Contributions
Abstract: P531
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Biomarkers
Background: Studies of multiple sclerosis (MS) patients have proposed prognostic values for different magnetic resonance imaging (MRI) parameters and molecular biomarkers. The role of cerebrospinal fluid (CSF) analysis has been emphasized in particular in patients with a first episode suggestive of MS. We here evaluate disease activity biomarkers distinguishing benign from aggressive MS disease courses that should allow a stratification of patients aiming at best treatment strategies.
Objectives: To assess the value of CSF biomarkers including multiparameter flow cytometry, neurofilament light chain (NfL) and chitinase 3-like 1 (CHI3L1) levels along with serum NfL levels as indicators of extreme manifestations of clinically isolated syndrome (CIS) and early MS.
Methods: From a cohort of 1024 patients, we selected 102 patients diagnosed with either CIS or early relapsing-remitting (RR)MS. These were divided into three different severity groups defined by MRI criteria. High activity was defined as ≥ 20 T2 lesions and ≥ 2 gadolinium-enhancing lesions or 1 tumefactive lesion. Low activity was defined as ≤ 3 T2 lesions and no gadolinium-enhancing lesions. Intermediate activity referred to patients neither fulfilling the criteria for high nor low activity. Leukocyte subsets in the CSF were analyzed by flow cytometry. CSF NfL and CHI3L1 levels were measured by enzyme-linked immunosorbent assay. Serum NfL levels were examined using single molecule array technology. MS patients with particularly high or low MRI-activity underwent up to 3 years of follow-up.
Results: Univariate analysis demonstrated that B cell/monocyte (CD20/CD14) ratios in CSF as well as NfL levels in CSF and serum were associated with the MRI-based severity grouping, whereas this association was not found for CSF CHI3L1 levels. NfL levels in CSF and serum highly correlated. Multivariate logistic regression with backward selection showed the best prediction for a model combining B cell/monocyte ratios and CSF NfL levels to identify patients with particularly high or low MRI-activity. Data will be presented about the prognostic value of these biomarkers for predicting future disease courses.
Conclusion: Patients with extreme manifestations of CIS and early MS defined by MRI parameters can be distinguished with regards to a combined biomarker panel of CSF NfL and B cell/monocyte ratios. This could stratify individual treatment decisions towards a more personalized immunotherapy.
Disclosure: Felix Luessi: nothing to disclose, Sinah Engel: nothing to disclose, Falk Steffen: nothing to disclose, Michaela Friedrich: nothing to disclose, Annette Spreer: nothing to disclose, Alicia Poplawski: nothing to disclose, Stefan Bittner: nothing to disclose, Frauke Zipp: nothing to disclose
Abstract: P531
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Biomarkers
Background: Studies of multiple sclerosis (MS) patients have proposed prognostic values for different magnetic resonance imaging (MRI) parameters and molecular biomarkers. The role of cerebrospinal fluid (CSF) analysis has been emphasized in particular in patients with a first episode suggestive of MS. We here evaluate disease activity biomarkers distinguishing benign from aggressive MS disease courses that should allow a stratification of patients aiming at best treatment strategies.
Objectives: To assess the value of CSF biomarkers including multiparameter flow cytometry, neurofilament light chain (NfL) and chitinase 3-like 1 (CHI3L1) levels along with serum NfL levels as indicators of extreme manifestations of clinically isolated syndrome (CIS) and early MS.
Methods: From a cohort of 1024 patients, we selected 102 patients diagnosed with either CIS or early relapsing-remitting (RR)MS. These were divided into three different severity groups defined by MRI criteria. High activity was defined as ≥ 20 T2 lesions and ≥ 2 gadolinium-enhancing lesions or 1 tumefactive lesion. Low activity was defined as ≤ 3 T2 lesions and no gadolinium-enhancing lesions. Intermediate activity referred to patients neither fulfilling the criteria for high nor low activity. Leukocyte subsets in the CSF were analyzed by flow cytometry. CSF NfL and CHI3L1 levels were measured by enzyme-linked immunosorbent assay. Serum NfL levels were examined using single molecule array technology. MS patients with particularly high or low MRI-activity underwent up to 3 years of follow-up.
Results: Univariate analysis demonstrated that B cell/monocyte (CD20/CD14) ratios in CSF as well as NfL levels in CSF and serum were associated with the MRI-based severity grouping, whereas this association was not found for CSF CHI3L1 levels. NfL levels in CSF and serum highly correlated. Multivariate logistic regression with backward selection showed the best prediction for a model combining B cell/monocyte ratios and CSF NfL levels to identify patients with particularly high or low MRI-activity. Data will be presented about the prognostic value of these biomarkers for predicting future disease courses.
Conclusion: Patients with extreme manifestations of CIS and early MS defined by MRI parameters can be distinguished with regards to a combined biomarker panel of CSF NfL and B cell/monocyte ratios. This could stratify individual treatment decisions towards a more personalized immunotherapy.
Disclosure: Felix Luessi: nothing to disclose, Sinah Engel: nothing to disclose, Falk Steffen: nothing to disclose, Michaela Friedrich: nothing to disclose, Annette Spreer: nothing to disclose, Alicia Poplawski: nothing to disclose, Stefan Bittner: nothing to disclose, Frauke Zipp: nothing to disclose