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Cerebrospinal fluid biomarkers for predicting development of multiple sclerosis in acute optic neuritis: a population-based prospective cohort study.


ABSTRACT:

Background

Long-term outcome in multiple sclerosis (MS) depends on early treatment. In patients with acute optic neuritis (ON), an early inflammatory event, we investigated markers in cerebrospinal fluid (CSF), which may predict a diagnosis of MS.

Methods

Forty patients with acute ON were recruited in a prospective population-based cohort with median 29?months (range 19-41) of follow-up. Paired CSF and serum samples were taken within 14?days (range 2-38), prior to treatment. Prospectively, 16/40 patients were by a uniform algorithm diagnosed with MS (MS-ON) and 24 patients continued to manifest isolated ON (ION) during follow-up. Levels of cytokines and neurofilament light chain (NF-L) were measured at the onset of acute ON and compared to healthy controls (HC). Significance levels were corrected for multiple comparisons ("q"). The predictive value of biomarkers was determined with multivariable prediction models using nomograms.

Results

CSF TNF-?, IL-10, and CXCL13 levels were increased in MS-ON compared to those in ION patients (q?=?0.021, 0.004, and 0.0006, respectively). MS-ON patients had increased CSF pleocytosis, IgG indices, and oligoclonal bands (OCBs) compared to ION (q?= 0.0007, q?= 0.0058, and q?= 0.0021, respectively). CSF levels of IL-10, TNF-a, IL-17A, and CXCL13 in MS-ON patients correlated with leukocyte counts (r?>?0.69 and p??0.55, p?ConclusionsCSF TNF-?, IL-10, CXCL13, and NF-L levels were associated with the development of MS, suggesting that the inflammatory and neurodegenerative processes occurred early. Based on subsequent diagnosis, we observed a high predictive value of routine and candidate biomarkers in CSF for the development of MS in acute ON. The nomogram predictions may be useful in the diagnostic work-up of MS.

SUBMITTER: Olesen MN 

PROVIDER: S-EPMC6410527 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Publications

Cerebrospinal fluid biomarkers for predicting development of multiple sclerosis in acute optic neuritis: a population-based prospective cohort study.

Olesen M N MN   Soelberg K K   Debrabant B B   Nilsson A C AC   Lillevang S T ST   Grauslund J J   Brandslund I I   Madsen J S JS   Paul F F   Smith T J TJ   Jarius S S   Asgari N N  

Journal of neuroinflammation 20190311 1


<h4>Background</h4>Long-term outcome in multiple sclerosis (MS) depends on early treatment. In patients with acute optic neuritis (ON), an early inflammatory event, we investigated markers in cerebrospinal fluid (CSF), which may predict a diagnosis of MS.<h4>Methods</h4>Forty patients with acute ON were recruited in a prospective population-based cohort with median 29 months (range 19-41) of follow-up. Paired CSF and serum samples were taken within 14 days (range 2-38), prior to treatment. Prosp  ...[more]

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