Axonal damage markers in the cerebrospinal fluid of patients with clinically isolated syndrome improve predicting conversion to definite multiple sclerosis
Axonal damage markers in the cerebrospinal fluid of patients with clinically isolated syndrome improve predicting conversion to definite multiple sclerosis
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DOI：
10.1191/135248506ms1263oa
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发表时间：
2006-04-01
影响因子：
5.8
通讯作者：
Tumani, H
中科院分区：
文献类型：
--
作者：
Brettschneider, J;Petzold, A;Tumani, H
临床孤立综合征 (CIS) 代表多发性硬化症 (MS) 的最早阶段。这项研究测试了轴突变性的生物标志物是否可以提高磁共振成像 (MRI) 参数在预测从 CIS 向 MS 转化时的敏感性和特异性。包括 CIS 患者 (n = 52)、复发缓解型 MS (RRMS，n = 38) 和年龄匹配的对照患者 (n = 25)。使用 ELISA 测量脑脊液 (CSF) 中 tau 蛋白和神经丝 (NfH(SMI35)) 的水平。记录 MRI T2 病变负荷和扩展残疾状态量表 (EDSS)。与对照组相比，CIS 中的 CSF tau 和 NfH(SMI35) 升高（P < 0.05）。急性复发的 RRMS 患者的 NfH(SMI35) 水平高于稳定患者。 Tau 和 NfH(SMI35) 水平与 CIS 和 RRMS 中的 EDSS 相关。在 RRMS 中，T2 病变的数量与 tau 水平相关（R = 0.53，P = 0.01）。结合 CSF 标志物（tau 或 NfH(SMI35) 升高）预测从 CIS 转化为 MS 的敏感性高于 MRI（40% 对 34%），但如果结合 CSF 和 MRI 标准，预测从 CIS 转化为 MS 的敏感性可进一步增加至 60%。同样，tau 和 NfH (SMI35) 的组合显示出比 MRI (82%) 更高的特异性 (94%)。 Tau 和 NfHSMI35 是 CIS 患者轴突损伤的有价值的生物标志物。如果脑脊液标记物与 MRI 相结合，可以改善从 CIS 向 MS 转化的预测。
Clinically isolated syndrome (CIS) represents the earliest phase of multiple sclerosis ( MS). This study tested whether biomarkers for axonal degeneration can improve upon sensitivity and specificity of magnetic resonance imaging (MRI) parameters in predicting conversion from CIS to MS. Patients with CIS ( n = 52), relapsing-remitting MS ( RRMS, n = 38) and age-matched controls ( n = 25) were included. Cerebrospinal fluid (CSF) levels of tau and neurofilaments (NfH(SMI35)) were measured using ELISA. The MRI T2-lesion load and the Expanded Disability Status Scale (EDSS) were recorded. CSF tau and NfH(SMI35) were elevated in CIS compared to controls (P< 0.05). RRMS patients with acute relapse had higher NfH(SMI35) levels than stable patients. Tau and NfH(SMI35) levels correlated with EDSS in CIS and RRMS. In RRMS, the number of T2-lesions correlated with tau levels ( R = 0.53, P = 0.01). The sensitivity predicting the conversion from CIS to MS was higher for the combination of CSF markers ( either tau or NfH(SMI35) elevated) than for MRI ( 40 versus 34%), but could be further increased to 60% if CSF and MRI criteria were combined. Similarly, the combination of tau and NfH(SMI35) showed higher specificity (94%) than MRI (82%). Tau and NfHSMI35 are valuable biomarkers for axonal damage in the CIS patients. Predicting conversion from CIS to MS can be improved if CSF markers are combined with MRI.