Axonal damage in relapsing multiple sclerosis is markedly reduced by natalizumab - PubMed (original) (raw)
Comparative Study
doi: 10.1002/ana.22247. Epub 2010 Dec 8.
Clas Malmeström, Markus Axelsson, Peter Sundström, Charlotte Dahle, Magnus Vrethem, Tomas Olsson, Fredrik Piehl, Niklas Norgren, Lars Rosengren, Anders Svenningsson, Jan Lycke
Affiliations
- PMID: 21280078
- DOI: 10.1002/ana.22247
Comparative Study
Axonal damage in relapsing multiple sclerosis is markedly reduced by natalizumab
Martin Gunnarsson et al. Ann Neurol. 2011 Jan.
Abstract
Objective: The impact of present disease-modifying treatments (DMTs) in multiple sclerosis (MS) on nerve injury and reactive astrogliosis is still unclear. Therefore, we studied the effect of natalizumab treatment on the release of 2 brain-specific tissue damage markers into cerebrospinal fluid (CSF) in MS patients.
Methods: CSF samples from 92 patients with relapsing forms of MS were collected in a prospective manner prior to natalizumab treatment and after 6 or 12 months. In 86 cases, natalizumab was used as second-line DMT due to breakthrough of disease activity. The levels of neurofilament light (NFL) and glial fibrillary acidic protein (GFAP) were determined using highly sensitive in-house developed enzyme-linked immunosorbent assays.
Results: Natalizumab treatment led to a 3-fold reduction of NFL levels, from a mean value of 1,300 (standard deviation [SD], 2,200) to 400 (SD, 270) ng/l (p < 0.001). The later value was not significantly different from that found in healthy control subjects (350 ng/l; SD, 170; n = 28). Subgroup analysis revealed a consistent effect on NFL release, regardless of previous DMT or whether patients had relapses or were in remission within 3 months prior to natalizumab treatment. No differences between pre- and post-treatment levels of GFAP were detected.
Interpretation: Our data demonstrate that natalizumab treatment reduces the accumulation of nerve injury in relapsing forms of MS. It is anticipated that highly effective anti-inflammatory treatment can reduce axonal loss, thereby preventing development of permanent neurological disability.
Copyright © 2010 American Neurological Association.
Comment in
- The neurofilament light chain is not stable in vitro.
Koel-Simmelink MJ, Teunissen CE, Behradkia P, Blankenstein MA, Petzold A. Koel-Simmelink MJ, et al. Ann Neurol. 2011 Jun;69(6):1065-6; author reply 1066-7. doi: 10.1002/ana.22438. Ann Neurol. 2011. PMID: 21681804 No abstract available.
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