Cerebrospinal Fluid Biomarkers in Differential Diagnosis of Multiple Sclerosis and Systemic Inflammatory Diseases with Central Nervous System Involvement

• Published in: Biomedicines Vol. 11; no. 2; p. 425
• Main Authors: Świderek-Matysiak, Mariola, Oset, Magdalena, Domowicz, Małgorzata, Galazka, Grażyna, Namiecińska, Magdalena, Stasiołek, Mariusz
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01-02-2023; MDPI
• Subjects: Biological markers; Biomarkers; Central nervous system; Cerebrospinal fluid; Cerebrovascular diseases; CXCL13 protein; Development and progression; Diagnosis; Diagnosis, Differential; Differential diagnosis; Glial fibrillary acidic protein; Health aspects; Inflammatory diseases; Interleukin 6; Lupus; Magnetic resonance imaging; Methods; Migraine; Multiple sclerosis; Nervous system; Neurodegeneration; Neurofilaments; neurofilaments light chain; oligoclonal bands; Osteopontin; Patients; Physiological aspects; Puncture; Spine; Vascular diseases; Poland; interleukin 6; differential diagnosis; neurofilaments light chain; multiple sclerosis; osteopontin; cerebrospinal fluid; oligoclonal bands
• ISSN: 2227-9059; 2227-9059
• DOI: 10.3390/biomedicines11020425

Diagnosis of multiple sclerosis (MS) is established on criteria according to clinical and radiological manifestation. Cerebrospinal fluid (CSF) analysis is an important part of differential diagnosis of MS and other inflammatory processes in the central nervous system (CNS).
In total, 242 CSF samples were collected from patients undergoing differential MS diagnosis because of the presence of T2-hyperintensive lesions on brain MRI. The non-MS patients were subdivided into systemic inflammatory diseases with CNS involvement (SID) or cerebrovascular diseases (CVD) or other non-inflammatory diseases (NID). All samples were analyzed for the presence of oligoclonal bands and ELISA was performed for detection of: INF gamma, IL-6, neurofilaments light chain (NF-L), GFAP, CHI3L1, CXCL13, and osteopontin.
The level of IL-6 (
= 0.024), osteopontin (
= 0.0002), and NF-L (
= 0.002) was significantly different among groups. IL-6 (
= 0.0350) and NF-L (
= 0.0015) level was significantly higher in SID compared to NID patients. A significantly higher level of osteopontin (
= 0.00026) and NF-L (
= 0.002) in MS compared to NID population was noted. ROC analysis found weak diagnostic power for osteopontin and NFL-L.
The classical and non-standard markers of inflammatory process and neurodegeneration do not allow for sufficient differentiation between MS and non-MS inflammatory CNS disorders. Weak diagnostic power observed for the osteopontin and NF-L needs to be further investigated.