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多发性硬化症患者血清可溶性细胞间黏附分子-1:与临床及钆增强磁共振成像活性以及与重组人干扰素β-1b治疗的关系

Serum soluble intercellular adhesion molecule-I in MS: relation to clinical and Gd-MRI activity and to rIFN beta-Ib treatment.

作者信息

Trojano M, Avolio C, Ruggieri M, Defazio G, Giuliani F, Paolicelli D, Livrea P

机构信息

Institute of Clinical Neurology, University of Bari, Italy.

出版信息

Mult Scler. 1998 Jun;4(3):183-7. doi: 10.1177/135245859800400318.

Abstract

The validity of serum sICAM-I levels to assess Multiple Sclerosis (MS) activity was evaluated in 49 untreated definite relapsing-remitting (RR) patients. sICAM-I levels were significantly (P = 0.0009) higher in the 'clinically active' group (No 22) than in the 'clinically inactive' (No 27), whereas no different values were found between patients with Gd-enhancing lesions at MRI (Gd-positive) (No 32) and patients without such lesions (Gd-negative) (No 17) independently of their clinical activity. Among the 'clinically active' MS, the Gd-positive (No 16) subgroup showed significant (P < 0.05) lower sICAM-I levels when compared to the Gd-negative (No 6) subgroup, but higher (P = 0.009) than those of the 'clinically inactive Gd-positive' (No 16) patients. The sICAM-I levels did not differ between the two 'clinically inactive' subgroups Gd-positive (No 16) and Gd-negative (No 11). Finally the clinically active Gd-negative (No 6) showed sICAM-I levels higher (P = 0.002) than the clinically inactive Gd-negative (No 11). The specificity of high serum sICAM-I levels (above M +/- 2 s.d. of control values) to assess the disease activity in MS resulted higher (100%) using clinical than Gd-MRI activity (76%) as gold standard. The changes induced by 1 year recombinant Interferon-beta-Ib (rIFN beta-Ib) treatment on sICAM-I serum levels were also longitudinally investigated in 36 of the 49 RR MS. sICAM-I levels at baseline significantly increased in the first 2 months (baseline vs 1st month P < 0.0001 and 1st vs 2nd month P = 0.02), persisted at high levels without any significant change after 3 months, showed a temporary decrease at 6 months, then significantly increased again at 9 and 12 months. Fourteen patients experienced relapses, with a total of 20 relapses, during the whole treatment duration. The mean relapse/rate and the frequency of patients with Gd-positive MRI scans resulted significantly higher in the first semester compared to the second semester of treatment. This study adds further insights into the validity of serum sICAM-I to assess disease activity in MS and on the immunomodulatory properties of rIFN beta-Ib.

摘要

在49例未经治疗的明确复发缓解型(RR)多发性硬化症(MS)患者中,评估了血清可溶性细胞间黏附分子-1(sICAM-1)水平用于评估MS疾病活动的有效性。“临床活动”组(22例)的sICAM-1水平显著高于(P = 0.0009)“临床非活动”组(27例),而磁共振成像(MRI)显示有钆增强病灶(钆阳性)的患者(32例)和无此类病灶(钆阴性)的患者(17例)之间,无论其临床活动状态如何,sICAM-1水平均无差异。在“临床活动”的MS患者中,钆阳性亚组(16例)的sICAM-1水平与钆阴性亚组(6例)相比显著降低(P < 0.05),但高于“临床非活动钆阳性”患者(16例)(P = 0.009)。两个“临床非活动”亚组(钆阳性16例和钆阴性11例)之间的sICAM-1水平无差异。最后,临床活动的钆阴性患者(6例)的sICAM-1水平高于临床非活动的钆阴性患者(11例)(P = (此处原文有误,推测应为P = 0.002))。以临床活动而非钆-MRI活动(76%)作为金标准时,血清sICAM-1高水平(高于对照值的M±2标准差)用于评估MS疾病活动的特异性更高(100%)。还对49例RR MS患者中的36例进行了纵向研究,观察了1年重组干扰素-β-1b(rIFNβ-1b)治疗对血清sICAM-1水平的影响。基线时sICAM-1水平在前2个月显著升高(基线与第1个月相比P < 0.0001,第1个月与第2个月相比P = 0.02),3个月后持续维持在高水平且无显著变化,6个月时出现暂时下降,然后在9个月和12个月时再次显著升高。在整个治疗期间,14例患者经历了复发,共20次复发。与治疗的第二学期相比,第一学期的平均复发率和MRI扫描钆阳性的患者频率显著更高。本研究进一步深入探讨了血清sICAM-1评估MS疾病活动的有效性以及rIFNβ-1b的免疫调节特性。

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