Looking in the blood or brain for inflammatory markers

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NDG may have something to say about this one. In this study they looked for inflammatory markers in the blood and spinal fluid in people with MS. I have removed the bits about predictors as those familiar with the blog, know that these are generally never good enough to say anythng about the individuals. The point I want to make is this, that you may been to be prepared to have a lumbar puncture to determine effects occuring in the brain as looking in the blood may not be sensitive enough. This goes for neurofilaments. One school of thought is that they are the same, but abit less sensitive and so they sell you the idea that simply loking in blood is OK. However, if you want more clarity you need to see whats in the spinal fluid.

The predictive value of CSF multiple assay in multiple sclerosis: A single center experience. De Fino C, Lucchini M, Lucchetti D, Nociti V, Losavio FA, Bianco A, Colella F, Ricciardi-Tenore C, Sgambato A, Mirabella M.Mult Scler Relat Disord. 2019 Jul 28;35:176-181. 

BACKGROUND: Multiple sclerosis (MS) is a chronic, immune-mediated, inflammatory, neurodegenerative disorder. Many studies are investigating the potential role of body fluid biomarkers as prognostic factors for early identification of patients presenting with clinical isolated syndrome (CIS) at high risk for conversion to MS or to recognize RRMS patients at high risk for progression.

OBJECTIVES:To evaluate the correlation between levels of BAFF, chitinase 3-like 1 (CHI3L1), sCD163, Osteopontin (OPN), both on serum and cerebral spinal fluid (CSF), and the disease activity and progression. We also want to explore a possible relationship between serological and CSF biomarker’s levels.

PATIENTS AND METHODS:We enrolled 82 patients between June 2014 and June 2016. Seventy-one received a diagnosis of demyelinating disease of CNS (46 RRMS and 25 CIS), while 11 were affected by other neurological diseases. All patients underwent a neural axis MRI, lumbar puncture and blood samples. Levels of BAFF, CHI3L1, sCD163, OPN on serum and CSF were analyzed by Luminex xMAP system, with a kit 11-plex ad hoc

RESULTS: The CSF CHI3L1, sCD163 and OPN levels were significantly higher in MS patients than in controls. We did not find significant differences in serum CHI3L1, sCD163 and OPN levels, nor CSF or serum BAFF levels between patient and control groups. We found significantly higher CSF level of sCD163 and CHI3L1 in all patients’ subgroups compared with controls, while OPN was higher in CIS and RR subgroups. We did not find significant differences for serum and CSF levels of all the markers between patients with or without clinical or radiological disease activity. CSF sCD163 and CHI3L1 levels was significant higher in CIS patients who converted to MS (p < 0.05).

CONCLUSIONS:CSF sCD163 CHI3L1 and OPN levels were higher in MS patients whereas serum CHI3L1, sCD163 and OPN levels did not show differences compared with controls. This finding confirms the high CSF specificity with regards to the analysis of processes, inflammatory and non-inflammatory, that occur within the CNS.

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