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Song LJ, Han QX, Ding ZB, Liu K, Zhang XX, Guo MF, Ma D, Wang Q, Xiao BG, Ma CG. Icariin ameliorates the cuprizone-induced demyelination associated with antioxidation and anti-inflammation. Inflammopharmacology 2024; 32:809-823. [PMID: 38177566 DOI: 10.1007/s10787-023-01388-6] [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: 06/12/2023] [Accepted: 08/23/2023] [Indexed: 01/06/2024]
Abstract
The treatment of immunomodulation in multiple sclerosis (MS) can alleviate the severity and relapses. However, it cannot improve the neurological disability of patients due to a lack of myelin protection and regeneration. Therefore, remyelinating therapies may be one of the feasible strategies that can prevent axonal degeneration and restore neurological disability. Natural product icariin (ICA) is a flavonol compound extracted from epimedium flavonoids, which has neuroprotective effects in several models of neurological diseases. Here, we attempt to explore whether ICA has the potential to treat demyelination and its possible mechanisms of action using lipopolysaccharide-treated BV2 microglia, primary microglia, bone marrow-derived macrophages, and cuprizone-induced demyelination model. The indicators of oxidative stress and inflammatory response were evaluated using commercial kits. The results showed that ICA significantly reduced the levels of oxidative intermediates nitric oxide, hydrogen peroxide, malondialdehyde, and inflammatory cytokines TNF-α, IL-1β, and increased the levels of antioxidants superoxide dismutase, catalase, glutathione peroxidase, and anti-inflammatory cytokines IL-10 and TGF-β in vitro cell experiments. In vivo demyelination model, ICA significantly alleviated the behavioral abnormalities and enhanced the integrated optical density/mm2 of Black Gold II and myelin basic protein myelin staining, accompanied by the inhibition of oxidative stress/inflammatory response. Immunohistochemical staining showed that ICA significantly induced the expression of nuclear factor erythroid derived 2/heme oxygenase-1 (Nrf2/HO-1) and inhibited the expression of toll-like receptor 4/ nuclear factor kappa B (TLR4/NF-κB), which are two key signaling pathways in antioxidant and anti-inflammatory processes. Our results strongly suggest that ICA may be used as a potential agent to treat demyelination via regulating Nrf2/HO-1-mediated antioxidative stress and TLR4/NF-κB-mediated inflammatory responses.
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Affiliation(s)
- Li-Juan Song
- The Key Research Laboratory of Benefiting Qi for Acting Blood Circulation Method to Treat Multiple Sclerosis of State Administration of Traditional Chinese Medicine, Shanxi University of Chinese Medicine, Taiyuan, China
- Department of Neurosurgery, Sinopharm Tongmei General Hospital, Datong, China
| | - Qing-Xian Han
- The Key Research Laboratory of Benefiting Qi for Acting Blood Circulation Method to Treat Multiple Sclerosis of State Administration of Traditional Chinese Medicine, Shanxi University of Chinese Medicine, Taiyuan, China
| | - Zhi-Bin Ding
- The Key Research Laboratory of Benefiting Qi for Acting Blood Circulation Method to Treat Multiple Sclerosis of State Administration of Traditional Chinese Medicine, Shanxi University of Chinese Medicine, Taiyuan, China
| | - Kexin Liu
- The Key Research Laboratory of Benefiting Qi for Acting Blood Circulation Method to Treat Multiple Sclerosis of State Administration of Traditional Chinese Medicine, Shanxi University of Chinese Medicine, Taiyuan, China
| | - Xiao-Xu Zhang
- Department of Neurosurgery, Sinopharm Tongmei General Hospital, Datong, China
| | - Min-Fang Guo
- Institute of Brain Science, Shanxi Datong University, Datong, China
| | - Dong Ma
- Department of Neurosurgery, Sinopharm Tongmei General Hospital, Datong, China
| | - Qing Wang
- The Key Research Laboratory of Benefiting Qi for Acting Blood Circulation Method to Treat Multiple Sclerosis of State Administration of Traditional Chinese Medicine, Shanxi University of Chinese Medicine, Taiyuan, China.
| | - Bao-Guo Xiao
- Institute of Neurology, Huashan Hospital, Institutes of Brain Science and State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China.
| | - Cun-Gen Ma
- The Key Research Laboratory of Benefiting Qi for Acting Blood Circulation Method to Treat Multiple Sclerosis of State Administration of Traditional Chinese Medicine, Shanxi University of Chinese Medicine, Taiyuan, China.
- Institute of Brain Science, Shanxi Datong University, Datong, China.
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2
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Fukushima A, Sugimoto M, Hiwa S, Hiroyasu T. Bayesian approach for predicting responses to therapy from high-dimensional time-course gene expression profiles. BMC Bioinformatics 2021; 22:132. [PMID: 33736614 PMCID: PMC7977599 DOI: 10.1186/s12859-021-04052-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/28/2021] [Indexed: 12/14/2022] Open
Abstract
Background Historical and updated information provided by time-course data collected during an entire treatment period proves to be more useful than information provided by single-point data. Accurate predictions made using time-course data on multiple biomarkers that indicate a patient’s response to therapy contribute positively to the decision-making process associated with designing effective treatment programs for various diseases. Therefore, the development of prediction methods incorporating time-course data on multiple markers is necessary. Results We proposed new methods that may be used for prediction and gene selection via time-course gene expression profiles. Our prediction method consolidated multiple probabilities calculated using gene expression profiles collected over a series of time points to predict therapy response. Using two data sets collected from patients with hepatitis C virus (HCV) infection and multiple sclerosis (MS), we performed numerical experiments that predicted response to therapy and evaluated their accuracies. Our methods were more accurate than conventional methods and successfully selected genes, the functions of which were associated with the pathology of HCV infection and MS. Conclusions The proposed method accurately predicted response to therapy using data at multiple time points. It showed higher accuracies at early time points compared to those of conventional methods. Furthermore, this method successfully selected genes that were directly associated with diseases. Supplementary Information The online version contains supplementary material available at 10.1186/s12859-021-04052-4.
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Affiliation(s)
- Arika Fukushima
- Graduate School of Life and Medical Sciences, Doshisha University, Kyotanabe-shi, Kyoto, 610-0321, Japan
| | - Masahiro Sugimoto
- Research and Development Center for Minimally Invasive Therapies, Institute of Medical Science, Tokyo Medical University, Shinjuku, Tokyo, 160-8402, Japan.,Institute for Advanced Biosciences, Keio University, Tsuruoka, Yamagata, 997-0052, Japan
| | - Satoru Hiwa
- Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe-shi, Kyoto, 610-0321, Japan
| | - Tomoyuki Hiroyasu
- Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe-shi, Kyoto, 610-0321, Japan.
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Feng X, Bao R, Li L, Deisenhammer F, Arnason BGW, Reder AT. Interferon-β corrects massive gene dysregulation in multiple sclerosis: Short-term and long-term effects on immune regulation and neuroprotection. EBioMedicine 2019; 49:269-283. [PMID: 31648992 PMCID: PMC6945282 DOI: 10.1016/j.ebiom.2019.09.059] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 09/26/2019] [Accepted: 09/27/2019] [Indexed: 12/23/2022] Open
Abstract
Background In multiple sclerosis (MS), immune up-regulation is coupled to subnormal immune response to interferon-β (IFN-β) and low serum IFN-β levels. The relationship between the defect in IFN signalling and acute and long-term effects of IFN-β on gene expression in MS is inadequately understood. Methods We profiled IFN-β-induced transcriptome shifts, using high-resolution microarrays on 227 mononuclear cell samples from IFN-β-treated MS Complete Responders (CR) stable for five years, and stable and active Partial Responders (PR), stable and active untreated MS, and healthy controls. Findings IFN-β injection induced short-term changes in 1,200 genes compared to baseline expression after 4-day IFN washout. Pre-injection after washout, and in response to IFN-β injections, PR more frequently had abnormal gene expression than CR. Surprisingly, short-term IFN-β induced little shift in Th1/Th17/Th2 gene expression, but up-regulated immune-inhibitory genes (ILT, IDO1, PD-L1). Expression of 8,800 genes was dysregulated in therapy-naïve compared to IFN-β-treated patients. These long-term changes in protein-coding and long non-coding RNAs affect immunity, synaptic transmission, and CNS cell survival, and correct the disordered therapy-naïve transcriptome to near-normal. In keeping with its impact on clinical course and brain repair in MS, long-term IFN-β treatment reversed the overexpression of proinflammatory and MMP genes, while enhancing genes involved in the oligodendroglia-protective integrated stress response, neuroprotection, and immunoregulation. In the rectified long-term signature, 277 transcripts differed between stable PR and CR patients. Interpretation IFN-β had minimal short-term effects on Th1 and Th2 pathways, but long-term it corrected gene dysregulation and induced immunoregulatory and neuroprotective genes. These data offer new biomarkers for IFN-β responsiveness. Funding Unrestricted grants from the US National MS Society, NMSS RG#4509A, and Bayer Pharmaceuticals
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Affiliation(s)
- Xuan Feng
- Department of Neurology and the Grossman Institute for Neuroscience, Quantitative Biology and Human Behavior, University of Chicago, Chicago, IL 60637, United States
| | - Riyue Bao
- Center for Research Informatics, University of Chicago, Chicago, IL 60637, United States; Department of Paediatrics, University of Chicago, Chicago, IL 60637, United States; Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA 15232, United States
| | - Lei Li
- Department of Neurology and the Grossman Institute for Neuroscience, Quantitative Biology and Human Behavior, University of Chicago, Chicago, IL 60637, United States; Hospital of Harbin Medical University, Harbin 150086, China
| | | | - Barry G W Arnason
- Department of Neurology and the Grossman Institute for Neuroscience, Quantitative Biology and Human Behavior, University of Chicago, Chicago, IL 60637, United States
| | - Anthony T Reder
- Department of Neurology and the Grossman Institute for Neuroscience, Quantitative Biology and Human Behavior, University of Chicago, Chicago, IL 60637, United States.
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4
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Hočevar K, Ristić S, Peterlin B. Pharmacogenomics of Multiple Sclerosis: A Systematic Review. Front Neurol 2019; 10:134. [PMID: 30863357 PMCID: PMC6399303 DOI: 10.3389/fneur.2019.00134] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 02/01/2019] [Indexed: 12/21/2022] Open
Abstract
Background: Over the past two decades, various novel disease-modifying drugs for multiple sclerosis (MS) have been approved. However, there is high variability in the patient response to the available medications, which is hypothesized to be partly attributed to genetics. Objectives: To conduct a systematic review of the current literature on the pharmacogenomics of MS therapy. Methods: A systematic literature search was conducted using PubMed/MEDLINE database searching for articles investigating a role of genetic variation in response to disease-modifying MS treatments, published in the English language up to October 9th, 2018. PRISMA guidelines for systematic reviews were applied. Studies were included if they investigated response or nonresponse to MS treatment defined as relapse rate, by expanded disability status scale score or based on magnetic resonance imaging. The following data were extracted: first author's last name, year of publication, PMID number, sample size, ethnicity of patients, method, genes, and polymorphisms tested, outcome, significant associations with corresponding P-values and confidence intervals, response criteria, and duration of the follow-up period. Results: Overall, 48 articles published up to October 2018, evaluating response to interferon-beta, glatiramer acetate, mitoxantrone, and natalizumab, met our inclusion criteria and were included in this review. Among those, we identified 42 (87.5%) candidate gene studies and 6 (12.5%) genome-wide association studies. Existing pharmacogenomic evidence is mainly based on the results of individual studies, or on results of multiple studies, which often lack consistency. In recent years, hypothesis-free approaches identified novel candidate genes that remain to be validated. Various study designs, including the definition of clinical response, duration of the follow-up period, and methodology as well as moderate sample sizes, likely contributed to discordances between studies. However, some of the significant associations were identified in the same genes, or in the genes involved in the same biological pathways. Conclusions: At the moment, there is no available clinically actionable pharmacogenomic biomarker that would enable more personalized treatment of MS. More large-scale studies with uniform design are needed to identify novel and validate existing pharmacogenomics findings. Furthermore, studies investigating associations between rare variants and treatment response in MS patients, using next-generation sequencing technologies are warranted.
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Affiliation(s)
- Keli Hočevar
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Smiljana Ristić
- Department of Biology and Medical Genetics, School of Medicine, University of Rijeka, Rijeka, Croatia
| | - Borut Peterlin
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia
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Fukushima A, Sugimoto M, Hiwa S, Hiroyasu T. Elastic net-based prediction of IFN-β treatment response of patients with multiple sclerosis using time series microarray gene expression profiles. Sci Rep 2019; 9:1822. [PMID: 30755676 PMCID: PMC6372673 DOI: 10.1038/s41598-018-38441-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 12/14/2018] [Indexed: 01/08/2023] Open
Abstract
INF-β has been widely used to treat patients with multiple sclerosis (MS) in relapse. Accurate prediction of treatment response is important for effective personalization of treatment. Microarray data have been frequently used to discover new genes and to predict treatment responses. However, conventional analytical methods suffer from three difficulties: high-dimensionality of datasets; high degree of multi-collinearity; and achieving gene identification in time-course data. The use of Elastic net, a sparse modelling method, would decrease the first two issues; however, Elastic net is currently unable to solve these three issues simultaneously. Here, we improved Elastic net to accommodate time-course data analyses. Numerical experiments were conducted using two time-course microarray datasets derived from peripheral blood mononuclear cells collected from patients with MS. The proposed methods successfully identified genes showing a high predictive ability for INF-β treatment response. Bootstrap sampling resulted in an 81% and 78% accuracy for each dataset, which was significantly higher than the 71% and 73% accuracy obtained using conventional methods. Our methods selected genes showing consistent differentiation throughout all time-courses. These genes are expected to provide new predictive biomarkers that can influence INF-β treatment for MS patients.
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Affiliation(s)
- Arika Fukushima
- Doshisha University, Graduate School of Life and Medical Sciences, Kyoto, Japan
| | - Masahiro Sugimoto
- Research and Development Center for Minimally Invasive Therapies Health Promotion and Preemptive Medicine, Tokyo Medical University, Shinjuku, Tokyo, 160-8402, Japan.,Institute for Advanced Biosciences, Keio University, Tsuruoka, Yamagata, 997-0052, Japan.,University of Tsukuba, Research and Development Center for Precision Medicine, Tukuba, Ibaraki, 305-8550, Japan
| | - Satoru Hiwa
- Doshisha University, Graduate School of Life and Medical Sciences, Kyoto, Japan
| | - Tomoyuki Hiroyasu
- Doshisha University, Graduate School of Life and Medical Sciences, Kyoto, Japan.
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6
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Gasperini C, Prosperini L, Tintoré M, Sormani MP, Filippi M, Rio J, Palace J, Rocca MA, Ciccarelli O, Barkhof F, Sastre-Garriga J, Vrenken H, Frederiksen JL, Yousry TA, Enzinger C, Rovira A, Kappos L, Pozzilli C, Montalban X, De Stefano N. Unraveling treatment response in multiple sclerosis: A clinical and MRI challenge. Neurology 2018; 92:180-192. [PMID: 30587516 DOI: 10.1212/wnl.0000000000006810] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 08/31/2018] [Indexed: 01/19/2023] Open
Abstract
Over the last few decades, the improved diagnostic criteria, the wide use of MRI, and the growing availability of effective pharmacologic treatments have led to substantial advances in the management of multiple sclerosis (MS). The importance of early diagnosis and treatment is now well-established, but there is still no consensus on how to define and monitor response to MS treatments. In particular, the clinical relevance of the detection of minimal MRI activity is controversial and recommendations on how to define and monitor treatment response are warranted. An expert panel of the Magnetic Resonance Imaging in MS Study Group analyzed and discussed published studies on treatment response in MS. The evolving concept of no evidence of disease activity and its effect on predicting long-term prognosis was examined, including the option of defining a more realistic target for daily clinical practice: minimal evidence of disease activity. Advantages and disadvantages associated with the use of MRI activity alone and quantitative scoring systems combining on-treatment clinical relapses and MRI active lesions to detect treatment response in the real-world setting were also discussed. While most published studies on this topic involved patients treated with interferon-β, special attention was given to more recent studies providing evidence based on treatment with other and more efficacious oral and injectable drugs. Finally, the panel identified future directions to pursue in this research field.
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Affiliation(s)
- Claudio Gasperini
- From the Department of Neurosciences (C.G., L.P.), San Camillo-Forlanini Hospital, Rome, Italy; Centre d'Esclerosi Multiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology (M.T., J.R., J.S.-G., X.M.), and Magnetic Resonance Unit, Department of Radiology (A.R.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Biostatistics Unit (M.P.S.), Department of Health Sciences, University of Genoa; Neuroimaging Research Unit (M.F., M.A.R.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Nuffield Department of Clinical Neurosciences (J.P.), West Wing, John Radcliffe Hospital, Oxford; Institutes of Neurology & Healthcare Engineering (O.C., F.B.), University College London (O.C.), UK; Amsterdam Neuroscience and Department of Radiology and Nuclear Medicine (F.B., H.V.), VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology (J.L.F.), Rigshospitalet Glostrup and University of Copenhagen, Denmark; Neuroradiological Academic Unit (T.A.Y.), Institute of Neurology, London, UK; Department of Neurology (C.E.), Medical University of Graz, Austria; Neurologic Clinic and Policlinic, Department of Medicine (L.K.), Clinical Research, Biomedicine and Biomedical Engineering, University Hospital Basel, University of Basel, Switzerland; Department of Neurology and Psychiatry (C.P.), Sapienza University, Rome; and Neurology and Neurometabolic Unit, Department of Neurological and Behavioral Sciences (N.D.S.), University of Siena, Italy.
| | - Luca Prosperini
- From the Department of Neurosciences (C.G., L.P.), San Camillo-Forlanini Hospital, Rome, Italy; Centre d'Esclerosi Multiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology (M.T., J.R., J.S.-G., X.M.), and Magnetic Resonance Unit, Department of Radiology (A.R.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Biostatistics Unit (M.P.S.), Department of Health Sciences, University of Genoa; Neuroimaging Research Unit (M.F., M.A.R.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Nuffield Department of Clinical Neurosciences (J.P.), West Wing, John Radcliffe Hospital, Oxford; Institutes of Neurology & Healthcare Engineering (O.C., F.B.), University College London (O.C.), UK; Amsterdam Neuroscience and Department of Radiology and Nuclear Medicine (F.B., H.V.), VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology (J.L.F.), Rigshospitalet Glostrup and University of Copenhagen, Denmark; Neuroradiological Academic Unit (T.A.Y.), Institute of Neurology, London, UK; Department of Neurology (C.E.), Medical University of Graz, Austria; Neurologic Clinic and Policlinic, Department of Medicine (L.K.), Clinical Research, Biomedicine and Biomedical Engineering, University Hospital Basel, University of Basel, Switzerland; Department of Neurology and Psychiatry (C.P.), Sapienza University, Rome; and Neurology and Neurometabolic Unit, Department of Neurological and Behavioral Sciences (N.D.S.), University of Siena, Italy
| | - Mar Tintoré
- From the Department of Neurosciences (C.G., L.P.), San Camillo-Forlanini Hospital, Rome, Italy; Centre d'Esclerosi Multiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology (M.T., J.R., J.S.-G., X.M.), and Magnetic Resonance Unit, Department of Radiology (A.R.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Biostatistics Unit (M.P.S.), Department of Health Sciences, University of Genoa; Neuroimaging Research Unit (M.F., M.A.R.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Nuffield Department of Clinical Neurosciences (J.P.), West Wing, John Radcliffe Hospital, Oxford; Institutes of Neurology & Healthcare Engineering (O.C., F.B.), University College London (O.C.), UK; Amsterdam Neuroscience and Department of Radiology and Nuclear Medicine (F.B., H.V.), VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology (J.L.F.), Rigshospitalet Glostrup and University of Copenhagen, Denmark; Neuroradiological Academic Unit (T.A.Y.), Institute of Neurology, London, UK; Department of Neurology (C.E.), Medical University of Graz, Austria; Neurologic Clinic and Policlinic, Department of Medicine (L.K.), Clinical Research, Biomedicine and Biomedical Engineering, University Hospital Basel, University of Basel, Switzerland; Department of Neurology and Psychiatry (C.P.), Sapienza University, Rome; and Neurology and Neurometabolic Unit, Department of Neurological and Behavioral Sciences (N.D.S.), University of Siena, Italy
| | - Maria Pia Sormani
- From the Department of Neurosciences (C.G., L.P.), San Camillo-Forlanini Hospital, Rome, Italy; Centre d'Esclerosi Multiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology (M.T., J.R., J.S.-G., X.M.), and Magnetic Resonance Unit, Department of Radiology (A.R.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Biostatistics Unit (M.P.S.), Department of Health Sciences, University of Genoa; Neuroimaging Research Unit (M.F., M.A.R.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Nuffield Department of Clinical Neurosciences (J.P.), West Wing, John Radcliffe Hospital, Oxford; Institutes of Neurology & Healthcare Engineering (O.C., F.B.), University College London (O.C.), UK; Amsterdam Neuroscience and Department of Radiology and Nuclear Medicine (F.B., H.V.), VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology (J.L.F.), Rigshospitalet Glostrup and University of Copenhagen, Denmark; Neuroradiological Academic Unit (T.A.Y.), Institute of Neurology, London, UK; Department of Neurology (C.E.), Medical University of Graz, Austria; Neurologic Clinic and Policlinic, Department of Medicine (L.K.), Clinical Research, Biomedicine and Biomedical Engineering, University Hospital Basel, University of Basel, Switzerland; Department of Neurology and Psychiatry (C.P.), Sapienza University, Rome; and Neurology and Neurometabolic Unit, Department of Neurological and Behavioral Sciences (N.D.S.), University of Siena, Italy
| | - Massimo Filippi
- From the Department of Neurosciences (C.G., L.P.), San Camillo-Forlanini Hospital, Rome, Italy; Centre d'Esclerosi Multiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology (M.T., J.R., J.S.-G., X.M.), and Magnetic Resonance Unit, Department of Radiology (A.R.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Biostatistics Unit (M.P.S.), Department of Health Sciences, University of Genoa; Neuroimaging Research Unit (M.F., M.A.R.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Nuffield Department of Clinical Neurosciences (J.P.), West Wing, John Radcliffe Hospital, Oxford; Institutes of Neurology & Healthcare Engineering (O.C., F.B.), University College London (O.C.), UK; Amsterdam Neuroscience and Department of Radiology and Nuclear Medicine (F.B., H.V.), VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology (J.L.F.), Rigshospitalet Glostrup and University of Copenhagen, Denmark; Neuroradiological Academic Unit (T.A.Y.), Institute of Neurology, London, UK; Department of Neurology (C.E.), Medical University of Graz, Austria; Neurologic Clinic and Policlinic, Department of Medicine (L.K.), Clinical Research, Biomedicine and Biomedical Engineering, University Hospital Basel, University of Basel, Switzerland; Department of Neurology and Psychiatry (C.P.), Sapienza University, Rome; and Neurology and Neurometabolic Unit, Department of Neurological and Behavioral Sciences (N.D.S.), University of Siena, Italy
| | - Jordi Rio
- From the Department of Neurosciences (C.G., L.P.), San Camillo-Forlanini Hospital, Rome, Italy; Centre d'Esclerosi Multiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology (M.T., J.R., J.S.-G., X.M.), and Magnetic Resonance Unit, Department of Radiology (A.R.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Biostatistics Unit (M.P.S.), Department of Health Sciences, University of Genoa; Neuroimaging Research Unit (M.F., M.A.R.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Nuffield Department of Clinical Neurosciences (J.P.), West Wing, John Radcliffe Hospital, Oxford; Institutes of Neurology & Healthcare Engineering (O.C., F.B.), University College London (O.C.), UK; Amsterdam Neuroscience and Department of Radiology and Nuclear Medicine (F.B., H.V.), VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology (J.L.F.), Rigshospitalet Glostrup and University of Copenhagen, Denmark; Neuroradiological Academic Unit (T.A.Y.), Institute of Neurology, London, UK; Department of Neurology (C.E.), Medical University of Graz, Austria; Neurologic Clinic and Policlinic, Department of Medicine (L.K.), Clinical Research, Biomedicine and Biomedical Engineering, University Hospital Basel, University of Basel, Switzerland; Department of Neurology and Psychiatry (C.P.), Sapienza University, Rome; and Neurology and Neurometabolic Unit, Department of Neurological and Behavioral Sciences (N.D.S.), University of Siena, Italy
| | - Jacqueline Palace
- From the Department of Neurosciences (C.G., L.P.), San Camillo-Forlanini Hospital, Rome, Italy; Centre d'Esclerosi Multiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology (M.T., J.R., J.S.-G., X.M.), and Magnetic Resonance Unit, Department of Radiology (A.R.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Biostatistics Unit (M.P.S.), Department of Health Sciences, University of Genoa; Neuroimaging Research Unit (M.F., M.A.R.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Nuffield Department of Clinical Neurosciences (J.P.), West Wing, John Radcliffe Hospital, Oxford; Institutes of Neurology & Healthcare Engineering (O.C., F.B.), University College London (O.C.), UK; Amsterdam Neuroscience and Department of Radiology and Nuclear Medicine (F.B., H.V.), VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology (J.L.F.), Rigshospitalet Glostrup and University of Copenhagen, Denmark; Neuroradiological Academic Unit (T.A.Y.), Institute of Neurology, London, UK; Department of Neurology (C.E.), Medical University of Graz, Austria; Neurologic Clinic and Policlinic, Department of Medicine (L.K.), Clinical Research, Biomedicine and Biomedical Engineering, University Hospital Basel, University of Basel, Switzerland; Department of Neurology and Psychiatry (C.P.), Sapienza University, Rome; and Neurology and Neurometabolic Unit, Department of Neurological and Behavioral Sciences (N.D.S.), University of Siena, Italy
| | - Maria A Rocca
- From the Department of Neurosciences (C.G., L.P.), San Camillo-Forlanini Hospital, Rome, Italy; Centre d'Esclerosi Multiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology (M.T., J.R., J.S.-G., X.M.), and Magnetic Resonance Unit, Department of Radiology (A.R.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Biostatistics Unit (M.P.S.), Department of Health Sciences, University of Genoa; Neuroimaging Research Unit (M.F., M.A.R.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Nuffield Department of Clinical Neurosciences (J.P.), West Wing, John Radcliffe Hospital, Oxford; Institutes of Neurology & Healthcare Engineering (O.C., F.B.), University College London (O.C.), UK; Amsterdam Neuroscience and Department of Radiology and Nuclear Medicine (F.B., H.V.), VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology (J.L.F.), Rigshospitalet Glostrup and University of Copenhagen, Denmark; Neuroradiological Academic Unit (T.A.Y.), Institute of Neurology, London, UK; Department of Neurology (C.E.), Medical University of Graz, Austria; Neurologic Clinic and Policlinic, Department of Medicine (L.K.), Clinical Research, Biomedicine and Biomedical Engineering, University Hospital Basel, University of Basel, Switzerland; Department of Neurology and Psychiatry (C.P.), Sapienza University, Rome; and Neurology and Neurometabolic Unit, Department of Neurological and Behavioral Sciences (N.D.S.), University of Siena, Italy
| | - Olga Ciccarelli
- From the Department of Neurosciences (C.G., L.P.), San Camillo-Forlanini Hospital, Rome, Italy; Centre d'Esclerosi Multiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology (M.T., J.R., J.S.-G., X.M.), and Magnetic Resonance Unit, Department of Radiology (A.R.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Biostatistics Unit (M.P.S.), Department of Health Sciences, University of Genoa; Neuroimaging Research Unit (M.F., M.A.R.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Nuffield Department of Clinical Neurosciences (J.P.), West Wing, John Radcliffe Hospital, Oxford; Institutes of Neurology & Healthcare Engineering (O.C., F.B.), University College London (O.C.), UK; Amsterdam Neuroscience and Department of Radiology and Nuclear Medicine (F.B., H.V.), VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology (J.L.F.), Rigshospitalet Glostrup and University of Copenhagen, Denmark; Neuroradiological Academic Unit (T.A.Y.), Institute of Neurology, London, UK; Department of Neurology (C.E.), Medical University of Graz, Austria; Neurologic Clinic and Policlinic, Department of Medicine (L.K.), Clinical Research, Biomedicine and Biomedical Engineering, University Hospital Basel, University of Basel, Switzerland; Department of Neurology and Psychiatry (C.P.), Sapienza University, Rome; and Neurology and Neurometabolic Unit, Department of Neurological and Behavioral Sciences (N.D.S.), University of Siena, Italy
| | - Frederik Barkhof
- From the Department of Neurosciences (C.G., L.P.), San Camillo-Forlanini Hospital, Rome, Italy; Centre d'Esclerosi Multiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology (M.T., J.R., J.S.-G., X.M.), and Magnetic Resonance Unit, Department of Radiology (A.R.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Biostatistics Unit (M.P.S.), Department of Health Sciences, University of Genoa; Neuroimaging Research Unit (M.F., M.A.R.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Nuffield Department of Clinical Neurosciences (J.P.), West Wing, John Radcliffe Hospital, Oxford; Institutes of Neurology & Healthcare Engineering (O.C., F.B.), University College London (O.C.), UK; Amsterdam Neuroscience and Department of Radiology and Nuclear Medicine (F.B., H.V.), VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology (J.L.F.), Rigshospitalet Glostrup and University of Copenhagen, Denmark; Neuroradiological Academic Unit (T.A.Y.), Institute of Neurology, London, UK; Department of Neurology (C.E.), Medical University of Graz, Austria; Neurologic Clinic and Policlinic, Department of Medicine (L.K.), Clinical Research, Biomedicine and Biomedical Engineering, University Hospital Basel, University of Basel, Switzerland; Department of Neurology and Psychiatry (C.P.), Sapienza University, Rome; and Neurology and Neurometabolic Unit, Department of Neurological and Behavioral Sciences (N.D.S.), University of Siena, Italy
| | - Jaume Sastre-Garriga
- From the Department of Neurosciences (C.G., L.P.), San Camillo-Forlanini Hospital, Rome, Italy; Centre d'Esclerosi Multiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology (M.T., J.R., J.S.-G., X.M.), and Magnetic Resonance Unit, Department of Radiology (A.R.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Biostatistics Unit (M.P.S.), Department of Health Sciences, University of Genoa; Neuroimaging Research Unit (M.F., M.A.R.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Nuffield Department of Clinical Neurosciences (J.P.), West Wing, John Radcliffe Hospital, Oxford; Institutes of Neurology & Healthcare Engineering (O.C., F.B.), University College London (O.C.), UK; Amsterdam Neuroscience and Department of Radiology and Nuclear Medicine (F.B., H.V.), VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology (J.L.F.), Rigshospitalet Glostrup and University of Copenhagen, Denmark; Neuroradiological Academic Unit (T.A.Y.), Institute of Neurology, London, UK; Department of Neurology (C.E.), Medical University of Graz, Austria; Neurologic Clinic and Policlinic, Department of Medicine (L.K.), Clinical Research, Biomedicine and Biomedical Engineering, University Hospital Basel, University of Basel, Switzerland; Department of Neurology and Psychiatry (C.P.), Sapienza University, Rome; and Neurology and Neurometabolic Unit, Department of Neurological and Behavioral Sciences (N.D.S.), University of Siena, Italy
| | - Hugo Vrenken
- From the Department of Neurosciences (C.G., L.P.), San Camillo-Forlanini Hospital, Rome, Italy; Centre d'Esclerosi Multiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology (M.T., J.R., J.S.-G., X.M.), and Magnetic Resonance Unit, Department of Radiology (A.R.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Biostatistics Unit (M.P.S.), Department of Health Sciences, University of Genoa; Neuroimaging Research Unit (M.F., M.A.R.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Nuffield Department of Clinical Neurosciences (J.P.), West Wing, John Radcliffe Hospital, Oxford; Institutes of Neurology & Healthcare Engineering (O.C., F.B.), University College London (O.C.), UK; Amsterdam Neuroscience and Department of Radiology and Nuclear Medicine (F.B., H.V.), VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology (J.L.F.), Rigshospitalet Glostrup and University of Copenhagen, Denmark; Neuroradiological Academic Unit (T.A.Y.), Institute of Neurology, London, UK; Department of Neurology (C.E.), Medical University of Graz, Austria; Neurologic Clinic and Policlinic, Department of Medicine (L.K.), Clinical Research, Biomedicine and Biomedical Engineering, University Hospital Basel, University of Basel, Switzerland; Department of Neurology and Psychiatry (C.P.), Sapienza University, Rome; and Neurology and Neurometabolic Unit, Department of Neurological and Behavioral Sciences (N.D.S.), University of Siena, Italy
| | - Jette L Frederiksen
- From the Department of Neurosciences (C.G., L.P.), San Camillo-Forlanini Hospital, Rome, Italy; Centre d'Esclerosi Multiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology (M.T., J.R., J.S.-G., X.M.), and Magnetic Resonance Unit, Department of Radiology (A.R.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Biostatistics Unit (M.P.S.), Department of Health Sciences, University of Genoa; Neuroimaging Research Unit (M.F., M.A.R.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Nuffield Department of Clinical Neurosciences (J.P.), West Wing, John Radcliffe Hospital, Oxford; Institutes of Neurology & Healthcare Engineering (O.C., F.B.), University College London (O.C.), UK; Amsterdam Neuroscience and Department of Radiology and Nuclear Medicine (F.B., H.V.), VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology (J.L.F.), Rigshospitalet Glostrup and University of Copenhagen, Denmark; Neuroradiological Academic Unit (T.A.Y.), Institute of Neurology, London, UK; Department of Neurology (C.E.), Medical University of Graz, Austria; Neurologic Clinic and Policlinic, Department of Medicine (L.K.), Clinical Research, Biomedicine and Biomedical Engineering, University Hospital Basel, University of Basel, Switzerland; Department of Neurology and Psychiatry (C.P.), Sapienza University, Rome; and Neurology and Neurometabolic Unit, Department of Neurological and Behavioral Sciences (N.D.S.), University of Siena, Italy
| | - Tarek A Yousry
- From the Department of Neurosciences (C.G., L.P.), San Camillo-Forlanini Hospital, Rome, Italy; Centre d'Esclerosi Multiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology (M.T., J.R., J.S.-G., X.M.), and Magnetic Resonance Unit, Department of Radiology (A.R.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Biostatistics Unit (M.P.S.), Department of Health Sciences, University of Genoa; Neuroimaging Research Unit (M.F., M.A.R.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Nuffield Department of Clinical Neurosciences (J.P.), West Wing, John Radcliffe Hospital, Oxford; Institutes of Neurology & Healthcare Engineering (O.C., F.B.), University College London (O.C.), UK; Amsterdam Neuroscience and Department of Radiology and Nuclear Medicine (F.B., H.V.), VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology (J.L.F.), Rigshospitalet Glostrup and University of Copenhagen, Denmark; Neuroradiological Academic Unit (T.A.Y.), Institute of Neurology, London, UK; Department of Neurology (C.E.), Medical University of Graz, Austria; Neurologic Clinic and Policlinic, Department of Medicine (L.K.), Clinical Research, Biomedicine and Biomedical Engineering, University Hospital Basel, University of Basel, Switzerland; Department of Neurology and Psychiatry (C.P.), Sapienza University, Rome; and Neurology and Neurometabolic Unit, Department of Neurological and Behavioral Sciences (N.D.S.), University of Siena, Italy
| | - Christian Enzinger
- From the Department of Neurosciences (C.G., L.P.), San Camillo-Forlanini Hospital, Rome, Italy; Centre d'Esclerosi Multiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology (M.T., J.R., J.S.-G., X.M.), and Magnetic Resonance Unit, Department of Radiology (A.R.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Biostatistics Unit (M.P.S.), Department of Health Sciences, University of Genoa; Neuroimaging Research Unit (M.F., M.A.R.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Nuffield Department of Clinical Neurosciences (J.P.), West Wing, John Radcliffe Hospital, Oxford; Institutes of Neurology & Healthcare Engineering (O.C., F.B.), University College London (O.C.), UK; Amsterdam Neuroscience and Department of Radiology and Nuclear Medicine (F.B., H.V.), VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology (J.L.F.), Rigshospitalet Glostrup and University of Copenhagen, Denmark; Neuroradiological Academic Unit (T.A.Y.), Institute of Neurology, London, UK; Department of Neurology (C.E.), Medical University of Graz, Austria; Neurologic Clinic and Policlinic, Department of Medicine (L.K.), Clinical Research, Biomedicine and Biomedical Engineering, University Hospital Basel, University of Basel, Switzerland; Department of Neurology and Psychiatry (C.P.), Sapienza University, Rome; and Neurology and Neurometabolic Unit, Department of Neurological and Behavioral Sciences (N.D.S.), University of Siena, Italy
| | - Alex Rovira
- From the Department of Neurosciences (C.G., L.P.), San Camillo-Forlanini Hospital, Rome, Italy; Centre d'Esclerosi Multiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology (M.T., J.R., J.S.-G., X.M.), and Magnetic Resonance Unit, Department of Radiology (A.R.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Biostatistics Unit (M.P.S.), Department of Health Sciences, University of Genoa; Neuroimaging Research Unit (M.F., M.A.R.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Nuffield Department of Clinical Neurosciences (J.P.), West Wing, John Radcliffe Hospital, Oxford; Institutes of Neurology & Healthcare Engineering (O.C., F.B.), University College London (O.C.), UK; Amsterdam Neuroscience and Department of Radiology and Nuclear Medicine (F.B., H.V.), VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology (J.L.F.), Rigshospitalet Glostrup and University of Copenhagen, Denmark; Neuroradiological Academic Unit (T.A.Y.), Institute of Neurology, London, UK; Department of Neurology (C.E.), Medical University of Graz, Austria; Neurologic Clinic and Policlinic, Department of Medicine (L.K.), Clinical Research, Biomedicine and Biomedical Engineering, University Hospital Basel, University of Basel, Switzerland; Department of Neurology and Psychiatry (C.P.), Sapienza University, Rome; and Neurology and Neurometabolic Unit, Department of Neurological and Behavioral Sciences (N.D.S.), University of Siena, Italy
| | - Ludwig Kappos
- From the Department of Neurosciences (C.G., L.P.), San Camillo-Forlanini Hospital, Rome, Italy; Centre d'Esclerosi Multiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology (M.T., J.R., J.S.-G., X.M.), and Magnetic Resonance Unit, Department of Radiology (A.R.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Biostatistics Unit (M.P.S.), Department of Health Sciences, University of Genoa; Neuroimaging Research Unit (M.F., M.A.R.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Nuffield Department of Clinical Neurosciences (J.P.), West Wing, John Radcliffe Hospital, Oxford; Institutes of Neurology & Healthcare Engineering (O.C., F.B.), University College London (O.C.), UK; Amsterdam Neuroscience and Department of Radiology and Nuclear Medicine (F.B., H.V.), VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology (J.L.F.), Rigshospitalet Glostrup and University of Copenhagen, Denmark; Neuroradiological Academic Unit (T.A.Y.), Institute of Neurology, London, UK; Department of Neurology (C.E.), Medical University of Graz, Austria; Neurologic Clinic and Policlinic, Department of Medicine (L.K.), Clinical Research, Biomedicine and Biomedical Engineering, University Hospital Basel, University of Basel, Switzerland; Department of Neurology and Psychiatry (C.P.), Sapienza University, Rome; and Neurology and Neurometabolic Unit, Department of Neurological and Behavioral Sciences (N.D.S.), University of Siena, Italy
| | - Carlo Pozzilli
- From the Department of Neurosciences (C.G., L.P.), San Camillo-Forlanini Hospital, Rome, Italy; Centre d'Esclerosi Multiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology (M.T., J.R., J.S.-G., X.M.), and Magnetic Resonance Unit, Department of Radiology (A.R.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Biostatistics Unit (M.P.S.), Department of Health Sciences, University of Genoa; Neuroimaging Research Unit (M.F., M.A.R.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Nuffield Department of Clinical Neurosciences (J.P.), West Wing, John Radcliffe Hospital, Oxford; Institutes of Neurology & Healthcare Engineering (O.C., F.B.), University College London (O.C.), UK; Amsterdam Neuroscience and Department of Radiology and Nuclear Medicine (F.B., H.V.), VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology (J.L.F.), Rigshospitalet Glostrup and University of Copenhagen, Denmark; Neuroradiological Academic Unit (T.A.Y.), Institute of Neurology, London, UK; Department of Neurology (C.E.), Medical University of Graz, Austria; Neurologic Clinic and Policlinic, Department of Medicine (L.K.), Clinical Research, Biomedicine and Biomedical Engineering, University Hospital Basel, University of Basel, Switzerland; Department of Neurology and Psychiatry (C.P.), Sapienza University, Rome; and Neurology and Neurometabolic Unit, Department of Neurological and Behavioral Sciences (N.D.S.), University of Siena, Italy
| | - Xavier Montalban
- From the Department of Neurosciences (C.G., L.P.), San Camillo-Forlanini Hospital, Rome, Italy; Centre d'Esclerosi Multiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology (M.T., J.R., J.S.-G., X.M.), and Magnetic Resonance Unit, Department of Radiology (A.R.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Biostatistics Unit (M.P.S.), Department of Health Sciences, University of Genoa; Neuroimaging Research Unit (M.F., M.A.R.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Nuffield Department of Clinical Neurosciences (J.P.), West Wing, John Radcliffe Hospital, Oxford; Institutes of Neurology & Healthcare Engineering (O.C., F.B.), University College London (O.C.), UK; Amsterdam Neuroscience and Department of Radiology and Nuclear Medicine (F.B., H.V.), VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology (J.L.F.), Rigshospitalet Glostrup and University of Copenhagen, Denmark; Neuroradiological Academic Unit (T.A.Y.), Institute of Neurology, London, UK; Department of Neurology (C.E.), Medical University of Graz, Austria; Neurologic Clinic and Policlinic, Department of Medicine (L.K.), Clinical Research, Biomedicine and Biomedical Engineering, University Hospital Basel, University of Basel, Switzerland; Department of Neurology and Psychiatry (C.P.), Sapienza University, Rome; and Neurology and Neurometabolic Unit, Department of Neurological and Behavioral Sciences (N.D.S.), University of Siena, Italy
| | - Nicola De Stefano
- From the Department of Neurosciences (C.G., L.P.), San Camillo-Forlanini Hospital, Rome, Italy; Centre d'Esclerosi Multiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology (M.T., J.R., J.S.-G., X.M.), and Magnetic Resonance Unit, Department of Radiology (A.R.), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Biostatistics Unit (M.P.S.), Department of Health Sciences, University of Genoa; Neuroimaging Research Unit (M.F., M.A.R.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Nuffield Department of Clinical Neurosciences (J.P.), West Wing, John Radcliffe Hospital, Oxford; Institutes of Neurology & Healthcare Engineering (O.C., F.B.), University College London (O.C.), UK; Amsterdam Neuroscience and Department of Radiology and Nuclear Medicine (F.B., H.V.), VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology (J.L.F.), Rigshospitalet Glostrup and University of Copenhagen, Denmark; Neuroradiological Academic Unit (T.A.Y.), Institute of Neurology, London, UK; Department of Neurology (C.E.), Medical University of Graz, Austria; Neurologic Clinic and Policlinic, Department of Medicine (L.K.), Clinical Research, Biomedicine and Biomedical Engineering, University Hospital Basel, University of Basel, Switzerland; Department of Neurology and Psychiatry (C.P.), Sapienza University, Rome; and Neurology and Neurometabolic Unit, Department of Neurological and Behavioral Sciences (N.D.S.), University of Siena, Italy
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7
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Adriani M, Nytrova P, Mbogning C, Hässler S, Medek K, Jensen PEH, Creeke P, Warnke C, Ingenhoven K, Hemmer B, Sievers C, Lindberg Gasser RL, Fissolo N, Deisenhammer F, Bocskei Z, Mikol V, Fogdell-Hahn A, Kubala Havrdova E, Broët P, Dönnes P, Mauri C, Jury EC. Monocyte NOTCH2 expression predicts IFN-β immunogenicity in multiple sclerosis patients. JCI Insight 2018; 3:99274. [PMID: 29875313 DOI: 10.1172/jci.insight.99274] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 04/24/2018] [Indexed: 01/25/2023] Open
Abstract
Multiple sclerosis (MS) is an autoimmune disease characterized by CNS inflammation leading to demyelination and axonal damage. IFN-β is an established treatment for MS; however, up to 30% of IFN-β-treated MS patients develop neutralizing antidrug antibodies (nADA), leading to reduced drug bioactivity and efficacy. Mechanisms driving antidrug immunogenicity remain uncertain, and reliable biomarkers to predict immunogenicity development are lacking. Using high-throughput flow cytometry, NOTCH2 expression on CD14+ monocytes and increased frequency of proinflammatory monocyte subsets were identified as baseline predictors of nADA development in MS patients treated with IFN-β. The association of this monocyte profile with nADA development was validated in 2 independent cross-sectional MS patient cohorts and a prospective cohort followed before and after IFN-β administration. Reduced monocyte NOTCH2 expression in nADA+ MS patients was associated with NOTCH2 activation measured by increased expression of Notch-responsive genes, polarization of monocytes toward a nonclassical phenotype, and increased proinflammatory IL-6 production. NOTCH2 activation was T cell dependent and was only triggered in the presence of serum from nADA+ patients. Thus, nADA development was driven by a proinflammatory environment that triggered activation of the NOTCH2 signaling pathway prior to first IFN-β administration.
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Affiliation(s)
- Marsilio Adriani
- Department of Rheumatology, University College Hospital, London, United Kingdom
| | - Petra Nytrova
- Department of Neurology and Center for Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Cyprien Mbogning
- CESP, Fac. De Médecine-Univ. Paris-Sud, Fac. De Médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
| | - Signe Hässler
- CESP, Fac. De Médecine-Univ. Paris-Sud, Fac. De Médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
| | - Karel Medek
- Department of Neurology and Center for Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Poul Erik H Jensen
- Neuroimmunology Laboratory, DMSC, Department of Neurology, Rigshospitalet, Region H, Copenhagen, Denmark
| | - Paul Creeke
- Neuroimmunology Unit, Centre for Neuroscience and Trauma, Blizard Institute, Queen Mary University of London, London, United Kingdom
| | - Clemens Warnke
- Department of Neurology, Medical Faculty, Research Group for Clinical and Experimental Neuroimmunology, Heinrich-Heine-University, Düsseldorf, Germany.,University Hospital Koeln, Deptartment of Neurology, Koeln, Germany
| | - Kathleen Ingenhoven
- Department of Neurology, Medical Faculty, Research Group for Clinical and Experimental Neuroimmunology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Bernhard Hemmer
- Klinikum rechts der Isar, Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Claudia Sievers
- Laboratory of Clinical Neuroimmunology, Departments of Biomedicine and Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Raija Lp Lindberg Gasser
- Laboratory of Clinical Neuroimmunology, Departments of Biomedicine and Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Nicolas Fissolo
- Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Florian Deisenhammer
- Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Zsolt Bocskei
- Translational Sciences Unit, Sanofi R&D, 91385 Chilly-Mazarin, Paris, France
| | - Vincent Mikol
- Translational Sciences Unit, Sanofi R&D, 91385 Chilly-Mazarin, Paris, France
| | - Anna Fogdell-Hahn
- Karolinska Institutet, Department of Clinical Neuroscience, Center for Molecular Medicine (CMM), Karolinska University Hospital, Sweden
| | - Eva Kubala Havrdova
- Department of Neurology and Center for Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Philippe Broët
- CESP, Fac. De Médecine-Univ. Paris-Sud, Fac. De Médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.,Assistance Publique - Hôpitaux de Paris, Hôpital Paul Brousse, Villejuif, France
| | | | - Claudia Mauri
- Department of Rheumatology, University College Hospital, London, United Kingdom
| | - Elizabeth C Jury
- Department of Rheumatology, University College Hospital, London, United Kingdom
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8
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Hegen H, Adrianto I, Lessard CJ, Millonig A, Bertolotto A, Comabella M, Giovannoni G, Guger M, Hoelzl M, Khalil M, Fazekas F, Killestein J, Lindberg RLP, Malucchi S, Mehling M, Montalban X, Rudzki D, Schautzer F, Sellebjerg F, Sorensen PS, Deisenhammer F, Steinman L, Axtell RC. Cytokine profiles show heterogeneity of interferon-β response in multiple sclerosis patients. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2016; 3:e202. [PMID: 26894205 PMCID: PMC4747480 DOI: 10.1212/nxi.0000000000000202] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 12/16/2015] [Indexed: 11/15/2022]
Abstract
Objective: To evaluate serum cytokine profiles for their utility to determine the heterogeneous responses to interferon (IFN)–β treatment in patients with multiple sclerosis (MS). Methods: Patients with relapsing-remitting MS (RRMS) or clinically isolated syndrome receiving de novo IFN-β treatment were included in this prospective, observational study. Number of relapses and changes in disability were assessed 2 years prior to and 2 years after initiation of treatment. Sera were collected at baseline and after 3 months on therapy. Cytokine levels in sera were assessed by Luminex multiplex assays. Baseline cytokine profiles were grouped by hierarchical clustering analysis. Demographic features, changes in cytokines, and clinical outcome were then assessed in the clustered patient groups. Results: A total of 157 patients were included in the study and clustered into 6 distinct subsets by baseline cytokine profiles. These subsets differed significantly in their clinical and biological response to IFN-β therapy. Two subsets were associated with patients who responded poorly to therapy. Two other subsets, associated with a good response to therapy, showed a significant reduction in relapse rates and no worsening of disability. Each subset also had differential changes in cytokine levels after 3 months of IFN-β treatment. Conclusions: There is heterogeneity in the immunologic pathways of the RRMS population, which correlates with IFN-β response.
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Affiliation(s)
- Harald Hegen
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Indra Adrianto
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Christopher J Lessard
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Alban Millonig
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Antonio Bertolotto
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Manuel Comabella
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Gavin Giovannoni
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Michael Guger
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Martina Hoelzl
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Michael Khalil
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Franz Fazekas
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Joep Killestein
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Raija L P Lindberg
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Simona Malucchi
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Matthias Mehling
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Xavier Montalban
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Dagmar Rudzki
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Franz Schautzer
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Finn Sellebjerg
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Per Soelberg Sorensen
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Florian Deisenhammer
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Lawrence Steinman
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Robert C Axtell
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
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9
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Martire S, Navone ND, Montarolo F, Perga S, Bertolotto A. A gene expression study denies the ability of 25 candidate biomarkers to predict the interferon-beta treatment response in multiple sclerosis patients. J Neuroimmunol 2016; 292:34-9. [PMID: 26943956 DOI: 10.1016/j.jneuroim.2016.01.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 01/07/2016] [Accepted: 01/14/2016] [Indexed: 11/18/2022]
Abstract
We studied the baseline expression level of 25 interferon-regulated genes (MxA, GPR3, IL17RC, ISG15, TRAIL, OASL, IFIT1, IFIT2, RSAD2, OAS3, IFI44L, TRIM22, IL10, CXCL10, STAT1, OAS1, OAS2, IFNAR1, IFNAR2, IFNβ, ISG20, IFI6, PKR, IRF7, USP18), recurrently proposed in the literature as predictive biomarkers of interferon-beta treatment response, in whole blood of 10 "responders" and 10 "non-responders" multiple sclerosis relapsing-remitting patients, retrospectively selected on the basis of stringent clinical criteria after a five years follow-up. However, we cannot confirm the predictive value of these candidate biomarkers.
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Affiliation(s)
- Serena Martire
- AOU San Luigi Gonzaga, Neurologia 2 - CReSM (Regional Referring Center of Multiple Sclerosis), Neurobiology Unit, Orbassano, TO, Italy; Neuroscience Institute Cavalieri Ottolenghi (NICO), Orbassano, TO, Italy.
| | - Nicole D Navone
- AOU San Luigi Gonzaga, SCDU Medical Oncology, Orbassano, TO, Italy.
| | - Francesca Montarolo
- AOU San Luigi Gonzaga, Neurologia 2 - CReSM (Regional Referring Center of Multiple Sclerosis), Neurobiology Unit, Orbassano, TO, Italy; Neuroscience Institute Cavalieri Ottolenghi (NICO), Orbassano, TO, Italy.
| | - Simona Perga
- AOU San Luigi Gonzaga, Neurologia 2 - CReSM (Regional Referring Center of Multiple Sclerosis), Neurobiology Unit, Orbassano, TO, Italy; Neuroscience Institute Cavalieri Ottolenghi (NICO), Orbassano, TO, Italy.
| | - Antonio Bertolotto
- AOU San Luigi Gonzaga, Neurologia 2 - CReSM (Regional Referring Center of Multiple Sclerosis), Neurobiology Unit, Orbassano, TO, Italy; Neuroscience Institute Cavalieri Ottolenghi (NICO), Orbassano, TO, Italy.
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10
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D'Ambrosio A, Pontecorvo S, Colasanti T, Zamboni S, Francia A, Margutti P. Peripheral blood biomarkers in multiple sclerosis. Autoimmun Rev 2015; 14:1097-110. [PMID: 26226413 DOI: 10.1016/j.autrev.2015.07.014] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 07/23/2015] [Indexed: 10/23/2022]
Abstract
Multiple sclerosis is the most common autoimmune disorder affecting the central nervous system. The heterogeneity of pathophysiological processes in MS contributes to the highly variable course of the disease and unpredictable response to therapies. The major focus of the research on MS is the identification of biomarkers in biological fluids, such as cerebrospinal fluid or blood, to guide patient management reliably. Because of the difficulties in obtaining spinal fluid samples and the necessity for lumbar puncture to make a diagnosis has reduced, the research of blood-based biomarkers may provide increasingly important tools for clinical practice. However, currently there are no clearly established MS blood-based biomarkers. The availability of reliable biomarkers could radically alter the management of MS at critical phases of the disease spectrum, allowing for intervention strategies that may prevent evolution to long-term neurological disability. This article provides an overview of this research field and focuses on recent advances in blood-based biomarker research.
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Affiliation(s)
- Antonella D'Ambrosio
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Rome, Italy
| | - Simona Pontecorvo
- Multiple Sclerosis Center of Department of Neurology and Psychiatry of "Sapienza" University of Rome, Italy
| | - Tania Colasanti
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Rome, Italy
| | - Silvia Zamboni
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Rome, Italy
| | - Ada Francia
- Multiple Sclerosis Center of Department of Neurology and Psychiatry of "Sapienza" University of Rome, Italy
| | - Paola Margutti
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Rome, Italy.
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11
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Gandhi R. miRNA in multiple sclerosis: search for novel biomarkers. Mult Scler 2015; 21:1095-103. [PMID: 25921051 DOI: 10.1177/1352458515578771] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 03/01/2015] [Indexed: 12/26/2022]
Abstract
A major challenge in multiple sclerosis (MS) is to develop biomarkers that could help in understanding individual MS patients, i.e. whether they are a responder or non-responder to therapy, which medicine is more effective, and the degree to which they may be entering the progressive phase of disease. In the last few years, a lot of attention has been drawn toward identification of diagnostic, prognostic, process-specific, and treatment-related biomarkers for MS. In this review, we will focus on the micro RNAs (miRNAs) as potential candidates for MS biomarkers.
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12
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Boivin N, Baillargeon J, Doss PMIA, Roy AP, Rangachari M. Interferon-β suppresses murine Th1 cell function in the absence of antigen-presenting cells. PLoS One 2015; 10:e0124802. [PMID: 25885435 PMCID: PMC4401451 DOI: 10.1371/journal.pone.0124802] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 03/19/2015] [Indexed: 01/08/2023] Open
Abstract
Interferon (IFN)-β is a front-line therapy for the treatment of the relapsing-remitting form of multiple sclerosis. However, its immunosuppressive mechanism of function remains incompletely understood. While it has been proposed that IFN-β suppresses the function of inflammatory myelin antigen-reactive T cells by promoting the release of immunomodulatory cytokines such as IL-27 from antigen-presenting cells (APCs), its direct effects on inflammatory CD4+ Th1 cells are less clear. Here, we establish that IFN-β inhibits mouse IFN-γ+ Th1 cell function in the absence of APCs. CD4+ T cells express the type I interferon receptor, and IFN-β can suppress Th1 cell proliferation under APC-free stimulation conditions. IFN-β-treated myelin antigen-specific Th1 cells are impaired in their ability to induce severe experimental autoimmune encephalomyelitis (EAE) upon transfer to lymphocyte-deficient Rag1-/- mice. Polarized Th1 cells downregulate IFN-γ and IL-2, and upregulate the negative regulatory receptor Tim-3, when treated with IFN-β in the absence of APCs. Further, IFN-β treatment of Th1 cells upregulates phosphorylation of Stat1, and downregulates phosphorylation of Stat4. Our data indicate that IFN-γ-producing Th1 cells are directly responsive to IFN-β and point to a novel mechanism of IFN-β-mediated T cell suppression that is independent of APC-derived signals.
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Affiliation(s)
- Nicolas Boivin
- Department of Neuroscience, Centre de recherche du CHU de Québec—Université Laval, Québec QC, Canada G1V 4G2
| | - Joanie Baillargeon
- Department of Neuroscience, Centre de recherche du CHU de Québec—Université Laval, Québec QC, Canada G1V 4G2
| | - Prenitha Mercy Ignatius Arokia Doss
- Department of Neuroscience, Centre de recherche du CHU de Québec—Université Laval, Québec QC, Canada G1V 4G2
- Graduate Programme in Microbiology and Immunology, Faculty of Medicine, Université Laval, Québec QC, Canada G1V 0A6
| | - Andrée-Pascale Roy
- Department of Neuroscience, Centre de recherche du CHU de Québec—Université Laval, Québec QC, Canada G1V 4G2
- Graduate Programme in Microbiology and Immunology, Faculty of Medicine, Université Laval, Québec QC, Canada G1V 0A6
| | - Manu Rangachari
- Department of Neuroscience, Centre de recherche du CHU de Québec—Université Laval, Québec QC, Canada G1V 4G2
- Department of Molecular Medicine, Faculty of Medicine, Université Laval, Québec QC, Canada G1V 0A6
- * E-mail:
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13
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Huber AK, Duncker PC, Irani DN. The conundrum of interferon-β non-responsiveness in relapsing-remitting multiple sclerosis. Cytokine 2015; 74:228-36. [PMID: 25691330 DOI: 10.1016/j.cyto.2015.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 01/10/2015] [Indexed: 01/01/2023]
Abstract
A series of controlled clinical trials have shown that exogenous interferon-beta (IFN-β) benefits patients with relapsing-remitting multiple sclerosis (RRMS) by reducing relapse rate, disability progression, and the formation of new brain and spinal cord lesions on magnetic resonance imaging (MRI) scans. Unfortunately, however, the effectiveness of IFN-β is limited in this setting by the occurrence of treatment non-responsiveness in nearly 25% of patients. Furthermore, clinicians who care for RRMS patients remain unable to accurately identify IFN-β non-responders prior to the initiation of therapy, causing delays in the use of alternative treatments and sometimes requiring that patients turn to medications with more significant side effects to control their disease. Progress has been made toward understanding how both endogenous and exogenous IFN-β act to slow RRMS as well as the related mouse model, experimental autoimmune encephalomyelitis (EAE). Most studies point to its inhibitory actions on circulating immune cells as being important for suppressing both disorders, but multiple potential target cells and inflammatory pathways have been implicated and those essential to confer its benefits remain undefined. This review focuses on the role of both endogenous and exogenous IFN-β in RRMS, paying particular attention to the issue of why certain individuals appear refractory to its disease-modifying effects. A continued goal in this field remains the identification of a convenient biomarker that accurately predicts IFN-β treatment non-responsiveness in individual RRMS patients. Development of such an assay will allow clinicians to customize therapy for patients with this complex disorder.
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Affiliation(s)
- Amanda K Huber
- Department of Neurology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Patrick C Duncker
- Department of Neurology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - David N Irani
- Department of Neurology, University of Michigan Medical School, Ann Arbor, MI, USA.
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14
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Torbati S, Karami F, Ghaffarpour M, Zamani M. Association of CD58 Polymorphism with Multiple Sclerosis and Response to Interferon ß Therapy in A Subset of Iranian Population. CELL JOURNAL 2015; 16:506-13. [PMID: 25685741 PMCID: PMC4297489 DOI: 10.22074/cellj.2015.505] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 12/24/2013] [Indexed: 11/25/2022]
Abstract
Objective Multiple sclerosis (MS) is one of the leading neurodegenerative causes of
physical disability world-wide. Genetic aberrations of autoimmunity pathway components
have been demonstrated to significantly influence MS development. Cluster of Differentiation 58 (CD58) is pertained to a group of genes which had been assayed in several recent
association studies. Given the significance of CD58 in modulation of T regulatory cells
that control autoimmune responses, the present study was conducted to investigate the
frequency of rs12044852 polymorphism and its effect on the outcome of interferon beta
(IFN-β) therapy in a subset of Iranian MS patients.
Materials and Methods Two hundred MS patients and equal number of healthy
controls were recruited to be genotyped in an experimental case-control based study
through polymerase chain reaction using specific sequence primers (PCR-SSP). Relapsing remitting multiple sclerosis (RRMS) patients administered IFN-β therapy were
followed up with clinical visits every three months up to two years. The mean of multiple sclerosis severity score (MSSS) and expanded disability status scale (EDSS)
were measured to monitor the change in severity of MS in response to IFN-β therapy.
Pearson’s Chi-square and analysis of variance (ANOVA) tests were the main statistical methods used in this study.
Results Strong association was found between the CC genotype and onset of MS
(p=0.001, OR=2.22). However, there was no association between rs12044852 and
various classifications and severity of MS. Pharmacogenetics-based analysis indicated that carriers of CC genotype had the highest MSSS score compared to others,
implying a negative impact of rs12044852 on response to IFN-β therapy.
Conclusion Taken together, our findings revealed the critical effect of rs12044852 polymorphism of CD58 on the progression of MS disease. This indicates that genotyping of
MS patients may expedite achieving personalized medical management of MS patients.
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Affiliation(s)
- Sara Torbati
- Department of Neurogenetics, Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Karami
- Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Ghaffarpour
- Department of Neurogenetics, Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Zamani
- Department of Neurogenetics, Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran ; Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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15
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Abstract
Multiple sclerosis (MS) is an autoimmune disease of unknown cause, in which chronic inflammation drives multifocal demyelination of axons in both white and gray matter in the CNS. The pathological course of the disease is heterogeneous and involves an early, predominantly inflammatory demyelinating disease phase of relapsing-remitting MS (RRMS), which, over a variable period of time, evolves into a progressively degenerative stage associated with axonal loss and scar formation, causing physical and cognitive disability. For patients with RRMS, there is a growing arsenal of disease-modifying agents (DMAs), with varying degrees of efficacy, as defined by reduced relapse rates, improved magnetic resonance imaging outcomes, and preservation of neurological function. Establishment of personalized treatment plans remains one of the biggest challenges in therapeutic decision-making in MS because the disease prognosis and individual therapeutic outcomes are extremely difficult to predict. Current research is aimed at discovery and validation of biomarkers that reliably measure disease progression and effective therapeutic intervention. Individual biomarker candidates with evident clinical utility are highlighted in this review and include neutralizing autoantibodies against DMAs, fetuin-A, osteopontin, isoprostanes, chemokine (C-X-C motif) ligand 13 (CXCL13), neurofilament light and heavy, and chitinase 3-like protein. In addition, application of more advanced screening technologies has opened up new categories of biomarkers that move beyond detection of individual soluble proteins, including gene expression and autoantibody arrays, microRNAs, and circulating microvesicles/exosomes. Development of clinically useful biomarkers in MS will not only shape the practice of personalized medicine but will also serve as surrogate markers to enable investigation of innovative treatments within clinical trials that are less costly, are of shorter duration, and have more certainty of outcomes.
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Affiliation(s)
- Violaine K. Harris
- Tisch Multiple Sclerosis Research Center of New York, 521 West 57th Street, New York, NY 10019 USA
| | - Saud A. Sadiq
- Tisch Multiple Sclerosis Research Center of New York, 521 West 57th Street, New York, NY 10019 USA
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16
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Baranzini SE, Madireddy LR, Cromer A, D'Antonio M, Lehr L, Beelke M, Farmer P, Battaglini M, Caillier SJ, Stromillo ML, De Stefano N, Monnet E, Cree BAC. Prognostic biomarkers of IFNb therapy in multiple sclerosis patients. Mult Scler 2014; 21:894-904. [PMID: 25392319 DOI: 10.1177/1352458514555786] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 09/17/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND Interferon beta (IFNb) reduces relapse frequency and disability progression in patients with multiple sclerosis (MS). OBJECTIVES Early identification of prognostic biomarkers of IFNb-treated patients will allow more effective management of MS. METHODS The IMPROVE study evaluated subcutaneous IFNb versus placebo in 180 patients with relapsing-remitting MS. Magnetic resonance imaging scans, clinical assessments, and blood samples were obtained at baseline and every 4 weeks from every participant. Thirty-nine biomarkers (32 transcripts; seven proteins) were studied in 155 patients from IMPROVE. Therapeutic response was defined by absence of new combined unique lesions, relapses, and sustained increase in Expanded Disability Status Scale over 1 year. A machine learning approach was used to examine the association between biomarker expression and treatment response. RESULTS While baseline levels of individual genes were relatively poor predictors, combinations of three genes were able to identify subjects with sub-optimal therapeutic responses. The triplet CASP2/IRF4/IRF6, previously identified in an independent dataset, was tested among other combinations. This triplet showed acceptable predictive accuracy (0.68) and specificity (0.88), but had relatively low sensitivity (0.22) resulting in an area under the curve (AUC) of 0.63. Other combinations of biomarkers resulted in AUC of up to 0.80 (e.g. CASP2/IL10/IL12Rb1). CONCLUSIONS Baseline expression, or induction ratios, of specific gene combinations correlate with future therapeutic response to IFNb, and have the potential to be prognostically useful.
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Affiliation(s)
- Sergio E Baranzini
- Department of Neurology, University of California, San Francisco (UCSF), San Francisco, USA/ Equal contribution
| | - Lohith R Madireddy
- Department of Neurology, University of California, San Francisco (UCSF), San Francisco, USA/ Equal contribution
| | - Anne Cromer
- Merck Serono S.A. - Geneva, Switzerland/During the completion of this study, Merck Serono closed its Geneva operations. These authors are no longer with the company
| | | | - Lorenz Lehr
- Merck Serono S.A. - Geneva, Switzerland/During the completion of this study, Merck Serono closed its Geneva operations. These authors are no longer with the company
| | - Manolo Beelke
- Merck Serono S.A. - Geneva, Switzerland/During the completion of this study, Merck Serono closed its Geneva operations. These authors are no longer with the company
| | - Pierre Farmer
- Merck Serono S.A. - Geneva, Switzerland/During the completion of this study, Merck Serono closed its Geneva operations. These authors are no longer with the company
| | | | - Stacy J Caillier
- Department of Neurology, University of California, San Francisco (UCSF), San Francisco, USA/ Equal contribution
| | - Maria L Stromillo
- Department of Neurology, University of California, San Francisco (UCSF), San Francisco, USA/ Equal contributionDepartment of Neurology, University of California, San Francisco (UCSF), San Francisco, USA/ Equal contributionMerck Serono S.A. - Geneva, Switzerland/During the completion of this study, Merck Serono closed its Geneva operations. These authors are no longer with the companyMerck Serono RBM S.p.A- Colleretto Giacosa, Turin, ItalyMerck Serono S.A. - Geneva, Switzerland/During the completion of this study, Merck Serono closed its Geneva operations. These authors are no longer with the companyMerck Serono S.A. - Geneva, Switzerland/During the completion of this study, Merck Serono closed its Geneva operations. These authors are no longer with the companyMerck Serono S.A. - Geneva, Switzerland/During the completion of this study, Merck Serono closed its Geneva operations. These authors are no longer with the companyUniversity of Siena, Siena, ItalyDepartment of Neurology, University of California, San Francisco (UCSF), San Francisco, USA/ Equal contributionMerck Serono S.A. - Geneva, Switzerland/During the completion of this study, Merck Serono closed its Geneva operations. These authors are no longer with the companyDepartment of Neurology, University of California, San Francisco (UCSF), San Francisco, USA/ Equal contribution
| | - Nicola De Stefano
- Department of Neurology, University of California, San Francisco (UCSF), San Francisco, USA/ Equal contributionDepartment of Neurology, University of California, San Francisco (UCSF), San Francisco, USA/ Equal contributionMerck Serono S.A. - Geneva, Switzerland/During the completion of this study, Merck Serono closed its Geneva operations. These authors are no longer with the companyMerck Serono RBM S.p.A- Colleretto Giacosa, Turin, ItalyMerck Serono S.A. - Geneva, Switzerland/During the completion of this study, Merck Serono closed its Geneva operations. These authors are no longer with the companyMerck Serono S.A. - Geneva, Switzerland/During the completion of this study, Merck Serono closed its Geneva operations. These authors are no longer with the companyMerck Serono S.A. - Geneva, Switzerland/During the completion of this study, Merck Serono closed its Geneva operations. These authors are no longer with the companyUniversity of Siena, Siena, ItalyDepartment of Neurology, University of California, San Francisco (UCSF), San Francisco, USA/ Equal contributionMerck Serono S.A. - Geneva, Switzerland/During the completion of this study, Merck Serono closed its Geneva operations. These authors are no longer with the companyDepartment of Neurology, University of California, San Francisco (UCSF), San Francisco, USA/ Equal contribution
| | - Emmanuel Monnet
- Merck Serono S.A. - Geneva, Switzerland/During the completion of this study, Merck Serono closed its Geneva operations. These authors are no longer with the company
| | - Bruce A C Cree
- Department of Neurology, University of California, San Francisco (UCSF), San Francisco, USA/ Equal contribution
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17
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Stürner KH, Borgmeyer U, Schulze C, Pless O, Martin R. A multiple sclerosis-associated variant of CBLB links genetic risk with type I IFN function. THE JOURNAL OF IMMUNOLOGY 2014; 193:4439-47. [PMID: 25261476 DOI: 10.4049/jimmunol.1303077] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Multiple sclerosis (MS) is an autoimmune disease of the CNS, and autoreactive CD4(+) T cells are considered important for its pathogenesis. The etiology of MS involves a complex genetic trait and environmental triggers that include viral infections, particularly the EBV. Among the risk alleles that have repeatedly been identified by genome-wide association studies, three are located near the Casitas B-lineage lymphoma proto-oncogene b gene (CBLB). The CBLB protein (CBL-B) is a key regulator of peripheral immune tolerance by limiting T cell activation and expansion and hence T cell-mediated autoimmunity through its ubiquitin E3-ligase activity. In this study, we show that CBL-B expression is reduced in CD4(+) T cells from relapsing-remitting MS (RR-MS) patients during relapse. The MS risk-related single nucleotide polymorphism of CBLB rs12487066 is associated with diminished CBL-B expression levels and alters the effects of type I IFNs on human CD4(+) T cell proliferation. Mechanistically, the CBLB rs12487066 risk allele mediates increased binding of the transcription factor C/EBPβ and reduced CBL-B expression in human CD4(+) T cells. Our data suggest a role of the CBLB rs12487066 variant in the interactions of a genetic risk factor and IFN function during viral infections in MS.
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Affiliation(s)
- Klarissa Hanja Stürner
- Institute of Neuroimmunology and Multiple Sclerosis, Center for Molecular Neurobiology Hamburg, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Uwe Borgmeyer
- Institute for Molecular and Cellular Cognition, Center for Molecular Neurobiology Hamburg, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Christian Schulze
- Systems Biology, Center for Molecular Neurobiology Hamburg, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Ole Pless
- Fraunhofer Institute for Molecular Biology and Applied Ecology, ScreeningPort, 22525 Hamburg, Germany; and
| | - Roland Martin
- Institute of Neuroimmunology and Multiple Sclerosis, Center for Molecular Neurobiology Hamburg, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; Neuroimmunology and MS Research Section, Department of Neurology, University Hospital Zürich, CH-8091 Zürich, Switzerland
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Kinkel RP, Simon JH, O'Connor P, Hyde R, Pace A. Early MRI activity predicts treatment nonresponse with intramuscular interferon beta-1a in clinically isolated syndrome. Mult Scler Relat Disord 2014; 3:712-9. [PMID: 25891550 DOI: 10.1016/j.msard.2014.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 07/31/2014] [Accepted: 08/18/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Determine whether MRI activity 6 months after treatment initiation in the Controlled High-Risk Subjects Avonex® Multiple Sclerosis Prevention Study (CHAMPS) predicted progression to clinically definite multiple sclerosis (CDMS) over the subsequent 30 months in intramuscular interferon beta-1a (IM IFNβ-1a)-treated patients vs placebo-treated patients. METHODS CHAMPS patients were randomized to once-weekly IM IFNβ-1a 30 μg or placebo for up to 36 months. MRI was performed every 6 months until CDMS confirmation. Patient groups were defined based on new T2 and/or Gd+ lesions at 6 months. RESULTS Thirteen IM IFNβ-1a patients (6.7%) and 24 placebo patients (12.6%) developed CDMS prior to month 6 and did not undergo the 6-month MRI. At 6 months, 29.7% of IM IFNβ-1a-treated patients vs 40.9% of placebo-treated patients were defined as having high MRI activity levels (≥2 new T2 and/or ≥2 Gd+ lesions). In this subgroup, estimated cumulative probabilities of CDMS were similar between groups (HR=0.88 [0.44-1.77], p=0.7227). A significant treatment response was seen for patients with <2 new T2 and <2 Gd+ lesions at 6 months (HR=0.39 [0.19-0.82], p=0.0120). CONCLUSION MRI scans 6 months after IM IFNβ-1a initiation in CIS patients predict early treatment non-response. Standardized scanning and monitoring may facilitate early disease management.
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Affiliation(s)
- R P Kinkel
- Department of Neurosciences, University of California San Diego, 9500 Gilman Dr, MC 0662, La Jolla, CA 92093, USA.
| | - J H Simon
- Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Road, Portland, OR 97239, USA.
| | - P O'Connor
- Multiple Sclerosis Clinic, St. Michael׳s Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada.
| | - R Hyde
- Biogen Idec Inc., 14 Cambridge Center, Cambridge, MA 02142, USA.
| | - A Pace
- Biogen Idec Inc., 14 Cambridge Center, Cambridge, MA 02142, USA.
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19
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Graber JJ, Dhib-Jalbut S. Biomarkers of Interferon Beta Therapy in Multiple Sclerosis. J Interferon Cytokine Res 2014; 34:600-4. [DOI: 10.1089/jir.2013.0144] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Jerome J. Graber
- Department of Neurology, Montefiore-Einstein Medical Center, Bronx, New York
| | - Suhayl Dhib-Jalbut
- Department of Neurology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
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20
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Reder AT, Feng X. How type I interferons work in multiple sclerosis and other diseases: some unexpected mechanisms. J Interferon Cytokine Res 2014; 34:589-99. [PMID: 25084175 PMCID: PMC4118715 DOI: 10.1089/jir.2013.0158] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 02/12/2014] [Indexed: 01/23/2023] Open
Abstract
Type I interferons (IFNs) are important in innate and adaptive immunity. They are used to treat virus infections, cancer, and multiple sclerosis (MS). There are 5 type I IFN families in humans-IFN-α with 13 subtypes, plus IFN-β, ɛ, κ, and ω. Because their receptor binding affinities vary, these IFNs have different gene induction profiles and quite variable therapeutic effects. IFN-α subtypes may each be specific for certain viruses, but can be neurotoxic. IFN-β induces IFN-α, plus has additional direct effects on target cells. IFN-β was the first therapy approved that could change the course of MS. It has broader specificity than IFN-α, enhances cognition in MS, and may be neuroprotective and can potentially enhance fertility in women. Priming the IFN signaling system with an injection of IFN-β can enhance subnormal type I IFN signals in MS. Many other commonly used drugs and vitamins may potentiate clinical benefits of IFN-β.
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Affiliation(s)
- Anthony T Reder
- Department of Neurology, University of Chicago , Chicago, Illinois
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21
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Kasper LH, Reder AT. Immunomodulatory activity of interferon-beta. Ann Clin Transl Neurol 2014; 1:622-31. [PMID: 25356432 PMCID: PMC4184564 DOI: 10.1002/acn3.84] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 06/19/2014] [Accepted: 06/19/2014] [Indexed: 12/14/2022] Open
Abstract
Multiple sclerosis (MS) is a complex disorder of the central nervous system that appears to be driven by a shift in immune functioning toward excess inflammation that results in demyelination and axonal loss. Beta interferons were the first class of disease-modifying therapies to be approved for patients with MS after treatment with this type I interferon improved the course of MS on both clinical and radiological measures in clinical trials. The mechanism of action of interferon-beta appears to be driven by influencing the immune system at many levels, including antigen-presenting cells, T cells, and B cells. One effect of these interactions is to shift cytokine networks in favor of an anti-inflammatory effect. The pleiotropic mechanism of action may be a critical factor in determining the efficacy of interferon-beta in MS. This review will focus on select immunological mechanisms that are influenced by this type I cytokine.
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Affiliation(s)
- Lloyd H Kasper
- Departments of Microbiology/Immunology and Medicine, Geisel School of Medicine, Dartmouth College Hanover, New Hampshire
| | - Anthony T Reder
- Department of Neurology, University of Chicago Chicago, Illinois
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22
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Affiliation(s)
- Sergio E Baranzini
- Department of Neurology, University of California San Francisco (UCSF), San Francisco, USA
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23
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Affiliation(s)
- Lawrence Steinman
- Departments of Pediatrics, Neurology and Neurological Sciences, Stanford University, Stanford, California 94305;
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24
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Wingerchuk DM, Carter JL. Multiple sclerosis: current and emerging disease-modifying therapies and treatment strategies. Mayo Clin Proc 2014; 89:225-40. [PMID: 24485135 DOI: 10.1016/j.mayocp.2013.11.002] [Citation(s) in RCA: 292] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Revised: 11/01/2013] [Accepted: 11/07/2013] [Indexed: 12/20/2022]
Abstract
Multiple sclerosis (MS) is a chronic inflammatory demyelinating central nervous system disease that typically strikes young adults, especially women. The pathobiology of MS includes inflammatory and neurodegenerative mechanisms that affect both white and gray matter. These mechanisms underlie the relapsing, and often eventually progressive, course of MS, which is heterogeneous; confident prediction of long-term individual prognosis is not yet possible. However, because revised MS diagnostic criteria that incorporate neuroimaging data facilitate early diagnosis, most patients are faced with making important long-term treatment decisions, most notably the use and selection of disease-modifying therapy (DMT). Currently, there are 10 approved MS DMTs with varying degrees of efficacy for reducing relapse risk and preserving neurological function, but their long-term benefits remain unclear. Moreover, available DMTs differ with respect to the route and frequency of administration, tolerability and likelihood of treatment adherence, common adverse effects, risk of major toxicity, and pregnancy-related risks. Thorough understanding of the benefit-risk profiles of these therapies is necessary to establish logical and safe treatment plans for individuals with MS. We review the available evidence supporting risk-benefit profiles for available and emerging DMTs. We also assess the place of individual DMTs within the context of several different MS management strategies, including those currently in use (sequential monotherapy, escalation therapy, and induction and maintenance therapy) and others that may soon become feasible (combination approaches and "personalized medicine"). We conducted this review using a comprehensive search of MEDLINE, PubMed, EMBASE, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials, from January 1, 1990, to August 31, 2013. The following search terms were used: multiple sclerosis, randomized controlled trials, interferon-beta, glatiramer acetate, mitoxantrone, natalizumab, fingolimod, teriflunomide, dimethyl fumarate, BG-12, alemtuzumab, rituximab, ocrelizumab, daclizumab, neutralizing antibodies, progressive multifocal leukoencephalopathy.
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25
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Dobson R, Rudick RA, Turner B, Schmierer K, Giovannoni G. Assessing treatment response to interferon-β: is there a role for MRI? Neurology 2014; 82:248-54. [PMID: 24336144 PMCID: PMC3902760 DOI: 10.1212/wnl.0000000000000036] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 10/02/2013] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Interferon-β (IFN-β) has been shown to reduce relapse rates in multiple sclerosis; however, the clinical response appears to vary among individuals. Can early MRI be used to identify those patients who have a poor response to treatment? METHODS A systematic review of studies examining differential treatment response and clinical endpoints in groups defined as responders or nonresponders to IFN-β was performed. Meta-analytic techniques were used to combine study results where appropriate. RESULTS Patients with MRI evidence of poor response to IFN-β treatment as defined by either ≥2 new hyperintense T2 lesions or new gadolinium-enhancing lesions had significantly increased risk of both future relapses and progression as defined by the Expanded Disability Status Scale. There appeared to be an increased risk of poor outcomes 16 years after treatment initiation in those with an initial poor response to treatment. Previous evidence has shown this not to be the case in placebo arms of clinical trials. CONCLUSIONS For those patients starting IFN-β, early MRI, within 6 to 24 months after starting treatment, has the potential to provide important information when counseling patients about the likelihood of future treatment failure. This can inform treatment decisions before clinical relapses or disease progression.
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Affiliation(s)
- Ruth Dobson
- From the Queen Mary University London (R.D., K.S., G.G.), Blizard Institute, UK; Neurological Institute (R.A.R.), Mellen Center for MS Treatment and Research, Cleveland, OH; and Royal London Hospital (R.D., B.T., K.S., G.G.), Barts Health NHS Trust, UK
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26
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Reder AT, Feng X. Aberrant Type I Interferon Regulation in Autoimmunity: Opposite Directions in MS and SLE, Shaped by Evolution and Body Ecology. Front Immunol 2013; 4:281. [PMID: 24062747 PMCID: PMC3775461 DOI: 10.3389/fimmu.2013.00281] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 08/30/2013] [Indexed: 01/18/2023] Open
Abstract
Studying the action of mechanisms of type I interferon (IFN) provides the insight to elucidate the cause and therapy for autoimmune diseases. There are high IFN responses in some diseases such as connective tissue diseases, but low responses in multiple sclerosis. Distinct IFN features lead us to understand pathology of a spectrum of autoimmune diseases and help us to search genetic changes, gene expression, and biomarkers for diagnosis, disease progression, and treatment response.
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Affiliation(s)
- Anthony T Reder
- Department of Neurology, The University of Chicago , Chicago, IL , USA
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27
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Ottoboni L, Keenan BT, Tamayo P, Kuchroo M, Mesirov JP, Buckle GJ, Khoury SJ, Hafler DA, Weiner HL, De Jager PL. An RNA profile identifies two subsets of multiple sclerosis patients differing in disease activity. Sci Transl Med 2013; 4:153ra131. [PMID: 23019656 DOI: 10.1126/scitranslmed.3004186] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The multiple sclerosis (MS) patient population is highly heterogeneous in terms of disease course and treatment response. We used a transcriptional profile generated from peripheral blood mononuclear cells to define the structure of an MS patient population. Two subsets of MS subjects (MS(A) and MS(B)) were found among 141 untreated subjects. We replicated this structure in two additional groups of MS subjects treated with one of the two first-line disease-modifying treatments in MS: glatiramer acetate (GA) (n = 94) and interferon-β (IFN-β) (n = 128). One of the two subsets of subjects (MS(A)) was distinguished by higher expression of molecules involved in lymphocyte signaling pathways. Further, subjects in this MS(A) subset were more likely to have a new inflammatory event while on treatment with either GA or IFN-β (P = 0.0077). We thus report a transcriptional signature that differentiates subjects with MS into two classes with different levels of disease activity.
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Affiliation(s)
- Linda Ottoboni
- Program in Translational Neuropsychiatric Genomics, Institute for the Neurosciences, Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA
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28
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Erbayat Altay E, Fisher E, Jones SE, Hara-Cleaver C, Lee JC, Rudick RA. Reliability of classifying multiple sclerosis disease activity using magnetic resonance imaging in a multiple sclerosis clinic. JAMA Neurol 2013; 70:338-44. [PMID: 23599930 DOI: 10.1001/2013.jamaneurol.211] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To assess the reliability of new magnetic resonance imaging (MRI) lesion counts by clinicians in a multiple sclerosis specialty clinic. DESIGN An observational study. SETTING A multiple sclerosis specialty clinic. PATIENTS Eighty-five patients with multiple sclerosis participating in a National Institutes of Health–supported longitudinal study were included. INTERVENTION Each patient had a brain MRI scan at entry and 6 months later using a standardized protocol. MAIN OUTCOME MEASURES The number of new T2 lesions, newly enlarging T2 lesions, and gadolinium-enhancing lesions were measured on the 6-month MRI using a computer-based image analysis program for the original study. For this study, images were reanalyzed by an expert neuroradiologist and 3 clinician raters. The neuroradiologist evaluated the original image pairs; the clinicians evaluated image pairs that were modified to simulate clinical practice. New lesion counts were compared across raters, as was classification of patients as MRI active or inactive. RESULTS Agreement on lesion counts was highest for gadolinium-enhancing lesions, intermediate for new T2 lesions, and poor for enlarging T2 lesions. In 18% to 25% of the cases, MRI activity was classified differently by the clinician raters compared with the neuroradiologist or computer program. Variability among the clinical raters for estimates of new T2 lesions was affected most strongly by the image modifications that simulated low image quality and different head position. CONCLUSIONS Between-rater variability in new T2 lesion counts may be reduced by improved standardization of image acquisitions, but this approach may not be practical in most clinical environments. Ultimately, more reliable, robust, and accessible image analysis methods are needed for accurate multiple sclerosis disease-modifying drug monitoring and decision making in the routine clinic setting.
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Affiliation(s)
- Edru Erbayat Altay
- Cleveland Clinic Mellen Center for Multiple Sclerosis Treatment and Research, 9500 Euclid Ave, Cleveland, OH 44195-5244, USA.
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29
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Bermel RA, You X, Foulds P, Hyde R, Simon JH, Fisher E, Rudick RA. Predictors of long-term outcome in multiple sclerosis patients treated with interferon β. Ann Neurol 2013; 73:95-103. [PMID: 23378325 DOI: 10.1002/ana.23758] [Citation(s) in RCA: 142] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Revised: 07/30/2012] [Accepted: 08/31/2012] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To identify early predictors of long-term outcomes in patients with relapsing-remitting multiple sclerosis (RRMS) treated with intramuscular (IM) interferon beta-1a (IFNβ-1a). METHODS A multicenter, observational, 15-year follow-up study of patients who completed ≥2 years in the pivotal trial of IM IFNβ-1a for RRMS was conducted. One hundred thirty-six patients participated in the 15-year follow-up (69 originally randomized to IM IFNβ-1a and 67 to placebo). After the 2-year clinical trial, treatment was not regulated by study protocol. Disease activity during the 2-year trial was defined as: ≥2 gadolinium-enhancing lesions (cumulative) on year 1 and/or year 2 magnetic resonance imaging (MRI); ≥3 new T2 lesions on year 2 MRI compared to baseline; and ≥2 relapses over 2 years. Odds ratios were calculated for early disease activity predicting severe Expanded Disability Status Scale (EDSS) worsening (worst quartile of change, ≥4.5 EDSS points) during the 15-year interval. RESULTS The proportion of patients experiencing early disease activity was lower in patients on IM IFNβ-1a than placebo for all disease activity markers (range, 23.5-29.0% vs 41.0-45.5%). In the IM IFNβ-1a group, persistent disease activity predicted severe EDSS worsening: gadolinium-enhancing lesions (odds ratio [OR], 8.96; p < 0.001); relapses (OR, 4.44; p = 0.010); and new T2 lesions (OR, 2.90; p = 0.080). In placebo patients, early disease activity was not as strongly associated with long-term outcomes (OR range, 1.53-2.62; p = 0.069-0.408). INTERPRETATION Disease activity despite treatment with IFNβ is associated with unfavorable long-term outcomes. Particular attention should be paid to gadolinium-enhancing lesions on IFNβ therapy, as their presence strongly correlates with severe disability 15 years later. The results provide rationale for monitoring IFNβ-treated patients with MRI, and for changing therapy in patients with active disease.
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Affiliation(s)
- Robert A Bermel
- Neurological Institute, Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, OH, USA.
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30
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Steinman L. Inflammatory cytokines at the summits of pathological signal cascades in brain diseases. Sci Signal 2013; 6:pe3. [PMID: 23322904 DOI: 10.1126/scisignal.2003898] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
When considering the hierarchical organization of pathological signaling cascades in immunological disorders of the brain, certain cytokines might be considered pinnacles of pathophysiological importance, with their presence determining the appearance or the course of a particular disease. Interleukin-1 (IL-1), IL-6, IL-17, and tumor necrosis factor are critical for the pathogenesis of inflammation in specific brain disorders. Targeting these cytokines or their receptors can alter the course of several neurological diseases, but the effects may be beneficial or harmful.
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Affiliation(s)
- Lawrence Steinman
- Departments of Pediatrics and Neurology and Neurological Sciences, Stanford University, Beckman Center for Molecular Medicine, Stanford, CA 94305-5316, USA.
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31
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Abstract
In multiple sclerosis, type I interferon (IFN) is considered immune-modulatory, and recombinant forms of IFN-β are the most prescribed treatment for this disease. This is in contrast to most other autoimmune disorders, because type I IFN contributes to the pathologies. Even within the relapsing-remitting multiple sclerosis (RRMS) population, 30-50% of MS patients are non-responsive to this treatment, and it consistently worsens neuromyelitis optica, a disease similar to RRMS. In this article, we discuss the recent advances in the field of autoimmunity and introduce the theory explain how type I IFNs can be pro-inflammatory in disease that is predominantly driven by a Th17 response and are therapeutic when disease is predominantly Th1.
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Affiliation(s)
- Robert C Axtell
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA 94305-5316, USA.
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32
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Sánchez-Pla A, Reverter F, Ruíz de Villa MC, Comabella M. Transcriptomics: mRNA and alternative splicing. J Neuroimmunol 2012; 248:23-31. [PMID: 22626445 DOI: 10.1016/j.jneuroim.2012.04.008] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 04/14/2012] [Accepted: 04/18/2012] [Indexed: 11/27/2022]
Abstract
Transcriptomics has emerged as a powerful approach for biomarker discovery. In the present review, the two main types of high throughput transcriptomic technologies - microarrays and next generation sequencing - that can be used to identify candidate biomarkers are briefly described. Microarrays, the mainstream technology of the last decade, have provided hundreds of valuable datasets in a wide variety of diseases including multiple sclerosis (MS), in which this approach has been used to disentangle different aspects of its complex pathogenesis. RNA-seq, the current next generation sequencing approach, is expected to provide similar power as microarrays but extending their capabilities to aspects up to now more difficult to analyse such as alternative splicing and discovery of novel transcripts.
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Hecker M, Paap BK, Goertsches RH, Kandulski O, Fatum C, Koczan D, Hartung HP, Thiesen HJ, Zettl UK. Reassessment of blood gene expression markers for the prognosis of relapsing-remitting multiple sclerosis. PLoS One 2011; 6:e29648. [PMID: 22216338 PMCID: PMC3246503 DOI: 10.1371/journal.pone.0029648] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Accepted: 12/02/2011] [Indexed: 01/04/2023] Open
Abstract
Despite considerable advances in the treatment of multiple sclerosis, current drugs are only partially effective. Most patients show reduced disease activity with therapy, but still experience relapses, increasing disability, and new brain lesions. Since there are no reliable clinical or biological markers of disease progression, long-term prognosis is difficult to predict for individual patients. We identified 18 studies that suggested genes expressed in blood as predictive biomarkers. We validated the prognostic value of those genes with three different microarray data sets comprising 148 patients in total. Using these data, we tested whether the genes were significantly differentially expressed between patients with good and poor courses of the disease. Poor progression was defined by relapses and/or increase of disability during a two-year follow-up, independent of the administered therapy. Of 110 genes that have been proposed as predictive biomarkers, most could not be confirmed in our analysis. However, the G protein-coupled membrane receptor GPR3 was expressed at significantly lower levels in patients with poor disease progression in all data sets. GPR3 has therefore a high potential to be a biomarker for predicting future disease activity. In addition, we examined the IL17 cytokines and receptors in more detail and propose IL17RC as a new, promising, transcript-based biomarker candidate. Further studies are needed to better understand the roles of these receptors in multiple sclerosis and its treatment and to clarify the utility of GPR3 and IL17RC expression levels in the blood as markers of long-term prognosis.
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Affiliation(s)
- Michael Hecker
- Steinbeis Transfer Center for Proteome Analysis, Rostock, Germany.
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