Format

Send to

Choose Destination
See comment in PubMed Commons below
Mult Scler. 2014 Jan;20(1):43-50. doi: 10.1177/1352458513490544. Epub 2013 May 23.

Immunosuppressive therapy reduces axonal damage in progressive multiple sclerosis.

Author information

1
Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Abstract

BACKGROUND:

In progressive multiple sclerosis (PMS), disease-modifying therapies have not been shown to reduce disability progression.

OBJECTIVE:

The impact from immunosuppressive therapy in PMS was explored by analyzing cerebrospinal fluid (CSF) biomarkers of axonal damage (neurofilament light protein, NFL), astrogliosis (glial fibrillary acidic protein, GFAP), and B-cell regulation (CXCL13).

METHODS:

CSF was obtained from 35 patients with PMS before and after 12-24 months of mitoxantrone (n=30) or rituximab (n=5) treatment, and from 14 age-matched healthy control subjects. The levels of NFL, GFAP, and CXCL13 were determined by immunoassays.

RESULTS:

The mean NFL level decreased by 51% (1781 ng/l, SD 2018 vs. 874 ng/l, SD 694, p=0.007), the mean CXCL13 reduction was 55% (9.71 pg/ml, SD 16.08, vs. 4.37 pg/ml, SD 1.94, p=0.008), while GFAP levels remained unaffected. Subgroup analysis showed that the NFL reduction was confined to previously untreated patients (n=20) and patients with Gd-enhancing lesions on magnetic resonance imaging (n=12) prior to study baseline.

CONCLUSIONS:

Our data imply that 12-24 months of immunosuppressive therapy reduces axonal damage in PMS, particularly in patients with ongoing disease activity. Determination of NFL levels in CSF is a potential surrogate marker for treatment efficacy and as endpoint in phase II trials of MS.

KEYWORDS:

CXCL13; Multiple sclerosis; axonal damage; biomarkers; cerebrospinal fluid; glial fibrillary acidic protein; immunosuppressive therapy; mitoxantrone; neurofilament light protein; rituximab

PMID:
23702432
DOI:
10.1177/1352458513490544
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Atypon
    Loading ...
    Support Center