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Cerebrospinal fluid biomarkers as a measure of disease activity and treatment efficacy in relapsing‐remitting multiple sclerosis
Author(s) -
Novakova Lenka,
Axelsson Markus,
Khademi Mohsen,
Zetterberg Henrik,
Blennow Kaj,
Malmeström Clas,
Piehl Fredrik,
Olsson Tomas,
Lycke Jan
Publication year - 2017
Publication title -
journal of neurochemistry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.75
H-Index - 229
eISSN - 1471-4159
pISSN - 0022-3042
DOI - 10.1111/jnc.13881
Subject(s) - multiple sclerosis , natalizumab , cerebrospinal fluid , medicine , biomarker , gastroenterology , pathology , oncology , immunology , chemistry , biochemistry
Cerebrospinal fluid ( CSF ) biomarkers can reflect different aspects of the pathophysiology of relapsing‐remitting multiple sclerosis ( RRMS ). Understanding the impact of different disease modifying therapies on the CSF biomarker profile may increase their implementation in clinical practice and their appropriateness for monitoring treatment efficacy. This study investigated the influence of first‐line (interferon beta) and second‐line (natalizumab) therapies on seven CSF biomarkers in RRMS and their correlation with clinical and radiological outcomes. We included 59 RRMS patients and 39 healthy controls. The concentrations of C‐X‐C motif chemokine 13 ( CXCL 13), C‐C motif chemokine ligand 2 ( CCL 2), chitinase‐3‐like protein 1 ( CHI 3L1), glial fibrillary acidic protein, neurofilament light protein ( NFL ), and neurogranin were determined by ELISA , and chitotriosidase ( CHIT 1) was analyzed by spectrofluorometry. RRMS patients had higher levels of NFL , CXCL 13, CHI 3L1, and CHIT 1 than controls ( p < 0.001). Subgroup analysis revealed higher NFL , CXCL 13 and CHIT 1 levels in patients treated with first‐line therapy compared to second‐line therapy ( p = 0.008, p = 0.001 and p = 0.026, respectively). NFL and CHIT 1 levels correlated with relapse status, and NFL and CXCL 13 levels correlated with the formation of new magnetic resonance imaging lesions. Furthermore, we found an association between inflammatory and degenerative biomarkers. The results indicate that CSF levels of NFL , CXCL 13, CHI 3L1, and CHIT 1 correlate with the clinical and/or radiological disease activity, providing additional dimensions in the assessment of treatment efficacy.