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Axonal damage in relapsing multiple sclerosis is markedly reduced by natalizumab
Martin Gunnarsson1, Clas Malmeström, Markus Axelsson
1Department of Neurology, Örebro University Hospital, Örebro, Göteborg.
Annals of Neurology
|February 1, 2011
Summary
Natalizumab treatment significantly reduced neurofilament light (NFL) levels in multiple sclerosis (MS) patients, indicating a decrease in nerve injury. This suggests effective disease-modifying treatments can prevent permanent neurological disability.
Area of Science:
- Neuroscience
- Immunology
- Neurology
Background:
- The effect of disease-modifying treatments (DMTs) on nerve injury and astrogliosis in multiple sclerosis (MS) remains unclear.
- Natalizumab is a DMT used for relapsing forms of MS.
Purpose of the Study:
- To investigate the impact of natalizumab on nerve injury markers in MS patients.
- To assess the release of neurofilament light (NFL) and glial fibrillary acidic protein (GFAP) in cerebrospinal fluid (CSF) before and after natalizumab treatment.
Main Methods:
- Prospective collection of CSF samples from 92 MS patients treated with natalizumab.
- Measurement of NFL and GFAP levels using sensitive enzyme-linked immunosorbent assays.
- Analysis of changes in marker levels after 6 or 12 months of treatment.
Main Results:
- Natalizumab treatment resulted in a 3-fold reduction in NFL levels (p < 0.001), normalizing them to levels seen in healthy controls.
- The reduction in NFL was consistent across subgroups, irrespective of prior DMT or disease activity.
- No significant changes in GFAP levels were observed post-treatment.
Conclusions:
- Natalizumab treatment effectively reduces nerve injury, as indicated by decreased NFL levels in MS patients.
- This suggests that potent anti-inflammatory therapies can mitigate axonal loss and prevent long-term neurological disability in MS.
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