Contributions
Abstract: P529
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Biomarkers
Background and purpose: Patients with Multiple Sclerosis (MS) have increased intestinal permeability.An altered intestinal barrier could lead to the translocation of gut commensals and associated molecules into the circulation that alter immunologic responses. Our aim was to measure the serum levels of Intestinal Fatty-Acid Binding Protein (IFABP), a marker of intestinal barrier integrity in patients with MS, and study if an altered intestinal barrier is associated with their clinical features.
Materials and methods: We included 112 patients with MS, 55 patients with RRMS (mean age 39.3 [range: 21-56] years, 69% female, mean EDSS 2.5 [range: 0-6.5], mean disease duration 10.1 [range: 1-37] years), and 57 patients with progressive MS (mean age 45.9 [range: 28-60] years, 63% female, mean EDSS 5.6 [range: 2-8.5], mean disease duration 13 [range: 3-36] years). We used 10 age and sex matched healthy individuals as controls. Blood-samples were used to measure IFABP by ELISA. Clinical, demographic and outcome measures were analyzed. A detectable serum IFABP was considered to be reflective of an altered intestinal barrier.
Results: In the progressive MS group, 57.9% of patients had SPMS and the rest had PPMS. In the RRMS group, 47.3% had recent (< 1 month) disease activity (enhancing lesion or a relapse). Patients with MS in either group had significantly higher concentrations of IFABP than controls (303±567 pg/mL in RRMS, 272.4±548 pg/mL in progressive MS, and 7.3±23 pg/mL in controls, respectively). IFABP levels were not associated with treatment, age or sex. At baseline, IFABP levels were not significantly different between active vs. non-active RRMS patients or between SPMS and PPMS. An altered intestinal barrier was found in 47.3% and 50.8% of patient with RRMS and progressive MS, respectively. In progressive MS patients, an altered intestinal barrier was not associated with disability progression. In RRMS, an altered intestinal barrier was significantly associated with the occurrence of a relapse within 1 year, even after adjusting for baseline disease activity and treatment.
Conclusions: Patients with MS have an altered intestinal barrier more often than controls. IFABP was not associated with clinical features in progressive MS. In RRMS, IFABP could not distinguish between active and non-active patients, but could predict a relapse within 1 year. More studies are needed to determine the clinical significance of having an altered intestinal barrier in MS.
Disclosure: CRCL is supported by the Denyse Lajoie-Lake Fellowship in Brain Research; VWY is a Canada Research Chair (Tier 1); Authors acknowledge support from the CIHR, MS Society of Canada and the Alberta Innovates- Health solutions Crio team. CRLC has no conflict of interest; LM has no conflict of interest; CS has no conflict of interest; JG has no conflict of interest; VWY has no conflict of interest
Abstract: P529
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Biomarkers
Background and purpose: Patients with Multiple Sclerosis (MS) have increased intestinal permeability.An altered intestinal barrier could lead to the translocation of gut commensals and associated molecules into the circulation that alter immunologic responses. Our aim was to measure the serum levels of Intestinal Fatty-Acid Binding Protein (IFABP), a marker of intestinal barrier integrity in patients with MS, and study if an altered intestinal barrier is associated with their clinical features.
Materials and methods: We included 112 patients with MS, 55 patients with RRMS (mean age 39.3 [range: 21-56] years, 69% female, mean EDSS 2.5 [range: 0-6.5], mean disease duration 10.1 [range: 1-37] years), and 57 patients with progressive MS (mean age 45.9 [range: 28-60] years, 63% female, mean EDSS 5.6 [range: 2-8.5], mean disease duration 13 [range: 3-36] years). We used 10 age and sex matched healthy individuals as controls. Blood-samples were used to measure IFABP by ELISA. Clinical, demographic and outcome measures were analyzed. A detectable serum IFABP was considered to be reflective of an altered intestinal barrier.
Results: In the progressive MS group, 57.9% of patients had SPMS and the rest had PPMS. In the RRMS group, 47.3% had recent (< 1 month) disease activity (enhancing lesion or a relapse). Patients with MS in either group had significantly higher concentrations of IFABP than controls (303±567 pg/mL in RRMS, 272.4±548 pg/mL in progressive MS, and 7.3±23 pg/mL in controls, respectively). IFABP levels were not associated with treatment, age or sex. At baseline, IFABP levels were not significantly different between active vs. non-active RRMS patients or between SPMS and PPMS. An altered intestinal barrier was found in 47.3% and 50.8% of patient with RRMS and progressive MS, respectively. In progressive MS patients, an altered intestinal barrier was not associated with disability progression. In RRMS, an altered intestinal barrier was significantly associated with the occurrence of a relapse within 1 year, even after adjusting for baseline disease activity and treatment.
Conclusions: Patients with MS have an altered intestinal barrier more often than controls. IFABP was not associated with clinical features in progressive MS. In RRMS, IFABP could not distinguish between active and non-active patients, but could predict a relapse within 1 year. More studies are needed to determine the clinical significance of having an altered intestinal barrier in MS.
Disclosure: CRCL is supported by the Denyse Lajoie-Lake Fellowship in Brain Research; VWY is a Canada Research Chair (Tier 1); Authors acknowledge support from the CIHR, MS Society of Canada and the Alberta Innovates- Health solutions Crio team. CRLC has no conflict of interest; LM has no conflict of interest; CS has no conflict of interest; JG has no conflict of interest; VWY has no conflict of interest