Roberta Magliozzi (Italy)
University of Verona Department of Neurosciences, Biomedicine and Movement SciencesAuthor Of 1 Presentation
CSF INFLAMMATORY PROFILE IN CLINICALLY ISOLATED SYNDROME AND DEFINITE MULTIPLE SCLEROSIS PATIENTS.
- Albulena Bajrami (Italy)
Abstract
Background and Aims:
Clinically isolated syndrome (CIS) characterizes the first episode of multiple sclerosis (MS). IgG oligoclonal bands (OCBs) and high levels of inflammatory factors in CSF represent promising biochemical markers of CIS and MS. Here we evaluated the levels of a complex panel of CSF inflammatory mediators in CIS and relapsing-remitting MS (RRMS) patients at time of diagnosis, both with and without OCB, compared with a control group.
Methods:
Patients with CIS (n=22), RRMS (82 OCB+; 36 OCB-) and controls (n=29) with other neurological diseases, wereenrolled at diagnosis and followed for two years. Mann-Whitney tests were used to compare CSF levels of 20 inflammatory mediators between groups.
Results:
CIS patients showed higher levels of CXCL13 (P<0.01), IFN-γ (P<0.001), CCL25, chitinase-3 L1, IFN-α2 (all P-values<0.05) than the control group, whereas showed increased levels of BAFF (P<0.01) and decreased levels of IFNλ2 (P<0.01) compared to RRMS patients. RRMS group presented higher levels of several molecules, including CXCL13 (p<0.001), IFN-γ (p<0.001), IFN-α2 (p<0.001), IFNλ2 (p<0.001), MMP2 (p<0.05) than the control group. In particular, OCB(+) RRMS patients, showed increased levels of CXCL13 (P<0.001), sCD163 (P<0.01), and decreased levels of BAFF (P<0.01), IFNλ2 (P<0.05), and IL10 (P<0.05) compared to OCB(-).
Conclusions:
Since early CIS episode, abnormal, specific CSF inflammatory profile, mainly pro-inflammatory immune response linked to both B- and T-cells, confirms the crucial role played by intrathecal CSF inflammation in the disease pathogenesis, even before the MS diagnosis. In particular, CSF BAFF levels, possibly mediating B-cell and T-cell activation, may represent an early candidate marker specific of CIS.