Cerebrospinal Fluid Biomarkers of Neuroinflammation and Axonal Degeneration in Patients with Multiple Sclerosis

Background: Inflammation mediators have important roles in leukocyte recruitment and the central nervous system (CNS) inflammation and damage. Axonal and neuronal damage are associated with the level of CNS inflammation and determine physical handicap on multiple sclerosis (MS) patients.

Objectives: On distinguishing and inspect the associations between a group of inflammatory biomarkers {matrix metalloproteinase 9 (MMP9), neurofilament light chain (NFL), osteopontin (OPN), and chemokine ligand 13 (CXCL13)} on MS patients.

Patients and Methods: We collected the patients the electronic Mansoura Neurology department data sheet, and all patients encountered assessment by Expanded Disability Status Scale (EDSS) at the onset. All patients and control had cerebrospinal fluid (CSF) biomarkers work-up (MMP9, CXCL13, OPN, and NFL) that measured by ELISA. A correlation statistic matrix was done to demonstrate the presence of relationships between CSF biomarkers within the MS cases.

Results: The enclosed fifty patients comprising different MS subtypes {relapsing-remitting (RRMS) (70%), secondary progressive (SPMS) (22%) and primary progressive (PPMS) (8%)} with the mean age of 34.6±8.9 years. Healthy controls (HC) were 25. The most common clinical presentations were sensory manifestations (34%) and optic neuritis (24%). We found that the levels of CXCL13, NF-L, OPN, and MMP-9 were highly significantly increased among MS patients (P<0.0001, P<0.0001, P<0.001, and P<0.0001 respectively). The correlations between CSF biomarker levels showed a highly significant correlation between CXCL13 and MMP-9 followed by OPN and NF-L.

Conclusion: Our results showed that there is a strong association between CSF biomarkers of inflammation and axonal damage and MS, especially in RRMS patients.