Changes of cerebrospinal fluid cytokine profile as a result of switching from first line MS-therapies to rituximab

• Background: New treatment strategies in multiple sclerosis provide insights not only in the clinical effects but also, by their differences in mechanisms of action, in the immunopathological mechanisms behind disease activity.Objective: This study describes the change in cyto- and chemokine profile over a two-year period in a cohort of patients with clinically stable RRMS after treatment shift from ongoing first-line injectable disease modifying therapy (iDMT), e.g. interferon beta or glatirameracetat, to the anti-CD20 depleting agent rituximab and the differences compared with a cohort of healthy controls.Method: CSF from 73 patients with clinically stable RRMS was analysed by an elektrochemiluminiscens-based ELISA for a panel of 22 cytokines before and one and two year after treatment shift to rituximab and compared with 55 healthy controls.Results: During the first year of treatment it was a significant reduction (p< 0.005) in levels of IL-6, IL-8, IL-10, IL-12, IL-15, IP-10, MCP-1, MDC, TARC, sICAM, sVCAM and a significant elevation (p< 0,005) in levels of IL-7 and MIP-1b.Compared to healthy controls it was a significantly higher (p< 0,005) level of IFN-gamma, IL-6, IL-8, IL-10, IL-12, IL-15, TNF, IP-10, MDC, MIP-1a, MIP-1b, TARC, SAA, sICAM and sVCAM in patients with RRMS before treatment shift. Levels of IL-5 and IL-7 were significantly lower. One year after treatment shift the levels of IFN-gamma, IL-6, IL-7, IL-15, MIP-1a and SAA did not differ significantly between patients with RRMS and healthy controls.Conclusion: This study demonstrates significant changes in cyto- and chemokine profile in patients with RRMS after treatment shift from iDMT to rituximab and compared with healthy controls.

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MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Neurologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Neurology (hsv//eng)

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