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Cerebrospinal fluid–related tissue damage in multiple sclerosis patients with iron rim lesions
BACKGROUND: In multiple sclerosis (MS), iron rim lesions (IRLs) are associated with pronounced tissue damage, higher disease severity and have been suggested as an imaging marker of chronic active inflammation behind the blood–brain barrier indicating progression. Furthermore, chronic intrathecal co...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10152561/ https://www.ncbi.nlm.nih.gov/pubmed/37119207 http://dx.doi.org/10.1177/13524585231155639 |
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author | Wittayer, Matthias Weber, Claudia E Kittel, Maximilian Platten, Michael Schirmer, Lucas Tumani, Hayrettin Gass, Achim Eisele, Philipp |
author_facet | Wittayer, Matthias Weber, Claudia E Kittel, Maximilian Platten, Michael Schirmer, Lucas Tumani, Hayrettin Gass, Achim Eisele, Philipp |
author_sort | Wittayer, Matthias |
collection | PubMed |
description | BACKGROUND: In multiple sclerosis (MS), iron rim lesions (IRLs) are associated with pronounced tissue damage, higher disease severity and have been suggested as an imaging marker of chronic active inflammation behind the blood–brain barrier indicating progression. Furthermore, chronic intrathecal compartmentalized inflammation has been suggested to be a mediator of a cerebrospinal fluid (CSF)–related tissue damage. OBJECTIVE: To investigate CSF markers of intrathecal inflammation in patients with at least one IRL compared to patients without IRLs and to investigate tissue damage in lesions and normal-appearing white matter (NAWM) with proximity to CSF spaces. METHODS: A total of 102 patients (51 with at least 1 IRL and 51 age-/sex-matched patients without IRL) scanned with the same 3T magnetic resonance imaging (MRI) and having CSF analysis data were included. RESULTS: Patients with at least one IRL had higher disability scores, higher lesion volumes, lower brain volumes and a higher intrathecal immunoglobulin G (IgG) synthesis. Apparent diffusion coefficient (ADC) values in IRLs were higher compared to non-IRLs. We observed a negative linear correlation of ADC values in all tissue classes and distance to CSF, which was stronger in patients with high IgG quotients. CONCLUSION: IRLs are associated with higher intrathecal IgG synthesis. CSF-mediated intrathecal smouldering inflammation could explain a CSF-related gradient of tissue damage. |
format | Online Article Text |
id | pubmed-10152561 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-101525612023-05-03 Cerebrospinal fluid–related tissue damage in multiple sclerosis patients with iron rim lesions Wittayer, Matthias Weber, Claudia E Kittel, Maximilian Platten, Michael Schirmer, Lucas Tumani, Hayrettin Gass, Achim Eisele, Philipp Mult Scler Original Research Papers BACKGROUND: In multiple sclerosis (MS), iron rim lesions (IRLs) are associated with pronounced tissue damage, higher disease severity and have been suggested as an imaging marker of chronic active inflammation behind the blood–brain barrier indicating progression. Furthermore, chronic intrathecal compartmentalized inflammation has been suggested to be a mediator of a cerebrospinal fluid (CSF)–related tissue damage. OBJECTIVE: To investigate CSF markers of intrathecal inflammation in patients with at least one IRL compared to patients without IRLs and to investigate tissue damage in lesions and normal-appearing white matter (NAWM) with proximity to CSF spaces. METHODS: A total of 102 patients (51 with at least 1 IRL and 51 age-/sex-matched patients without IRL) scanned with the same 3T magnetic resonance imaging (MRI) and having CSF analysis data were included. RESULTS: Patients with at least one IRL had higher disability scores, higher lesion volumes, lower brain volumes and a higher intrathecal immunoglobulin G (IgG) synthesis. Apparent diffusion coefficient (ADC) values in IRLs were higher compared to non-IRLs. We observed a negative linear correlation of ADC values in all tissue classes and distance to CSF, which was stronger in patients with high IgG quotients. CONCLUSION: IRLs are associated with higher intrathecal IgG synthesis. CSF-mediated intrathecal smouldering inflammation could explain a CSF-related gradient of tissue damage. SAGE Publications 2023-02-19 2023-04 /pmc/articles/PMC10152561/ /pubmed/37119207 http://dx.doi.org/10.1177/13524585231155639 Text en © The Author(s), 2023 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Papers Wittayer, Matthias Weber, Claudia E Kittel, Maximilian Platten, Michael Schirmer, Lucas Tumani, Hayrettin Gass, Achim Eisele, Philipp Cerebrospinal fluid–related tissue damage in multiple sclerosis patients with iron rim lesions |
title | Cerebrospinal fluid–related tissue damage in multiple sclerosis patients with iron rim lesions |
title_full | Cerebrospinal fluid–related tissue damage in multiple sclerosis patients with iron rim lesions |
title_fullStr | Cerebrospinal fluid–related tissue damage in multiple sclerosis patients with iron rim lesions |
title_full_unstemmed | Cerebrospinal fluid–related tissue damage in multiple sclerosis patients with iron rim lesions |
title_short | Cerebrospinal fluid–related tissue damage in multiple sclerosis patients with iron rim lesions |
title_sort | cerebrospinal fluid–related tissue damage in multiple sclerosis patients with iron rim lesions |
topic | Original Research Papers |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10152561/ https://www.ncbi.nlm.nih.gov/pubmed/37119207 http://dx.doi.org/10.1177/13524585231155639 |
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