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

Yıl 2025, Cilt: 9 Sayı: 3, 346 - 351, 22.12.2025
https://doi.org/10.46332/aemj.1640948

Öz

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.

Etik Beyan

This study has been approved by the Ethics Committee of Recep Tayyip Erdoğan University Faculty of Medicine (dated September 7, 2012, and numbered 2012/126).

Kaynakça

  • 1. Oh J, Vidal-Jordana A, Montalban X. Multiple sclerosis: Clinical aspects. Curr Opin Neurol. 2018;31(6):752–759.
  • 2. Ruiz F, Vigne S, Pot C. Resolution of inflammation during multiple sclerosis. Semin Immunopathol. 2019;41(6):711–726.
  • 3. Garg N, Smith TW. An update on immunopathogenesis, diagnosis, and treatment of multiple sclerosis. Brain Behav. 2015;5(9):362.
  • 4. Tian J, Jiang L, Chen Z, et al. Tissue-resident immune cells in the pathogenesis of multiple sclerosis. Inflamm Res. 2023;72(3):363–372.
  • 5. Lassmann H. Multiple Sclerosis Pathology. Cold Spring Harb Perspect Med. 2018;8(3):28936.
  • 6. Deng Y, Li G, Chang D, Su X. YKL-40 as a novel biomarker in cardio-metabolic disorders and inflammatory diseases. Clin Chim Acta. 2020;511:40–46.
  • 7. Kim JS. Protein biomarkers in multiple sclerosis. Encephalitis. 2023;3(2):54–63.
  • 8. Hinsinger G, Du Trieu De Terdonck L, Urbach S, et al. CD138 as a Specific CSF Biomarker of Multiple Sclerosis. Neurol Neuroimmunol Neuroinflamm. 2024;11(3):200230.
  • 9. Chen XL, Li Q, Huang WS, et al. Serum YKL-40, a prognostic marker in patients with large-artery atherosclerotic stroke. Acta Neurol Scand. 2017;136(2):97–102.
  • 10. Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17(2):162–173.
  • 11. Comabella M, Fernández M, Martin R, et al. Cerebrospinal fluid chitinase 3-like 1 levels are associated with conversion to multiple sclerosis. Brain. 2010;133(4):1082–1093.
  • 12. López-Gómez J, Sacristán Enciso B, Caro Miró MA, Querol Pascual MR. Clinically isolated syndrome: Diagnosis and risk of developing clinically definite multiple sclerosis. Neurologia (Engl Ed). 2023;38(9):663–670.
  • 13. Tamam Y, Gunes B, Akbayir E, et al. CSF levels of HoxB3 and YKL-40 may predict conversion from clinically isolated syndrome to relapsing remitting multiple sclerosis. Mult Scler Relat Disord. 2021;48:102697.
  • 14. Bastos A, Soares M, Guimarães J. Markers of secondary progression in multiple sclerosis. Mult Scler Relat Disord. 2024;91:105881.
  • 15. Floro S, Carandini T, Pietroboni AM, De Riz MA, Scarpini E, Galimberti D. Role of Chitinase 3-like 1 as a Biomarker in Multiple Sclerosis: A Systematic Review and Meta-analysis. Neurol Neuroimmunol Neuroinflamm. 2022;9(4):1164.
  • 16. Kusnierova P, Revendova KZ, Karasova K, et al. Neurofilament heavy chain and chitinase 3-like 1 as markers for monitoring therapeutic response in multiple sclerosis. Mult Scler Relat Disord. 2024;91:105915.
  • 17. Rieckmann P. Neurodegeneration and clinical relevance for early treatment in multiple sclerosis. Int MS J. 2005;12(2):42–51.
  • 18. Lereim RR, Nytrova P, Guldbrandsen A, et al. Natalizumab promotes anti-inflammatory and repair effects in multiple sclerosis. PLoS One. 2024;19(3):300914.
  • 19. Marastoni D, Foschi M, Eccher C, et al. CSF levels of Chitinase3like1 correlate with early response to cladribine in multiple sclerosis. Front Immunol. 2024;15:1343892.

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

Yıl 2025, Cilt: 9 Sayı: 3, 346 - 351, 22.12.2025
https://doi.org/10.46332/aemj.1640948

Öz

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.

Etik Beyan

Bu çalışma, Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi Etik Kurulu tarafından onaylanmıştır (Tarih: 7 Eylül 2012, Karar numarası: 2012/126).

Kaynakça

  • 1. Oh J, Vidal-Jordana A, Montalban X. Multiple sclerosis: Clinical aspects. Curr Opin Neurol. 2018;31(6):752–759.
  • 2. Ruiz F, Vigne S, Pot C. Resolution of inflammation during multiple sclerosis. Semin Immunopathol. 2019;41(6):711–726.
  • 3. Garg N, Smith TW. An update on immunopathogenesis, diagnosis, and treatment of multiple sclerosis. Brain Behav. 2015;5(9):362.
  • 4. Tian J, Jiang L, Chen Z, et al. Tissue-resident immune cells in the pathogenesis of multiple sclerosis. Inflamm Res. 2023;72(3):363–372.
  • 5. Lassmann H. Multiple Sclerosis Pathology. Cold Spring Harb Perspect Med. 2018;8(3):28936.
  • 6. Deng Y, Li G, Chang D, Su X. YKL-40 as a novel biomarker in cardio-metabolic disorders and inflammatory diseases. Clin Chim Acta. 2020;511:40–46.
  • 7. Kim JS. Protein biomarkers in multiple sclerosis. Encephalitis. 2023;3(2):54–63.
  • 8. Hinsinger G, Du Trieu De Terdonck L, Urbach S, et al. CD138 as a Specific CSF Biomarker of Multiple Sclerosis. Neurol Neuroimmunol Neuroinflamm. 2024;11(3):200230.
  • 9. Chen XL, Li Q, Huang WS, et al. Serum YKL-40, a prognostic marker in patients with large-artery atherosclerotic stroke. Acta Neurol Scand. 2017;136(2):97–102.
  • 10. Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17(2):162–173.
  • 11. Comabella M, Fernández M, Martin R, et al. Cerebrospinal fluid chitinase 3-like 1 levels are associated with conversion to multiple sclerosis. Brain. 2010;133(4):1082–1093.
  • 12. López-Gómez J, Sacristán Enciso B, Caro Miró MA, Querol Pascual MR. Clinically isolated syndrome: Diagnosis and risk of developing clinically definite multiple sclerosis. Neurologia (Engl Ed). 2023;38(9):663–670.
  • 13. Tamam Y, Gunes B, Akbayir E, et al. CSF levels of HoxB3 and YKL-40 may predict conversion from clinically isolated syndrome to relapsing remitting multiple sclerosis. Mult Scler Relat Disord. 2021;48:102697.
  • 14. Bastos A, Soares M, Guimarães J. Markers of secondary progression in multiple sclerosis. Mult Scler Relat Disord. 2024;91:105881.
  • 15. Floro S, Carandini T, Pietroboni AM, De Riz MA, Scarpini E, Galimberti D. Role of Chitinase 3-like 1 as a Biomarker in Multiple Sclerosis: A Systematic Review and Meta-analysis. Neurol Neuroimmunol Neuroinflamm. 2022;9(4):1164.
  • 16. Kusnierova P, Revendova KZ, Karasova K, et al. Neurofilament heavy chain and chitinase 3-like 1 as markers for monitoring therapeutic response in multiple sclerosis. Mult Scler Relat Disord. 2024;91:105915.
  • 17. Rieckmann P. Neurodegeneration and clinical relevance for early treatment in multiple sclerosis. Int MS J. 2005;12(2):42–51.
  • 18. Lereim RR, Nytrova P, Guldbrandsen A, et al. Natalizumab promotes anti-inflammatory and repair effects in multiple sclerosis. PLoS One. 2024;19(3):300914.
  • 19. Marastoni D, Foschi M, Eccher C, et al. CSF levels of Chitinase3like1 correlate with early response to cladribine in multiple sclerosis. Front Immunol. 2024;15:1343892.
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri (Diğer)
Bölüm Araştırma Makalesi
Yazarlar

Serkan Kırbaş 0000-0002-3501-9401

Aynur Kırbaş 0000-0002-7676-2162

Medine Cumhur Cüre 0000-0001-9253-6459

Gönderilme Tarihi 16 Şubat 2025
Kabul Tarihi 1 Ağustos 2025
Yayımlanma Tarihi 22 Aralık 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 9 Sayı: 3

Kaynak Göster

APA Kırbaş, S., Kırbaş, A., & Cumhur Cüre, M. (2025). Levels of YKL-40 in Cerebrospinal Fluid and Serum of Newly Diagnosed Patients with Relapsing-Remitting Multiple Sclerosis. Ahi Evran Medical Journal, 9(3), 346-351. https://doi.org/10.46332/aemj.1640948
AMA Kırbaş S, Kırbaş A, Cumhur Cüre M. Levels of YKL-40 in Cerebrospinal Fluid and Serum of Newly Diagnosed Patients with Relapsing-Remitting Multiple Sclerosis. Ahi Evran Medical Journal. Aralık 2025;9(3):346-351. doi:10.46332/aemj.1640948
Chicago Kırbaş, Serkan, Aynur Kırbaş, ve Medine Cumhur Cüre. “Levels of YKL-40 in Cerebrospinal Fluid and Serum of Newly Diagnosed Patients with Relapsing-Remitting Multiple Sclerosis”. Ahi Evran Medical Journal 9, sy. 3 (Aralık 2025): 346-51. https://doi.org/10.46332/aemj.1640948.
EndNote Kırbaş S, Kırbaş A, Cumhur Cüre M (01 Aralık 2025) Levels of YKL-40 in Cerebrospinal Fluid and Serum of Newly Diagnosed Patients with Relapsing-Remitting Multiple Sclerosis. Ahi Evran Medical Journal 9 3 346–351.
IEEE S. Kırbaş, A. Kırbaş, ve M. Cumhur Cüre, “Levels of YKL-40 in Cerebrospinal Fluid and Serum of Newly Diagnosed Patients with Relapsing-Remitting Multiple Sclerosis”, Ahi Evran Medical Journal, c. 9, sy. 3, ss. 346–351, 2025, doi: 10.46332/aemj.1640948.
ISNAD Kırbaş, Serkan vd. “Levels of YKL-40 in Cerebrospinal Fluid and Serum of Newly Diagnosed Patients with Relapsing-Remitting Multiple Sclerosis”. Ahi Evran Medical Journal 9/3 (Aralık2025), 346-351. https://doi.org/10.46332/aemj.1640948.
JAMA Kırbaş S, Kırbaş A, Cumhur Cüre M. Levels of YKL-40 in Cerebrospinal Fluid and Serum of Newly Diagnosed Patients with Relapsing-Remitting Multiple Sclerosis. Ahi Evran Medical Journal. 2025;9:346–351.
MLA Kırbaş, Serkan vd. “Levels of YKL-40 in Cerebrospinal Fluid and Serum of Newly Diagnosed Patients with Relapsing-Remitting Multiple Sclerosis”. Ahi Evran Medical Journal, c. 9, sy. 3, 2025, ss. 346-51, doi:10.46332/aemj.1640948.
Vancouver Kırbaş S, Kırbaş A, Cumhur Cüre M. Levels of YKL-40 in Cerebrospinal Fluid and Serum of Newly Diagnosed Patients with Relapsing-Remitting Multiple Sclerosis. Ahi Evran Medical Journal. 2025;9(3):346-51.

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