Department of Clinical Neurosciences, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.
Department of Neurology, University Hospital Ostrava, Ostrava, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2023 Mar;167(1):30-35. doi: 10.5507/bp.2023.002. Epub 2023 Jan 25.
The aim of this study was to identify whether NfL and CXCL13 cerebrospinal fluid (CSF) concentrations at diagnostic lumbar puncture can predict the course of multiple sclerosis (MS) in terms of relapses, higher expanded disability status scale (EDSS) and magnetic resonance imaging (MRI) activity.
We conducted a single-centre prospective observational cohort study at the MS center, University Hospital Ostrava, Czech Republic. CSF NfL (cNfL) and CXCL13 concentrations were examined (ELISA method) in patients with clinically isolated syndrome (CIS) and relapsing-remitting MS (RRMS) at the time of diagnostic lumbar puncture.
A total of 44 patients with CIS or early RRMS were enrolled, 31 (70.5%) of whom were women. The median age at the time of CSF sampling was 31.21 years (IQR 25.43-39.32), and the follow-up period was 54.6 months (IQR 44.03-59.48). In the simple and multiple logistic regression models, CXCL13 levels did not predict relapses, MRI activity or EDSS > 2.5. Similarly, cNfL concentrations did not predict relapses or MRI activity in either model. In the multiple regression, higher cNfL levels were associated with reaching EDSS > 2.5 (odds ratio [OR] 1.002, 95% confidence interval [CI] 1.000 to 1.003).
Our data did not confirm cNfL and/or CXCL13 CSF levels were predictive factors for disease activity such as relapses and MRI activity at the time of diagnostic lumbar puncture in patients with RRMS. While cNfL CSF levels predicted higher disability only after adjustment for other known risk factors, elevated CSF CXCL13 did not predict higher disability at all.
本研究旨在确定诊断性腰椎穿刺时脑脊液（CSF）中的 NfL 和 CXCL13 浓度是否可以预测多发性硬化（MS）的疾病进程，包括复发、更高的扩展残疾状况量表（EDSS）和磁共振成像（MRI）活动。
我们在捷克共和国奥斯特拉瓦大学医院的 MS 中心进行了一项单中心前瞻性观察队列研究。在诊断性腰椎穿刺时，对临床孤立综合征（CIS）和复发缓解型 MS（RRMS）患者的 CSF NfL（cNfL）和 CXCL13 浓度进行了检查（ELISA 法）。
共纳入 44 例 CIS 或早期 RRMS 患者，其中 31 例（70.5%）为女性。CSF 取样时的中位年龄为 31.21 岁（IQR 25.43-39.32），随访时间为 54.6 个月（IQR 44.03-59.48）。在简单和多元逻辑回归模型中，CXCL13 水平均不能预测复发、MRI 活动或 EDSS > 2.5。同样，在两个模型中，cNfL 浓度均不能预测复发或 MRI 活动。在多元回归中，较高的 cNfL 水平与达到 EDSS > 2.5 相关（优势比[OR]1.002，95%置信区间[CI]1.000 至 1.003）。
我们的数据并未证实 cNfL 和/或 CSF CXCL13 水平是 RRMS 患者诊断性腰椎穿刺时疾病活动（如复发和 MRI 活动）的预测因素。虽然 cNfL CSF 水平仅在调整其他已知危险因素后才可预测更高的残疾程度，但 CSF CXCL13 升高并不能预测更高的残疾程度。
