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Spinal Fluid Myeloid Microvesicles Predict Disease Course in Multiple Sclerosis.

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  • 1Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Annals of Neurology
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Summary

Cerebrospinal fluid myeloid microvesicles are effective biomarkers for diagnosing and predicting multiple sclerosis (MS) disease activity and prognosis. These microvesicles indicate neuroinflammation and microglial activity, aiding clinical assessment.

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Area of Science:

  • Neuroimmunology
  • Biomarker Discovery
  • Clinical Neurology

Background:

  • In vivo assessment of myeloid cell activity shows promise for multiple sclerosis (MS) diagnostics.
  • Cerebrospinal fluid (CSF) myeloid microvesicles reflect microglial/macrophage activity and neuroinflammation in MS.
  • Previous research established CSF myeloid microvesicles as potential MS biomarkers.

Purpose of the Study:

  • To evaluate the diagnostic and prognostic utility of CSF myeloid microvesicles in a clinical setting for neuroinflammatory diseases.
  • To investigate the correlation between myeloid microvesicle levels and disease activity metrics in multiple sclerosis.

Main Methods:

  • Enrolled 601 patients with neuroinflammatory, neurodegenerative, or no neurological disease.
  • Quantified myeloid microvesicles in fresh CSF using flow cytometry (isolectin B4-positive events).
  • Collected clinical, demographic, and MRI data at diagnosis and during follow-up.

Main Results:

  • CSF myeloid microvesicles were elevated in neuroinflammatory conditions compared to neurodegenerative and control groups.
  • In MS, higher microvesicle levels correlated with MRI disease activity and lesion count.
  • Microvesicles demonstrated high accuracy in differentiating MS subtypes and predicting future disease activity and disability.

Conclusions:

  • CSF myeloid microvesicles serve as clinically significant biomarkers for in vivo neuroinflammation and microglial/macrophage activity.
  • These findings support the potential clinical application of myeloid microvesicles in diagnosing and assessing prognosis in neurological diseases.
  • Myeloid microvesicles offer a valuable tool for enhancing diagnostic workup and prognostic evaluation in clinical practice.