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Subclinical central inflammation is risk for RIS and CIS conversion to MS.

S Rossi1, C Motta1, V Studer2

  • 1Clinica Neurologica, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy/IRCCS Istituto Neurologico Mediterraneo (INM) Neuromed, Pozzilli, Italy.

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Subtle intrathecal inflammation, indicated by interleukin-8 (IL-8), predicts conversion to multiple sclerosis (MS) in early stages and disease activity in established MS.

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Clinically isolated syndromeIL-8intrathecal inflammationprogressionradiologically isolated syndromerelapse

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Area of Science:

  • Neuroimmunology
  • Biomarker Discovery

Background:

  • Subtle intrathecal inflammation is often undetectable by conventional neuroimaging.
  • This inflammation may significantly impact the disease course of multiple sclerosis (MS).

Purpose of the Study:

  • To investigate the role of subclinical intrathecal inflammation in the conversion of radiologically isolated syndrome (RIS) and clinically isolated syndrome (CIS) to MS.
  • To assess the link between intrathecal inflammation and early MS disease reactivation.

Main Methods:

  • Cerebrospinal fluid (CSF) levels of interleukin-8 (IL-8) were measured in 193 subjects with RIS, CIS, relapsing-remitting MS (RRMS), or primary progressive MS (PPMS), and 76 controls.
  • Subjects were followed for 2 years, monitoring clinical and imaging disease progression.
  • IL-8 served as a biomarker for intrathecal inflammation.

Main Results:

  • Elevated CSF IL-8 levels were associated with clinical progression in RIS and increased MS conversion risk in CIS, irrespective of lesion load.
  • Higher IL-8 levels correlated with increased disease activity in RRMS.
  • Patients with high IL-8 experienced more relapses and shorter inter-attack intervals.

Conclusions:

  • Interleukin-8 (IL-8) can identify active intrathecal inflammation.
  • IL-8 may be valuable for diagnosing and managing MS, particularly in ambiguous cases.