Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic.
Laboratory for Cerebrospinal Fluid, Neuroimmunology, Pathology and Special Diagnostics, Topelex, Prague, Czech Republic.
Eur J Neurosci. 2024 Jun;59(11):2955-2966. doi: 10.1111/ejn.16300. Epub 2024 Mar 7.
The initial phase of multiple sclerosis (MS), often known as clinically isolated syndrome (CIS), is a critical period for identifying individuals at high risk of progressing to full-blown MS and initiating timely treatment. In this study, we aimed to evaluate the prognostic value of C-X-C motif chemokine ligand 13 (CXCL13) and interleukin-8 (IL-8) as potential markers for CIS patients' conversion to MS. Our study encompassed patients with CIS, those with relapsing-remitting MS (RRMS), and control subjects, with sample analysis conducted on both cerebrospinal fluid (CSF) and serum. Patients were categorized into four groups: CIS-CIS (no MS development within 2 years), CIS-RRMS (conversion to RRMS within 2 years), RRMS (already diagnosed), and a control group (CG) with noninflammatory central nervous system disorders. Results showed significantly elevated levels of CXCL13 in CSF across all patient groups compared with the CG (p < 0.0001, Kruskal-Wallis test). Although CXCL13 concentrations were slightly higher in the CIS-RRMS group, statistical significance was not reached. Similarly, significantly higher levels of IL-8 were detected in CSF samples from all patient groups compared with the CG (p < 0.0001, Kruskal-Wallis test). Receiver operating characteristic analysis in the CIS-RRMS group identified both CXCL13 (area under receiver operating characteristic curve = .959) and IL-8 (area under receiver operating characteristic curve = .939) in CSF as significant predictors of CIS to RRMS conversion. In conclusion, our study suggests a trend towards elevated CSF IL-8 and CSF CXCL13 levels in CIS patients progressing to RRMS. These findings emphasize the importance of identifying prognostic markers to guide appropriate treatment strategies for individuals in the early stages of MS.
多发性硬化症(MS)的初始阶段,通常称为临床孤立综合征(CIS),是识别处于向完全型 MS 进展高风险并及时开始治疗的个体的关键时期。在这项研究中,我们旨在评估 C-X-C 基序趋化因子配体 13(CXCL13)和白细胞介素-8(IL-8)作为 CIS 患者向 MS 转化的潜在标志物的预后价值。我们的研究包括 CIS 患者、复发缓解型 MS(RRMS)患者和对照组,对脑脊液(CSF)和血清进行样本分析。患者分为四组:CIS-CIS(2 年内无 MS 进展)、CIS-RRMS(2 年内转化为 RRMS)、RRMS(已诊断)和对照组(CG),具有非炎症性中枢神经系统疾病。结果显示,与 CG 相比,所有患者组的 CSF 中 CXCL13 水平均显著升高(p < 0.0001,Kruskal-Wallis 检验)。尽管 CIS-RRMS 组的 CXCL13 浓度略高,但未达到统计学意义。同样,与 CG 相比,所有患者组的 CSF 样本中 IL-8 水平均显著升高(p < 0.0001,Kruskal-Wallis 检验)。在 CIS-RRMS 组中进行的接收器工作特征分析表明,CSF 中的 CXCL13(接收器工作特征曲线下面积=0.959)和 IL-8(接收器工作特征曲线下面积=0.939)均为 CIS 向 RRMS 转化的重要预测因子。总之,我们的研究表明,向 RRMS 进展的 CIS 患者的 CSF IL-8 和 CSF CXCL13 水平呈升高趋势。这些发现强调了识别预后标志物以指导 MS 早期个体适当治疗策略的重要性。