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Ayrignac X, Aouinti S, Vincent T, Carra-Dallière C, Charif M, Duflos C, Hirtz C, Dos Santos A, Menjot de Champfleur N, Labauge P, Lehmann S. Serum NfL and GFAP are weak predictors of long-term multiple sclerosis prognosis: A 6-year follow-up. Mult Scler Relat Disord 2024; 89:105747. [PMID: 39053395 DOI: 10.1016/j.msard.2024.105747] [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: 08/26/2023] [Revised: 06/19/2024] [Accepted: 06/23/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Serum neurofilament light chain (sNfL) and glial fibrillary acidic protein (sGFAP) are promising biomarkers that might be associated with clinical and radiological markers of multiple sclerosis (MS) severity. However, it is not known whether they can accurately identify patients at risk of disability progression in the medium and long term. OBJECTIVES We wanted to determine the association between sNfL and sGFAP, Expanded Disability Status Scale score changes, and conversion to secondary progressive MS (SPMS) in a cohort of 133 patients with relapsing remitting MS. METHODS Blood samples were collected at inclusion to measure SNfL and sGFAP by single molecule array and their prognostic value was assessed using a linear mixed model. RESULTS In this cohort, 37 patients (27.8 % of 133) experienced disability progression and 12 patients (9.0 %) converted to SPMS during the follow-up (mean follow-up duration: 6.4 years). Only sNfL (p = 0.03) was associated with conversion to SPMS, and neither SNfL nor sGFAP was associated with disability progression. CONCLUSION Serum NfL and GFAP do not seem to accurately predict MS outcome in the long term. More studies are needed to determine how serum biomarkers, associated with other clinical and MRI biomarkers, might be used to improve MS prognostication.
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Affiliation(s)
- Xavier Ayrignac
- University of Montpellier, INM, INSERM, MS referral center & reference center for adult-onset leukodystrophies, CHU Montpellier, Montpellier, France.
| | - Safa Aouinti
- Clinical Research and Epidemiology Unit, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Thierry Vincent
- University of Montpellier, INM, INSERM, CHU Montpellier, Department of Immunology, CHU Montpellier, Montpellier, France
| | - Clarisse Carra-Dallière
- University of Montpellier, INM, INSERM, MS referral center & reference center for adult-onset leukodystrophies, CHU Montpellier, Montpellier, France
| | - Mahmoud Charif
- University of Montpellier, INM, INSERM, MS referral center & reference center for adult-onset leukodystrophies, CHU Montpellier, Montpellier, France
| | - Claire Duflos
- Clinical Research and Epidemiology Unit, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Christophe Hirtz
- University of Montpellier, IRMB CHU de Montpellier, INM INSERM, Montpellier, France
| | | | - Nicolas Menjot de Champfleur
- University of Montpellier, INSERM, CHU Montpellier, CNRS, Department of Neuroradiology, CHU Montpellier, Montpellier, France
| | - Pierre Labauge
- University of Montpellier, INM, INSERM, MS referral center & reference center for adult-onset leukodystrophies, CHU Montpellier, Montpellier, France
| | - Sylvain Lehmann
- University of Montpellier, IRMB CHU de Montpellier, INM INSERM, Montpellier, France
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Barcutean L, Hutanu A, Andone S, Maier S, Balasa R. The Peripheral Profile of the Chitinase 3-like-1 in Benign Multiple Sclerosis - A Single Centre's Experience. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2024; 23:791-799. [PMID: 37303176 DOI: 10.2174/1871527322666230609164534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/15/2023] [Accepted: 05/25/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND A limited subgroup of multiple sclerosis (MS) patients present with a longterm disease evolution characterized by a limited disease progression, known as benign MS (BMS). Chitinase 3-like-1 (CHI3L1) levels are sensitive to inflammatory processes and may play a role in the pathogenesis of MS. In this observational, cross-sectional study, we aimed to evaluate the implications of serum CHI3L1 and inflammatory cytokines in BMS patients treated with interferon β-1b for over a decade. METHODS We collected serum samples from 17 BMS patients and 17 healthy controls (HC) to measure serum CHI3L1 levels and a Th17 panel of inflammatory cytokines. Serum levels of CHI3L1 were analysed using the sandwich ELISA method and the Th17 panel was assessed using the multiplex XMap technology on a Flexmap 3D Analyzer. RESULTS Serum CHI3L1 levels did not differ significantly from HC. We identified a positive correlation between CHI3L1 levels and relapses during treatment. CONCLUSION Our findings suggest that there are no differences in serum CHI3L1 levels between BMS patients and HC. However, serum CHI3L1 levels are sensitive to clinical inflammatory activity and may be associated with relapses in BMS patients.
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Affiliation(s)
- Laura Barcutean
- Ist Neurology Clinic, Emergency Clinical County Hospital Targu Mures, 540136 Targu Mures, Romania
- Department of Neurology, University of Medicine, Pharmacy, Science and Technology Târgu Mures, 540136 Târgu Mures, Romania
| | - Adina Hutanu
- Department of Laboratory Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
- Laboratory Medicine, Emergency Clinical County Hospital Targu Mures, 540136 Targu Mures, Romania
| | - Sebastian Andone
- Ist Neurology Clinic, Emergency Clinical County Hospital Targu Mures, 540136 Targu Mures, Romania
- Department of Neurology, University of Medicine, Pharmacy, Science and Technology Târgu Mures, 540136 Târgu Mures, Romania
| | - Smaranda Maier
- Ist Neurology Clinic, Emergency Clinical County Hospital Targu Mures, 540136 Targu Mures, Romania
- Department of Neurology, University of Medicine, Pharmacy, Science and Technology Târgu Mures, 540136 Târgu Mures, Romania
| | - Rodica Balasa
- Ist Neurology Clinic, Emergency Clinical County Hospital Targu Mures, 540136 Targu Mures, Romania
- Department of Neurology, University of Medicine, Pharmacy, Science and Technology Târgu Mures, 540136 Târgu Mures, Romania
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Petitfour J, Ayrignac X, Ginestet N, Prin P, Carra-Dallière C, Hirtz C, Charif M, Lehmann S, Labauge P. CSF β-amyloid is not a prognostic marker in multiple sclerosis patients. Mult Scler Relat Disord 2022; 68:104096. [PMID: 36037751 DOI: 10.1016/j.msard.2022.104096] [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: 08/03/2022] [Accepted: 08/07/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is the most common chronic inflammatory, demyelinating disorder. Given its variable prognosis, the identification of new prognostic biomarkers is needed. OBJECTIVES The aims of our study were to assess the prognostic values of CSF β-amyloid-42 (Aβ42) and β-amyloid-40 (Aβ40) levels in MS patients. METHODS Eighty-nine (55 RRMS, 34 PPMS) patients with a recent diagnosis and 27 controls were included in this single-centre retrospective study. Clinical, MRI and CSF data have been collected and were analysed to evaluate the potential value of CSF Aβ42 and Aβ40 levels as MS biomarkers. RESULTS CSF Aβ levels as well as Aβ42/Aβ40 ratio were identical in MS patients and controls. Although CSF Aβ42 and Aβ40 levels were higher in PPMS than in RRMS and in patients with higher EDSS, a multivariate analysis including age and EDSS demonstrated that only age of patients was associated with CSF amyloid levels. Additionally, 55 RRMS patients were followed for 3 years. We found no association between baseline amyloid levels and 3-year disability. CONCLUSION Our data do not support an association between CSF amyloid levels and MS status and disease severity. We suggest that CSF amyloid levels are not a prognostic biomarker in recently diagnosed RRMS.
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Affiliation(s)
- Justine Petitfour
- Département de Neurologie, Univ Montpellier, INM, INSERM, MS Referral Centre & Reference Centre for Adult-Onset Leukodystrophies, CHU Montpellier, 80 Av Augustin Fliche, Montpellier 34295, France
| | - Xavier Ayrignac
- Département de Neurologie, Univ Montpellier, INM, INSERM, MS Referral Centre & Reference Centre for Adult-Onset Leukodystrophies, CHU Montpellier, 80 Av Augustin Fliche, Montpellier 34295, France.
| | - Nelly Ginestet
- Univ Montpellier, INM, IRMB, INSERM, CHU Montpellier, CNRS, Montpellier, France
| | - Pauline Prin
- Département de Neurologie, Univ Montpellier, INM, INSERM, MS Referral Centre & Reference Centre for Adult-Onset Leukodystrophies, CHU Montpellier, 80 Av Augustin Fliche, Montpellier 34295, France
| | - Clarisse Carra-Dallière
- Département de Neurologie, Univ Montpellier, INM, INSERM, MS Referral Centre & Reference Centre for Adult-Onset Leukodystrophies, CHU Montpellier, 80 Av Augustin Fliche, Montpellier 34295, France
| | - Christophe Hirtz
- Univ Montpellier, INM, IRMB, INSERM, CHU Montpellier, CNRS, Montpellier, France
| | - Mahmoud Charif
- Département de Neurologie, Univ Montpellier, INM, INSERM, MS Referral Centre & Reference Centre for Adult-Onset Leukodystrophies, CHU Montpellier, 80 Av Augustin Fliche, Montpellier 34295, France
| | - Sylvain Lehmann
- Univ Montpellier, INM, IRMB, INSERM, CHU Montpellier, CNRS, Montpellier, France
| | - Pierre Labauge
- Département de Neurologie, Univ Montpellier, INM, INSERM, MS Referral Centre & Reference Centre for Adult-Onset Leukodystrophies, CHU Montpellier, 80 Av Augustin Fliche, Montpellier 34295, France
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4
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Kölliker Frers RA, Otero-Losada M, Kobiec T, Udovin LD, Aon Bertolino ML, Herrera MI, Capani F. Multidimensional overview of neurofilament light chain contribution to comprehensively understanding multiple sclerosis. Front Immunol 2022; 13:912005. [PMID: 35967312 PMCID: PMC9368191 DOI: 10.3389/fimmu.2022.912005] [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: 04/03/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
Multiple sclerosis (MS) is an inflammatory neurodegenerative disease characterized by demyelination, progressive axonal loss, and varying clinical presentations. Axonal damage associated with the inflammatory process causes neurofilaments, the major neuron structural proteins, to be released into the extracellular space, reaching the cerebrospinal fluid (CSF) and the peripheral blood. Methodological advances in neurofilaments’ serological detection and imaging technology, along with many clinical and therapeutic studies in the last years, have deepened our understanding of MS immunopathogenesis. This review examines the use of light chain neurofilaments (NFLs) as peripheral MS biomarkers in light of the current clinical and therapeutic evidence, MS immunopathology, and technological advances in diagnostic tools. It aims to highlight NFL multidimensional value as a reliable MS biomarker with a diagnostic-prognostic profile while improving our comprehension of inflammatory neurodegenerative processes, mainly RRMS, the most frequent clinical presentation of MS.
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Affiliation(s)
- Rodolfo A. Kölliker Frers
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Centro de Altos Estudios en Ciencias Humanas y de la Salud, Universidad Abierta Interamericana, Consejo Nacional de Investigaciones Científicas y Técnicas (CAECIHS. UAI-CONICET), Buenos Aires, Argentina
- Unidad de Parasitología, Hospital J. M. Ramos Mejía, Buenos Aires, Argentina
| | - Matilde Otero-Losada
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Centro de Altos Estudios en Ciencias Humanas y de la Salud, Universidad Abierta Interamericana, Consejo Nacional de Investigaciones Científicas y Técnicas (CAECIHS. UAI-CONICET), Buenos Aires, Argentina
- *Correspondence: Matilde Otero-Losada,
| | - Tamara Kobiec
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Centro de Altos Estudios en Ciencias Humanas y de la Salud, Universidad Abierta Interamericana, Consejo Nacional de Investigaciones Científicas y Técnicas (CAECIHS. UAI-CONICET), Buenos Aires, Argentina
- Centro de Investigaciones en Psicología y Psicopedagogía (CIPP), Facultad de Psicología y Psicopedagogía, Pontificia Universidad Católica Argentina (UCA), Buenos Aires, Argentina
| | - Lucas D. Udovin
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Centro de Altos Estudios en Ciencias Humanas y de la Salud, Universidad Abierta Interamericana, Consejo Nacional de Investigaciones Científicas y Técnicas (CAECIHS. UAI-CONICET), Buenos Aires, Argentina
| | - María Laura Aon Bertolino
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Centro de Altos Estudios en Ciencias Humanas y de la Salud, Universidad Abierta Interamericana, Consejo Nacional de Investigaciones Científicas y Técnicas (CAECIHS. UAI-CONICET), Buenos Aires, Argentina
| | - María I. Herrera
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Centro de Altos Estudios en Ciencias Humanas y de la Salud, Universidad Abierta Interamericana, Consejo Nacional de Investigaciones Científicas y Técnicas (CAECIHS. UAI-CONICET), Buenos Aires, Argentina
- Centro de Investigaciones en Psicología y Psicopedagogía (CIPP), Facultad de Psicología y Psicopedagogía, Pontificia Universidad Católica Argentina (UCA), Buenos Aires, Argentina
| | - Francisco Capani
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Centro de Altos Estudios en Ciencias Humanas y de la Salud, Universidad Abierta Interamericana, Consejo Nacional de Investigaciones Científicas y Técnicas (CAECIHS. UAI-CONICET), Buenos Aires, Argentina
- Departamento de Biología, Universidad Argentina John Kennedy (UAJK), Buenos Aires, Argentina
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5
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Petržalka M, Meluzínová E, Libertínová J, Mojžišová H, Hanzalová J, Ročková P, Elišák M, Kmetonyová S, Šanda J, Sobek O, Marusič P. IL-2, IL-6 and chitinase 3-like 2 might predict early relapse activity in multiple sclerosis. PLoS One 2022; 17:e0270607. [PMID: 35759479 PMCID: PMC9236235 DOI: 10.1371/journal.pone.0270607] [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: 03/25/2022] [Accepted: 06/13/2022] [Indexed: 11/19/2022] Open
Abstract
Background The possibility to better predict the severity of the disease in a patient newly diagnosed with multiple sclerosis would allow the treatment strategy to be personalized and lead to better clinical outcomes. Prognostic biomarkers are highly needed. Objective To assess the prognostic value of intrathecal IgM synthesis, cerebrospinal fluid and serum IL-2, IL-6, IL-10, chitinase 3-like 2 and neurofilament heavy chains obtained early after the onset of the disease. Methods 58 patients after the first manifestation of multiple sclerosis were included. After the initial diagnostic assessment including serum and cerebrospinal fluid biomarkers, all patients initiated therapy with either glatiramer acetate, teriflunomide, or interferon beta. To assess the evolution of the disease, we followed the patients clinically and with MRI for two years. Results The IL-2:IL-6 ratio (both in cerebrospinal fluid) <0.48 (p = 0.0028), IL-2 in cerebrospinal fluid ≥1.23pg/ml (p = 0.026), and chitinase 3-like 2 in cerebrospinal fluid ≥7900pg/ml (p = 0.033), as well as baseline EDSS ≥1.5 (p = 0.0481) and age <22 (p = 0.0312), proved to be independent markers associated with shorter relapse free intervals. Conclusion The IL-2:IL-6 ratio, IL-2, and chitinase 3-like 2 (all in cerebrospinal fluid) might be of value as prognostic biomarkers in early phases of multiple sclerosis.
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Affiliation(s)
- Marko Petržalka
- Second Faculty of Medicine, Department of Neurology, Charles University and Motol University Hospital, Prague, Czech Republic
- * E-mail:
| | - Eva Meluzínová
- Second Faculty of Medicine, Department of Neurology, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Jana Libertínová
- Second Faculty of Medicine, Department of Neurology, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Hana Mojžišová
- Second Faculty of Medicine, Department of Neurology, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Jitka Hanzalová
- Second Faculty of Medicine, Department of Neurology, Charles University and Motol University Hospital, Prague, Czech Republic
- Second Faculty of Medicine, Department of Immunology, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Petra Ročková
- Second Faculty of Medicine, Department of Neurology, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Martin Elišák
- Second Faculty of Medicine, Department of Neurology, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Silvia Kmetonyová
- Second Faculty of Medicine, Department of Neurology, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Jan Šanda
- Second Faculty of Medicine, Department of Radiology, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Ondřej Sobek
- Topelex sro, Laboratory for CSF, Neuroimmunology, Pathology and Special Diagnostics, Prague, Czech Republic
| | - Petr Marusič
- Second Faculty of Medicine, Department of Neurology, Charles University and Motol University Hospital, Prague, Czech Republic
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Made to Measure: Patient-Tailored Treatment of Multiple Sclerosis Using Cell-Based Therapies. Int J Mol Sci 2021; 22:ijms22147536. [PMID: 34299154 PMCID: PMC8304207 DOI: 10.3390/ijms22147536] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 12/14/2022] Open
Abstract
Currently, there is still no cure for multiple sclerosis (MS), which is an autoimmune and neurodegenerative disease of the central nervous system. Treatment options predominantly consist of drugs that affect adaptive immunity and lead to a reduction of the inflammatory disease activity. A broad range of possible cell-based therapeutic options are being explored in the treatment of autoimmune diseases, including MS. This review aims to provide an overview of recent and future advances in the development of cell-based treatment options for the induction of tolerance in MS. Here, we will focus on haematopoietic stem cells, mesenchymal stromal cells, regulatory T cells and dendritic cells. We will also focus on less familiar cell types that are used in cell therapy, including B cells, natural killer cells and peripheral blood mononuclear cells. We will address key issues regarding the depicted therapies and highlight the major challenges that lie ahead to successfully reverse autoimmune diseases, such as MS, while minimising the side effects. Although cell-based therapies are well known and used in the treatment of several cancers, cell-based treatment options hold promise for the future treatment of autoimmune diseases in general, and MS in particular.
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7
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Effect of Eight –Weeks of Resistance Training on Serum Levels of Neurofilament Light Chain and Tau Protein in Women with Multiple Sclerosis. MEDICAL LABORATORY JOURNAL 2021. [DOI: 10.52547/mlj.15.4.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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8
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Ferreira-Atuesta C, Reyes S, Giovanonni G, Gnanapavan S. The Evolution of Neurofilament Light Chain in Multiple Sclerosis. Front Neurosci 2021; 15:642384. [PMID: 33889068 PMCID: PMC8055958 DOI: 10.3389/fnins.2021.642384] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/17/2021] [Indexed: 12/18/2022] Open
Abstract
Multiple sclerosis (MS) is an autoimmune, inflammatory neurodegenerative disease of the central nervous system characterized by demyelination and axonal damage. Diagnosis and prognosis are mainly assessed through clinical examination and neuroimaging. However, more sensitive biomarkers are needed to measure disease activity and guide treatment decisions in MS. Prompt and individualized management can reduce inflammatory activity and delay disease progression. Neurofilament Light chain (NfL), a neuron-specific cytoskeletal protein that is released into the extracellular fluid following axonal injury, has been identified as a biomarker of disease activity in MS. Measurement of NfL levels can capture the extent of neuroaxonal damage, especially in early stages of the disease. A growing body of evidence has shown that NfL in cerebrospinal fluid (CSF) and serum can be used as reliable indicators of prognosis and treatment response. More recently, NfL has been shown to facilitate individualized treatment decisions for individuals with MS. In this review, we discuss the characteristics that make NfL a highly informative biomarker and depict the available technologies used for its measurement. We further discuss the growing role of serum and CSF NfL in MS research and clinical settings. Finally, we address some of the current topics of debate regarding the use of NfL in clinical practice and examine the possible directions that this biomarker may take in the future.
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Affiliation(s)
- Carolina Ferreira-Atuesta
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.,Department of Neurology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Saúl Reyes
- Department of Neurology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia.,The Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Gavin Giovanonni
- The Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Department of Neurology, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Sharmilee Gnanapavan
- The Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Department of Neurology, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
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9
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Dangond F, Donnelly A, Hohlfeld R, Lubetzki C, Kohlhaas S, Leocani L, Ciccarelli O, Stankoff B, Sormani MP, Chataway J, Bozzoli F, Cucca F, Melton L, Coetzee T, Salvetti M. Facing the urgency of therapies for progressive MS - a Progressive MS Alliance proposal. Nat Rev Neurol 2021; 17:185-192. [PMID: 33483719 DOI: 10.1038/s41582-020-00446-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2020] [Indexed: 12/20/2022]
Abstract
Therapies for infiltrative inflammation in multiple sclerosis (MS) have advanced greatly, but neurodegeneration and compartmentalized inflammation remain virtually untargeted as in other diseases of the nervous system. Consequently, many therapies are available for the relapsing-remitting form of MS, but the progressive forms remain essentially untreated. The objective of the International Progressive MS Alliance is to expedite the development of effective therapies for progressive MS through new initiatives that foster innovative thinking and concrete advancements. Based on these principles, the Alliance is developing a new funding programme that will focus on experimental medicine trials. Here, we discuss the reasons behind the focus on experimental medicine trials, the strengths and weaknesses of these approaches and of the programme, and why we hope to advance therapies while improving the understanding of progression in MS. We are soliciting public and academic feedback, which will help shape the programme and future strategies of the Alliance.
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Affiliation(s)
| | - Alexis Donnelly
- Department of Computer Science, O'Reilly Institute, Trinity College, Dublin, Ireland
| | - Reinhard Hohlfeld
- Institute of Clinical Neuroimmunology, Biomedical Center and Hospital of the Ludwig Maximilians Universität München, Munich, Germany.,Munich Cluster for Systems Neurology (Synergy), Munich, Germany
| | - Catherine Lubetzki
- Neurology Department, Sorbonne University, Pitié-Salpêtrière Hospital, Paris, France
| | | | - Letizia Leocani
- Vita-Salute San Raffaele University, Milan, Italy.,Neurorehabilitation Department and Experimental Neurophysiology Unit, INSPE, Scientific Institute Hospital San Raffaele, Milan, Italy
| | - Olga Ciccarelli
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.,National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK
| | - Bruno Stankoff
- Sorbonne University, Brain and Spine Institute, ICM, Pitié-Salpêtrière Hospital, Paris, France
| | - Maria Pia Sormani
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy.,IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Jeremy Chataway
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.,National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK
| | | | - Francesco Cucca
- Dipartimento di Scienze Biomediche, Università di Sassari, Sassari, Italy
| | - Lisa Melton
- MS Research Australia, North Sydney, New South Wales, Australia
| | | | - Marco Salvetti
- Department of Neurosciences, Mental Health and Sensory Organs, Centre for Experimental Neurological Therapies (CENTERS), Faculty of Medicine and Psychology, Sapienza University, Rome, Italy. .,IRCCS Istituto Neurologico Mediterraneo (INM) Neuromed, Pozzilli, Italy.
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10
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Tauil CB, da Rocha Lima AD, Ferrari BB, da Silva VA, Moraes AS, da Silva FM, Melo-Silva CA, Farias AS, Brandão CO, Leonilda MD, dos Santos-Neto LL. Depression and anxiety in patients with multiple sclerosis treated with interferon-beta or fingolimod: Role of indoleamine 2,3-dioxygenase and pro-inflammatory cytokines. Brain Behav Immun Health 2020; 9:100162. [PMID: 34589900 PMCID: PMC8474597 DOI: 10.1016/j.bbih.2020.100162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 10/16/2020] [Accepted: 10/21/2020] [Indexed: 01/25/2023] Open
Abstract
Depression/anxiety (D/A) occurs in up to 50% of multiple sclerosis (MS) patients. Proinflammatory cytokines induce classical symptoms of depression. Activation of the inflammatory response also triggers production of indoleamine 2,3-dioxygenase (IDO), which catabolizes tryptophan, the amino acid precursor of serotonin and melatonin. It has been suggested that IDO is the link between the immune and serotonergic systems. This study aimed to quantify the levels of IDO and pro-inflammatory and anti-inflammatory cytokines in patients with MS and depression, according to treatment with interferon-beta (IFN-β) or fingolimod. The study inclusion criteria were age 18-60 years and a clinical and radiological diagnosis of MS. One hundred and thirty-two patients diagnosed by McDonald's criteria and followed up at Brasília District Hospital, Brazil, with relapsing-remitting MS were identified as potential study participants. Thirty-five of these patients were identified to be receiving treatment with fingolimod or IFN-β and to have a diagnosis of D/A. IDO and pro-inflammatory and anti-inflammatory cytokine levels were compared between these 35 patients and 18 healthy controls. The level of IL-10 (an anti-inflammatory cytokine) was lower in both the fingolimod-treated (P < 0.001) and IFN-β-treated (P < 0.01) patient groups than in the control group. IFN-β-treated patients showed increased IDO expression and decreased inflammatory cytokine levels. In contrast, fingolimod-treated patients showed significantly decreased expression of IDO and significantly increased levels of proinflammatory cytokines produced by innate immune cells, including tumor necrosis factor-alpha and interleukin-6. The agents used to treat MS maintain symptoms of D/A in patients with MS via different mechanisms.
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Affiliation(s)
- Carlos B. Tauil
- Department of Medical Sciences, University of Brasília, Brazil
| | - Amanda D. da Rocha Lima
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology and Immunology, Biology Institute, University of Campinas, Brazil
| | - Breno B. Ferrari
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology and Immunology, Biology Institute, University of Campinas, Brazil
| | - Verônica A.G. da Silva
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology and Immunology, Biology Institute, University of Campinas, Brazil
| | - Adriel S. Moraes
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology and Immunology, Biology Institute, University of Campinas, Brazil
| | | | | | - Alessandro S. Farias
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology and Immunology, Biology Institute, University of Campinas, Brazil
- National Institute of Science and Technology on Neuroimmunomodulation (INCT-NIM), CNPq, Brazil
| | - Carlos O. Brandão
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology and Immunology, Biology Institute, University of Campinas, Brazil
| | - M.B. dosSantos Leonilda
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology and Immunology, Biology Institute, University of Campinas, Brazil
- National Institute of Science and Technology on Neuroimmunomodulation (INCT-NIM), CNPq, Brazil
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11
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Raftopoulos R, Kuhle J, Grant D, Hickman SJ, Altmann DR, Leppert D, Blennow K, Zetterberg H, Kapoor R, Giovannoni G, Gnanapavan S. Neurofilament results for the phase II neuroprotection study of phenytoin in optic neuritis. Eur J Neurol 2020; 28:587-594. [PMID: 33058438 DOI: 10.1111/ene.14591] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/05/2020] [Accepted: 10/08/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND A randomized trial of phenytoin in acute optic neuritis (ON) demonstrated a 30% reduction in retinal nerve fiber layer (RNFL) loss with phenytoin versus placebo. Here we present the corresponding serum neurofilament analyses. METHODS Eighty-six acute ON cases were randomized to receive phenytoin (4-6 mg/kg/day) or placebo for 3 months, and followed up for 6 months. Serum was collected at baseline, 3 and 6 months for analysis of neurofilament heavy chain (NfH) and neurofilament light chain (NfL). RESULTS Sixty-four patients had blood sampling. Of these, 58 and 56 were available at 3 months, and 55 and 54 were available at 6 months for NfH and NfL, respectively. There was no significant correlation between serum NfH and NfL at the time points tested. For NfH, the difference in mean placebo - phenytoin was -44 pg/ml at 3 months (P = 0.019) and -27 pg/ml at 6 months (P = 0.234). For NfL, the difference was 1.4 pg/ml at 3 months (P = 0.726) and -1.6 pg/ml at 6 months (P = 0.766). CONCLUSIONS At 3 months, there was a reduction in NfH, but not NFL, in the phenytoin versus placebo group, while differences at 6 months were not statistically significant. This suggests a potential neuroprotective role for phenytoin in acute ON, with the lower NfH at 3 months, when levels secondary to degeneration of the anterior visual pathway are still elevated, but not at 6 months, when levels have normalized.
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Affiliation(s)
- R Raftopoulos
- University College London Institute of Neurology, London, UK
| | - J Kuhle
- Department of Neurology, University Hospital Basel, Basel, Switzerland
| | - D Grant
- University College London Institute of Neurology, London, UK
| | - S J Hickman
- Department of Neurology, Royal Hallamshire Hospital, Sheffield, UK
| | - D R Altmann
- Medical Statistics Department, London School of Hygiene & Tropical Medicine, London, UK
| | - D Leppert
- Department of Neurology, University Hospital Basel, Basel, Switzerland
| | - K Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - H Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | - R Kapoor
- University College London Institute of Neurology, London, UK
| | - G Giovannoni
- Department of Neuroscience & Trauma, QMUL, London, UK
| | - S Gnanapavan
- Department of Neuroscience & Trauma, QMUL, London, UK
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12
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Reyes S, Smets I, Holden D, Carrillo-Loza K, Christmas T, Bianchi L, Ammoscato F, Turner B, Marta M, Schmierer K, Giovannoni G, Gnanapavan S. CSF neurofilament light chain testing as an aid to determine treatment strategies in MS. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2020; 7:e880. [PMID: 32826298 PMCID: PMC7455313 DOI: 10.1212/nxi.0000000000000880] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/20/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the use of CSF neurofilament light chain (NfL) measurements in clinical practice as well as their effect on treatment strategies and outcomes in patients with MS. METHODS This was an observational cohort study of patients with MS who had a CSF NfL measurement between December 2015 and July 2018 as part of their routine clinical care. Treatment strategies were classified as "No Treatment/No Escalation" (no treatment or no escalation of treatment) or "Treatment/Escalation" (first-line injectable/oral disease-modifying therapies (DMTs), highly active DMTs, or treatment escalation). Change in Expanded Disability Status Scale (EDSS) scores was evaluated after 1-year follow-up. RESULTS Of 203 patients with MS, 117 (58%) had relapsing-remitting MS. Disease activity was most frequently indicated by elevated CSF NfL (n = 85), followed by clinical (n = 81) and MRI activity (n = 65). CSF NfL measurements were independently associated with clinical (p = 0.02) and MRI activity (p < 0.001). Of those with elevated CSF NfL as the only evidence of disease activity (n = 22), 77% had progressive MS (PMS). In patients with PMS, 17 (20%) had elevated CSF NfL as the sole indicator of disease activity. Elevated CSF NfL resulted more frequently in Treatment/Escalation than normal CSF NfL (p < 0.001). Median EDSS change at follow-up was similar between patients receiving No Treatment/No Escalation and Treatment/Escalation decisions (p = 0.81). CONCLUSIONS CSF NfL measurements informed treatment strategies, alongside clinical and MRI measures. CSF NfL levels were the only indicator of disease activity in a subset of patients, which was more pronounced in patients with PMS. Elevated CSF NfL was associated with more Treatment/Escalation strategies, which had an impact on EDSS outcomes at 1 year.
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Affiliation(s)
- Saúl Reyes
- From the The Blizard Institute (S.R., I.S., D.H., K.C.-L., T.C., L.B., F.A., M.M., K.S., G.G., S.G.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and Clinical Board Medicine (Neuroscience) (S.R., I.S., B.T., M.M., K.S., G.G., S.G.), The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Ide Smets
- From the The Blizard Institute (S.R., I.S., D.H., K.C.-L., T.C., L.B., F.A., M.M., K.S., G.G., S.G.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and Clinical Board Medicine (Neuroscience) (S.R., I.S., B.T., M.M., K.S., G.G., S.G.), The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - David Holden
- From the The Blizard Institute (S.R., I.S., D.H., K.C.-L., T.C., L.B., F.A., M.M., K.S., G.G., S.G.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and Clinical Board Medicine (Neuroscience) (S.R., I.S., B.T., M.M., K.S., G.G., S.G.), The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Karina Carrillo-Loza
- From the The Blizard Institute (S.R., I.S., D.H., K.C.-L., T.C., L.B., F.A., M.M., K.S., G.G., S.G.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and Clinical Board Medicine (Neuroscience) (S.R., I.S., B.T., M.M., K.S., G.G., S.G.), The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Tatiana Christmas
- From the The Blizard Institute (S.R., I.S., D.H., K.C.-L., T.C., L.B., F.A., M.M., K.S., G.G., S.G.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and Clinical Board Medicine (Neuroscience) (S.R., I.S., B.T., M.M., K.S., G.G., S.G.), The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Lucia Bianchi
- From the The Blizard Institute (S.R., I.S., D.H., K.C.-L., T.C., L.B., F.A., M.M., K.S., G.G., S.G.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and Clinical Board Medicine (Neuroscience) (S.R., I.S., B.T., M.M., K.S., G.G., S.G.), The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Francesca Ammoscato
- From the The Blizard Institute (S.R., I.S., D.H., K.C.-L., T.C., L.B., F.A., M.M., K.S., G.G., S.G.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and Clinical Board Medicine (Neuroscience) (S.R., I.S., B.T., M.M., K.S., G.G., S.G.), The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Benjamin Turner
- From the The Blizard Institute (S.R., I.S., D.H., K.C.-L., T.C., L.B., F.A., M.M., K.S., G.G., S.G.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and Clinical Board Medicine (Neuroscience) (S.R., I.S., B.T., M.M., K.S., G.G., S.G.), The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Monica Marta
- From the The Blizard Institute (S.R., I.S., D.H., K.C.-L., T.C., L.B., F.A., M.M., K.S., G.G., S.G.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and Clinical Board Medicine (Neuroscience) (S.R., I.S., B.T., M.M., K.S., G.G., S.G.), The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Klaus Schmierer
- From the The Blizard Institute (S.R., I.S., D.H., K.C.-L., T.C., L.B., F.A., M.M., K.S., G.G., S.G.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and Clinical Board Medicine (Neuroscience) (S.R., I.S., B.T., M.M., K.S., G.G., S.G.), The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Gavin Giovannoni
- From the The Blizard Institute (S.R., I.S., D.H., K.C.-L., T.C., L.B., F.A., M.M., K.S., G.G., S.G.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and Clinical Board Medicine (Neuroscience) (S.R., I.S., B.T., M.M., K.S., G.G., S.G.), The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Sharmilee Gnanapavan
- From the The Blizard Institute (S.R., I.S., D.H., K.C.-L., T.C., L.B., F.A., M.M., K.S., G.G., S.G.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; and Clinical Board Medicine (Neuroscience) (S.R., I.S., B.T., M.M., K.S., G.G., S.G.), The Royal London Hospital, Barts Health NHS Trust, London, UK.
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13
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Dubchenko E, Ivanov A, Spirina N, Smirnova N, Melnikov M, Boyko A, Gusev E, Kubatiev A. Hyperhomocysteinemia and Endothelial Dysfunction in Multiple Sclerosis. Brain Sci 2020; 10:brainsci10090637. [PMID: 32947812 PMCID: PMC7564574 DOI: 10.3390/brainsci10090637] [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: 08/08/2020] [Revised: 09/07/2020] [Accepted: 09/14/2020] [Indexed: 12/24/2022] Open
Abstract
Endothelial dysfunction is recognized as one of the leading factors in the pathogenesis of diseases of the central nervous system of various etiologies. Numerous studies have shown the role of hyperhomocysteinemia in the development of endothelial dysfunction and the prothrombogenic state. The most important condition in the development of multiple sclerosis (MS) is a dysregulation of the blood-brain barrier (BBB) and transendothelial leukocyte migration. It has been proven that homocysteine also contributes to the damage of neurons by the mechanism of excitotoxicity and the induction of the apoptosis of neurons. These processes can be one of the factors of neurodegenerative brain damage, which plays a leading role in the progression of MS. This review describes the pleiotropic effect of homocysteine on these processes and its role in MS pathogenesis.
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Affiliation(s)
- Ekaterina Dubchenko
- Department of Neuroimmunology of Federal Center of Brain and Neurotechnology of the Federal Medical-Biological Agency of Russia, 117997 Moscow, Russia; (E.D.); (N.S.); (A.B.)
- Interdistrict Department of Multiple Sclerosis at the State Clinical Hospital VV Veresaeva, 127644 Moscow, Russia
| | - Alexander Ivanov
- Federal State Budgetary Scientific Institution “Institute of General Pathology and Pathophysiology”, 125315 Moscow, Russia; (A.I.); (A.K.)
| | - Natalia Spirina
- Department of Nervous Diseases with Medical Genetics and Neurosurgery Yaroslavl State Medical University, 150000 Yaroslavl, Russia;
| | - Nina Smirnova
- Department of Neuroimmunology of Federal Center of Brain and Neurotechnology of the Federal Medical-Biological Agency of Russia, 117997 Moscow, Russia; (E.D.); (N.S.); (A.B.)
- Department of Neurology, Neurosurgery and Medical Genetic of Pirogov Russian National Research Medical University, 117997 Moscow, Russia;
| | - Mikhail Melnikov
- Department of Neuroimmunology of Federal Center of Brain and Neurotechnology of the Federal Medical-Biological Agency of Russia, 117997 Moscow, Russia; (E.D.); (N.S.); (A.B.)
- Department of Neurology, Neurosurgery and Medical Genetic of Pirogov Russian National Research Medical University, 117997 Moscow, Russia;
- Laboratory of Clinical Immunology, National Research Center Institute of Immunology of the Federal Medical-Biological Agency of Russia, 115478 Moscow, Russia
- Correspondence: ; Tel.: +7-926-331-8946
| | - Alexey Boyko
- Department of Neuroimmunology of Federal Center of Brain and Neurotechnology of the Federal Medical-Biological Agency of Russia, 117997 Moscow, Russia; (E.D.); (N.S.); (A.B.)
- Department of Neurology, Neurosurgery and Medical Genetic of Pirogov Russian National Research Medical University, 117997 Moscow, Russia;
| | - Evgeniy Gusev
- Department of Neurology, Neurosurgery and Medical Genetic of Pirogov Russian National Research Medical University, 117997 Moscow, Russia;
| | - Aslan Kubatiev
- Federal State Budgetary Scientific Institution “Institute of General Pathology and Pathophysiology”, 125315 Moscow, Russia; (A.I.); (A.K.)
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14
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Novakova L, Axelsson M, Malmeström C, Zetterberg H, Blennow K, Svenningsson A, Lycke J. NFL and CXCL13 may reveal disease activity in clinically and radiologically stable MS. Mult Scler Relat Disord 2020; 46:102463. [PMID: 32862040 DOI: 10.1016/j.msard.2020.102463] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/20/2020] [Accepted: 08/22/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cerebrospinal fluid (CSF) levels of neurofilament light (NFL), a biomarker of axonal damage, and CXCL13, a chemokine involved in B-cell regulation, are both associated with disease activity in multiple sclerosis (MS). OBJECTIVE To explore the potential of NFL and CXCL13 to detect residual disease activity in patients with no signs of clinical or ongoing radiological activity and to study the clinical relevance of such activity. METHODS NFL and CXCL13 concentrations were determined with ELISA in CSF obtained from 90 relapsing-remitting (RR) MS and 47 Progressive (Pr) MS (including primary and secondary PrMS) at baseline and after 12 months of follow-up. The patients were assessed at baseline, before initiating or switching disease modifying therapy (DMT) and again after 12 and 27 months of follow-up. RESULTS All patients with ongoing disease activity (relapse or contrast-enhancing lesions on MRI) had increased NFL or CXCL13. The proportion of RRMS and PrMS patients without ongoing disease activity with elevation of either NFL or CXCL13 (residual disease activity) was 39% and 50%, respectively, and both were increased in 11% and 16%, respectively. The treatment with DMTs decreased the proportion with residual disease activity in both RRMS and PrMS significantly. We could not show any significant association between residual disease activity and clinical or MRI measures at 12 or 27 months of follow-up. CONCLUSIONS Although most of this real-world study population had been treated with second-line DMTs and achieved clinical and radiological stability, a significant proportion of patients still displayed increased CSF levels of both NFL and CXCL13, indicating residual disease activity. Thus, these markers seemed considerably more sensitive to disease activity than clinical and MRI measures. However, the long-term clinical significance of such activity remains to be determined.
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Affiliation(s)
- L Novakova
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden.
| | - M Axelsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden
| | - C Malmeström
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden
| | - H Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK; UK Dementia Research Institute at UCL, London, UK
| | - K Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - A Svenningsson
- Department of Clinical Sciences Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - J Lycke
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden
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15
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Ayrignac X, Le Bars E, Duflos C, Hirtz C, Maleska Maceski A, Carra-Dallière C, Charif M, Pinna F, Prin P, Menjot de Champfleur N, Deverdun J, Kober T, Marechal B, Fartaria MJ, Corredor Jerez R, Labauge P, Lehmann S. Serum GFAP in multiple sclerosis: correlation with disease type and MRI markers of disease severity. Sci Rep 2020; 10:10923. [PMID: 32616916 PMCID: PMC7331703 DOI: 10.1038/s41598-020-67934-2] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 04/15/2020] [Indexed: 01/19/2023] Open
Abstract
Neurofilament light chain (NfL) has been demonstrated to correlate with multiple sclerosis disease severity as well as treatment response. Nevertheless, additional serum biomarkers are still needed to better differentiate disease activity from disease progression. The aim of our study was to assess serum glial fibrillary acid protein (s-GFAP) and neurofilament light chain (s-NfL) in a cohort of 129 multiple sclerosis (MS) patients. Eighteen primary progressive multiple sclerosis (PPMS) and 111 relapsing remitting MS (RRMS) were included. We showed that these 2 biomarkers were significantly correlated with each other (R = 0.72, p < 0.001). Moreover, both biomarkers were higher in PPMS than in RRMS even if multivariate analysis only confirmed this difference for s-GFAP (130.3 ± 72.8 pg/ml vs 83.4 ± 41.1 pg/ml, p = 0.008). Finally, s-GFAP was correlated with white matter lesion load and inversely correlated with WM and GM volume. Our results seem to confirm the added value of s-GFAP in the context of multiple sclerosis.
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Affiliation(s)
- Xavier Ayrignac
- Département de Neurologie, CRC sclérose en Plaques, CHU Montpellier, Univ Montpellier, INSERM, 80 Av Augustin Fliche, 34295, Montpellier, France.
| | - Emmanuelle Le Bars
- Department of Neuroradiology, Montpellier University Hospital Center, Montpellier, France.,I2FH, Institut D'Imagerie Fonctionnelle Humaine, Hôpital Gui de Chauliac, CHRU de Montpellier, Montpellier, France.,Laboratoire Charles Coulomb, CNRS UMR 5221, Université de Montpellier, Montpellier, France
| | - Claire Duflos
- Economic Evaluation Unit, Centre Hospitalier Regional Universitaire de Montpellier, Montpellier, France
| | - Christophe Hirtz
- Laboratoire de Biochimie-Protéomique Clinique, Centre Hospitalier Regional Universitaire de Montpellier, Montpellier, France.,IRB, Institute of Regenerative Medicine and Biotherapy IRMB - INSERM, Montpellier, France
| | - Aleksandra Maleska Maceski
- Laboratoire de Biochimie-Protéomique Clinique, Centre Hospitalier Regional Universitaire de Montpellier, Montpellier, France.,IRB, Institute of Regenerative Medicine and Biotherapy IRMB - INSERM, Montpellier, France
| | - Clarisse Carra-Dallière
- Département de Neurologie, CRC sclérose en Plaques, CHU Montpellier, Univ Montpellier, INSERM, 80 Av Augustin Fliche, 34295, Montpellier, France
| | - Mahmoud Charif
- Département de Neurologie, CRC sclérose en Plaques, CHU Montpellier, Univ Montpellier, INSERM, 80 Av Augustin Fliche, 34295, Montpellier, France
| | - Frédéric Pinna
- Département de Neurologie, CRC sclérose en Plaques, CHU Montpellier, Univ Montpellier, INSERM, 80 Av Augustin Fliche, 34295, Montpellier, France
| | - Pauline Prin
- Département de Neurologie, CRC sclérose en Plaques, CHU Montpellier, Univ Montpellier, INSERM, 80 Av Augustin Fliche, 34295, Montpellier, France
| | - Nicolas Menjot de Champfleur
- Department of Neuroradiology, Montpellier University Hospital Center, Montpellier, France.,I2FH, Institut D'Imagerie Fonctionnelle Humaine, Hôpital Gui de Chauliac, CHRU de Montpellier, Montpellier, France.,Laboratoire Charles Coulomb, CNRS UMR 5221, Université de Montpellier, Montpellier, France
| | - Jérémy Deverdun
- Department of Neuroradiology, Montpellier University Hospital Center, Montpellier, France.,I2FH, Institut D'Imagerie Fonctionnelle Humaine, Hôpital Gui de Chauliac, CHRU de Montpellier, Montpellier, France.,Laboratoire Charles Coulomb, CNRS UMR 5221, Université de Montpellier, Montpellier, France
| | - Tobias Kober
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland.,Department of Radiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.,LTS5, École Polytechnique, Lausanne, Switzerland
| | - Bénédicte Marechal
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland.,Department of Radiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.,LTS5, École Polytechnique, Lausanne, Switzerland
| | - Mario Joao Fartaria
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland.,Department of Radiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.,LTS5, École Polytechnique, Lausanne, Switzerland
| | - Ricardo Corredor Jerez
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland.,Department of Radiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.,LTS5, École Polytechnique, Lausanne, Switzerland
| | - Pierre Labauge
- Département de Neurologie, CRC sclérose en Plaques, CHU Montpellier, Univ Montpellier, INSERM, 80 Av Augustin Fliche, 34295, Montpellier, France
| | - Sylvain Lehmann
- Laboratoire de Biochimie-Protéomique Clinique, Centre Hospitalier Regional Universitaire de Montpellier, Montpellier, France.,IRB, Institute of Regenerative Medicine and Biotherapy IRMB - INSERM, Montpellier, France
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16
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Dubchenko EA, Ivanov AV, Boiko AN, Spirina NN, Gusev EI, Kubatiev AA. [Hyperhomocysteinemia and endothelial dysfunction in patients with cerebral vascular and autoimmune diseases]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 119:133-138. [PMID: 31851185 DOI: 10.17116/jnevro2019119111133] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Endothelial dysfunction today is recognized as one of the leading factors in the pathogenesis of diseases of the central nervous system of various etiologies. Numerous studies have shown the role of hyperhomocysteinemia in the development of endothelial dysfunction and prothrombogenic state. The most important condition in the development of multiple sclerosis (MS) is dysregulation of the blood-brain barrier (BBB) and transendothelial leukocyte migration. It has been proven that homocysteine also contributes to the damage of neurons by the mechanism of excitotoxicity and induction of apoptosis of neurons. These processes can be one of the factors of neurodegenerative brain damage, which plays a leading role in the progression of MS. This review describes the pleiotropic effect of homocysteine on these processes and its role in the pathogenesis of MS.
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Affiliation(s)
- E A Dubchenko
- Pirogov Russian National Research Medical University, Moscow, Russia; Interdistrict Department of Multiple Sclerosis Veresaev Clinical Hospital Department of Health of Moscow, Russia, Moscow; Federal Institute of Cerebrovascular Pathology and Stroke, Russia, Moscow
| | - A V Ivanov
- Institute of General Pathology and Pathophysiology, Russia, Moscow
| | - A N Boiko
- Pirogov Russian National Research Medical University, Moscow, Russia; Federal Institute of Cerebrovascular Pathology and Stroke, Russia, Moscow
| | - N N Spirina
- Yaroslavl State Medical University, Yaroslavl, Russia
| | - E I Gusev
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - A A Kubatiev
- Institute of General Pathology and Pathophysiology, Russia, Moscow
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17
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Neurofilament light chain as an indicator of exacerbation prior to clinical symptoms in multiple sclerosis. Mult Scler Relat Disord 2019; 31:59-61. [DOI: 10.1016/j.msard.2019.03.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 01/02/2019] [Accepted: 03/22/2019] [Indexed: 11/21/2022]
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Yildiz O, Mao Z, Adams A, Dubuisson N, Allen-Philbey K, Giovannoni G, Malaspina A, Baker D, Gnanapavan S, Schmierer K. Disease activity in progressive multiple sclerosis can be effectively reduced by cladribine. Mult Scler Relat Disord 2018; 24:20-27. [PMID: 29860198 DOI: 10.1016/j.msard.2018.05.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/18/2018] [Accepted: 05/11/2018] [Indexed: 01/29/2023]
Abstract
BACKGROUND Evidence suggests people with non-relapsing deteriorating ("progressive") multiple sclerosis (pwPMS) may benefit from disease-modifying immune therapy (DMT). However, only one such treatment (ocrelizumab) has been licensed and is highly restricted to pwPMS suffering from the primary progressive phenotype. The difficulties assessing treatment outcome in pwPMS is one important reason for the lack of respective DMT. The concentration of neurofilaments in the cerebrospinal fluid (CSF) provides a biomarker of neuro-axonal damage, and both neurofilament light (NfL) and heavy chain (NfH) levels have been used as outcome indices and to guide treatment choices. METHODS We report on two pwPMS, who were treated with subcutaneous cladribine undergoing CSF NfL testing, alongside MRI and clinical follow-up, before and after treatment. RESULTS Cladribine treatment was well tolerated without any side effects. CSF NfL after treatment revealed significant reduction (by 73% and 80%, respectively) corroborating the MRI detectable drop in disease activity. Disability mildly progressed in one, and remained stable in the other pwPMS. CONCLUSIONS pwPMS with detectable disease activity (MRI, elevated NfL) should be considered for DMT. NfL appears to be a sensitive index of treatment effect in pwPMS, and may be a useful outcome in clinical trials targeting this patient group. Over and above its licensed indication (relapsing MS), cladribine may be an effective treatment option for pwPMS.
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Affiliation(s)
- O Yildiz
- The Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, United Kingdom; Clinical Board: Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Z Mao
- The Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, United Kingdom; Department of Neurology, Shenzhen University General Hospital, Shenzhen University, Shenzhen, China; Shenzhen University Clinical Medical Academy, Shenzhen University, Shenzhen, China
| | - A Adams
- Department of Neuroradiology, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - N Dubuisson
- The Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, United Kingdom
| | - K Allen-Philbey
- Clinical Board: Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - G Giovannoni
- The Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, United Kingdom; Clinical Board: Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - A Malaspina
- The Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, United Kingdom; Clinical Board: Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - D Baker
- The Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, United Kingdom
| | - S Gnanapavan
- The Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, United Kingdom; Clinical Board: Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - K Schmierer
- The Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, United Kingdom; Clinical Board: Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom.
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Boyko AN, Guseva MR, Khachanova NV, Gusev EI. Issues of the current terminology in multiple sclerosis. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:121-127. [DOI: 10.17116/jnevro2018118082121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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