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14-3-3 protein in the CSF as prognostic marker in early multiple sclerosis

From the Service of Neurology (Drs. Martínez–Yélamos, Casado, and Arbizu) and Preventive Medicine (Dr. Ramón), Ciutat Sanitaria Universitaria de Bellvitge, L’Hospitalet, and Service of Neurology (Drs. Saiz, Sanchez–Valle, and Graus), Institut d’Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Spain.

Address correspondence and reprint requests to Dr. Albert Saiz, Servei de Neurologia, Hospital Clínic, Villarroel 170, Barcelona 08036, Spain; e-mail: asaiz{at}clinic.ub.es

Axonal damage probably occurs early in the evolution of MS. Five of 38 (13%) patients had a positive assay for the neuronal 14-3-3 protein in the CSF obtained at the first clinically isolated syndrome suggestive of MS. A positive 14-3-3 assay was the only independent predictor for a shorter time to conversion to clinical definite MS (risk ratio 4.1; 95% CI 1.1 to 15) and to reach an Expanded Disability Status Scale (EDSS) 2 at the end of follow-up (odds ratio 14.8; 95% CI 2.86 to 76.8). The detection of the 14-3-3 protein in the CSF at the first neurologic event suggestive of MS may be a useful predictor of short-term evolution.

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