comparative study of four different assays for the detection of binding antibodies against interferon-beta. Mult Scler 2008; 14:830-6. [PMID: 18535018 DOI: 10.1177/1352458508089228] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Binding antibodies (BAB) against interferon-beta (IFNbeta) are often determined as screening assays before performing an expensive and elaborate neutralizing antibody (NAB) test. METHODS In this study, we compared four BAB tests, a western blot (WB), a direct binding enzyme-linked immunosorbent assay (ELISA) (dELISA), a capture ELISA (cELISA), and a commercial enzyme immuno-assay (EIA) in 325 multiple sclerosis patients with and without neutralizing antibodies to evaluate the sensitivity and specificity to detect NAB by receiver operating characteristics analysis. RESULTS The area under the curve (AUC) values were 0.907 for the dELISA, 0.925 for the cELISA, and 0.776 for the EIA (P < 0.0001 for all). At a sensitivity of 95%, the specificity was approximately 30% in the dELISA, 55% in the cELISA, and 13% in the EIA. The WB as a qualitative BAB detection method had a given sensitivity of 97% and a specificity of 55%. There was a strong and significant correlation between high NAB titers (>500 neutralizing units [NU]) and titers obtained by all quantitative BAB assays. However, low to medium NAB titers (20-500 NU) did not significantly correlate with BAB titers. CONCLUSION We conclude that the cELISA seems to be most suitable for NAB screening, but BAB titers cannot reliably predict NAB titers.
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Affiliation(s)
- C Gneiss
- Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
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Gilli F, Marnetto F, Caldano M, Valentino P, Granieri L, Di Sapio A, Capobianco M, Sala A, Malucchi S, Kappos L, Lindberg RLP, Bertolotto A. Anti-interferon-beta neutralising activity is not entirely mediated by antibodies. J Neuroimmunol 2007; 192:198-205. [PMID: 17950468 DOI: 10.1016/j.jneuroim.2007.09.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2007] [Revised: 06/27/2007] [Accepted: 09/24/2007] [Indexed: 12/25/2022]
Abstract
Many multiple sclerosis (MS) patients treated with interferon-beta (IFNbeta) develop anti-IFNbeta antibodies (BAbs), which can interfere with both in vitro and in vivo bioactivity of the injected cytokine. Objective of this study was to correlate these measures. Among the 256 enrolled patients, 11 (4.3%) showed a significant inhibition of the IFNbeta activity in vitro, but no measurable BAbs. As a whole, in vivo bioactivity was inhibited in 9/11 (82%) of these patients. A minority of IFNbeta treated patients have a non-antibody mediated neutralising activity, which competitively inhibits the bioactivity both in vitro and in vivo.
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Affiliation(s)
- Francesca Gilli
- Centro di Riferimento Regionale Sclerosi Multipla (CReSM) & Neurobiologia Clinica, ASO S. Luigi Gonzaga, Orbassano, Torino, Italy.
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Abstract
Although the occurrence of neutralizing antibodies (NAbs) to interferon (IFN)-beta has been acknowledged since the pivotal trials of IFN-beta in multiple sclerosis (MS), the effect of these antibodies has for several reasons been debated. The main reason for the controversies has been insufficient knowledge of the fact that clinically relevant NAbs do not appear until 12-18 months after initiation of IFN-beta therapy which make studies of 2 years or less unsuited to assess the clinical relevance of NAbs. Further, changes in NAb affinity occur and contribute to increase NAb effects by time. The present paper reviews our current knowledge of NAbs and stresses the importance of using measurements of NAbs routinely. It is concluded that NAb titres are important for the biological response to IFN-beta. Patients with low or intermediate titres may have preserved a full or partial biological response and might still benefit from IFN-beta therapy. However, persistent high titres of NAbs indicate an abrogation of the biological response and, hence, absence of therapeutic efficacy, and this observation should lead to a change of therapy. The application of the existing information about NAbs in clinical practice would lead to improved efficacy of IFN-beta treatment for the benefit of patients with MS.
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Affiliation(s)
- D Hesse
- Department of Neurology, Danish Multiple Sclerosis Research Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
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Chiu AW, Ehrmantraut M, Richert ND, Ikonomidou VN, Pellegrini S, McFarland HF, Frank JA, Bagnato F. A case study on the effect of neutralizing antibodies to interferon beta 1b in multiple sclerosis patients followed for 3 years with monthly imaging. Clin Exp Immunol 2007; 150:61-7. [PMID: 17666095 PMCID: PMC2219272 DOI: 10.1111/j.1365-2249.2007.03467.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Interferon beta (IFN-beta) is among the first-line treatment options for patients with multiple sclerosis (MS). A potential caveat of therapy, however, is the development of neutralizing antibodies (NAb) and/or neutralizing activity (NA) non-antibody mediated, although debate is still ongoing as to whether NAb significantly hampers the efficacy of the drug or rather represents an immunologically irrelevant epiphenomenon. In the present study, we describe the effect of NAb on IFN-beta-1b through clinical and magnetic resonance imaging (MRI) outcome measures of five relapsing-remitting multiple sclerosis (RRMS) patients who were treated with 250 mug of subcutaneously administered IFN-beta-1b every other day and developed NAb at varying titres and times during the course of therapy. Despite the small number of NAb(+) patients, heterogeneity in MRI/clinical response to IFN-beta-1b was identified. Response to IFN-beta-1b therapy was observed in the absence or presence of NAb. Also observed was failure to IFN-beta-1b coincident with high and sustained NAb titres, but also before NAb development or in the presence of low NAb titres. Multiple MRI and NAb measurements performed within the same individual allow for a better description of the complex heterogeneous response to IFN-beta-1b with respect to NAb occurrence.
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Affiliation(s)
- A W Chiu
- Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD 20892-1400, USA
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