Response to interferon in multiple sclerosis is related to lipid-specific oligoclonal IgM bands
Response to interferon in multiple sclerosis is related to lipid-specific oligoclonal IgM bands
复制标题
DOI：
10.1177/1352458510371961
复制
发表时间：
2010-07-01
影响因子：
5.8
通讯作者：
Casanova, B.
中科院分区：
文献类型：
--
作者：
Bosca, I.;Villar, L. M.;Casanova, B.
本研究的目的是调查脑脊液 (CSF) 中脂质特异性寡克隆 IgM 带 (LS-OCMB) 的存在是否影响复发缓解型多发性硬化症 (RRMS) 患者对 β-干扰素治疗的反应。我们进行了一项合作前瞻性研究，包括在开始干扰素治疗之前对 RRMS 患者进行脑部 MRI 和 LS-OCMB 研究。主要终点是治疗开始后复发的风险。次要终点包括复发率、复发率降低、无复发患者比例以及随访期间持续残疾患者比例增加。其中包括一百零两名患者。平均随访 37.4 个月后，LS-OCMB 患者复发的风险高出两倍（风险比 2.0，95% 置信区间 1.1-3.8）。 LS-OCMB+ 患者的复发率降低幅度较小（51.8% 对比 80.8%；p < 0.0001），第一年复发率较高（0.8 对比 0.2；p=0.001），无复发患者比例较低（25% 对比 61.3%；p=0.003），扩展残疾状态评分持续增加 1.0 的患者比例较高（45% 对比 12.9%；p=0.0003）。总之，LS-OCMB 可以影响 RRMS 患者对干扰素治疗的反应。它们可以用作生物标记来预测治疗后的高炎症活动。
The objective of this study was to investigate whether the presence of lipid-specific oligoclonal IgM bands (LS-OCMB) in cerebrospinal fluid (CSF) influences the response to treatment with beta-interferon in relapsing-remitting multiple sclerosis (RRMS) patients. We performed a collaborative prospective study including RRMS patients with brain MRI and LS-OCMB studies performed before starting interferon treatment. The primary endpoint was the risk of having a relapse after treatment initiation. Secondary endpoints included relapse rate, relapse-rate reduction, proportion of relapse-free patients and proportion of patients with sustained disability increase during follow-up. One-hundred and two patients were included. After a mean follow-up of 37.4 months, the risk of suffering a relapse was two-fold higher in patients with LS-OCMB (hazard ratio 2.0, 95% confidence interval 1.1-3.8). LS-OCMB+ patients showed lower reduction in relapse rate (51.8% versus 80.8%; p < 0.0001), higher relapse rate in the first year (0.8 versus 0.2; p=0.001), lower proportion of relapse-free patients (25% versus 61.3%; p=0.003), and higher proportion of patients with sustained 1.0 increase in the Expanded Disability Status Score (45% versus 12.9%; p=0.0003). In conclusion, LS-OCMB can have an influence on the response to interferon treatment in RRMS patients. They could be used as a biological marker to predict high inflammatory activity after treatment.