以神经丝重链和几丁质酶 3-like 1 为标志监测多发性硬化症的治疗反应。

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders Pub Date : 2024-10-02 DOI:10.1016/j.msard.2024.105915

P. Kusnierova , K․Zondra Revendova , K. Karasova , D. Zeman , R. Bunganic , P. Hradilek , O. Volny , A. Ganesh , I. Kovacova , D. Stejskal

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引用次数: 0

摘要

目的：本研究旨在评估血清神经丝蛋白重链（sNfH）和几丁质酶 3-like 1（sCHI3L1）与多发性硬化症（MS）治疗反应和疾病活动的关系：这项单中心、前瞻性、观察性队列研究于2020年5月至2023年8月在捷克共和国俄斯特拉发大学医院多发性硬化症中心进行。采用了结果变量对数变换的混合效应线性模型：我们分析了来自 57 名多发性硬化症患者的 459 份样本。在 21.9 个月的随访期间，患者平均采样 8.05 次。采样时复发患者的 sNfH 浓度比缓解患者高 50%（exp(β) 1.5，95 % CI 1.15-1.96）。治疗时间越长，sNfH 浓度越低（exp(β) 0.95，95 % CI 0.94-0.96）。与仅接受低效DMTs治疗的患者相比，从低效改良疾病疗法（DMTs）转为高效DMTs治疗的患者sNfH更高（exp(β) 1.95，95 % CI 1.35-2.81）。较高的 sCHI3L1 值与年龄（exp(β) 1.01，95 % CI 1.00-1.02）和使用 DMT 的时间（exp(β) 1.01，95 % CI 1.00-1.02）相关。sCHI3L1 值与采样时的复发、肾功能、性别或 DMT 类型无关：与sCHI3L1相比，sNfH可能是监测治疗反应和确认多发性硬化症临床复发的潜在生物标志物。要确定sNfH的长期动态变化并制定相关的治疗策略，还需要进一步的研究。

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Neurofilament heavy chain and chitinase 3-like 1 as markers for monitoring therapeutic response in multiple sclerosis

Aims

The aim of this study was to evaluate the association of serum neurofilament heavy chain (sNfH) and chitinase 3-like 1 (sCHI3L1) with treatment response and disease activity in multiple sclerosis (MS).

Methods

This single-center, prospective, observational cohort study was conducted at the MS Centre, University Hospital Ostrava, Czech Republic, from May 2020 to August 2023. sNfH and sCHI3L1 were determined using ELISA. A mixed-effects linear model with a log-transformed outcome variable was applied.

Results

We analyzed 459 samples from 57 people with MS. Patients were sampled an average of 8.05 times during 21.9 months of follow-up. Those experiencing a relapse at sampling had a sNfH concentration 50 % higher than those in remission (exp(β) 1.5, 95 % CI 1.15–1.96). A longer duration of treatment was associated with lower sNfH (exp(β) 0.95, 95 % CI 0.94–0.96). Patients switched from low- to high-efficacy disease-modifying therapies (DMTs) had higher sNfH than patients treated with low-efficacy DMTs only (exp(β) 1.95, 95 % CI 1.35–2.81). Higher sCHI3L1 was associated with older age (exp(β) 1.01, 95 % CI 1.00–1.02) and longer DMT use (exp(β) 1.01, 95 % CI 1.00–1.02). sCHI3L1 values were not associated with relapse at the time of sampling, renal function, sex, or type of DMT.

Conclusion

In contrast to sCHI3L1, sNfH may be a potential biomarker for monitoring treatment response and confirming clinical relapse in MS. Further research is needed to determine the long-term dynamics of sNfH and develop related treatment strategies.

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来源期刊

Multiple sclerosis and related disorders CLINICAL NEUROLOGY-

CiteScore

5.80

自引率

20.00%

发文量

814

审稿时长

66 days

期刊介绍： Multiple Sclerosis is an area of ever expanding research and escalating publications. Multiple Sclerosis and Related Disorders is a wide ranging international journal supported by key researchers from all neuroscience domains that focus on MS and associated disease of the central nervous system. The primary aim of this new journal is the rapid publication of high quality original research in the field. Important secondary aims will be timely updates and editorials on important scientific and clinical care advances, controversies in the field, and invited opinion articles from current thought leaders on topical issues. One section of the journal will focus on teaching, written to enhance the practice of community and academic neurologists involved in the care of MS patients. Summaries of key articles written for a lay audience will be provided as an on-line resource. A team of four chief editors is supported by leading section editors who will commission and appraise original and review articles concerning: clinical neurology, neuroimaging, neuropathology, neuroepidemiology, therapeutics, genetics / transcriptomics, experimental models, neuroimmunology, biomarkers, neuropsychology, neurorehabilitation, measurement scales, teaching, neuroethics and lay communication.