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表没食子儿茶素没食子酸酯治疗进展性多发性硬化症患者的视网膜厚度分析:SUPREMES研究的光学相干断层扫描结果

Retinal Thickness Analysis in Progressive Multiple Sclerosis Patients Treated With Epigallocatechin Gallate: Optical Coherence Tomography Results From the SUPREMES Study.

作者信息

Klumbies Katharina, Rust Rebekka, Dörr Jan, Konietschke Frank, Paul Friedemann, Bellmann-Strobl Judith, Brandt Alexander U, Zimmermann Hanna G

机构信息

Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.

NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.

出版信息

Front Neurol. 2021 Apr 28;12:615790. doi: 10.3389/fneur.2021.615790. eCollection 2021.

Abstract

Epigallocatechin gallate (EGCG) is an anti-inflammatory agent and has proven neuroprotective properties in animal models of multiple sclerosis (MS). Optical coherence tomography (OCT) assessed retinal thickness analysis can reflect treatment responses in MS. To analyze the influence of EGCG treatment on retinal thickness analysis as secondary and exploratory outcomes of the randomized controlled trial (SUPREMES, NCT00799890). SUPREMES patients underwent OCT with the Heidelberg Spectralis device at a subset of visits. We determined peripapillary retinal nerve fiber layer (pRNFL) thickness from a 12° ring scan around the optic nerve head and thickness of the ganglion cell/inner plexiform layer (GCIP) and inner nuclear layer (INL) within a 6 mm diameter grid centered on the fovea from a macular volume scan. Longitudinal OCT data were available for exploratory analysis from 31 SUPREMES participants (12/19 primary/secondary progressive MS (PPMS/SPMS); mean age 51 ± 7 years; 12 female; mean time since disease onset 16 ± 11 years). We tested the null hypothesis of no treatmenttime interaction using nonparametric analysis of longitudinal data in factorial experiments. After 2 years, there were no significant differences in longitudinal retinal thickness changes between EGCG treated and placebo arms in any OCT parameter (Mean change [confidence interval] ECGC vs. Placebo: pRNFL: -0.83 [1.29] μm vs. -0.64 [1.56] μm, = 0.156; GCIP: -0.67 [0.67] μm vs. -0.14 [0.47] μm, = 0.476; INL: -0.06 [0.58] μm vs. 0.22 [0.41] μm, = 0.455). Retinal thickness analysis did not reveal a neuroprotective effect of EGCG. While this is in line with the results of the main SUPREMES trial, our study was probably underpowered to detect an effect. www.ClinicalTrials.gov, identifier: NCT00799890.

摘要

表没食子儿茶素没食子酸酯(EGCG)是一种抗炎剂,在多发性硬化症(MS)动物模型中已证实具有神经保护特性。光学相干断层扫描(OCT)评估的视网膜厚度分析能够反映MS的治疗反应。为了分析EGCG治疗对视网膜厚度分析的影响,将其作为随机对照试验(SUPREMES,NCT00799890)的次要和探索性结果。SUPREMES研究中的患者在部分访视时使用海德堡Spectralis设备进行了OCT检查。我们通过围绕视神经乳头的12°环形扫描确定了视乳头周围视网膜神经纤维层(pRNFL)的厚度,并通过以黄斑为中心的6毫米直径网格内的黄斑容积扫描确定了神经节细胞/内网状层(GCIP)和内核层(INL)的厚度。31名SUPREMES研究参与者(12/19例原发/继发进展型MS(PPMS/SPMS);平均年龄51±7岁;12名女性;疾病发病后的平均时间为16±11年)的纵向OCT数据可用于探索性分析。我们在析因实验中使用纵向数据的非参数分析检验了无治疗时间交互作用的零假设。2年后,在任何OCT参数中,EGCG治疗组和安慰剂组之间的视网膜厚度纵向变化均无显著差异(平均变化[置信区间]EGCG组与安慰剂组:pRNFL:-0.83[1.29]μm对-0.64[1.56]μm,P = 0.156;GCIP:-0.67[0.67]μm对-0.14[0.47]μm,P = 0.476;INL:-0.06[0.58]μm对0.22[0.41]μm,P = 0.455)。视网膜厚度分析未显示EGCG具有神经保护作用。虽然这与SUPREMES主要试验的结果一致,但我们的研究可能因效能不足而无法检测到这种效应。ClinicalTrials.gov网站,标识符:NCT00799890。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95ed/8113620/9adda58fffe6/fneur-12-615790-g0001.jpg

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