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Göteborgs universitets publikationer

Immunosuppressive therapy reduces axonal damage in progressive multiple sclerosis.

Författare och institution:
Markus Axelsson (Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering); Clas Malmeström (Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering); Martin Gunnarsson (-); Henrik Zetterberg (Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi); Peter Sundström (-); Jan Lycke (Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering); Anders Svenningsson (-)
Publicerad i:
Multiple sclerosis (Houndmills, Basingstoke, England), 20 ( 1 ) s. 43-50
ISSN:
1477-0970
Publikationstyp:
Artikel, refereegranskad vetenskaplig
Publiceringsår:
2014
Språk:
engelska
Fulltextlänk:
Sammanfattning (abstract):
BACKGROUND: In progressive multiple sclerosis (PMS), disease-modifying therapies have not been shown to reduce disability progression. OBJECTIVE: The impact from immunosuppressive therapy in PMS was explored by analyzing cerebrospinal fluid (CSF) biomarkers of axonal damage (neurofilament light protein, NFL), astrogliosis (glial fibrillary acidic protein, GFAP), and B-cell regulation (CXCL13). METHODS: CSF was obtained from 35 patients with PMS before and after 12-24 months of mitoxantrone (n=30) or rituximab (n=5) treatment, and from 14 age-matched healthy control subjects. The levels of NFL, GFAP, and CXCL13 were determined by immunoassays. RESULTS: The mean NFL level decreased by 51% (1781 ng/l, SD 2018 vs. 874 ng/l, SD 694, p=0.007), the mean CXCL13 reduction was 55% (9.71 pg/ml, SD 16.08, vs. 4.37 pg/ml, SD 1.94, p=0.008), while GFAP levels remained unaffected. Subgroup analysis showed that the NFL reduction was confined to previously untreated patients (n=20) and patients with Gd-enhancing lesions on magnetic resonance imaging (n=12) prior to study baseline. CONCLUSIONS: Our data imply that 12-24 months of immunosuppressive therapy reduces axonal damage in PMS, particularly in patients with ongoing disease activity. Determination of NFL levels in CSF is a potential surrogate marker for treatment efficacy and as endpoint in phase II trials of MS.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
MEDICIN OCH HÄLSOVETENSKAP ->
Medicinska grundvetenskaper
MEDICIN OCH HÄLSOVETENSKAP ->
Medicinska grundvetenskaper ->
Neurovetenskaper ->
Neurokemi
Nyckelord:
Multiple sclerosis, immunosuppressive therapy, mitoxantrone, rituximab, biomarkers, cerebrospinal fluid, neurofilament light protein, glial fibrillary acidic protein, CXCL13, axonal damage
Postens nummer:
184491
Posten skapad:
2013-10-02 14:17
Posten ändrad:
2016-08-30 09:08

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