Comparison of the degenerative and inflammatory markers in cerebrospinal fluid in multiple sclerosis patients with relapsing-remitting course of disease and after clinically isolated syndrome

• Published in: Multiple sclerosis 2008-09, Vol.14, p.S287-S287
• Main Authors: Sladkova, V, Mares, J, Lubenova, B, Kollarova, K, Kanovsky, P
• Format: Article
• Language: English
• ISSN: 1352-4585

Background: Multiple sclerosis (MS) is an autoimmune inflammatory disease of the central nervous system (CNS) leading to demyelination and axonal loss. Cerebrospinal fuid (CSF) examination is the basic examination to evaluate inflammation activity and the degree of degeneration in the CNS. Objective: To assess whether are there any differences in inflammatory and degenerative marker levels in CSF in relapsing-remitting MS (RRMS) and after clinically isolated syndrome (CIS). Methods: We examined 149 patients: 66 MS patients (46 RRMS and 20 CIS) and 83 controls with other non-inflammatory diseases. We evaluated markers of BBB integrity: albumin quotient and prealbumin, inflammatory markers: CRP, C3, C4, transferin, haptoglobin, beta-2-microglobulin, orosomucoid, markers of tissue destruction: ApoA-I, Apo-B, cystatin C, neuron-specific enolase, tauprotein and beta-amyloid. The intrathecal synthesis was assessed according to the number of oligoclonal IgG bands in alkaline fraction in IEF and IgG quotient. We also evaluated alfa-1-antitrypsin, which is considered as protective factor in the CNS. Results: We found increases in some inflammatory and degenerative CSF markers even after CIS. Intrathecal synthesis was higher in RRMS, but the number of oligoIgG bands was higher after CIS. As inflammatory markers, values of transferin, beta-2-microglobulin and neuron-specific enolase were higher after CIS; haptoglobin and transferin were lower. As degenerative markers, values of ApoA-I, tau-protein were higher after CIS; the value of Apo-B was higher in RRMS. The values of beta-amyloid and alfa-1-antitrypsin were normal. Conclusions: There were no statistically significant differences between particular degenerative and inflammatory markers in patients after CIS and RRMS, except for cystatin. We found statistically significantly lower values of cystatin in CSF in RRMS patients compared with patients after CIS. It is an indicator of high disease activity even after the first attack of MS.