Contributions
Abstract: P832
Type: Poster
Abstract Category: Clinical aspects of MS - 1 Diagnosis and differential diagnosis
In majority of multiple sclerosis (MS) patients, disease starts with a single clinical attack, called clinically isolated syndrome (CIS). Prediction of the CIS patients that will convert to MS (CIS-MS) is important for treatment and prognosis decisions. In this study, we aimed to identify a biomarker to predict this conversion.
Consecutive 42 CIS patients with at least 5 years of follow-up were included and cerebrospinal fluid (CSF) samples obtained at initial diagnosis were kept frozen. During their prospective follow-up, 20 patients fulfilled the McDonald criteria for definite MS. CSF samples obtained during the first attacks of all patients were screened for their protein content with mass spectrometry. Levels of CSF proteins were determined with ELISA. Controls included 36 patients with non-inflammatory neurological diseases, neuromyelitis optica (NMO), Neuro-Behçet's disease and primary progressive MS.
Mass spectrometry analysis identified 72 proteins that were exclusively found in CIS-MS CSF. Among these levels of 5 proteins that were most significantly higher in CIS-MS patients (homeobox protein HoxB3, tumor necrosis factor receptor superfamily member 21, chitinase-3-like protein 1, Kv channel-interacting protein 4 and iduronate 2-sulfatase) were determined. When CIS patients with and without MS conversion were compared, only HoxB3 levels were found out to be significantly higher in CIS-MS patients (3.3 ± 0.3 ng/ml vs 2.9 ± 0.5 ng/ml; p=0.014). ROC curve analysis yielded that higher than 3 ng/ml of HoxB3 levels had a 83% sensitivity and 62% specificity for prediction of MS conversion. Univariate Cox regression analysis also showed that HoxB3 levels > 3 ng/ml was a good indicator of MS conversion (Hazard ratio = 3,3; 95% CI 1.1-10,2; p=0.04). 85% of MS patients with both oligoclonal bands and HoxB3 levels > 3 ng/ml converted to MS on the 60th month.
Our study suggests that elevated CSF HoxB3 levels strongly predicts MS conversion. OCB positivity as an independent factor improves the prediction power of HoxB3 levels.
Disclosure:
Erdem Tuzun: Nothing to disclose
Zerrin Karaaslan: Nothing to disclose
Özlem Timirci-Kahraman: Nothing to disclose
Canan Ulusoy: Nothing to disclose
Cem İsmail Küçükali: Nothing to disclose
Tuncay Gündüz: Nothing to disclose
Murat Kürtüncü: Nothing to disclose
Mefkure Eraksoy: Nothing to disclose
Abstract: P832
Type: Poster
Abstract Category: Clinical aspects of MS - 1 Diagnosis and differential diagnosis
In majority of multiple sclerosis (MS) patients, disease starts with a single clinical attack, called clinically isolated syndrome (CIS). Prediction of the CIS patients that will convert to MS (CIS-MS) is important for treatment and prognosis decisions. In this study, we aimed to identify a biomarker to predict this conversion.
Consecutive 42 CIS patients with at least 5 years of follow-up were included and cerebrospinal fluid (CSF) samples obtained at initial diagnosis were kept frozen. During their prospective follow-up, 20 patients fulfilled the McDonald criteria for definite MS. CSF samples obtained during the first attacks of all patients were screened for their protein content with mass spectrometry. Levels of CSF proteins were determined with ELISA. Controls included 36 patients with non-inflammatory neurological diseases, neuromyelitis optica (NMO), Neuro-Behçet's disease and primary progressive MS.
Mass spectrometry analysis identified 72 proteins that were exclusively found in CIS-MS CSF. Among these levels of 5 proteins that were most significantly higher in CIS-MS patients (homeobox protein HoxB3, tumor necrosis factor receptor superfamily member 21, chitinase-3-like protein 1, Kv channel-interacting protein 4 and iduronate 2-sulfatase) were determined. When CIS patients with and without MS conversion were compared, only HoxB3 levels were found out to be significantly higher in CIS-MS patients (3.3 ± 0.3 ng/ml vs 2.9 ± 0.5 ng/ml; p=0.014). ROC curve analysis yielded that higher than 3 ng/ml of HoxB3 levels had a 83% sensitivity and 62% specificity for prediction of MS conversion. Univariate Cox regression analysis also showed that HoxB3 levels > 3 ng/ml was a good indicator of MS conversion (Hazard ratio = 3,3; 95% CI 1.1-10,2; p=0.04). 85% of MS patients with both oligoclonal bands and HoxB3 levels > 3 ng/ml converted to MS on the 60th month.
Our study suggests that elevated CSF HoxB3 levels strongly predicts MS conversion. OCB positivity as an independent factor improves the prediction power of HoxB3 levels.
Disclosure:
Erdem Tuzun: Nothing to disclose
Zerrin Karaaslan: Nothing to disclose
Özlem Timirci-Kahraman: Nothing to disclose
Canan Ulusoy: Nothing to disclose
Cem İsmail Küçükali: Nothing to disclose
Tuncay Gündüz: Nothing to disclose
Murat Kürtüncü: Nothing to disclose
Mefkure Eraksoy: Nothing to disclose