Predicting autoimmunity after alemtuzumab treatment of multiple sclerosis.
OBJECTIVE
We have previously shown that autoimmunity following alemtuzumab treatment of multiple sclerosis can be predicted by high baseline serum interleukin IL-21 (IL-21), as measured using a now 'redundant' enzyme linked immunosorbent assay (ELISA). Here we ask whether currently available ELISAs have similar prognostic value.


DESIGN
Serum IL-21 from 141 individuals with relapsing remitting multiple sclerosis was measured using the now 'redundant' IL-21 ELISA and five further currently available kits. All patients had been treated with alemtuzumab; 61/141 had developed secondary autoimmunity.


RESULTS
The 'redundant kit', and one current kit, confirmed higher baseline serum IL-21 in patients with autoimmunity (542 pg/mL vs. 222 pg/mL and 53.1 pg/mL vs. 9.3 pg/mL respectively) and showed positive correlation. However, only the 'redundant' kit had predictive utility.


CONCLUSIONS
Currently available IL-21 ELISA kits should not be used to counsel individuals with multiple sclerosis considering treatment with alemtuzumab.
['Azzopardi|Laura|L|', 'Thompson|Sara A J|SA|', 'Harding|Katherine E|KE|', 'Cossburn|Mark|M|', 'Robertson|Neil|N|', 'Compston|Alastair|A|', 'Coles|Alasdair J|AJ|', 'Jones|Joanne L|JL|']
D000293:Adolescent D000328:Adult D000074323:Alemtuzumab D061067:Antibodies, Monoclonal, Humanized D001327:Autoimmune Diseases D015551:Autoimmunity D015415:Biomarkers D004797:Enzyme-Linked Immunosorbent Assay D005260:Female D006801:Humans D007378:Interleukins D008297:Male D008875:Middle Aged D020529:Multiple Sclerosis, Relapsing-Remitting D011237:Predictive Value of Tests D055815:Young Adult
Multiple Sclerosis Immunology