Bitsch A, Bahner D, Wachter C, Elitok E, Bogumil T, Dressel A, Polak T, Tumani H, Weber F, Poser S, Kitze B
Neurologische Klinik, Ruppiner Kliniken GmbH, Neuruppin, Germany.
Acta Neurol Scand. 2004 Dec;110(6):386-92. doi: 10.1111/j.1600-0404.2004.00347.x.
Endothelial activation is a key feature of multiple sclerosis (MS) pathogenesis. It is modulated by interferon beta-1b (IFNB-1b) treatment in relapsing-remitting MS (RRMS) patients. This particular pharmacodynamic effect still has to be proven in primary progressive MS (PPMS). In the current study, serum concentrations of soluble vascular cell adhesion molecule-1 (sVCAM-1) and sE-selectin were analyzed longitudinally in 18 PPMS patients before, during and after 12 months of treatment with IFNB-1b. During drug therapy there was a significant early and sustained increase of sVCAM-1 (overall P < 0.0001). Flu-like symptoms induced by IFNB-1b and also concomitant infections were associated with higher sVCAM-1 levels. Neutralizing antibodies to IFNB-1b were associated with lower sVCAM-1 levels. In conclusion, IFNB-1b modulates the adhesion cascade in patients with PPMS in a similar way it does in RRMS. Nevertheless, a clinical effect of IFNB in PPMS still has to be proven in a randomized controlled clinical trial.
内皮细胞活化是多发性硬化症(MS)发病机制的关键特征。在复发缓解型MS(RRMS)患者中,它受β-1b干扰素(IFNB-1b)治疗的调节。这种特殊的药效学效应在原发性进展型MS(PPMS)中仍有待证实。在本研究中,对18例PPMS患者在接受IFNB-1b治疗12个月之前、期间和之后,纵向分析血清可溶性血管细胞黏附分子-1(sVCAM-1)和sE-选择素的浓度。在药物治疗期间,sVCAM-1有显著的早期和持续升高(总体P<0.0001)。IFNB-1b诱导的流感样症状以及同时发生的感染与较高的sVCAM-1水平相关。针对IFNB-1b的中和抗体与较低的sVCAM-1水平相关。总之,IFNB-1b在PPMS患者中调节黏附级联反应的方式与在RRMS中相似。然而,IFNB在PPMS中的临床疗效仍有待在随机对照临床试验中得到证实。