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Related Experiment Video

Updated: May 11, 2026

Determining Immune System Suppression versus CNS Protection for Pharmacological Interventions in Autoimmune Demyelination

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Published on: September 12, 2016

Immunosuppressive therapy reduces axonal damage in progressive multiple sclerosis.

Markus Axelsson¹, Clas Malmeström, Martin Gunnarsson

¹Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Multiple Sclerosis (Houndmills, Basingstoke, England)

|May 25, 2013

Summary

Immunosuppressive therapy significantly reduced axonal damage and B-cell activity in progressive multiple sclerosis (PMS) patients. Neurofilament light protein (NFL) in cerebrospinal fluid (CSF) shows promise as a treatment efficacy marker.

Keywords:

CXCL13 Multiple sclerosis axonal damage biomarkers cerebrospinal fluid glial fibrillary acidic protein immunosuppressive therapy mitoxantrone neurofilament light protein rituximab

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Area of Science:

Neuroimmunology
Neurology
Clinical Trials

Background:

Progressive multiple sclerosis (PMS) lacks effective disease-modifying therapies to halt disability.
Assessing treatment impact on PMS requires sensitive biomarkers.

Purpose of the Study:

To evaluate the efficacy of immunosuppressive therapy in PMS by analyzing cerebrospinal fluid (CSF) biomarkers.
Investigate changes in axonal damage (NFL), astrogliosis (GFAP), and B-cell activity (CXCL13) following treatment.

Main Methods:

CSF samples from 35 PMS patients and 14 healthy controls were analyzed before and after 12-24 months of mitoxantrone or rituximab treatment.
Immunoassays were used to quantify levels of neurofilament light protein (NFL), glial fibrillary acidic protein (GFAP), and CXCL13.

Main Results:

Significant reductions were observed in mean NFL levels (51%) and CXCL13 (55%), indicating decreased axonal damage and B-cell activity.
Glial fibrillary acidic protein (GFAP) levels remained unchanged, suggesting no significant impact on astrogliosis.
NFL reduction was most pronounced in previously untreated patients and those with active lesions at baseline.

Conclusions:

Immunosuppressive therapy demonstrates potential in reducing axonal damage in PMS, especially in patients with active disease.
Cerebrospinal fluid (CSF) neurofilament light protein (NFL) levels may serve as a valuable surrogate marker for treatment efficacy in MS clinical trials.