Assessment of Functional Capacity of Immune System in Patients with Multiple Sclerosis using QuantiFERON Monitor

Abstract

Background. The QuantiFERON®-Monitor (QFM) is an assay that measures interferon-γ production and was developed to provide an objective marker of complex immune response. In this study, we evaluated the use of the QFM test in patients with two forms of multiple sclerosis (MS), relapsing–remitting form treated with fingolimod (fMS) and secondarily progressive form not treated pharmacologically (pMS), and in healthy controls (HC). We hypothesized that IFN-γ levels would be lower in those subjects who are relatively more immunosuppressed and higher in those with normal or activated immune function. Methods. This single-center observational study was conducted from November 2020 to October 2021 and compared results in three groups of patients: 86 healthy controls, 96 patients with pMS, and 78 fMS. Combination of lyophilized stimulants was added to 1 ml heparinized whole blood within 8 hr of collection. Plasmatic IFN-γ was measured using the ELISA kit for the QFM and data were obtained in IU/ml. Results. The results showed that controls had nearly 2-fold higher levels of IFN-γ (QFM score) in median (q25, q75) 228.00 (112.20, 358.67) than the MS patient groups: pMS 144.80 (31.23, 302.00); fMS 130.50 (39.95, 217.07) which is statistically significant difference P-value: HC vs. pMS = 0.0071; HC vs. fMS = 0.0468. This result was also confirmed by a validation analysis to exclude impact of variable factors, such as disease duration and Expanded Disability Status Scale scores. Conclusions. Results showed that controls had higher levels of IFN-γ production than the MS patient groups and suggest that MS patients included in this study have a lower ability of immune system activation than HC. Results confirm that fingolimod is able to suppress production of IFN-γ. The fact that the QFM score of MS patients is significantly lower than that of HC may indicate a dysfunctional state of the immune system in baseline conditions.

Quantiferon Monitor Testing Sheds Light on Immune System Disparities between Multiple Sclerosis Patients and Healthy Individuals

“…While previously employed in fields such as transplantation, infectious medicine, and hepatology, its application in neurology, especially for multiple sclerosis patients, marks a novel approach. In our previous work, we were the first to use this monitor for evaluating immune functions in MS patients, breaking new ground in the assessment and understanding of MS [19].…”

“…The objective of this research was to undertake QFM assessments for individuals with MS, aimed at assessing the immune system's condition by evaluating a range of specific cytokines in stimulated blood samples to gain deeper insights into the immune reactions. Building on the findings from a preceding publication [19], which employed activated serum samples initially for determining IFN-γ, our present investigation shifted its focus toward a broader array of cytokines to uncover further details about the immune response. We employed Luminex technology for an initial screening, leading to intriguing results, which were then meticulously validated through ELISA, offering a nuanced exploration of cytokine patterns.…”