Macrophages in MS

Stilund M, Reuschlein AK, Christensen T, Møller HJ, Rasmussen PV, Petersen T.Soluble CD163 as a Marker of Macrophage Activity in Newly Diagnosed Patients with Multiple Sclerosis. PLoS One. 2014 Jun;9(6):e98588.

BACKGROUND:Soluble CD163 (sCD163) is a macrophage specific protein known to be up-regulated in serum from patients with multiple sclerosis(MS).

OBJECTIVE:To investigate sCD163 in serum and CSF (cerebrospinal fluid) from patients undergoing MS diagnostic work-up and analyse its potential as a diagnostic biomarker.

METHODS:After a full MS diagnostic work-up, including collection of paired samples of CSF and serum, 183 patients were evaluated for inclusion in this study. Patients were divided into groups based on their diagnosis. Patients with normal clinical and paraclinical findings were grouped as symptomatic controls. Serum and CSF levels of sCD163 were determined by enzyme-linked immunosorbent assay (ELISA).

RESULTS:sCD163 could be measured in all serum and CSF samples. A high sCD163 CSF/serum ratio in relation to molecular weight was found, strongly indicating local production in the CNS. Median levels of sCD163 were significantly decreased in serum and significantly elevated in CSF in patients with relapsing-remitting, and primary- progressive MS. There were, however, some overlaps of the measures between groups.

CONCLUSION:The sCD163 CSF/serum ratio was significantly increased in patients with MS and may reflect macrophage activation in MS lesions. These results suggest that primary progressive MS also is driven by inflammation in which the innate immune system plays a pivotal role.
So further evidence that inflammatory events are occurring in the CNS in both relapsing and progressive MS

Parenchymal accumulation of CD163+ macrophages/microglia in multiple sclerosis brains. Zhang Z, Zhang ZY, Schittenhelm J, Wu Y, Meyermann R, Schluesener HJ. J Neuroimmunol. 2011;237(1-2):73-9.

Macrophages in inflammatory multiple sclerosis lesions have an intermediate activation status. Vogel DY, Vereyken EJ, Glim JE, Heijnen PD, Moeton M, van der Valk P, Amor S, Teunissen CE, van Horssen J, Dijkstra CD.

J Neuroinflammation. 2013 Mar 4;10:35.

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  • Mouse,

    Thanks for all your efforts on this blog.

    The current thinking seems to be that both immune systems (inside the cns and outside) are involved. Do they require different therapies ( it looks to me as if the highly effective therapies address the external immune attack)? Also, what process comes first – does the internal immune system start first? What about B cells and EBV?

    • I think they probably do need different therapies,as you say the external immune response is being addressed but the immune system inside the CNS needs dealing with.

      Which comes first…depends on which side of the fence you want to sit.

      B cels and EBV could be inside could be outside

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