再発 remitting型多発性硬化症患者における血清バイオマーカーの選択：3年間の前向きパイロットスタディ

The aim of this study was to evaluate the significance of serum concentrations of the inflammatory marker osteopontin, the blood-brain barrier damage marker occludin, and the neurodegeneration marker neurofilament light chain (NFL) in patients with relapsing-remitting multiple sclerosis (RRMS) for predicting disease activity and progression.

This prospective cohort study enrolled 150 patients with RRMS. Initial serum levels of NFL, occludin, and osteopontin were compared between patients who met or did not meet the no evidence of disease activity (NEDA) criteria and its components (relapses, magnetic resonance imaging activity, and Expanded Disability Status Scale progression) within 36 months of observation. Independent factors affecting study outcomes at month 36 were identified from baseline data, including age, gender, initial prognostic profile, and serum levels of NFL, occludin, and osteopontin, as well as treatment type.

We found lower osteopontin concentrations in patients receiving highly effective treatment compared with those receiving platform therapies (13.64 ± 5.41 ng/mL, CI 11.75-15.53 vs. 17.33 ± 8.00 ng/mL, CI 15.66-18.61; p = 0.03). There was a significant correlation between NFL levels and patient age (Spearman's rho = 0.3045, p = 0.0002) and between NFL levels and disease duration (Spearman's rho = 0.1945, p = 0.02). NEDA during the 3-year observation period was achieved by 58 (38.67%) patients. Patients with NEDA showed significantly lower serum concentrations of occludin, NFL, and osteopontin than those without NEDA.

Serum levels of NFL, osteopontin, and occludin may serve as biomarkers of disease activity in patients with RRMS. The clinical relevance of these biomarkers should be confirmed through repeated serum marker assessments in MS patients and validation studies involving larger sample sizes.