Background: This study aimed to investigate if treatment response could retrospectively be related to inflammatory or axonal pathology as measured by plasma surrogate markers. Methods:In this 1-year observational study 30 MS patients with relapsingremitting disease were treated with intra-muscular IFNβ-1a or subcutaneous IFNβ-1b. Responders and non-responders were defined according to clinical and MRI criteria. The control group consisted of 14 healthy subjects. Plasma levels of surrogate markers for inflammation (nitric oxide metabolites (NO x )), astrocytic activation (S100B) and axonal damage (NfH SMI35 ) were measured using standard assays.Results: There were 11 non-responders and 19 responders to IFNβ treatment. Median S100B levels were elevated in a higher proportion of treatment responders (63%, 42.9 pg/mL) compared to non-responders (18%, 11.7 pg/mL, p<0.05, Fisher's exact test) and controls (0%, 2 pg/mL, p< 0.001). Levels of NO x were found to be more frequently elevated in non-responders (72%, 39 µM) compared to healthy controls (0%, 37 µM, p<0.05). Levels of NfH SMI35 were more frequently elevated in responders (58%, 300 pg/mL, p<0.001) and non-responders (72%, 500 pg/mL, p<0.001) compared to controls (0%, 4.5 pg/mL). Conclusion:Patients with relapsing-remitting MS who had surrogate marker supported evidence for astrocytic activation responded more frequently to treatment with IFNβ.

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Background and study aims: Caustic ingestion is a potentially severe condition; early identification of poor outcome is essential for improve management, but prediction based only on endoscopy can overestimate its severity. The aim of the study was to develop and validate a prognostic score. Patients and methods: A prospective cohort study was designed to include all patients older than 15 years consecutively attended in our tertiary care hospital between 1995 and 2017. Adverse outcome was defined by any of the following conditions: intensive care unit admission, urgent surgery or death. The predictive value of clinical, analytical and endoscopic variables was assessed in a first cohort of cases (derivation cohort) and a prognostic score based on the resulting risk factors was developed by logistic regression; internal validation (bootstrapping) was performed and then external validation was checked in an independent sample of patients (validation cohort). Results: 469 cases were included, 265 in the derivation cohort and 204 in the validation one. Ingestion of acid substances (OR 3.13, 95%CI:2.33-4.21), neutrophil count (OR 1.05, 95%CI:1.04-1.06), metabolic acidosis (bicarbonate value, OR 0.82, 95%CI:0.78-0.85) and endoscopic injury (OR 3.81, 95%CI:3.35-4.34) were independent risk factors of poor outcome. The prognostic score based on these variables provided better accuracy than endoscopy alone (p=0.038), with high sensitivity, specificity, positive, negative predictive values (93.3%, 92.7%, 72.7%, 98.5%, respectively) and area under the curve (0.976, 95%CI:0.973-0.976, p<0.001). Conclusions: This score allows a reliable prognosis of caustic ingestion and is more accurate than the classical evaluation based only on endoscopy.