Axonal metabolic recovery in multiple sclerosis patients treated with interferon β-1b
Axonal metabolic recovery in multiple sclerosis patients treated with interferon β-1b
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DOI：
10.1007/s004150170052
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发表时间：
2001-11-01
影响因子：
6
通讯作者：
Arnold, DL
中科院分区：
文献类型：
--
作者：
Narayanan, S;De Stefano, N;Arnold, DL
多发性硬化症（MS）患者可以从干扰素β -1b治疗中获益。然而，这种药物的作用机制尚不完全清楚，干扰素β -1b对轴突损伤的影响尚不清楚。利用磁共振波谱法量化神经元标记物n -乙酰基-部分氨酸（NAA）的共振强度，可以在体内测量轴突损伤。在一项小型试点研究中，我们对10例复发缓解型MS患者在开始皮下干扰素β -1b治疗前和治疗后1年进行了磁共振成像和磁共振波谱成像联合检查。在大的中央脑容量中测量NAA相对于肌酸（Cr）的共振强度。将这些测量结果与6名未经治疗的患者进行比较，这些患者在扩展残疾状态量表和基线时的平均NAA/Cr评分范围相似。治疗组NAA/Cr[2.74(0.16)，平均（SD）]在治疗开始12个月后增加5.5% [2.89 (0.24),p = 0.05]，而未治疗组NAA/Cr下降，但不显著[基线2.76(0.1)，12个月2.65 (0.14),p >.1]。治疗组在12个月时NAA/Cr显著高于未治疗组（p = 0.03）。我们的数据表明，除了失去轴突外，慢性多发性硬化症患者还遭受慢性、亚致死性轴突损伤，这种损伤至少部分可通过干扰素β -1b治疗逆转。
Patients with multiple sclerosis (MS) can benefit from treatment with interferon beta -1b. However, the mechanisms of action of this drug are incompletely understood and effects of interferon beta -1b on axonal injury are not known. A measure of axonal injury can be obtained in vivo using magnetic resonance spectroscopy to quantify the resonance intensity of the neuronal marker, N-acetylas-partate (NAA). In a small pilot study, we performed combined magnetic resonance imaging and magnetic resonance spectroscopic imaging on 10 patients with relapsing-remitting MS before and 1 year after starting treatment with subcutaneous interferon beta -1b. Resonance intensities of NAA relative to creatine (Cr) were measured in a large, central brain volume. These measurements were compared with those made in a group of 6 untreated patients selected to have a similar range of scores on the Expanded Disability Status Scale and mean NAA/Cr at baseline. NAA/Cr in the treated group [2.74 (0.16), mean (SD)] showed an increase of 5.5 % 12 months after the start of therapy [2.89 (0.24), p = 0.05], while NAA/Cr in the untreated group decreased, but not significantly [2.76 (0.1) at baseline, 2.65 (0.14) at 12 months,p > 0.1]. NAA/Cr had become significantly higher in the treated group at 12 months than in the untreated group (p = 0.03). Our data suggest that, in addition to losing axons, patients with chronic multiple sclerosis suffer from chronic, sublethal axonal injury that is at least partially reversible with interferon beta -1b therapy.