Levels of YKL-40 in Cerebrospinal Fluid and Serum of Newly Diagnosed Patients with Relapsing-Remitting Multiple Sclerosis

Abstract

Purpose: Chitinase-3-like protein 1 (CHI3L1 or YKL-40), novel inflammatory glycoprotein predominantly produced by reactive astrocytes. The aim of this study was to investigate YKL-40 levels in serum and cerebrospinal fluid (CSF) of newly diagnosed relapsingremitting multiple sclerosis (RRMS) patients. Materials and Methods: This study was conducted at the Neurology Clinic of Recep Tayyip Erdogan University Faculty of Medicine Training and Research Hospital between October 2012 and November 2016. A total of 50 participants, including 30 newly diagnosed and untreated RRMS patients (18 females, 12 males, age range 18-40 year) and 20 controls (12 females, 8 males, age range 20-40 year) were included in the study. CSF and serum YKL-40 levels of RRMS patients and controls were measured by ELISA. Results: CSF YKL-40 levels of RRMS patients were significantly higher than in controls. (respectively,168.8±28.3 ng/ml and 70.1±14.3 ng/ml, p<0.001). However, no significant differences were detected in serum YKL-40 levels between RRMS patients and controls. Serum YKL-40 levels were 51.2±12.1 ng/ml in RRMS patients and 46.8±8.2 ng/ml in controls (p=0.102). There were no correlation between serum and CSF YKL-40 activity in patients with RRMS (r=0.134 p=0.308). Conclusion: Our study supports the activation microglial in the early stages of newly diagnosed RRMS, as evidenced by elevated CSF YKL-40 levels. These findings should be corroborated by larger-scale clinical studies employing more specific glial inflammatory biomarkers. This may pave the way for the future use of drugs targeting glial inflammation in the early treatment of RRMS patients.

Keywords

• biomarker
• chitinase-3-like protein 1
• multiple sclerosis

Yeni Tanı Alan Atak ve Remisyonlarla Seyreden Multiple Sklerozlu Hastaların Beyin Omurilik Sıvısı ve Serumlarında YKL-40 Seviyeleri

Abstract

Amaç: Kitinaz-3 benzeri protein 1 (CHI3L1 yada YKL-40), reaktif astrositler tarafından ağırlıklı olarak üretilen yeni bir inflamatuar glikoproteindir. Bu çalışmanın amacı, yeni tanı alan atak ve remisyonlarla seyreden multipl skleroz (RRMS) hastalarının serum ve beyin omurilik sıvısındaki (BOS) YKL-40 seviyelerini araştırmaktır. Araçlar ve Yöntem: Bu çalışma Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi Eğitim ve Araştırma Hastanesi Nöroloji Kliniğinde 2012 Ekim ile 2016 Kasım ayları arasında yapıldı. Çalışmaya, 30 yeni tanı alan ve tedavi edilmemiş RRMS hastası (18 kadın, 12 erkek, yaş aralığı 18-40 yıl ) ve 20 kontrol (12 kadın, 8 erkek, yaş aralığı 20-40 yıl ) dahil olmak üzere toplam 50 katılımcı dahil edildi. RRMS hastalarının ve kontrollerin BOS ve serum YKL-40 düzeyleri ELISA testi ile ölçüldü. Bulgular: RRMS hastalarında BOS YKL-40 seviyeleri (sırasıyla 168.8±28.3 ng/ml ve 70.1±14.3 ng/ml, p<0.001) kontrollere göre anlamlı olarak daha yüksekti. Ancak, serum YKL-40 seviyeleri açısından RRMS hastaları ve kontroller arasında anlamlı bir fark saptanmadı. RRMS hastalarında ve kontrollerde serum YKL-40 seviyeleri sırasıyla 51.2±12.1 ng/ml ve 46.8±8.2 ng/ml idi (p=0.102). RRMS hastalarında serum ve BOS YKL-40 aktivitesi arasında ilişki yoktu (r=0.134, p=0.308). Sonuç: Çalışmamız, yeni tanı alan RRMS hastalarında tanısal lomber ponksiyon sırasında artmış BOS YKL-40 seviyeleri, hastalığın erken döneminde mikroglial aktivasyonun varlığını desteklemektedir. Bu sonuçlar daha spesifik glial inflamatuar biyobelirteçler ile yapılacak geniş ölçekli klinik çalışmalarla desteklenmelidir. Böylece gelecekte RRMS hastalarının erken tedavisinde glial inflamasyon üzerine etkili ilaçların da kullanımı ortaya çıkacaktır.

Keywords

• biyobelirteç
• kitinaz-3 benzeri protein 1
• multiple skleroz

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