Cerebrospinal fluid CXCL13 in clinically isolated syndrome patients: Association with oligoclonal IgM bands and prediction of Multiple Sclerosis diagnosis

Ferraro, Diana; Galli, Veronica; Vitetta, Francesca; Simone, Anna Maria; Bedin, Roberta; Giovane, Cinzia Del; Morselli, Franca; Filippini, M; Nichelli, Paolo Frigio; Sola, Patrizia

doi:10.1016/j.jneuroim.2015.04.011

Cited by 50 publications

(28 citation statements)

References 34 publications

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“…It has been previously demonstrated that there is an association between individual CSF molecules, such as IgM index, kappa light chains, chemokine CXCL13, neurofilament protein light chain, and glial fibrillary acidic protein with the severity of the disease evolution. 22,23 However, most of the previous studies examined one or a few molecules in correlation with limited clinical or imaging parameters, and whether a complex CSF inflammatory profile associates with disease activity has not been addressed. 22,23 With the large number of currently available DMTs, characterized by different efficacy and safety profiles, efforts are being made to implement a personalized therapeutic approach early in the disease course, which can maximize the chances of achieving disease control in the long term.…”

Section: Discussionmentioning

confidence: 99%

“…22,23 However, most of the previous studies examined one or a few molecules in correlation with limited clinical or imaging parameters, and whether a complex CSF inflammatory profile associates with disease activity has not been addressed. 22,23 With the large number of currently available DMTs, characterized by different efficacy and safety profiles, efforts are being made to implement a personalized therapeutic approach early in the disease course, which can maximize the chances of achieving disease control in the long term. However, early clinical and radiological features have limited prognostic value and optimizing the treatment selection, based on the patient's expected clinical outcome, remains a significant challenge.…”

Section: Discussionmentioning

confidence: 99%

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The CSF Profile Linked to Cortical Damage Predicts Multiple Sclerosis Activity

Magliozzi

Scalfari

Pisani

et al. 2020

Annals of Neurology

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Objective Intrathecal inflammation correlates with the grey matter damage since the early stages of multiple sclerosis (MS), but whether the cerebrospinal fluid (CSF) profile can help to identify patients at risk of disease activity is still unclear. Methods We evaluated the association between CSF levels of 18 cytokines, previously found to be associated to grey matter damage, and the disease activity, among 99 patients with relapsing‐remitting MS, who underwent blinded clinical and 3 T magnetic resonance imaging (MRI) evaluations for 4 years. Groups with evidence of disease activity (EDA) or no evidence of disease activity (NEDA; occurrence of relapses, new white matter lesions, and Expanded Disability Status Scale [EDSS] change) were identified. Cortical lesions and the annualized cortical thinning were also evaluated. Results Forty‐one patients experienced EDA and, compared to the NEDA group, had at diagnosis higher CSF levels of CXCL13, CXCL12, IFNγ, TNF, sCD163, LIGHT, and APRIL (p < 0.001). In the multivariate analysis, CXCL13 (hazard ratio [HR] = 1.35; p = 0.0002), LIGHT (HR = 1.22; p = 0.005) and APRIL (HR = 1.78; p = 0.0001) were the CSF molecules more strongly associated with the risk of EDA. The model, including CSF variables, predicted more accurately the occurrence of disease activity than the model with only clinical/MRI parameters (C‐index at 4 years = 71% vs 44%). Finally, higher CSF levels of CXCL13 (β = 4.7*10−4; p < 0.001), TNF (β = 3.1*10−3; p = 0.004), LIGHT (β = 2.6*10−4; p = 0.003), sCD163 (β = 4.3*10−3; p = 0.009), and TWEAK (β = 3.4*10−3; p = 0.024) were associated with more severe cortical thinning. Interpretation A specific CSF profile, mainly characterized by elevated levels of B‐cell related cytokines, distinguishes patients at high risk of disease activity and severe cortical damage. The CSF analysis may allow stratifications of patients at diagnosis for optimizing therapeutic approaches. ANN NEUROL 2020;88:562–573

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The CSF Profile Linked to Cortical Damage Predicts Multiple Sclerosis Activity

Magliozzi

Scalfari

Pisani

et al. 2020

Annals of Neurology

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“…CXCL13 is increased in the CSF of patients with several MS forms and its levels seem to correlate with disease activity. 15,16 …”

Section: Cerebrospinal Fluid Biomarkers Of Disease Activitymentioning

confidence: 99%

The cerebrospinal fluid in multiple sclerosis: far beyond the bands

Domingues¹,

Fernandes

Leite

et al. 2017

Einstein (São Paulo)

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The cerebrospinal fluid analysis has been employed for supporting multiple sclerosis diagnosis and ruling out the differential diagnoses. The most classical findings reflect the inflammatory nature of the disease, including mild pleocytosis, mild protein increase, intrathecal synthesis of immunoglobulin G, and, most typically, the presence of oligoclonal bands. In recent years, new biomarkers have emerged in the context of multiple sclerosis. The search for new biomarkers reflect the need of a better evaluation of disease activity, disease progression, and treatment efficiency. A more refined evaluation of disease and therapy status can contribute to better therapeutic choices, particularly in escalation of therapies. This is very relevant taking into account the availability of a greater number of drugs for multiple sclerosis treatment in recent years. In this review, we critically evaluate the current literature regarding the most important cerebrospinal fluid biomarkers in multiple sclerosis. The determination of biomarkers levels, such as chemokine ligand 13, fetuin A, and mainly light neurofilament has shown promising results in the evaluation of this disease, providing information that along with clinical and neuroimaging data may contribute to better therapeutic decisions.

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“…The B-cell chemoattractant chemokine CXCL13 was also shown to serve as a prognostic marker for conversion to CDMS in patients with CIS, especially when combined with the Barkhof MRI criteria (Festa et al, 2009;Alvarez et al, 2013;Ferraro et al, 2015;Khademi et al, 2011).…”

Section: Additional Immunological Biomarkersmentioning

confidence: 99%

Multiple Sclerosis

Karussis

2017

International Encyclopedia of Public Health

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Cerebrospinal fluid CXCL13 in clinically isolated syndrome patients: Association with oligoclonal IgM bands and prediction of Multiple Sclerosis diagnosis

Cited by 50 publications

References 34 publications

The CSF Profile Linked to Cortical Damage Predicts Multiple Sclerosis Activity

The CSF Profile Linked to Cortical Damage Predicts Multiple Sclerosis Activity

The cerebrospinal fluid in multiple sclerosis: far beyond the bands

Multiple Sclerosis

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