Cerebrospinal fluid analysis in the context of CNS demyelinating diseases

Matas, Sandro Luiz de Andrade; Glehn, Felipe von; Fernandes, Gustavo Bruniera Peres; Soares, Carlos Augusto Senne

doi:10.1590/0004-282x20130151

Cited by 10 publications

(11 citation statements)

References 30 publications

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“…These results may be distinct characteristics of the Chinese population, but this hypothesis still needs to be confirmed by multiple sites studies with larger sample sizes. Total CSF white cell counts and CSF protein levels were generally consistent with what reported previously,[1] except for the CSF protein level and white cell count in NMOSD during relapses which were lower. [1] The levels of CSF white cell counts and CSF protein were slightly elevated than the normal range, indicating inflammatory activity during relapses.…”

Section: Discussionsupporting

confidence: 89%

“…CSF pleocytosis is present in around 50% of NMOSD samples. [1] NMO CSF white cell is usually ≥50 × 10 6 /L, while in MS it is <50 × 10 6 /L. [314] However, in our study, mean CSF white cell was 10.6 × 10 6 /L in NMOSD group and 7.8 × 10 6 /L in MS group.…”

Section: Discussioncontrasting

confidence: 64%

“…Slight elevation of CSF protein levels (450–700 mg/L) has been reported in MS patients, while CSF protein level in NMOSD was elevated up to 2900–6400 mg/L during relapses and stayed between 330 and 630 mg/L at the remission phase. [1] CSF protein level was slightly elevated than normal, with average 400 mg/L in MS group and average 483 mg/L in NMOSD group in our findings. CSF pleocytosis is present in around 50% of NMOSD samples.…”

Section: Discussionmentioning

confidence: 40%

“…[1] Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are the most studied subgroups of IIDDs. In patients misdiagnosed with MS, the alternative true diagnosis is often NMOSD, due to the similarities and overlaps among those diseases.…”

Section: Introductionmentioning

confidence: 99%

“…[1] NMOSD, an inflammatory disease of the central nervous system (CNS), is characterized by severe attacks of myelitis and optic neuritis. [12]…”

Section: Introductionmentioning

confidence: 99%

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Clinical Features of Patients with Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders

Hai

Liu

Zhang

et al. 2016

Chinese Medical Journal

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Background:Neuromyelitis optica spectrum disorder (NMOSD) was long believed to be an aggressive form of multiple sclerosis (MS). This study aimed to describe the clinical features of patients with MS and NMOSD to assist in differential diagnoses in clinical practice.Methods:Data including the patients’ serum and cerebrospinal fluid (CSF) tests, image findings, and clinical information from 175 patients with MS or NMOSD at Xuanwu Hospital, Capital Medical University from November 2012 to May 2014 were collected and analyzed retrospectively. An enzyme-linked immunosorbent assay was performed to detect the myelin oligodendrocyte glycoprotein (MOG) autoantibodies in CSF and serum. Cell-based assays were used to detect aquaporin-4-antibody (AQP4-Ab). The Chi-square test was used to compare the categorical variables. Wilcoxon rank sum test was performed to analyze the continuous variables.Results:Totally 85 MS patients (49%) and 90 NMOSD patients (51%) were enrolled, including 124 (71%) women and 51 (29%) men. Fewer MS patients (6%) had autoimmune diseases compared to NMOSD (19%) (χ2 = 6.9, P < 0.01). Patients with NMOSD had higher Expanded Disability Status Scale scores (3.5 [3]) than MS group (2 [2]) (Z = −3.69, P < 0.01). The CSF levels of white cell count and protein in both two groups were slightly elevated than the normal range, without significant difference between each other. Positivity of serum AQP4-Ab in NMOSD patients was higher than that in MS patients (MS: 0, NMOSD: 67%; χ2 = 63.9, P < 0.01). Oligoclonal bands in CSF among NMOSD patients were remarkably lower than that among MS (MS: 59%, NMOSD: 20%; χ2 = 25.7, P < 0.01). No significant difference of MOG autoantibodies was found between the two groups.Conclusion:The different CSF features combined with clinical, magnetic resonance imaging, and serum characteristics between Chinese patients with MS and NMOSD could assist in the differential diagnosis.

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Section: Discussionsupporting

confidence: 89%

Section: Discussioncontrasting

confidence: 64%

Section: Discussionmentioning

confidence: 40%

Section: Introductionmentioning

confidence: 99%

“…[1] NMOSD, an inflammatory disease of the central nervous system (CNS), is characterized by severe attacks of myelitis and optic neuritis. [12]…”

Section: Introductionmentioning

confidence: 99%

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Clinical Features of Patients with Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders

Hai

Liu

Zhang

et al. 2016

Chinese Medical Journal

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Gastrodin promotes CNS myelination via a lncRNA Gm7237/miR-142a/MRF pathway

et al. 2020

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Treatment of central nervous system (CNS) demyelination is greatly hindered by lack of the knowledge regarding to underlying molecular mechanisms as well as therapeutic agents. Here, we report a novel small molecule agent, gastrodin (GAS), which can significantly promote CNS myelination in in vivo mice models. By using high-throughput sequencing analysis, we discover a key long non-coding RNA Gm7237 that can enhance CNS myelination and is up-regulated by GAS. Through using bioinformatic analysis and experimental validations, we further unravel that microRNA-142a (miR-142a) and its target myelin gene regulatory factor (MRF) is under the direct regulation by Gm7237. Finally, we demonstrate that Gm7237/miR-142a/MRF axis is the key pathway involved in CNS myelination mediated by GAS. Overall, our results provide not only a novel agent for therapeutic treatment of CNS demyelination but also a molecular basis responsible for GAS-promoted CNS myelination.

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Utility of chemokines CCL2, CXCL8, 10 and 13 and interleukin 6 in the pediatric cohort for the recognition of neuroinflammation and in the context of traditional cerebrospinal fluid neuroinflammatory biomarkers

et al. 2019

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Background The recognition of active inflammation in the central nervous system (CNS) in the absence of infectious agents is challenging. The present study aimed to determine the diagnostic relevance of five selected chemo/cytokines in the recognition of CNS inflammation and in the context of traditional cerebrospinal fluid (CSF) biomarkers (white blood cell [WBC] counts, oligoclonal bands, protein levels, CSF/serum albumin ratios) and clinical diagnoses. Methods C-C and C-X-C motif ligands (CCL2, CXCL8, 10 and 13) and interleukin (IL) 6 levels in the CSF and serum from 37 control and 87 symptomatic children with ten different (mostly noninfectious) inflammatory CNS disorders (16 of which had follow-up samples after recovery) were determined using Luminex multiple bead technology and software. Nonparametric tests were used; p < 0.05 was considered statistically significant. Receiver operating characteristic curves were constructed to analyze controls and 1) all symptomatic samples or 2) symptomatic samples without CSF pleocytosis. Results Compared with the control CSF samples, levels of all investigated chemo/cytokines were increased in symptomatic CSF samples, and only IL-6 remained elevated in recovery samples (p ≤ 0.001). CSF CXCL-13 levels (> 10.9 pg/mL) were the best individual discriminatory criterion to differentiate neuroinflammation (specificity/sensitivity: 97/72% and 97/61% for samples without pleocytosis), followed by CSF WBC counts (specificity/sensitivity: 97/62%). The clinical utility of the remaining CSF chemo/cytokine levels was determined in descending order of sensitivities corresponding to thresholds that ensured 97% specificity for neuroinflammation in samples without pleocytosis (pg/mL; sensitivity %): IL-6 (3.8; 34), CXCL8 (32; 26), CXCL10 (317; 24) and CCL2 (387; 10). Different diagnosis-related patterns of CSF chemo/cytokines were observed. Conclusions The increased CSF level of CXCL13 was the marker with the greatest predictive utility for the general recognition of neuroinflammation among all of the individually investigated biomarkers. The potential clinical utility of chemo/cytokines in the differential diagnosis of neuroinflammatory diseases was identified.

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Cerebrospinal fluid analysis in the context of CNS demyelinating diseases

Cited by 10 publications

References 30 publications

Clinical Features of Patients with Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders

Clinical Features of Patients with Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders

Gastrodin promotes CNS myelination via a lncRNA Gm7237/miR-142a/MRF pathway

Utility of chemokines CCL2, CXCL8, 10 and 13 and interleukin 6 in the pediatric cohort for the recognition of neuroinflammation and in the context of traditional cerebrospinal fluid neuroinflammatory biomarkers

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