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Iron homeostasis, complement, and coagulation cascade as CSF signature of cortical lesions in early multiple sclerosis

Title: Iron homeostasis, complement, and coagulation cascade as CSF signature of cortical lesions in early multiple sclerosis
Authors: Magliozzi, R; Hametner, S; Facchiano, F; Marastoni, D; Rossi, S; Castellaro, M; Poli, A; Lattanzi, F; Visconti, A; Nicholas, R; Reynolds, R; Monaco, S; Lassmann, H; Calabrese, M
Source: 2163 ; 2150
Publisher Information: Wiley Open Access
Publication Year: 2019
Collection: Imperial College London: Spiral
Subject Terms: Science & Technology; Life Sciences & Biomedicine; Clinical Neurology; Neurosciences; Neurosciences & Neurology; BRAIN-BARRIER DISRUPTION; CEREBROSPINAL-FLUID; B-CELLS; MENINGEAL INFLAMMATION; HEMOGLOBIN; DEMYELINATION; FIBRINOGEN; PROTEIN; IDENTIFICATION; WIDESPREAD; 1103 Clinical Sciences; 1109 Neurosciences
Description: Objective Intrathecal inflammation, compartmentalized in cerebrospinal fluid (CSF) and in meningeal infiltrates, has fundamental role in inflammation, demyelination, and neuronal injury in cerebral cortex in multiple sclerosis (MS). Since the exact link between intrathecal inflammation and mechanisms of cortical pathology remains unknown, we aimed to investigate a detailed proteomic CSF profiling which is able to reflect cortical damage in early MS. Methods We combined new proteomic method, TRIDENT, CSF analysis, and advanced 3T magnetic resonance imaging (MRI), in 64 MS patients at the time of diagnosis and 26 controls with other neurological disorders. MS patients were stratified according to cortical lesion (CL) load. Results We identified 227 proteins differently expressed between the patients with high and low CL load. These were mainly related to complement and coagulation cascade as well as to iron homeostasis pathway (30 and 6% of all identified proteins, respectively). Accordingly, in the CSF of MS patients with high CL load at diagnosis, significantly higher levels of sCD163 (P < 0.0001), free hemoglobin (Hb) (P < 0.05), haptoglobin (P < 0.0001), and fibrinogen (P < 0.01) were detected. By contrast, CSF levels of sCD14 were significantly (P < 0.05) higher in MS patients with low CL load. Furthermore, CSF levels of sCD163 positively correlated (P < 0.01) with CSF levels of neurofilament, fibrinogen, and B cell‐related molecules, such as CXCL13, CXCL12, IL10, and BAFF. Interpretation Intrathecal dysregulation of iron homeostasis and coagulation pathway as well as B‐cell and monocyte activity are strictly correlated with cortical damage at early disease stages.
Document Type: article in journal/newspaper
Language: English
Relation: Annals of Clinical and Translational Neurology; http://hdl.handle.net/10044/1/76881
DOI: 10.1002/acn3.50893
Availability: http://hdl.handle.net/10044/1/76881; https://doi.org/10.1002/acn3.50893
Rights: © 2019 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals, Inc on behalf of American Neurological Association. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Accession Number: edsbas.3F162E9C
Database: BASE