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In 't Veld SGJG, Arkani M, Post E, Antunes-Ferreira M, D'Ambrosi S, Vessies DCL, Vermunt L, Vancura A, Muller M, Niemeijer ALN, Tannous J, Meijer LL, Le Large TYS, Mantini G, Wondergem NE, Heinhuis KM, van Wilpe S, Smits AJ, Drees EEE, Roos E, Leurs CE, Tjon Kon Fat LA, van der Lelij EJ, Dwarshuis G, Kamphuis MJ, Visser LE, Harting R, Gregory A, Schweiger MW, Wedekind LE, Ramaker J, Zwaan K, Verschueren H, Bahce I, de Langen AJ, Smit EF, van den Heuvel MM, Hartemink KJ, Kuijpers MJE, Oude Egbrink MGA, Griffioen AW, Rossel R, Hiltermann TJN, Lee-Lewandrowski E, Lewandrowski KB, De Witt Hamer PC, Kouwenhoven M, Reijneveld JC, Leenders WPJ, Hoeben A, Verdonck-de Leeuw IM, Leemans CR, Baatenburg de Jong RJ, Terhaard CHJ, Takes RP, Langendijk JA, de Jager SC, Kraaijeveld AO, Pasterkamp G, Smits M, Schalken JA, Łapińska-Szumczyk S, Łojkowska A, Żaczek AJ, Lokhorst H, van de Donk NWCJ, Nijhof I, Prins HJ, Zijlstra JM, Idema S, Baayen JC, Teunissen CE, Killestein J, Besselink MG, Brammen L, Bachleitner-Hofmann T, Mateen F, Plukker JTM, Heger M, de Mast Q, Lisman T, Pegtel DM, Bogaard HJ, Jassem J, Supernat A, Mehra N, Gerritsen W, de Kroon CD, Lok CAR, Piek JMJ, Steeghs N, van Houdt WJ, Brakenhoff RH, Sonke GS, Verheul HM, Giovannetti E, Kazemier G, Sabrkhany S, Schuuring E, Sistermans EA, Wolthuis R, Meijers-Heijboer H, Dorsman J, Oudejans C, Ylstra B, Westerman BA, van den Broek D, Koppers-Lalic D, Wesseling P, Nilsson RJA, Vandertop WP, Noske DP, Tannous BA, Sol N, Best MG, Wurdinger T. Detection and localization of early- and late-stage cancers using platelet RNA. Cancer Cell 2022; 40:999-1009.e6. [PMID: 36055228 DOI: 10.1016/j.ccell.2022.08.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 05/06/2022] [Accepted: 08/08/2022] [Indexed: 01/12/2023]
Abstract
Cancer patients benefit from early tumor detection since treatment outcomes are more favorable for less advanced cancers. Platelets are involved in cancer progression and are considered a promising biosource for cancer detection, as they alter their RNA content upon local and systemic cues. We show that tumor-educated platelet (TEP) RNA-based blood tests enable the detection of 18 cancer types. With 99% specificity in asymptomatic controls, thromboSeq correctly detected the presence of cancer in two-thirds of 1,096 blood samples from stage I-IV cancer patients and in half of 352 stage I-III tumors. Symptomatic controls, including inflammatory and cardiovascular diseases, and benign tumors had increased false-positive test results with an average specificity of 78%. Moreover, thromboSeq determined the tumor site of origin in five different tumor types correctly in over 80% of the cancer patients. These results highlight the potential properties of TEP-derived RNA panels to supplement current approaches for blood-based cancer screening.
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Affiliation(s)
- Sjors G J G In 't Veld
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Clinical Chemistry, Neurochemistry Lab, Boelelaan 1117, Amsterdam, the Netherlands; Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Mohammad Arkani
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Pulmonary Medicine, Boelelaan 1117, Amsterdam, the Netherlands
| | - Edward Post
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands
| | - Mafalda Antunes-Ferreira
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands
| | - Silvia D'Ambrosi
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands
| | - Daan C L Vessies
- Department of Laboratory Medicine, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Lisa Vermunt
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Clinical Chemistry, Neurochemistry Lab, Boelelaan 1117, Amsterdam, the Netherlands; Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Adrienne Vancura
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands
| | - Mirte Muller
- Department of Thoracic Oncology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Anna-Larissa N Niemeijer
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Pulmonary Medicine, Boelelaan 1117, Amsterdam, the Netherlands
| | - Jihane Tannous
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Neuroscience Program, Harvard Medical School, Boston, MA, USA
| | - Laura L Meijer
- Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Surgery, Boelelaan 1117, Amsterdam, the Netherlands
| | - Tessa Y S Le Large
- Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Surgery, Boelelaan 1117, Amsterdam, the Netherlands
| | - Giulia Mantini
- Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Medical Oncology, Boelelaan 1117, Amsterdam, the Netherlands
| | - Niels E Wondergem
- Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Otolaryngology and Head and Neck Surgery, Boelelaan 1117, Amsterdam, the Netherlands
| | - Kimberley M Heinhuis
- Department of Medical Oncology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands; Department of Clinical Pharmacology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Sandra van Wilpe
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - A Josien Smits
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Pulmonary Medicine, Boelelaan 1117, Amsterdam, the Netherlands
| | - Esther E E Drees
- Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Pathology, Boelelaan 1117, Amsterdam, the Netherlands
| | - Eva Roos
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Surgery, Boelelaan 1117, Amsterdam, the Netherlands
| | - Cyra E Leurs
- Neuroscience Campus Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurology, Boelelaan 1117, Amsterdam, the Netherlands; MS Center Amsterdam, Amsterdam, the Netherlands
| | | | - Ewoud J van der Lelij
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands
| | - Govert Dwarshuis
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands
| | - Maarten J Kamphuis
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands
| | - Lisanne E Visser
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands
| | - Romee Harting
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands
| | - Annemijn Gregory
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands
| | - Markus W Schweiger
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Neuroscience Program, Harvard Medical School, Boston, MA, USA
| | - Laurine E Wedekind
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands
| | - Jip Ramaker
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands
| | - Kenn Zwaan
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands
| | - Heleen Verschueren
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands
| | - Idris Bahce
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Pulmonary Medicine, Boelelaan 1117, Amsterdam, the Netherlands
| | - Adrianus J de Langen
- Department of Thoracic Oncology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Egbert F Smit
- Department of Thoracic Oncology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Michel M van den Heuvel
- Department of Thoracic Oncology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands; Department of Respiratory Diseases, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Koen J Hartemink
- Department of Thoracic Surgery, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Marijke J E Kuijpers
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands; Thrombosis Expertise Centre, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Mirjam G A Oude Egbrink
- Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Arjan W Griffioen
- Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Medical Oncology, Boelelaan 1117, Amsterdam, the Netherlands
| | - Rafael Rossel
- Translational Research Unit, Dr. Rosell Oncology Institute, Quirón Dexeus University Hospital, Barcelona, Spain; Pangaea Biotech SL, Barcelona, Spain; Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Barcelona, Spain; Molecular Oncology Research (MORe) Foundation, Barcelona, Spain
| | - T Jeroen N Hiltermann
- University of Groningen, Department of Pulmonary Diseases, University Medical Center Groningen, Groningen, the Netherlands
| | | | - Kent B Lewandrowski
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Philip C De Witt Hamer
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands
| | - Mathilde Kouwenhoven
- Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurology, Boelelaan 1117, Amsterdam, the Netherlands
| | - Jaap C Reijneveld
- Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurology, Boelelaan 1117, Amsterdam, the Netherlands; Department of Neurology, Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, the Netherlands
| | - William P J Leenders
- Department of Biochemistry, Radboud Institute for Molecular Life Sciences, Nijmegen, the Netherlands
| | - Ann Hoeben
- Department of Medical Oncology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, the Netherlands
| | - Irma M Verdonck-de Leeuw
- Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Otolaryngology and Head and Neck Surgery, Boelelaan 1117, Amsterdam, the Netherlands; Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences & Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - C René Leemans
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Otolaryngology and Head and Neck Surgery, Boelelaan 1117, Amsterdam, the Netherlands
| | - Robert J Baatenburg de Jong
- Department of Otolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Chris H J Terhaard
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Robert P Takes
- Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Johannes A Langendijk
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Saskia C de Jager
- Department of Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Adriaan O Kraaijeveld
- Department of Cardiology, Division of Heart and Lungs, Utrecht University Medical Center, Utrecht, the Netherlands
| | - Gerard Pasterkamp
- Department of Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Minke Smits
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jack A Schalken
- Urological Research Laboratory, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Urology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Sylwia Łapińska-Szumczyk
- Department of Gynaecology, Gynaecological Oncology and Gynaecological Endocrinology, Medical University of Gdańsk, Gdańsk, Poland
| | - Anna Łojkowska
- Department of Gynaecology, Gynaecological Oncology and Gynaecological Endocrinology, Medical University of Gdańsk, Gdańsk, Poland
| | - Anna J Żaczek
- Laboratory of Translational Oncology, Intercollegiate Faculty of Biotechnology, University of Gdańsk and Medical University of Gdańsk, Gdańsk, Poland
| | - Henk Lokhorst
- Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Hematology, Boelelaan 1117, Amsterdam, the Netherlands
| | - Niels W C J van de Donk
- Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Hematology, Boelelaan 1117, Amsterdam, the Netherlands
| | - Inger Nijhof
- Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Hematology, Boelelaan 1117, Amsterdam, the Netherlands
| | - Henk-Jan Prins
- Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Hematology, Boelelaan 1117, Amsterdam, the Netherlands
| | - Josée M Zijlstra
- Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Hematology, Boelelaan 1117, Amsterdam, the Netherlands
| | - Sander Idema
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands
| | - Johannes C Baayen
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands
| | - Charlotte E Teunissen
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Clinical Chemistry, Neurochemistry Lab, Boelelaan 1117, Amsterdam, the Netherlands; Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Joep Killestein
- Neuroscience Campus Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurology, Boelelaan 1117, Amsterdam, the Netherlands; MS Center Amsterdam, Amsterdam, the Netherlands
| | - Marc G Besselink
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Surgery, Boelelaan 1117, Amsterdam, the Netherlands
| | - Lindsay Brammen
- Department of Surgery, Division of General Surgery, Medical University of Vienna, Vienna, Austria
| | | | - Farrah Mateen
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - John T M Plukker
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Michal Heger
- Department of Pharmaceutics, Jiaxing Key Laboratory for Photonanomedicine and Experimental Therapeutics, College of Medicine, Jiaxing University, Jiaxing, Zhejiang, PR China; Department of Pathology, Laboratory Experimental Oncology, Erasmus MC, Rotterdam, the Netherlands
| | - Quirijn de Mast
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ton Lisman
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Surgical Research Laboratory, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - D Michiel Pegtel
- Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Pathology, Boelelaan 1117, Amsterdam, the Netherlands
| | - Harm-Jan Bogaard
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Pulmonary Medicine, Boelelaan 1117, Amsterdam, the Netherlands
| | - Jacek Jassem
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | - Anna Supernat
- Laboratory of Translational Oncology, Intercollegiate Faculty of Biotechnology, University of Gdańsk and Medical University of Gdańsk, Gdańsk, Poland
| | - Niven Mehra
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Winald Gerritsen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Cornelis D de Kroon
- Department of Obstetrics and Gynaecology, Leiden University Medical Center, Leiden, the Netherlands
| | - Christianne A R Lok
- Department of Gynaecological Oncology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, the Netherlands; Center of Gynaecologic Oncology Amsterdam, the Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | - Jurgen M J Piek
- Department of Obstetrics and Gynaecology and Catharina Cancer Institute, Catharina Hospital, Eindhoven, the Netherlands
| | - Neeltje Steeghs
- Department of Medical Oncology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands; Department of Clinical Pharmacology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Winan J van Houdt
- Department of Surgical Oncology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Ruud H Brakenhoff
- Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Otolaryngology and Head and Neck Surgery, Boelelaan 1117, Amsterdam, the Netherlands
| | - Gabe S Sonke
- Department of Medical Oncology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Henk M Verheul
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Elisa Giovannetti
- Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Medical Oncology, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Pharmacology Lab, AIRC Start-Up Unit, Fondazione Pisana per La Scienza, Pisa, Italy
| | - Geert Kazemier
- Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Surgery, Boelelaan 1117, Amsterdam, the Netherlands
| | - Siamack Sabrkhany
- Department of Physiology, Maastricht University, Maastricht, the Netherlands
| | - Ed Schuuring
- Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Erik A Sistermans
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Clinical Genetics, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Reproduction & Development Research Institute, Amsterdam, the Netherlands
| | - Rob Wolthuis
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Clinical Genetics, Boelelaan 1117, Amsterdam, the Netherlands
| | - Hanne Meijers-Heijboer
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Clinical Genetics, Boelelaan 1117, Amsterdam, the Netherlands
| | - Josephine Dorsman
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Clinical Genetics, Boelelaan 1117, Amsterdam, the Netherlands
| | - Cees Oudejans
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Clinical Chemistry, Boelelaan 1117, Amsterdam, the Netherlands
| | - Bauke Ylstra
- Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Pathology, Boelelaan 1117, Amsterdam, the Netherlands
| | - Bart A Westerman
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands
| | - Daan van den Broek
- Department of Laboratory Medicine, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Danijela Koppers-Lalic
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands
| | - Pieter Wesseling
- Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Pathology, Boelelaan 1117, Amsterdam, the Netherlands; Department of Pathology, Princess Máxima Center for Pediatric Oncology and University Medical Center Utrecht, Utrecht, the Netherlands
| | - R Jonas A Nilsson
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - W Peter Vandertop
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands
| | - David P Noske
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands
| | - Bakhos A Tannous
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Neuroscience Program, Harvard Medical School, Boston, MA, USA
| | - Nik Sol
- Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurology, Boelelaan 1117, Amsterdam, the Netherlands
| | - Myron G Best
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands.
| | - Thomas Wurdinger
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Neurosurgery, Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam and Liquid Biopsy Center, Amsterdam, the Netherlands; Brain Tumor Center Amsterdam, Amsterdam, the Netherlands.
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Bridel C, Leurs CE, van Lierop ZYGJ, van Kempen ZLE, Dekker I, Twaalfhoven HAM, Moraal B, Barkhof F, Uitdehaag BMJ, Killestein J, Teunissen CE. Serum Neurofilament Light Association With Progression in Natalizumab-Treated Patients With Relapsing-Remitting Multiple Sclerosis. Neurology 2021; 97:e1898-e1905. [PMID: 34504023 DOI: 10.1212/wnl.0000000000012752] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 07/26/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To investigate the potential of serum neurofilament light (NfL) to reflect or predict progression mostly independent of acute inflammatory disease activity in patients with relapsing-remitting multiple sclerosis (RRMS) treated with natalizumab. METHODS Patients were selected from a prospective observational cohort study initiated in 2006 at the VU University Medical Center Amsterdam, the Netherlands, including patients with RRMS treated with natalizumab. Selection criteria included an age of 18 years or older and a minimum follow-up of 3 years from natalizumab initiation. Clinical and MRI assessments were performed on a yearly basis, and serum NfL was measured at 5 time points during the follow-up, including on the day of natalizumab initiation (baseline), 3 months, 1 year, and 2 years after natalizumab initiation, and on last follow-up visit. Using general linear regression models, we compared the longitudinal dynamics of NfL between patients with and without confirmed Expanded Disability Status Scale (EDSS) progression between year 1 visit and last follow-up, and between individuals with and without EDSS+ progression, a composite endpoint including the EDSS, 9-hole peg test, and timed 25-foot walk. RESULTS Eighty-nine natalizumab-treated patients with RRMS were included. Median follow-up time was 5.2 years (interquartile range [IQR] 4.3-6.7, range 3.0-11.0) after natalizumab initiation, mean age at time of natalizumab initiation was 36.9 years (SD 8.5), and median disease duration was 7.4 years (IQR 3.8-12.1). Between year 1 and the last follow-up, 28/89 (31.5%) individuals showed confirmed EDSS progression. Data for the EDSS+ endpoint was available for 73 out of the 89 patients and 35/73 (47.9%) showed confirmed EDSS+ progression. We observed a significant reduction in NfL levels 3 months after natalizumab initiation, which reached its nadir of close to 50% of baseline levels 1 year after treatment initiation. We found no difference in the longitudinal dynamics of NfL in progressors vs nonprogressors. NfL levels at baseline and 1 year after natalizumab initiation did not predict progression at last follow-up. CONCLUSION In our cohort of natalizumab-treated patients with RRMS, NfL fails to capture or predict progression that occurs largely independently of clinical or radiologic signs of acute focal inflammatory disease activity. Additional biomarkers may thus be needed to monitor progression in these patients. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that serum NfL levels are not associated with disease progression in natalizumab-treated patients with RRMS.
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Affiliation(s)
- Claire Bridel
- From the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland.
| | - Cyra E Leurs
- From the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland
| | - Zoë Y G J van Lierop
- From the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland
| | - Zoé L E van Kempen
- From the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland
| | - Iris Dekker
- From the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland
| | - Harry A M Twaalfhoven
- From the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland
| | - Bastiaan Moraal
- From the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland
| | - Frederik Barkhof
- From the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland
| | - Bernard M J Uitdehaag
- From the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland
| | - Joep Killestein
- From the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland
| | - Charlotte E Teunissen
- From the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland
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3
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Sestito C, Leurs CE, Steenwijk MD, Brevé JJP, Twisk JWR, Wilhelmus MMM, Drukarch B, Teunissen CE, van Dam AM, Killestein J. Tissue Transglutaminase Expression Associates With Progression of Multiple Sclerosis. Neurol Neuroimmunol Neuroinflamm 2021; 8:8/4/e998. [PMID: 33906937 PMCID: PMC8105890 DOI: 10.1212/nxi.0000000000000998] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 02/22/2021] [Indexed: 11/25/2022]
Abstract
Objective The clinical course of multiple sclerosis (MS) is variable and largely unpredictable pointing to an urgent need for markers to monitor disease activity and progression. Recent evidence revealed that tissue transglutaminase (TG2) is altered in patient-derived monocytes. We hypothesize that blood cell–derived TG2 messenger RNA (mRNA) can potentially be used as biomarker in patients with MS. Methods In peripheral blood mononuclear cells (PBMCs) from 151 healthy controls and 161 patients with MS, TG2 mRNA was measured and correlated with clinical and MRI parameters of disease activity (annualized relapse rate, gadolinium-enhanced lesions, and T2 lesion volume) and disease progression (Expanded Disability Status Scale [EDSS], normalized brain volume, and hypointense T1 lesion volume). Results PBMC-derived TG2 mRNA levels were significantly associated with disease progression, i.e., worsening of the EDSS over 2 years of follow-up, normalized brain volume, and normalized gray and white matter volume in the total MS patient group at baseline. Of these, in patients with relapsing-remitting MS, TG2 expression was significantly associated with worsening of the EDSS scores over 2 years of follow-up. In the patients with primary progressive (PP) MS, TG2 mRNA levels were significantly associated with EDSS, normalized brain volume, and normalized gray and white matter volume at baseline. In addition, TG2 mRNA associated with T1 hypointense lesion volume in the patients with PP MS at baseline. Conclusion PBMC-derived TG2 mRNA levels hold promise as biomarker for disease progression in patients with MS. Classification of Evidence This study provides Class II evidence that in patients with MS, PBMC-derived TG2 mRNA levels are associated with disease progression.
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Affiliation(s)
- Claudia Sestito
- From Amsterdam UMC, Vrije Universiteit, Amsterdam Neuroscience, MS Center Amsterdam, Department of Anatomy and Neurosciences (C.S., M.D.S., J.J.P.B., M.M.M.W., B.D., A.-M.v.D.), Department of Neurology (C.E.L., J.K.), Department of Epidemiology and Biostatistics (J.W.R.T.), and Department of Clinical Chemistry (C.E.T.), Amsterdam, the Netherlands
| | - Cyra E Leurs
- From Amsterdam UMC, Vrije Universiteit, Amsterdam Neuroscience, MS Center Amsterdam, Department of Anatomy and Neurosciences (C.S., M.D.S., J.J.P.B., M.M.M.W., B.D., A.-M.v.D.), Department of Neurology (C.E.L., J.K.), Department of Epidemiology and Biostatistics (J.W.R.T.), and Department of Clinical Chemistry (C.E.T.), Amsterdam, the Netherlands
| | - Martijn D Steenwijk
- From Amsterdam UMC, Vrije Universiteit, Amsterdam Neuroscience, MS Center Amsterdam, Department of Anatomy and Neurosciences (C.S., M.D.S., J.J.P.B., M.M.M.W., B.D., A.-M.v.D.), Department of Neurology (C.E.L., J.K.), Department of Epidemiology and Biostatistics (J.W.R.T.), and Department of Clinical Chemistry (C.E.T.), Amsterdam, the Netherlands
| | - John J P Brevé
- From Amsterdam UMC, Vrije Universiteit, Amsterdam Neuroscience, MS Center Amsterdam, Department of Anatomy and Neurosciences (C.S., M.D.S., J.J.P.B., M.M.M.W., B.D., A.-M.v.D.), Department of Neurology (C.E.L., J.K.), Department of Epidemiology and Biostatistics (J.W.R.T.), and Department of Clinical Chemistry (C.E.T.), Amsterdam, the Netherlands
| | - Jos W R Twisk
- From Amsterdam UMC, Vrije Universiteit, Amsterdam Neuroscience, MS Center Amsterdam, Department of Anatomy and Neurosciences (C.S., M.D.S., J.J.P.B., M.M.M.W., B.D., A.-M.v.D.), Department of Neurology (C.E.L., J.K.), Department of Epidemiology and Biostatistics (J.W.R.T.), and Department of Clinical Chemistry (C.E.T.), Amsterdam, the Netherlands
| | - Micha M M Wilhelmus
- From Amsterdam UMC, Vrije Universiteit, Amsterdam Neuroscience, MS Center Amsterdam, Department of Anatomy and Neurosciences (C.S., M.D.S., J.J.P.B., M.M.M.W., B.D., A.-M.v.D.), Department of Neurology (C.E.L., J.K.), Department of Epidemiology and Biostatistics (J.W.R.T.), and Department of Clinical Chemistry (C.E.T.), Amsterdam, the Netherlands
| | - Benjamin Drukarch
- From Amsterdam UMC, Vrije Universiteit, Amsterdam Neuroscience, MS Center Amsterdam, Department of Anatomy and Neurosciences (C.S., M.D.S., J.J.P.B., M.M.M.W., B.D., A.-M.v.D.), Department of Neurology (C.E.L., J.K.), Department of Epidemiology and Biostatistics (J.W.R.T.), and Department of Clinical Chemistry (C.E.T.), Amsterdam, the Netherlands
| | - Charlotte E Teunissen
- From Amsterdam UMC, Vrije Universiteit, Amsterdam Neuroscience, MS Center Amsterdam, Department of Anatomy and Neurosciences (C.S., M.D.S., J.J.P.B., M.M.M.W., B.D., A.-M.v.D.), Department of Neurology (C.E.L., J.K.), Department of Epidemiology and Biostatistics (J.W.R.T.), and Department of Clinical Chemistry (C.E.T.), Amsterdam, the Netherlands
| | - Anne-Marie van Dam
- From Amsterdam UMC, Vrije Universiteit, Amsterdam Neuroscience, MS Center Amsterdam, Department of Anatomy and Neurosciences (C.S., M.D.S., J.J.P.B., M.M.M.W., B.D., A.-M.v.D.), Department of Neurology (C.E.L., J.K.), Department of Epidemiology and Biostatistics (J.W.R.T.), and Department of Clinical Chemistry (C.E.T.), Amsterdam, the Netherlands.
| | - Joep Killestein
- From Amsterdam UMC, Vrije Universiteit, Amsterdam Neuroscience, MS Center Amsterdam, Department of Anatomy and Neurosciences (C.S., M.D.S., J.J.P.B., M.M.M.W., B.D., A.-M.v.D.), Department of Neurology (C.E.L., J.K.), Department of Epidemiology and Biostatistics (J.W.R.T.), and Department of Clinical Chemistry (C.E.T.), Amsterdam, the Netherlands
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4
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van Lierop ZY, Wieske L, Koel-Simmelink MJ, Chatterjee M, Dekker I, Leurs CE, Willemse EA, Moraal B, Barkhof F, Eftimov F, Uitdehaag BM, Killestein J, Teunissen CE. Serum contactin-1 as a biomarker of long-term disease progression in natalizumab-treated multiple sclerosis. Mult Scler 2021; 28:102-110. [PMID: 33890520 PMCID: PMC8689420 DOI: 10.1177/13524585211010097] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Natalizumab treatment provides a model for non-inflammation-induced disease progression in multiple sclerosis (MS). OBJECTIVE To study serum contactin-1 (sCNTN1) as a novel biomarker for disease progression in natalizumab-treated relapsing-remitting MS (RRMS) patients. METHODS Eighty-nine natalizumab-treated RRMS patients with minimum follow-up of 3 years were included. sCNTN1 was analyzed at baseline (before natalizumab initiation), 3, 12, 24 months (M) and last follow-up (median 5.2 years) and compared to 222 healthy controls (HC) and 15 primary progressive MS patients (PPMS). Results were compared between patients with progressive, stable, or improved disability according to EDSS-plus criteria. RESULTS Median sCNTN1 levels (ng/mL,) in RRMS (baseline: 10.7, 3M: 9.7, 12M: 10.4, 24M: 10.8; last follow-up: 9.7) were significantly lower compared to HC (12.5; p ⩽ 0.001). It was observed that 48% of patients showed progression during follow-up, 11% improved, and 40% remained stable. sCNTN1 levels were significantly lower in progressors both at baseline and at 12M compared to non-progressors. A 1 ng/mL decrease in baseline sCNTN1 was consistent with an odds ratio of 1.23 (95% confidence interval 1.04-1.45) (p = 0.017) for progression during follow-up. CONCLUSION Lower baseline sCNTN1 concentrations were associated with long-term disability progression during natalizumab treatment, making it a possible blood-based prognostic biomarker for RRMS.
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Affiliation(s)
- Zoë Ygj van Lierop
- Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Luuk Wieske
- Department of Neurology and Neurophysiology, Amsterdam UMC, Academisch Medisch Centrum, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Marleen Ja Koel-Simmelink
- Department of Clinical Chemistry, Amsterdam UMC, Vrije Universiteit Amsterdam, Neurochemistry Laboratory and Biobank, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Madhurima Chatterjee
- Department of Clinical Chemistry, Amsterdam UMC, Vrije Universiteit Amsterdam, Neurochemistry Laboratory and Biobank, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Iris Dekker
- Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands/Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Cyra E Leurs
- Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Eline Aj Willemse
- Department of Clinical Chemistry, Amsterdam UMC, Vrije Universiteit Amsterdam, Neurochemistry Laboratory and Biobank, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Bastiaan Moraal
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands/Institutes of Neurology and Healthcare Engineering, University College London, London, UK
| | - Filip Eftimov
- Department of Neurology and Neurophysiology, Amsterdam UMC, Academisch Medisch Centrum, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Bernhard Mj Uitdehaag
- Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Joep Killestein
- Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Department of Clinical Chemistry, Amsterdam UMC, Vrije Universiteit Amsterdam, Neurochemistry Laboratory and Biobank, Amsterdam Neuroscience, Amsterdam, The Netherlands
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5
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Sol N, Leurs CE, Veld SGI', Strijbis EM, Vancura A, Schweiger MW, Teunissen CE, Mateen FJ, Tannous BA, Best MG, Würdinger T, Killestein J. Blood platelet RNA enables the detection of multiple sclerosis. Mult Scler J Exp Transl Clin 2020; 6:2055217320946784. [PMID: 32843989 PMCID: PMC7418262 DOI: 10.1177/2055217320946784] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/05/2020] [Accepted: 07/13/2020] [Indexed: 12/15/2022] Open
Abstract
Background In multiple sclerosis (MS), clinical assessment, MRI and cerebrospinal fluid are important in the diagnostic process. However, no blood biomarker has been confirmed as a useful tool in the diagnostic work-up. Objectives Blood platelets contain a rich spliced mRNA repertoire that can alter during megakaryocyte development but also during platelet formation and platelet circulation. In this proof of concept study, we evaluate the diagnostic potential of spliced blood platelet RNA for the detection of MS. Methods We isolated and sequenced platelet RNA of blood samples obtained from 57 MS patients and 66 age- and gender-matched healthy controls (HCs). 60% was used to develop a particle swarm-optimized (PSO) support vector machine classification algorithm. The remaining 40% served as an independent validation series. Results In total, 1249 RNAs with differential spliced junction expression levels were identified between platelets of MS patients as compared to HCs, including EPSTI1, IFI6, and RPS6KA3, in line with reported inflammatory signatures in the blood of MS patients. The RNAs were subsequently used as input for a MS classifier, capable of detecting MS with 80% accuracy in the independent validation series. Conclusions Spliced platelet RNA may enable the blood-based diagnosis of MS, warranting large-scale validation.
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Affiliation(s)
- Nik Sol
- Department of Neurology, Neuroscience Amsterdam, VUmc MS Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands.,Brain Tumor Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Cyra E Leurs
- Department of Neurology, Neuroscience Amsterdam, VUmc MS Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands
| | - Sjors Gjg In 't Veld
- Brain Tumor Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands.,Department of Neurosurgery, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Eva M Strijbis
- Department of Neurology, Neuroscience Amsterdam, VUmc MS Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands
| | - Adrienne Vancura
- Brain Tumor Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands.,Department of Neurosurgery, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Markus W Schweiger
- Brain Tumor Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands.,Department of Neurosurgery, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands.,Department of Neurology, Massachusetts General Hospital Harvard Medical School, Boston, MA, USA
| | - Charlotte E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands
| | - Farrah J Mateen
- Department of Neurology, Massachusetts General Hospital Harvard Medical School, Boston, MA, USA
| | - Bakhos A Tannous
- Department of Neurology, Massachusetts General Hospital Harvard Medical School, Boston, MA, USA
| | - Myron G Best
- Brain Tumor Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands.,Department of Neurosurgery, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands.,Department of Pathology, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Thomas Würdinger
- Brain Tumor Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands.,Department of Neurosurgery, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Joep Killestein
- Department of Neurology, Neuroscience Amsterdam, VUmc MS Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands
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6
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Eshaghi A, Marinescu RV, Young AL, Firth NC, Prados F, Jorge Cardoso M, Tur C, De Angelis F, Cawley N, Brownlee WJ, De Stefano N, Laura Stromillo M, Battaglini M, Ruggieri S, Gasperini C, Filippi M, Rocca MA, Rovira A, Sastre-Garriga J, Geurts JJG, Vrenken H, Wottschel V, Leurs CE, Uitdehaag B, Pirpamer L, Enzinger C, Ourselin S, Gandini Wheeler-Kingshott CA, Chard D, Thompson AJ, Barkhof F, Alexander DC, Ciccarelli O. Progression of regional grey matter atrophy in multiple sclerosis. Brain 2019; 141:1665-1677. [PMID: 29741648 PMCID: PMC5995197 DOI: 10.1093/brain/awy088] [Citation(s) in RCA: 223] [Impact Index Per Article: 44.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 02/09/2018] [Indexed: 12/15/2022] Open
Abstract
See Stankoff and Louapre (doi:10.1093/brain/awy114) for a scientific commentary on this article. Grey matter atrophy is present from the earliest stages of multiple sclerosis, but its temporal ordering is poorly understood. We aimed to determine the sequence in which grey matter regions become atrophic in multiple sclerosis and its association with disability accumulation. In this longitudinal study, we included 1417 subjects: 253 with clinically isolated syndrome, 708 with relapsing-remitting multiple sclerosis, 128 with secondary-progressive multiple sclerosis, 125 with primary-progressive multiple sclerosis, and 203 healthy control subjects from seven European centres. Subjects underwent repeated MRI (total number of scans 3604); the mean follow-up for patients was 2.41 years (standard deviation = 1.97). Disability was scored using the Expanded Disability Status Scale. We calculated the volume of brain grey matter regions and brainstem using an unbiased within-subject template and used an established data-driven event-based model to determine the sequence of occurrence of atrophy and its uncertainty. We assigned each subject to a specific event-based model stage, based on the number of their atrophic regions. Linear mixed-effects models were used to explore associations between the rate of increase in event-based model stages, and T2 lesion load, disease-modifying treatments, comorbidity, disease duration and disability accumulation. The first regions to become atrophic in patients with clinically isolated syndrome and relapse-onset multiple sclerosis were the posterior cingulate cortex and precuneus, followed by the middle cingulate cortex, brainstem and thalamus. A similar sequence of atrophy was detected in primary-progressive multiple sclerosis with the involvement of the thalamus, cuneus, precuneus, and pallidum, followed by the brainstem and posterior cingulate cortex. The cerebellum, caudate and putamen showed early atrophy in relapse-onset multiple sclerosis and late atrophy in primary-progressive multiple sclerosis. Patients with secondary-progressive multiple sclerosis showed the highest event-based model stage (the highest number of atrophic regions, P < 0.001) at the study entry. All multiple sclerosis phenotypes, but clinically isolated syndrome, showed a faster rate of increase in the event-based model stage than healthy controls. T2 lesion load and disease duration in all patients were associated with increased event-based model stage, but no effects of disease-modifying treatments and comorbidity on event-based model stage were observed. The annualized rate of event-based model stage was associated with the disability accumulation in relapsing-remitting multiple sclerosis, independent of disease duration (P < 0.0001). The data-driven staging of atrophy progression in a large multiple sclerosis sample demonstrates that grey matter atrophy spreads to involve more regions over time. The sequence in which regions become atrophic is reasonably consistent across multiple sclerosis phenotypes. The spread of atrophy was associated with disease duration and with disability accumulation over time in relapsing-remitting multiple sclerosis.
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Affiliation(s)
- Arman Eshaghi
- Queen Square Multiple Sclerosis Centre, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.,Centre for Medical Image Computing (CMIC), Department of Computer Science, University College London, UK
| | - Razvan V Marinescu
- Centre for Medical Image Computing (CMIC), Department of Computer Science, University College London, UK
| | - Alexandra L Young
- Centre for Medical Image Computing (CMIC), Department of Computer Science, University College London, UK
| | - Nicholas C Firth
- Centre for Medical Image Computing (CMIC), Department of Computer Science, University College London, UK
| | - Ferran Prados
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), Department of Medical Physics and Bioengineering, University College London, London, UK
| | - M Jorge Cardoso
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), Department of Medical Physics and Bioengineering, University College London, London, UK
| | - Carmen Tur
- Queen Square Multiple Sclerosis Centre, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Floriana De Angelis
- Queen Square Multiple Sclerosis Centre, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Niamh Cawley
- Queen Square Multiple Sclerosis Centre, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Wallace J Brownlee
- Queen Square Multiple Sclerosis Centre, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Nicola De Stefano
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - M Laura Stromillo
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Marco Battaglini
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Serena Ruggieri
- Department of Neurosciences, S Camillo Forlanini Hospital, Rome, Italy.,Department of Neurology and Psychiatry, University of Rome Sapienza, Rome, Italy
| | - Claudio Gasperini
- Department of Neurosciences, S Camillo Forlanini Hospital, Rome, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Alex Rovira
- MR Unit and Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jaume Sastre-Garriga
- Department of Neurology/Neuroimmunology, Multiple Sclerosis Centre of Catalonia (CEMCAT), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jeroen J G Geurts
- Department of Anatomy and Neurosciences, VUmc MS Center, Neuroscience Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Hugo Vrenken
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam, The Netherlands
| | - Viktor Wottschel
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam, The Netherlands
| | - Cyra E Leurs
- Department of Neurology, MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Bernard Uitdehaag
- Department of Neurology, MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Lukas Pirpamer
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Christian Enzinger
- Department of Neurology, Medical University of Graz, Graz, Austria.,Division of Neuroradiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Sebastien Ourselin
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), Department of Medical Physics and Bioengineering, University College London, London, UK.,National Institute for Health Research (NIHR), University College London Hospitals (UCLH) Biomedical Research Centre (BRC), London, UK
| | - Claudia A Gandini Wheeler-Kingshott
- Queen Square Multiple Sclerosis Centre, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Brain MRI 3T Research Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - Declan Chard
- Queen Square Multiple Sclerosis Centre, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.,National Institute for Health Research (NIHR), University College London Hospitals (UCLH) Biomedical Research Centre (BRC), London, UK
| | - Alan J Thompson
- Queen Square Multiple Sclerosis Centre, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Frederik Barkhof
- Queen Square Multiple Sclerosis Centre, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.,Translational Imaging Group, Centre for Medical Image Computing (CMIC), Department of Medical Physics and Bioengineering, University College London, London, UK.,National Institute for Health Research (NIHR), University College London Hospitals (UCLH) Biomedical Research Centre (BRC), London, UK.,Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam, The Netherlands
| | - Daniel C Alexander
- Centre for Medical Image Computing (CMIC), Department of Computer Science, University College London, UK
| | - Olga Ciccarelli
- Queen Square Multiple Sclerosis Centre, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.,National Institute for Health Research (NIHR), University College London Hospitals (UCLH) Biomedical Research Centre (BRC), London, UK
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Leurs CE, Twaalfhoven H, Lissenberg-Witte BI, van Pesch V, Dujmovic I, Drulovic J, Castellazzi M, Bellini T, Pugliatti M, Kuhle J, Villar LM, Alvarez-Cermeño JC, Alvarez-Lafuente R, Hegen H, Deisenhammer F, Walchhofer LM, Thouvenot E, Comabella M, Montalban X, Vécsei L, Rajda C, Galimberti D, Scarpini E, Altintas A, Rejdak K, Frederiksen JL, Pihl-Jensen G, Jensen P, Khalil M, Voortman MM, Fazekas F, Saiz A, La Puma D, Vercammen M, Vanopdenbosch L, Uitdehaag B, Killestein J, Bridel C, Teunissen C. Kappa free light chains is a valid tool in the diagnostics of MS: A large multicenter study. Mult Scler 2019; 26:912-923. [PMID: 31066634 PMCID: PMC7350201 DOI: 10.1177/1352458519845844] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To validate kappa free light chain (KFLC) and lambda free light chain (LFLC) indices as a diagnostic biomarker in multiple sclerosis (MS). METHODS We performed a multicenter study including 745 patients from 18 centers (219 controls and 526 clinically isolated syndrome (CIS)/MS patients) with a known oligoclonal IgG band (OCB) status. KFLC and LFLC were measured in paired cerebrospinal fluid (CSF) and serum samples. Gaussian mixture modeling was used to define a cut-off for KFLC and LFLC indexes. RESULTS The cut-off for the KFLC index was 6.6 (95% confidence interval (CI) = 5.2-138.1). The cut-off for the LFLC index was 6.9 (95% CI = 4.5-22.2). For CIS/MS patients, sensitivity of the KFLC index (0.88; 95% CI = 0.85-0.90) was higher than OCB (0.82; 95%CI = 0.79-0.85; p < 0.001), but specificity (0.83; 95% CI = 0.78-0.88) was lower (OCB = 0.92; 95% CI = 0.89-0.96; p < 0.001). Both sensitivity and specificity for the LFLC index were lower than OCB. CONCLUSION Compared with OCB, the KFLC index is more sensitive but less specific for diagnosing CIS/MS. Lacking an elevated KFLC index is more powerful for excluding MS compared with OCB but the latter is more important for ruling in a diagnosis of CIS/MS.
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Affiliation(s)
- C E Leurs
- Department of Neurology, MS Center Amsterdam, VU University Medical Center, De Boelelaan 1118, Amsterdam 1081 HZ, The Netherlands
| | - Ham Twaalfhoven
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - B I Lissenberg-Witte
- Department of Epidemiology and Biostatistics, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - V van Pesch
- Department of Neurology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Sint-Lambrechts-Woluwe, Belgium
| | - I Dujmovic
- Clinic of Neurology, Clinical Centre of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - J Drulovic
- Clinic of Neurology, Clinical Centre of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - M Castellazzi
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - T Bellini
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - M Pugliatti
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - J Kuhle
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - L M Villar
- Department of Immunology, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain/ Red Española de Esclerosis Múltiple (REEM), Madrid, Spain
| | - J C Alvarez-Cermeño
- Red Española de Esclerosis Múltiple (REEM), Madrid, Spain/Department of Neurology, Hospital Ramón y Cajal, IRYICIS, Madrid, Spain
| | - R Alvarez-Lafuente
- Red Española de Esclerosis Múltiple (REEM), Madrid, Spain/Grupo de Investigación de Esclerosis Múltiple, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - H Hegen
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - F Deisenhammer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - L M Walchhofer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - E Thouvenot
- Department of Neurology, CHU Nîmes, Hôpital Caremeau, Nîmes, France/Institut de Génomique Fonctionnelle, UMR5203, Université Montpellier, Montpellier, France
| | - M Comabella
- Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - X Montalban
- Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - L Vécsei
- Department of Neurology, University of Szeged, Szeged, Hungary/MTA-SZTE Neuroscience Research Group, Szeged, Hungary
| | - C Rajda
- Department of Neurology, University of Szeged, Szeged, Hungary
| | - D Galimberti
- Multiple Sclerosis Centre, University of Milan, Dino Ferrari Centre, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - E Scarpini
- Multiple Sclerosis Centre, University of Milan, Dino Ferrari Centre, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - A Altintas
- Koc University, School of Medicine, Neurology Department, Istanbul, Turkey
| | - K Rejdak
- Department of Neurology, Medical University of Lublin, Lublin, Poland
| | - J L Frederiksen
- Department of Neurology, Rigshospitalet Glostrup and University of Copenhagen, Copenhagen, Denmark
| | - G Pihl-Jensen
- Department of Neurology, Rigshospitalet Glostrup and University of Copenhagen, Copenhagen, Denmark
| | - Peh Jensen
- Danish Multiple Sclerosis Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - M Khalil
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - M M Voortman
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - F Fazekas
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - A Saiz
- Center of Neuroimmunology, Service of Neurology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - D La Puma
- Center of Neuroimmunology, Service of Neurology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - M Vercammen
- Department of Laboratory Medicine, AZ Sint-Jan Brugge-Oostende, Brugge, Belgium
| | - L Vanopdenbosch
- Department of Neurology, AZ Sint-Jan Brugge-Oostende, Brugge, Belgium
| | - Bmj Uitdehaag
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - J Killestein
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - C Bridel
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - C Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
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8
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Bridel C, Eijlers AJC, van Wieringen WN, Koel-Simmelink M, Leurs CE, Schoonheim MM, Killestein J, Teunissen CE. No Plasmatic Proteomic Signature at Clinical Disease Onset Associated With 11 Year Clinical, Cognitive and MRI Outcomes in Relapsing-Remitting Multiple Sclerosis Patients. Front Mol Neurosci 2018; 11:371. [PMID: 30429773 PMCID: PMC6220078 DOI: 10.3389/fnmol.2018.00371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 09/18/2018] [Indexed: 01/06/2023] Open
Abstract
Background: The clinical course of relapsing-remitting multiple sclerosis (RRMS) is highly heterogeneous and prognostic biomarkers at time of diagnosis are lacking. Objective: We investigated the predictive value of the plasma proteome at time of diagnosis in RRMS patients. Methods: The plasma proteome was interrogated using a novel aptamer-based proteomics platform, which allows to measure the levels of a predefined set of 1310 proteins. Results: In 67 clinically and radiologically well characterized RRMS patients, we found no association between the plasma proteome at diagnosis and clinical, cognitive or MRI outcomes after 11 years. Conclusions: Proteomics studies on cerebrospinal fluid may be better suited to identify prognostic biomarkers in early RRMS.
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Affiliation(s)
- Claire Bridel
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands
| | - Anand J C Eijlers
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands
| | - Wessel N van Wieringen
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands and Department of Mathematics, VU University, Amsterdam, Netherlands
| | - Marleen Koel-Simmelink
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands
| | - Cyra E Leurs
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands
| | - Menno M Schoonheim
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands
| | - Joep Killestein
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands
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9
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van Geest Q, Douw L, van 't Klooster S, Leurs CE, Genova HM, Wylie GR, Steenwijk MD, Killestein J, Geurts JJG, Hulst HE. Information processing speed in multiple sclerosis: Relevance of default mode network dynamics. Neuroimage Clin 2018; 19:507-515. [PMID: 29984159 PMCID: PMC6030565 DOI: 10.1016/j.nicl.2018.05.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 04/30/2018] [Accepted: 05/13/2018] [Indexed: 11/19/2022]
Abstract
Objective To explore the added value of dynamic functional connectivity (dFC) of the default mode network (DMN) during resting-state (RS), during an information processing speed (IPS) task, and the within-subject difference between these conditions, on top of conventional brain measures in explaining IPS in people with multiple sclerosis (pwMS). Methods In 29 pwMS and 18 healthy controls, IPS was assessed with the Letter Digit Substitution Test and Stroop Card I and combined into an IPS-composite score. White matter (WM), grey matter (GM) and lesion volume were measured using 3 T MRI. WM integrity was assessed with diffusion tensor imaging. During RS and task-state fMRI (i.e. symbol digit modalities task, IPS), stationary functional connectivity (sFC; average connectivity over the entire time series) and dFC (variation in connectivity using a sliding window approach) of the DMN was calculated, as well as the difference between both conditions (i.e. task-state minus RS; ΔsFC-DMN and ΔdFC-DMN). Regression analysis was performed to determine the most important predictors for IPS. Results Compared to controls, pwMS performed worse on IPS-composite (p = 0.022), had lower GM volume (p < 0.05) and WM integrity (p < 0.001), but no alterations in sFC and dFC at the group level. In pwMS, 52% of variance in IPS-composite could be predicted by cortical volume (β = 0.49, p = 0.01) and ΔdFC-DMN (β = 0.52, p < 0.01). After adding dFC of the DMN to the model, the explained variance in IPS increased with 26% (p < 0.01). Conclusion On top of conventional brain measures, dFC from RS to task-state explains additional variance in IPS. This highlights the potential importance of the DMN to adapt upon cognitive demands to maintain intact IPS in pwMS. Problems with information processing speed occur often in multiple sclerosis (MS) Dynamics in brain communication can reflect information transfer within the brain With fMRI, dynamic communication can be measured, which increases upon task demands This increase in dynamics explains information processing speed in MS
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Affiliation(s)
- Q van Geest
- Department of Anatomy & Neurosciences, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
| | - L Douw
- Department of Anatomy & Neurosciences, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands; Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - S van 't Klooster
- Department of Anatomy & Neurosciences, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - C E Leurs
- Department of Neurology, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - H M Genova
- Neuropsychology and Neuroscience Laboratory, Kessler Foundation, West Orange, NJ, USA; Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - G R Wylie
- Neuropsychology and Neuroscience Laboratory, Kessler Foundation, West Orange, NJ, USA; Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - M D Steenwijk
- Department of Anatomy & Neurosciences, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - J Killestein
- Department of Neurology, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - J J G Geurts
- Department of Anatomy & Neurosciences, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - H E Hulst
- Department of Anatomy & Neurosciences, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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10
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Eshaghi A, Prados F, Brownlee WJ, Altmann DR, Tur C, Cardoso MJ, De Angelis F, van de Pavert SH, Cawley N, De Stefano N, Stromillo ML, Battaglini M, Ruggieri S, Gasperini C, Filippi M, Rocca MA, Rovira A, Sastre‐Garriga J, Vrenken H, Leurs CE, Killestein J, Pirpamer L, Enzinger C, Ourselin S, Wheeler‐Kingshott CAG, Chard D, Thompson AJ, Alexander DC, Barkhof F, Ciccarelli O. Deep gray matter volume loss drives disability worsening in multiple sclerosis. Ann Neurol 2018; 83:210-222. [PMID: 29331092 PMCID: PMC5838522 DOI: 10.1002/ana.25145] [Citation(s) in RCA: 253] [Impact Index Per Article: 42.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 10/09/2017] [Accepted: 10/10/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Gray matter (GM) atrophy occurs in all multiple sclerosis (MS) phenotypes. We investigated whether there is a spatiotemporal pattern of GM atrophy that is associated with faster disability accumulation in MS. METHODS We analyzed 3,604 brain high-resolution T1-weighted magnetic resonance imaging scans from 1,417 participants: 1,214 MS patients (253 clinically isolated syndrome [CIS], 708 relapsing-remitting [RRMS], 128 secondary-progressive [SPMS], and 125 primary-progressive [PPMS]), over an average follow-up of 2.41 years (standard deviation [SD] = 1.97), and 203 healthy controls (HCs; average follow-up = 1.83 year; SD = 1.77), attending seven European centers. Disability was assessed with the Expanded Disability Status Scale (EDSS). We obtained volumes of the deep GM (DGM), temporal, frontal, parietal, occipital and cerebellar GM, brainstem, and cerebral white matter. Hierarchical mixed models assessed annual percentage rate of regional tissue loss and identified regional volumes associated with time-to-EDSS progression. RESULTS SPMS showed the lowest baseline volumes of cortical GM and DGM. Of all baseline regional volumes, only that of the DGM predicted time-to-EDSS progression (hazard ratio = 0.73; 95% confidence interval, 0.65, 0.82; p < 0.001): for every standard deviation decrease in baseline DGM volume, the risk of presenting a shorter time to EDSS worsening during follow-up increased by 27%. Of all longitudinal measures, DGM showed the fastest annual rate of atrophy, which was faster in SPMS (-1.45%), PPMS (-1.66%), and RRMS (-1.34%) than CIS (-0.88%) and HCs (-0.94%; p < 0.01). The rate of temporal GM atrophy in SPMS (-1.21%) was significantly faster than RRMS (-0.76%), CIS (-0.75%), and HCs (-0.51%). Similarly, the rate of parietal GM atrophy in SPMS (-1.24-%) was faster than CIS (-0.63%) and HCs (-0.23%; all p values <0.05). Only the atrophy rate in DGM in patients was significantly associated with disability accumulation (beta = 0.04; p < 0.001). INTERPRETATION This large, multicenter and longitudinal study shows that DGM volume loss drives disability accumulation in MS, and that temporal cortical GM shows accelerated atrophy in SPMS than RRMS. The difference in regional GM atrophy development between phenotypes needs to be taken into account when evaluating treatment effect of therapeutic interventions. Ann Neurol 2018;83:210-222.
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Affiliation(s)
- Arman Eshaghi
- Queen Square Multiple Sclerosis Centre, UCL Institute of NeurologyFaculty of Brain SciencesUniversity College London
- Centre for Medical Image Computing (CMIC), Department of Computer ScienceUniversity College LondonLondonUnited Kingdom
| | - Ferran Prados
- Queen Square Multiple Sclerosis Centre, UCL Institute of NeurologyFaculty of Brain SciencesUniversity College London
- Centre for Medical Image Computing (CMIC), Department of Computer ScienceUniversity College LondonLondonUnited Kingdom
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), Department of Medical Physics and BioengineeringUniversity College LondonLondonUnited Kingdom
- National Institute for Health Research (NIHR)University College London Hospitals (UCLH) Biomedical Research Centre (BRC)LondonUnited Kingdom
| | - Wallace J. Brownlee
- Queen Square Multiple Sclerosis Centre, UCL Institute of NeurologyFaculty of Brain SciencesUniversity College London
| | - Daniel R. Altmann
- Queen Square Multiple Sclerosis Centre, UCL Institute of NeurologyFaculty of Brain SciencesUniversity College London
- Medical Statistics DepartmentLondon School of Hygiene & Tropical MedicineLondonUnited Kingdom
| | - Carmen Tur
- Queen Square Multiple Sclerosis Centre, UCL Institute of NeurologyFaculty of Brain SciencesUniversity College London
| | - M. Jorge Cardoso
- Centre for Medical Image Computing (CMIC), Department of Computer ScienceUniversity College LondonLondonUnited Kingdom
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), Department of Medical Physics and BioengineeringUniversity College LondonLondonUnited Kingdom
| | - Floriana De Angelis
- Queen Square Multiple Sclerosis Centre, UCL Institute of NeurologyFaculty of Brain SciencesUniversity College London
| | - Steven H. van de Pavert
- Queen Square Multiple Sclerosis Centre, UCL Institute of NeurologyFaculty of Brain SciencesUniversity College London
| | - Niamh Cawley
- Queen Square Multiple Sclerosis Centre, UCL Institute of NeurologyFaculty of Brain SciencesUniversity College London
| | - Nicola De Stefano
- Department of Medicine, Surgery and NeuroscienceUniversity of SienaSienaItaly
| | - M. Laura Stromillo
- Department of Medicine, Surgery and NeuroscienceUniversity of SienaSienaItaly
| | - Marco Battaglini
- Department of Medicine, Surgery and NeuroscienceUniversity of SienaSienaItaly
| | - Serena Ruggieri
- Department of NeurosciencesS Camillo Forlanini HospitalRomeItaly
- Department of Neurology and PsychiatryUniversity of Rome SapienzaRomeItaly
| | | | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental NeurologyDivision of Neuroscience, San Raffaele Scientific Institute, Vita‐Salute San Raffaele UniversityMilanItaly
| | - Maria A. Rocca
- Neuroimaging Research Unit, Institute of Experimental NeurologyDivision of Neuroscience, San Raffaele Scientific Institute, Vita‐Salute San Raffaele UniversityMilanItaly
| | - Alex Rovira
- MR Unit and Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'HebronUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - Jaume Sastre‐Garriga
- Department of Neurology/Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'HebronUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - Hugo Vrenken
- Department of Radiology and Nuclear MedicineVU University Medical CentreAmsterdamThe Netherlands
| | - Cyra E. Leurs
- Department of Neurology, MS Center AmsterdamVU University Medical CenterAmsterdamThe Netherlands
| | - Joep Killestein
- Department of Neurology, MS Center AmsterdamVU University Medical CenterAmsterdamThe Netherlands
| | - Lukas Pirpamer
- Department of NeurologyMedical University of GrazGrazAustria
| | - Christian Enzinger
- Department of NeurologyMedical University of GrazGrazAustria
- Division of Neuroradiology, Vascular & Interventional Radiology, Department of RadiologyMedical University of GrazGrazAustria
| | - Sebastien Ourselin
- Centre for Medical Image Computing (CMIC), Department of Computer ScienceUniversity College LondonLondonUnited Kingdom
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), Department of Medical Physics and BioengineeringUniversity College LondonLondonUnited Kingdom
- National Institute for Health Research (NIHR)University College London Hospitals (UCLH) Biomedical Research Centre (BRC)LondonUnited Kingdom
| | - Claudia A.M. Gandini Wheeler‐Kingshott
- Queen Square Multiple Sclerosis Centre, UCL Institute of NeurologyFaculty of Brain SciencesUniversity College London
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
- Brain MRI 3T Mondino Research CenterC. Mondino National Neurological InstitutePaviaItaly
| | - Declan Chard
- Queen Square Multiple Sclerosis Centre, UCL Institute of NeurologyFaculty of Brain SciencesUniversity College London
- National Institute for Health Research (NIHR)University College London Hospitals (UCLH) Biomedical Research Centre (BRC)LondonUnited Kingdom
| | - Alan J. Thompson
- Queen Square Multiple Sclerosis Centre, UCL Institute of NeurologyFaculty of Brain SciencesUniversity College London
| | - Daniel C. Alexander
- Centre for Medical Image Computing (CMIC), Department of Computer ScienceUniversity College LondonLondonUnited Kingdom
| | - Frederik Barkhof
- Queen Square Multiple Sclerosis Centre, UCL Institute of NeurologyFaculty of Brain SciencesUniversity College London
- Centre for Medical Image Computing (CMIC), Department of Computer ScienceUniversity College LondonLondonUnited Kingdom
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), Department of Medical Physics and BioengineeringUniversity College LondonLondonUnited Kingdom
- National Institute for Health Research (NIHR)University College London Hospitals (UCLH) Biomedical Research Centre (BRC)LondonUnited Kingdom
- Department of Radiology and Nuclear MedicineVU University Medical CentreAmsterdamThe Netherlands
| | - Olga Ciccarelli
- Queen Square Multiple Sclerosis Centre, UCL Institute of NeurologyFaculty of Brain SciencesUniversity College London
- National Institute for Health Research (NIHR)University College London Hospitals (UCLH) Biomedical Research Centre (BRC)LondonUnited Kingdom
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11
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Kleerekooper I, van Kempen ZLE, Leurs CE, Dekker I, Rispens T, Lissenberg-Witte BI, van Munster CEP, de Jong BA, van Oosten BW, Uitdehaag BMJ, Wattjes MP, Killestein J. Disease activity following pregnancy-related discontinuation of natalizumab in MS. Neurol Neuroimmunol Neuroinflamm 2017; 5:e424. [PMID: 29379823 PMCID: PMC5778770 DOI: 10.1212/nxi.0000000000000424] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 10/19/2017] [Indexed: 11/22/2022]
Abstract
Objective: To investigate disease activity and disability progression following pregnancy-related discontinuation of natalizumab (NTZ) in patients with relapsing-remitting MS. Methods: A retrospective cohort study of clinical and radiologic data in patients who discontinued NTZ for pregnancy-related reasons. Results: Twenty-two pregnancy-related NTZ discontinuations in 17 patients were evaluated. The median time to conception was 3.4 months. Relapses were more frequent in patients in whom conception did not occur within 6 months (p = 0.022). Confirmed disability progression occurred in 27.3% and was associated with time to conception (p < 0.001). Conclusions: Early conception after NTZ discontinuation is associated with a reduced risk of disease activity and disability progression. Continuation of NTZ treatment until confirmed pregnancy should be considered in patients with previously active MS. However, the advantages of continuing the drug until pregnancy should be balanced against the uncertainties in postnatal outcomes.
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Affiliation(s)
- Iris Kleerekooper
- Department of Neurology (I.K., Z.L.E.v.K., C.E.L., I.D., C.E.P.v.M., B.A.d.J., B.W.v.O., B.M.J.U., J.K.), Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center; Department of Immunology (T.R.), Landsteiner Laboratory Sanquin Research, Amsterdam; Department of Epidemiology and Biostatistics (B.I.L.-W.), VU University Medical Center; and Department of Radiology & Nuclear Medicine (I.D., M.P.W.), VUmc MS Center, Amsterdam, The Netherlands
| | - Zoé L E van Kempen
- Department of Neurology (I.K., Z.L.E.v.K., C.E.L., I.D., C.E.P.v.M., B.A.d.J., B.W.v.O., B.M.J.U., J.K.), Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center; Department of Immunology (T.R.), Landsteiner Laboratory Sanquin Research, Amsterdam; Department of Epidemiology and Biostatistics (B.I.L.-W.), VU University Medical Center; and Department of Radiology & Nuclear Medicine (I.D., M.P.W.), VUmc MS Center, Amsterdam, The Netherlands
| | - Cyra E Leurs
- Department of Neurology (I.K., Z.L.E.v.K., C.E.L., I.D., C.E.P.v.M., B.A.d.J., B.W.v.O., B.M.J.U., J.K.), Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center; Department of Immunology (T.R.), Landsteiner Laboratory Sanquin Research, Amsterdam; Department of Epidemiology and Biostatistics (B.I.L.-W.), VU University Medical Center; and Department of Radiology & Nuclear Medicine (I.D., M.P.W.), VUmc MS Center, Amsterdam, The Netherlands
| | - Iris Dekker
- Department of Neurology (I.K., Z.L.E.v.K., C.E.L., I.D., C.E.P.v.M., B.A.d.J., B.W.v.O., B.M.J.U., J.K.), Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center; Department of Immunology (T.R.), Landsteiner Laboratory Sanquin Research, Amsterdam; Department of Epidemiology and Biostatistics (B.I.L.-W.), VU University Medical Center; and Department of Radiology & Nuclear Medicine (I.D., M.P.W.), VUmc MS Center, Amsterdam, The Netherlands
| | - Theo Rispens
- Department of Neurology (I.K., Z.L.E.v.K., C.E.L., I.D., C.E.P.v.M., B.A.d.J., B.W.v.O., B.M.J.U., J.K.), Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center; Department of Immunology (T.R.), Landsteiner Laboratory Sanquin Research, Amsterdam; Department of Epidemiology and Biostatistics (B.I.L.-W.), VU University Medical Center; and Department of Radiology & Nuclear Medicine (I.D., M.P.W.), VUmc MS Center, Amsterdam, The Netherlands
| | - Birgit I Lissenberg-Witte
- Department of Neurology (I.K., Z.L.E.v.K., C.E.L., I.D., C.E.P.v.M., B.A.d.J., B.W.v.O., B.M.J.U., J.K.), Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center; Department of Immunology (T.R.), Landsteiner Laboratory Sanquin Research, Amsterdam; Department of Epidemiology and Biostatistics (B.I.L.-W.), VU University Medical Center; and Department of Radiology & Nuclear Medicine (I.D., M.P.W.), VUmc MS Center, Amsterdam, The Netherlands
| | - Caspar E P van Munster
- Department of Neurology (I.K., Z.L.E.v.K., C.E.L., I.D., C.E.P.v.M., B.A.d.J., B.W.v.O., B.M.J.U., J.K.), Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center; Department of Immunology (T.R.), Landsteiner Laboratory Sanquin Research, Amsterdam; Department of Epidemiology and Biostatistics (B.I.L.-W.), VU University Medical Center; and Department of Radiology & Nuclear Medicine (I.D., M.P.W.), VUmc MS Center, Amsterdam, The Netherlands
| | - Brigit A de Jong
- Department of Neurology (I.K., Z.L.E.v.K., C.E.L., I.D., C.E.P.v.M., B.A.d.J., B.W.v.O., B.M.J.U., J.K.), Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center; Department of Immunology (T.R.), Landsteiner Laboratory Sanquin Research, Amsterdam; Department of Epidemiology and Biostatistics (B.I.L.-W.), VU University Medical Center; and Department of Radiology & Nuclear Medicine (I.D., M.P.W.), VUmc MS Center, Amsterdam, The Netherlands
| | - Bob W van Oosten
- Department of Neurology (I.K., Z.L.E.v.K., C.E.L., I.D., C.E.P.v.M., B.A.d.J., B.W.v.O., B.M.J.U., J.K.), Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center; Department of Immunology (T.R.), Landsteiner Laboratory Sanquin Research, Amsterdam; Department of Epidemiology and Biostatistics (B.I.L.-W.), VU University Medical Center; and Department of Radiology & Nuclear Medicine (I.D., M.P.W.), VUmc MS Center, Amsterdam, The Netherlands
| | - Bernard M J Uitdehaag
- Department of Neurology (I.K., Z.L.E.v.K., C.E.L., I.D., C.E.P.v.M., B.A.d.J., B.W.v.O., B.M.J.U., J.K.), Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center; Department of Immunology (T.R.), Landsteiner Laboratory Sanquin Research, Amsterdam; Department of Epidemiology and Biostatistics (B.I.L.-W.), VU University Medical Center; and Department of Radiology & Nuclear Medicine (I.D., M.P.W.), VUmc MS Center, Amsterdam, The Netherlands
| | - Mike P Wattjes
- Department of Neurology (I.K., Z.L.E.v.K., C.E.L., I.D., C.E.P.v.M., B.A.d.J., B.W.v.O., B.M.J.U., J.K.), Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center; Department of Immunology (T.R.), Landsteiner Laboratory Sanquin Research, Amsterdam; Department of Epidemiology and Biostatistics (B.I.L.-W.), VU University Medical Center; and Department of Radiology & Nuclear Medicine (I.D., M.P.W.), VUmc MS Center, Amsterdam, The Netherlands
| | - Joep Killestein
- Department of Neurology (I.K., Z.L.E.v.K., C.E.L., I.D., C.E.P.v.M., B.A.d.J., B.W.v.O., B.M.J.U., J.K.), Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center; Department of Immunology (T.R.), Landsteiner Laboratory Sanquin Research, Amsterdam; Department of Epidemiology and Biostatistics (B.I.L.-W.), VU University Medical Center; and Department of Radiology & Nuclear Medicine (I.D., M.P.W.), VUmc MS Center, Amsterdam, The Netherlands
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12
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Leurs CE, van Kempen ZLE, Dekker I, Balk LJ, Wattjes MP, Rispens T, Uitdehaag BM, Killestein J. Switching natalizumab to fingolimod within 6 weeks reduces recurrence of disease activity in MS patients. Mult Scler 2017; 24:1453-1460. [PMID: 28823223 PMCID: PMC6174622 DOI: 10.1177/1352458517726381] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Natalizumab is an effective treatment in relapsing-remitting multiple sclerosis (MS). Mainly because of the risk of progressive multifocal leukoencephalopathy (PML), a substantial proportion of John Cunningham (JC) virus-positive patients switch to fingolimod. Previous reports show a clear benefit when the duration of a washout (WO) period of natalizumab is 0-3 months in comparison to longer WO periods. However, there is no consensus regarding the optimal duration of a WO period under 3 months. OBJECTIVE We compared MS disease activity after different WO periods. In addition, we investigated several factors that possibly influence recurrence of disease activity, including serum natalizumab concentration and lymphocyte counts. METHODS From a prospective observational cohort study of natalizumab-treated patients, we selected 52 patients who switched to fingolimod. We divided the patients in three groups (<6 weeks, 6-8 weeks, >8 weeks WO). Serum natalizumab concentration and lymphocyte count were assessed during and after natalizumab treatment. RESULTS Patients with a WO period of >8 weeks had a significant higher recurrence of disease activity (odds ratio, 6.8; 95% confidence interval, 1.4-32.8) compared to patients with a WO period of <6 weeks. Serum natalizumab concentration and lymphocyte count did not predict recurrence of disease activity. INTERPRETATION A short WO period decreases the risk of recurrence of disease activity. The possible impact of a short WO period on the risk of carry-over PML in JC virus-positive patients remains uncertain.
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Affiliation(s)
- Cyra E Leurs
- Department of Neurology, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Zoé LE van Kempen
- Department of Neurology, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Iris Dekker
- Department of Neurology, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands / Department of Radiology and Nuclear Medicine, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Lisanne J Balk
- Department of Neurology, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Mike P Wattjes
- Department of Radiology and Nuclear Medicine, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Theo Rispens
- Department of Immunology, Landsteiner Laboratory Sanquin Research, Amsterdam, The Netherlands
| | - Bernard Mj Uitdehaag
- Department of Neurology, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Joep Killestein
- Department of Neurology, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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13
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Killestein J, Leurs CE, Hoogervorst EL, van Eijk J, Mostert JP, van den Eertwegh AJ, Uitdehaag BM. Five cases of malignant melanoma during fingolimod treatment in Dutch patients with MS. Neurology 2017; 89:970-972. [DOI: 10.1212/wnl.0000000000004293] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 05/22/2017] [Indexed: 11/15/2022] Open
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14
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van Kempen ZLE, Leurs CE, de Vries A, Vennegoor A, Rispens T, Wattjes MP, Killestein J. John Cunningham virus conversion in relation to natalizumab concentration in multiple sclerosis patients. Eur J Neurol 2017; 24:1196-1199. [PMID: 28707781 DOI: 10.1111/ene.13355] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 06/01/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Infection with the John Cunningham virus (JCV) is required for the development of progressive multifocal leukoencephalopathy, the feared complication of natalizumab treatment in multiple sclerosis patients. The JCV seroconversion rate seems higher in natalizumab treated patients than in the normal population, with an unknown cause. METHODS Natalizumab concentration was correlated to JCV antibody status and seroconversion in a large cohort of multiple sclerosis patients. RESULTS One hundred and thirty-five patients were included. No correlation was found between natalizumab concentration and JCV status, JCV seroconversion or JCV index. CONCLUSIONS Higher natalizumab concentrations do not explain the increased JCV seroconversion rate in natalizumab treated patients.
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Affiliation(s)
- Z L E van Kempen
- Department of Neurology, Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - C E Leurs
- Department of Neurology, Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - A de Vries
- Biologicals Lab, Sanquin Diagnostic Services, Sanquin, Amsterdam, The Netherlands
| | - A Vennegoor
- Department of Neurology, Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - T Rispens
- Department of Immunology, Sanquin Research and Landsteiner Laboratory, Amsterdam, The Netherlands
| | - M P Wattjes
- Department of Radiology & Nuclear Medicine, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - J Killestein
- Department of Neurology, Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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15
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van Kempen ZLE, Leurs CE, Witte BI, de Vries A, Wattjes MP, Rispens T, Killestein J. The majority of natalizumab-treated MS patients have high natalizumab concentrations at time of re-dosing. Mult Scler 2017; 24:805-810. [PMID: 28485678 PMCID: PMC5971363 DOI: 10.1177/1352458517708464] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Natalizumab is efficacious in the treatment of relapsing-remitting multiple sclerosis. All patients receive the same treatment regimen of 300 mg every 4 weeks, despite differences in pharmacokinetics between individual patients. Objective: To give neurologists insight into natalizumab concentrations at time of re-dosing, we investigated longitudinal natalizumab concentrations in 80 patients in relation to disease activity, with possible influencing factors. Methods: In a prospective observational cohort study, natalizumab trough serum concentrations were measured in 80 patients. Data on demographics, duration of treatment, Expanded Disability Status Scale, clinical exacerbations, brain magnetic resonance imaging (MRI), and body weight were collected. Results: We measured high (≥10 µg/mL) natalizumab trough concentrations in 94% of patients. Intra-individual concentrations were stable. The spread in concentrations was substantial and did not correlate with disease activity. We found a negative association between natalizumab concentration and body weight (β = −0.30, p = 0.010). Interpretation: The majority of patients showed high natalizumab serum concentrations at time of re-dosing. Alternative treatment regimens could lead to more efficient use of natalizumab, but caution is warranted regarding the possibility of recurrence of disease activity. Prospective clinical trials are needed to establish the safety of extended dose intervals in natalizumab treatment.
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Affiliation(s)
- Zoé LE van Kempen
- Department of Neurology, Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Cyra E Leurs
- Department of Neurology, Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Birgit I Witte
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Annick de Vries
- Biologicals Lab, Sanquin Diagnostic Services, Sanquin, Amsterdam, The Netherlands
| | - Mike P Wattjes
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Theo Rispens
- Department of Immunology, Sanquin Research and Landsteiner Laboratory, Amsterdam, The Netherlands
| | - Joep Killestein
- Department of Neurology, Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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16
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Leurs CE, Podlesniy P, Trullas R, Balk L, Steenwijk MD, Malekzadeh A, Piehl F, Uitdehaag BM, Killestein J, van Horssen J, Teunissen CE. Cerebrospinal fluid mtDNA concentration is elevated in multiple sclerosis disease and responds to treatment. Mult Scler 2017; 24:472-480. [PMID: 28294696 PMCID: PMC5987988 DOI: 10.1177/1352458517699874] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Mitochondrial dysfunction is increasingly recognized as an important feature of multiple sclerosis (MS) pathology and may be relevant for clinical disease progression. However, it is unknown whether mitochondrial DNA (mtDNA) levels in the cerebrospinal fluid (CSF) associate with disease progression and therapeutic response. OBJECTIVES To evaluate whether CSF concentrations of mtDNA in MS patients can serve as a marker of ongoing neuropathology and may be helpful to differentiate between MS disease subtypes. To explore the effect of disease-modifying therapies on mtDNA levels in the CSF. METHODS CSF mtDNA was measured using a digital polymerase chain reaction (PCR) CSF mtDNA in two independent MS cohorts. The cohorts included 92 relapsing-remitting multiple sclerosis (RRMS) patients, 40 progressive multiple sclerosis (PMS) patients (27 secondary progressive and 13 primary progressive), 50 various neurologic disease controls, and 5 healthy controls. RESULTS Patients with PMS showed a significant increase in CSF mtDNA compared to non-inflammatory neurologic disease controls. Patients with higher T2 lesion volumes and lower normalized brain volumes showed increased concentration of mtDNA. Patients treated with fingolimod had significantly lower mtDNA copy levels at follow-up compared to baseline. CONCLUSION Our results showed a non-specific elevation of concentration of mtDNA in PMS patients. mtDNA concentrations respond to fingolimod and may be used to monitor biological effect of this treatment.
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Affiliation(s)
- Cyra E Leurs
- Department of Neurology, MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Petar Podlesniy
- Institute of Biomedical Research of Barcelona, CSIC-IDIBAPS, CIBERNED, Barcelona, Spain
| | - Ramon Trullas
- Institute of Biomedical Research of Barcelona, CSIC-IDIBAPS, CIBERNED, Barcelona, Spain
| | - Lisanne Balk
- Department of Neurology, MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Martijn D Steenwijk
- Departments of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Arjan Malekzadeh
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Fredrik Piehl
- Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Bernard Mj Uitdehaag
- Department of Neurology, MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Joep Killestein
- Department of Neurology, MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Jack van Horssen
- Department of Molecular Cell Biology and Immunology, VU University Medical Center, Amsterdam, The Netherlands
| | - C E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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17
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van Kempen ZLE, Leurs CE, Vennegoor A, Wattjes MP, Rispens T, Uitdehaag BMJ, Killestein J. Natalizumab-associated progressive multifocal leukoencephalopathy is not preceded by elevated drug concentrations. Mult Scler 2016; 23:995-999. [DOI: 10.1177/1352458516684023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: In recent years, a small but increasing number of neurologists choose to extend dose intervals of natalizumab with the aim of reducing the risk of progressive multifocal leukoencephalopathy (PML). This idea is based on the hypothesis that high drug concentrations increase the risk of PML. Objective: We investigated the relation between longitudinal natalizumab concentrations in patients who developed PML and patients who did not develop PML. Methods: In a prospective observational cohort study of 219 patients with relapsing–remitting multiple sclerosis treated with natalizumab, serum samples were taken every 12 weeks prior to natalizumab infusion. In this cohort, 5 patients developed PML and were matched with 10 patients from the cohort who did not develop PML. Natalizumab concentrations were measured in available samples, and the longitudinal results were compared between the two patient groups. Results: Mean natalizumab concentrations in the five patients developing PML was 18.9 µg/mL (standard deviation (SD): ±13.4) versus 23.8 µg/mL (SD: ±11.5) of the control patients. Furthermore, we did not observe a clear rise in concentration levels in patients subsequently developing PML. Conclusion: Our results provide preliminary evidence that contradicts the hypothesis that exposure to elevated concentrations of natalizumab is a relevant risk factor of developing PML.
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Affiliation(s)
- Zoé LE van Kempen
- Department of Neurology, Neuroscience Campus Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Cyra E Leurs
- Department of Neurology, Neuroscience Campus Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Anke Vennegoor
- Department of Neurology, Neuroscience Campus Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Mike P Wattjes
- Department of Radiology & Nuclear Medicine, Neuroscience Campus Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Theo Rispens
- Landsteiner Laboratory, Department of Immunology, Sanquin Research, Amsterdam, The Netherlands
| | - Bernard MJ Uitdehaag
- Department of Neurology, Neuroscience Campus Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Joep Killestein
- Department of Neurology, Neuroscience Campus Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
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