| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Department of Neurology and the Center for Neuroimmunology, University of Alabama at Birmingham; and Neurology and Research Services of the Birmingham Veterans Medical Center (Dr. Whitaker), Birmingham, AL.
Address correspondence and reprint requests to Dr. Khurram Bashir, Department of Neurology, University of Alabama at Birmingham, 1205 JT, 625 19th Street South, Birmingham, AL 35233-7340.
OBJECTIVE: To compare the clinical and laboratory features of primary progressive (PP) and secondary progressive (SP) MS, to evaluate the role of CSF and urine myelin basic protein-like material (MBPLM) in differentiating PP from SP MS, and to assess the utility of urine MBPLM as a surrogate marker of disease activity in progressive MS.
BACKGROUND: The current categorization of subtypes of MS is based solely on clinical and temporal characteristics of the disease. Laboratory markers are needed that can differentiate reliably the subtypes of MS and serve as surrogate markers of disease progression.
METHODS: Clinical and paraclinical data of 51 PPMS and 140 SPMS patients were reviewed retrospectively. CSF and urine MBPLM were measured using a double-antibody radioimmunoassay.
RESULTS: PPMS was more likely to present with progressive myelopathy (p 
0.001) after the age of 40 years (p = 0.001), and it affected men relatively more often than SPMS (male-to-female ratio, 1:1.7 versus 1:3.2 respectively). Ambulatory assistance was required by PP patients more often and earlier than in those with SPMS. The incidence of abnormal CSF, evoked potential, and cranial MRI studies was similar in the two groups. Spinal cord MRI abnormalities were noted significantly more often in SP disease. There was an insignificant trend of higher CSF MBPLM in SPMS compared with PPMS. Urine MBPLM and MBPLM/creatinine were significantly higher in SPMS than in PPMS. However, the values of urine MBPLM and MBPLM/creatinine at the initial visits of patients with PPMS and SPMS were not significantly different. Urine MBPLM/creatinine was significantly higher in both PPMS and SPMS compared with normal control subjects. No correlation was found between urine MBPLM and disease duration or between urine MBPLM and clinical disability. There was no correlation between urine MBPLM/creatinine and either disease duration or clinical disability.
CONCLUSIONS: These findings provide additional evidence of the differences in PPMS and SPMS, notably in the associated changes in MBPLM in urine, and also suggest a possible role for urine MBPLM in identifying patient cohorts. The high urine MBPLM levels in progressive MS patients indicate a potential role of this marker for assessing responsiveness to therapeutic interventions.
Key words: CSF—Urine—Myelin basic protein—MS.
This article has been cited by other articles:
|
|
 |
|
  J S Sloka, W E. Pryse-Phillips, and M Stefanelli The relation between menarche and the age of first symptoms in a multiple sclerosis cohort Multiple Sclerosis, June 1, 2006; 12(3): 333 - 339. [Abstract] [PDF]
|
|
|
|
 |
|
 G T Ingle, J Sastre-Garriga, D H Miller, and A J Thompson Is inflammation important in early PPMS? a longitudinal MRI study J. Neurol. Neurosurg. Psychiatry, September 1, 2005; 76(9): 1255 - 1258. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. H. van den Broek, J. G. Damoiseaux, M. H De Baets, and R. M. Hupperts The influence of sex hormones on cytokines in multiple sclerosis and experimental autoimmune encephalomyelitis: a review Multiple Sclerosis, June 1, 2005; 11(3): 349 - 359. [Abstract] [PDF]
|
|
|
|
|
|
J M Greer and M P Pender The presence of glutamic acid at positions 71 or 74 in pocket 4 of the HLA-DR{beta}1 chain is associated with the clinical course of multiple sclerosis J. Neurol. Neurosurg. Psychiatry, May 1, 2005; 76(5): 656 - 662. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M J Tullman, R J Oshinsky, F D Lublin, and G R Cutter Clinical characteristics of progressive relapsing multiple sclerosis Multiple Sclerosis, August 1, 2004; 10(4): 451 - 454. [Abstract] [PDF]
|
|
|
|
|
|
C. Lucchinetti and W. Bruck The pathology of primary progressive multiple sclerosis Multiple Sclerosis, June 1, 2004; 10(1_suppl): S23 - S30. [Abstract] [PDF]
|
|
|
|
|
|
C. Lucchinetti and W. Bruck The pathology of primary progressive multiple sclerosis Multiple Sclerosis, May 1, 2004; 10(3_suppl): S23 - S30. [Abstract] [PDF]
|
|
|
|
|
|
G V McDonnell, J Cabrera-Gomez, D B Calne, D K. Li, and J Oger Clinical presentation of primary progressive multiple sclerosis 10 years after the incidental finding of typical magnetic resonance imaging brain lesions: The subclinical stage of primary progressive multiple sclerosis may last 10 years Multiple Sclerosis, April 1, 2003; 9(2): 204 - 209. [Abstract] [PDF]
|
|
|
|
|
|
M-L Sumelahti, P J Tienari, M Hakama, and J Wikstrom Multiple sclerosis in Finland: incidence trends and differences in relapsing remitting and primary progressive disease courses J. Neurol. Neurosurg. Psychiatry, January 1, 2003; 74(1): 25 - 28. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. L. Simone, D. Carrara, C. Tortorella, M. Liguori, V. Lepore, F. Pellegrini, A. Bellacosa, A. Ceccarelli, I. Pavone, and P. Livrea Course and prognosis in early-onset MS: Comparison with adult-onset forms Neurology, December 24, 2002; 59(12): 1922 - 1928. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. S. Burks, B. G. Arnason, P. K. Coyle, C. C. Ford, A. Noronha, and K. W. Rammohan Issues and Practices in Multiple Sclerosis Neurorehabil Neural Repair, December 1, 2002; 16(4): 307 - 320. [Abstract] [PDF]
|
|
|
|
|
|
L. Weiner, N. Kachuck, W. Gilmore, and B. Lund Immunological aspects of secondary progressive multiple sclerosis Multiple Sclerosis, September 1, 2002; 8(1_suppl): 83 - 84. [PDF]
|
|
|
|
|
|
W Bruck, C Lucchinetti, and H Lassmann The pathology of primary progressive multiple sclerosis Multiple Sclerosis, April 1, 2002; 8(2): 93 - 97. [Abstract] [PDF]
|
|
|
|
|
|
M. A. Rocca, P. M. Matthews, D. Caputo, A. Ghezzi, A. Falini, G. Scotti, G. Comi, and M. Filippi Evidence for widespread movement-associated functional MRI changes in patients with PPMS Neurology, March 26, 2002; 58(6): 866 - 872. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L P Weiner, N J Kachuck, W Gilmore, and B Lund Immunological aspects of secondary progressive multiple sclerosis Multiple Sclerosis, February 1, 2002; 8(1): 83 - 84. [PDF]
|
|
|
|
|
|
J. de Seze, D. Devos, G. Castelnovo, P. Labauge, S. Dubucquoi, T. Stojkovic, D. Ferriby, and P. Vermersch The prevalence of Sjogren syndrome in patients with primary progressive multiple sclerosis Neurology, October 23, 2001; 57(8): 1359 - 1363. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. E Walker and S. B Margolin Pirfenidone for chronic progressive multiple sclerosis Multiple Sclerosis, October 1, 2001; 7(5): 305 - 312. [Abstract] [PDF]
|
|
|
|
 |
|
 J. T. Phillips Rethinking Multiple Sclerosis Arch Neurol, January 1, 2001; 58(1): 30 - 32. [Full Text] [PDF]
|
|
|
|
|
|
J. N. Whitaker, J. S. Wolinsky, P. A. Narayana, A. A. Bartolucci, J. H. Noseworthy, F. D. Lublin, A. Linde, P. Gjorstrup, H. C. Sullivan, and for the North American Linomide Investigators Relationship of Urinary Myelin Basic Protein-Like Material With Cranial Magnetic Resonance Imaging in Advanced Multiple Sclerosis Arch Neurol, January 1, 2001; 58(1): 49 - 54. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. A. Jason, R. R. Taylor, C. L. Kennedy, K. Jordan, S. Song, D. E. Johnson, and S. R. Torres Chronic Fatigue Syndrome: Sociodemographic Subtypes in A Community-Based Sample Eval Health Prof, September 1, 2000; 23(3): 243 - 263. [Abstract] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
