Interleukin-12p40 in the spinal fluid as a biomarker for clinically isolated syndrome.
BACKGROUND
The cerebrospinal (CSF) constitutes a specific immune micro-environment to the central nervous system, thus it may contain specific biomarkers involved in the pathogenesis of multiple sclerosis (MS).


OBJECTIVES
We aimed to study a large array of inflammatory CSF biomarkers in patients with suspected MS to recognize potential early diagnostic markers.


METHODS
CSF samples were obtained from 115 patients who presented with neurological symptomatology suggestive of MS as follows: clinically isolated syndrome (CIS) = 49, relapsing-remitting multiple sclerosis (RRMS) = 29, and other neurologic disorders (OND) = 37. Protein expression profiles of 30 inflammatory biomarkers were measured by multiplex Luminex bead assay and further analyzed by group comparison statistics, correlation studies and receiver-operating characteristic (ROC) analysis.


RESULTS
Interleukin-12 subunit p40 (IL12p40) demonstrated a significant differential expression pattern between the groups (CIS vs OND: p = 1.17*10(-7); RRMS vs OND: p = 4.98*10(-5)), with higher levels in CIS and RRMS patients. ROC analysis demonstrated excellent diagnostic performance of IL12p40 for discrimination between CIS and OND patients (area under the curve = 0.87 (95% CI 0.78-0.93), p = 0.0001). No associations were found with disease activity or severity measures.


CONCLUSIONS
An increased IL12p40 level characterizes the CSF of MS patients and appears to be helpful in identifying CIS and OND patients early in the process of clinical diagnostic assessment.
['Orbach|Rotem|R|', 'Gurevich|Michael|M|', 'Achiron|Anat|A|']
D000293:Adolescent D000328:Adult D000368:Aged D019540:Area Under Curve D015415:Biomarkers D002493:Central Nervous System Diseases D003711:Demyelinating Diseases D004797:Enzyme-Linked Immunosorbent Assay D005260:Female D006801:Humans D053762:Interleukin-12 Subunit p40 D008297:Male D008875:Middle Aged D020529:Multiple Sclerosis, Relapsing-Remitting D012372:ROC Curve D055815:Young Adult
clinically isolated syndrome Multiple sclerosis interleukin-12 subunit p40 biological markers cerebrospinal fluid immunology