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J Neurol Neurosurg Psychiatry. 2014 Jul;85(7):795-8. doi: 10.1136/jnnp-2013-307042. Epub 2013 Dec 24.

Predicting autoimmunity after alemtuzumab treatment of multiple sclerosis.

Author information

1
Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
2
Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK.

Abstract

OBJECTIVE:

We have previously shown that autoimmunity following alemtuzumab treatment of multiple sclerosis can be predicted by high baseline serum interleukin IL-21 (IL-21), as measured using a now 'redundant' enzyme linked immunosorbent assay (ELISA). Here we ask whether currently available ELISAs have similar prognostic value.

DESIGN:

Serum IL-21 from 141 individuals with relapsing remitting multiple sclerosis was measured using the now 'redundant' IL-21 ELISA and five further currently available kits. All patients had been treated with alemtuzumab; 61/141 had developed secondary autoimmunity.

RESULTS:

The 'redundant kit', and one current kit, confirmed higher baseline serum IL-21 in patients with autoimmunity (542 pg/mL vs. 222 pg/mL and 53.1 pg/mL vs. 9.3 pg/mL respectively) and showed positive correlation. However, only the 'redundant' kit had predictive utility.

CONCLUSIONS:

Currently available IL-21 ELISA kits should not be used to counsel individuals with multiple sclerosis considering treatment with alemtuzumab.

KEYWORDS:

Immunology; Multiple Sclerosis

PMID:
24368840
DOI:
10.1136/jnnp-2013-307042
[Indexed for MEDLINE]
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