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Magnetization transfer ratio in new MS lesions before and during therapy with IFNbeta-1a
M Kita1, D E Goodkin, P Bacchetti
1UCSF/Mt. Zion Multiple Sclerosis Center, University of California at San Francisco, USA.
Objective:
The authors examined the effect of 6.0 MIU interferon beta-1a (IFNbeta-1a) administered IM each week on the evolution of monthly magnetization transfer ratio (MTR) within new gadolinium-enhancing (Gd+) lesions in patients with very early relapsing-remitting (RR) MS.
Background:
IFNbeta is an effective disease-modifying treatment for patients with RRMS. Among other effects, it has been shown to decrease the number of new Gd+ and T2-weighted lesions. MTR is a putative marker for irreversible tissue damage and evolution of MTR within a lesion may reflect recovery of tissue damage. It is not known whether IFNbeta-1a affects the recovery phase of lesions.
Methods:
Eight untreated patients with RRMS who completed up to 14 monthly brain MRI sessions elected to initiate treatment with IFNbeta-1a. Four out of eight patients developed new Gd+ lesions during treatment. MTR of lesions at the time of appearance and subsequent rate of change of monthly MTR were compared before and after treatment (stratified Mann-Whitney test).
Results:
The difference between MTR at appearance of 47 new Gd+ lesions before treatment versus 23 new Gd+ lesions during treatment was not significant. Twenty-two of 47 new Gd+ lesions before treatment and 11 of 23 new Gd+ lesions after treatment were monitored for up to 6 months. After appearance of new Gd+ lesions, the rate of increase in MTR was faster during therapy (p = 0.037).
Conclusion:
MTR abnormalities within new Gd+ lesions evolve at a faster rate during treatment with IFNbeta-1a than before initiating therapy. This is consistent with the hypothesis that IFNbeta-1a promotes resolution of new Gd+ lesions.
Insights
Interferon beta-1a (IFNbeta-1a) treatment accelerated the resolution of new gadolinium-enhancing lesions in relapsing-remitting multiple sclerosis (RRMS) patients. This suggests IFNbeta-1a promotes tissue recovery in early MS lesions.
Area of Science:
- Neuroscience
- Radiology
- Immunology
Background:
- Interferon beta (IFNbeta) is a disease-modifying treatment for relapsing-remitting multiple sclerosis (RRMS).
- IFNbeta reduces new T2-weighted and gadolinium-enhancing (Gd+) lesions.
- Magnetization transfer ratio (MTR) may indicate irreversible tissue damage, and its evolution can reflect lesion recovery.
Purpose of the Study:
- To investigate the effect of weekly intramuscular interferon beta-1a (IFNbeta-1a) on the evolution of MTR in new Gd+ lesions in very early RRMS.
- To determine if IFNbeta-1a influences the recovery phase of MS lesions.
Main Methods:
- Eight untreated RRMS patients initiated weekly IM IFNbeta-1a treatment.
- Monthly brain MRI scans were performed for up to 14 months.
- MTR of new Gd+ lesions was compared before and during IFNbeta-1a therapy.
Main Results:
- The MTR at the appearance of Gd+ lesions did not significantly differ between pre-treatment and during-treatment periods.
- The rate of MTR increase after lesion appearance was significantly faster during IFNbeta-1a therapy (p = 0.037).
- This faster MTR increase suggests accelerated lesion resolution.
Conclusions:
- IFNbeta-1a treatment accelerates the evolution of MTR abnormalities in new Gd+ lesions.
- This finding supports the hypothesis that IFNbeta-1a promotes the resolution of acute MS lesions.
- IFNbeta-1a may enhance tissue recovery processes in early-stage RRMS.