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Cuello JP, Martínez Ginés ML, Kuhle J, García Domínguez JM, Lozano Ros A, Romero Delgado F, Higueras Y, Meldaña Rivera A, Goicochea Briceño H, García-Tizon Larroca S, De León-Luis J, Michalak Z, Barro C, Álvarez Lafuente R, Medina Heras S, Fernández Velasco JI, Tejeda-Velarde A, Domínguez-Mozo MI, Muriel A, de Andrés C, Villar LM. Neurofilament light chain levels in pregnant multiple sclerosis patients: a prospective cohort study. Eur J Neurol 2019; 26:1200-1204. [PMID: 30977955 DOI: 10.1111/ene.13965] [Citation(s) in RCA: 10] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 04/03/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND PURPOSE Neurofilament light chain is a cytoskeletal protein of neurons. Its levels are increasingly recognized as measures of neuroaxonal damage. The aim of this study was to explore serum neurofilament light chain (sNfL) levels in multiple sclerosis (MS) patients and healthy controls during pregnancy and puerperium. METHODS This was a prospective, longitudinal, single-center study. sNfL concentration was assessed using a highly sensitive single-molecule array during pregnancy and in puerperium, in a cohort of 39 pregnant patients with relapsing multiple sclerosis (P-MS). Twenty-one healthy pregnant women (HPW) served as a control group. Eight P-MS suffered relapses during pregnancy (P-MS-R) in the first or second trimesters. RESULTS No differences in pregnancy and delivery data were observed between P-MS and HPW. P-MS showed higher sNfL values than HPW in the first trimester, independently of the presence (P = 0.002) or not (P = 0.02) of relapses during pregnancy. However, in the third trimester, only P-MS-R showed higher sNfL values than HPW (P = 0.001). These differences extended to the puerperium, where P-MS-R showed higher sNfL values than those with no relapses during gestation (P = 0.02). CONCLUSION These data strongly suggest that sNfL levels reflect MS activity during pregnancy. Additionally, the absence of relapses during pregnancy may have a beneficial effect on neurodegeneration during puerperium.
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Affiliation(s)
- J P Cuello
- Hospital General Universitario Gregrorio Marañón, Madrid, España
| | | | - J Kuhle
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | | | - A Lozano Ros
- Hospital General Universitario Gregrorio Marañón, Madrid, España
| | - F Romero Delgado
- Hospital General Universitario Gregrorio Marañón, Madrid, España
| | - Y Higueras
- Hospital General Universitario Gregrorio Marañón, Madrid, España
| | - A Meldaña Rivera
- Hospital General Universitario Gregrorio Marañón, Madrid, España
| | | | | | - J De León-Luis
- Hospital General Universitario Gregrorio Marañón, Madrid, España
| | - Z Michalak
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - C Barro
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - R Álvarez Lafuente
- Grupo de Investigación de Esclerosis Múltiple, Instituto de investigación Sanitaria San Carlos (IdISSC)/Hospital Clínico San Carlos, Madrid, España
| | | | | | | | - M I Domínguez-Mozo
- Grupo de Investigación de Esclerosis Múltiple, Instituto de investigación Sanitaria San Carlos (IdISSC)/Hospital Clínico San Carlos, Madrid, España
| | - A Muriel
- Hospital Universitario Ramón y Cajal, Madrid, España
| | - C de Andrés
- Hospital General Universitario Gregrorio Marañón, Madrid, España
| | - L M Villar
- Hospital Universitario Ramón y Cajal, Madrid, España
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De León-Luis J, Gámez F, Bravo C, Tenías JM, Arias Á, Pérez R, Maroto E, Aguarón Á, Ortiz-Quintana L. Second-trimester fetal aberrant right subclavian artery: original study, systematic review and meta-analysis of performance in detection of Down syndrome. Ultrasound Obstet Gynecol 2014; 44:147-153. [PMID: 24585513 DOI: 10.1002/uog.13336] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Revised: 01/28/2014] [Accepted: 01/31/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVES First, to estimate the prevalence of fetal aberrant right subclavian artery (ARSA) in our population and its association with Down syndrome. Second, to determine the feasibility of ultrasound to visualize ARSA in the three planes. Finally, to carry out a systematic review of the literature on the performance of second-trimester ARSA to identify fetuses with Down syndrome. METHODS ARSA was assessed by ultrasound in the axial plane and confirmed in the longitudinal and coronal planes during the second half of pregnancy in women attending our unit (from February 2011 to December 2012). A search of diagnostic tests for the assessment of ARSA was carried out in international databases. Relevant studies were subjected to a critical reading, and meta-analysis was performed with Meta-DiSc. RESULTS Of the 8781 fetuses in our population (mean gestational age: 24 ± 5.4 weeks), 22 had Down syndrome. ARSA was detected in the axial view in 60 cases (0.7%) and confirmed in the coronal view in 96.7% and in the longitudinal view in 6.7% (P < 0.001). Seven cases with ARSA had Down syndrome and all were in the non-isolated-ARSA group. The estimates of positive likelihood ratio (LR) were 0 for isolated ARSA and 199 (95% CI, 88.9-445.2) for non-isolated ARSA. In the systematic review, six studies were selected for quantitative synthesis. The pooled estimates of positive and negative LRs for global ARSA were, respectively, 35.3 (95% CI, 24.4-51.1) and 0.75 (95% CI, 0.64-0.87). For isolated ARSA, the positive and negative LRs were 0 (95% CI, 0.0-14.7) and 0.98 (95% CI, 0.94-1.02), respectively. CONCLUSIONS The prevalence of ARSA seems close to 1%. The coronal plane is the most suitable for its confirmation after detection in the axial plane. Detection of isolated or non-isolated ARSA should guide decisions about karyotyping given that isolated ARSA shows a weak association with Down syndrome.
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Affiliation(s)
- J De León-Luis
- Department of Obstetrics and Gynecology, Hospital General Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain
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