Correlation between IGFBP7 and inflammatory cytokines in patients with multiple sclerosis

Inflammatory cytokines contribute to neuroinflammation in multiple sclerosis (MS), yet their diagnostic value in serum and cerebrospinal fluid (CSF) remains inconsistent. Insulin-like growth factor binding protein 7 (IGFBP7) has been implicated in inflammatory and repair-related pathways, but its clinical relevance and relationship with cytokine activity in MS are not well defined.

This study aimed to evaluate the diagnostic and clinical relevance of serum and CSF inflammatory cytokines and IGFBP7 in MS, and to determine whether combining IGFBP7 with key cytokines improves diagnostic discrimination.

A retrospective cohort included 139 patients with MS to 148 non-inflammatory neurological controls (NINCs). A prospective study included 20 patients with MS (surum and CSF), 20 healthy controls (serum), and 20 NINCs (CSF). Tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, IL-8, and IGFBP7 were quantified using chemiluminescence immunoassay or ELISA. Group differences, MS subtype comparisons, correlations with disability, and diagnostic performance were assessed.

In the retrospective cohort, serum and CSF TNF-α and IL-8 were higher in MS patients than in NINCs. CSF TNF-α and serum IL-1β levels were higher in secondary progressive MS (SPMS) than relapsing-remitting MS (RRMS). In the prospective cohort, CSF IGFBP7 levels were higher in MS than in NINCs and showed a significant positive correlation with CSF TNF-α (P < 0.001). Both CSF TNF-α (AUC = 0.711) and IGFBP7 (AUC = 0.885) demonstrated diagnostic utility, and their combination improved discrimination (AUC = 0.939). No biomarker was significantly associated with Expanded Disability Status Scale (EDSS) scores.

CSF IGFBP7 was found to be closely associated with CSF TNF-α, showing potential diagnostic utility in MS. A dual-marker model combining CSF IGFBP7 and TNF-α improved diagnostic performance, suggesting that IGFBP7 reflects inflammatory processes relevant to MS.