Contributions
Abstract: EP1597
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - 25 Biomarkers
Background: The increasing armamentarium of immunotherapeutics for multiple sclerosis (MS) calls for reliable biomarkers to better monitor disease activity, predict progression and evaluate treatment response in individual patients. CSF lactate, beta2-microglobulin and angiotensin converting enzyme (ACE) levels were all reported to reflect various aspects of MS disease activity which we validated in a large cohort of MS patients.
Methods and results: An automated search identified 554 patients with MS who received an analysis of CSF lactate, beta2-microglobulin and ACE levels as part of their routine diagnostic workup in our department between 2005 and 2012. Manual chart review allowed their classification as purely relapsing-remitting MS including cases of clinically isolated syndrome (RRMS, n=321), secondary progressive MS (SPMS, n=170) or primary progressive MS (PPMS, n=63) according to the 2010 revision of the McDonald diagnostic criteria. Patients were further characterized by EDSS score, disease duration, Multiple Sclerosis Severity Score (MSSS) and current relapse activity. We found that beta2-microglobulin was significantly elevated in CSF of patients with PPMS (mean 1.42 mg/l, p< 0.05) and SPMS (mean 1.59 mg/l, p< 0.01) compared to those with RRMS (mean 1.17 mg/l), while CSF levels of lactate and ACE did not differ between these three groups. In patients with stable but not in those with active RRMS (n=104 and n=217, respectively), we found a moderate positive Spearman correlation between both MSSS (r=0.39, p=0.0023) or EDSS (r=0.41, p=0.0015) and beta2-microglobulin in CSF. In contrast, CSF lactate weakly correlated with MSSS and EDSS in patients with active, but not in those with stable RRMS (r=0.21, p=0.0035; r=0.16, p=0.026, respectively).
Conclusions: In our cohort, CSF beta2-microglobulin but not lactate or ACE levels were higher in chronic progressive than in relapsing-remitting MS patients, in whom in currently relapse-free patients a higher CSF beta2-microglobulin level correlated with higher disease severity and disability.
Disclosure: Axel Haarmann, Luzia Hähnel, Michael Schuhmann, Guido Stoll and Mathias Buttmann have nothing to disclose.
Abstract: EP1597
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - 25 Biomarkers
Background: The increasing armamentarium of immunotherapeutics for multiple sclerosis (MS) calls for reliable biomarkers to better monitor disease activity, predict progression and evaluate treatment response in individual patients. CSF lactate, beta2-microglobulin and angiotensin converting enzyme (ACE) levels were all reported to reflect various aspects of MS disease activity which we validated in a large cohort of MS patients.
Methods and results: An automated search identified 554 patients with MS who received an analysis of CSF lactate, beta2-microglobulin and ACE levels as part of their routine diagnostic workup in our department between 2005 and 2012. Manual chart review allowed their classification as purely relapsing-remitting MS including cases of clinically isolated syndrome (RRMS, n=321), secondary progressive MS (SPMS, n=170) or primary progressive MS (PPMS, n=63) according to the 2010 revision of the McDonald diagnostic criteria. Patients were further characterized by EDSS score, disease duration, Multiple Sclerosis Severity Score (MSSS) and current relapse activity. We found that beta2-microglobulin was significantly elevated in CSF of patients with PPMS (mean 1.42 mg/l, p< 0.05) and SPMS (mean 1.59 mg/l, p< 0.01) compared to those with RRMS (mean 1.17 mg/l), while CSF levels of lactate and ACE did not differ between these three groups. In patients with stable but not in those with active RRMS (n=104 and n=217, respectively), we found a moderate positive Spearman correlation between both MSSS (r=0.39, p=0.0023) or EDSS (r=0.41, p=0.0015) and beta2-microglobulin in CSF. In contrast, CSF lactate weakly correlated with MSSS and EDSS in patients with active, but not in those with stable RRMS (r=0.21, p=0.0035; r=0.16, p=0.026, respectively).
Conclusions: In our cohort, CSF beta2-microglobulin but not lactate or ACE levels were higher in chronic progressive than in relapsing-remitting MS patients, in whom in currently relapse-free patients a higher CSF beta2-microglobulin level correlated with higher disease severity and disability.
Disclosure: Axel Haarmann, Luzia Hähnel, Michael Schuhmann, Guido Stoll and Mathias Buttmann have nothing to disclose.