Defining active progressive multiple sclerosis

Research output: Contribution to journalJournal articleResearchpeer-review

Finn Sellebjerg, Lars Börnsen, Cecilie Ammitzbøll, Jørgen Erik Nielsen, Tua Vinther-Jensen, Lena Elisabeth Hjermind, Marina von Essen, Rikke Lenhard Ratzer, Per Soelberg Sørensen, Jeppe Romme Christensen

BACKGROUND: It is unknown whether disease activity according to consensus criteria (magnetic resonance imaging activity or clinical relapses) associate with cerebrospinal fluid (CSF) changes in progressive multiple sclerosis (MS).

OBJECTIVE: To compare CSF biomarkers in active and inactive progressive MS according to consensus criteria.

METHODS: Neurofilament light chain (NFL), myelin basic protein (MBP), IgG-index, chitinase-3-like-1 (CHI3L1), matrix metalloproteinase-9 (MMP-9), chemokine CXCL13, terminal complement complex, leukocyte counts and nitric oxide metabolites were measured in primary ( n = 26) and secondary progressive MS ( n = 26) and healthy controls ( n = 24).

RESULTS: Progressive MS patients had higher CSF cell counts, IgG-index, CHI3L1, MMP-9, CXCL13, NFL and MBP concentrations. Active patients were younger and had higher NFL, CXCL13 and MMP-9 concentrations than inactive patients. Patients with active disease according to consensus criteria or detectable CXCL13 or MMP-9 in CSF were defined as having combined active progressive MS. These patients had increased CSF cell counts, IgG-index and MBP, NFL and CHI3L1 concentrations. Combined inactive patients only had increased IgG-index and MBP concentrations.

CONCLUSION: Patients with combined active progressive MS show evidence of inflammation, demyelination and neuronal/axonal damage, whereas the remaining patients mainly show evidence of active demyelination. This challenges the idea that neurodegeneration independent of inflammation is crucial in disease progression.

Original languageEnglish
JournalMultiple Sclerosis
Issue number13
Pages (from-to)1727-1735
Publication statusPublished - 2017

ID: 195162929