Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2015
Cytokines and matrix metalloproteinases in the cerebrospinal fluid of patients with acute transverse myelitis: an outcome analysis.
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Dixit Puneet, Garg Ravindra Kumar, Malhotra Hardeep Singh, Jain Amita, Verma Rajesh, Sharma Praveen Kumar, Kumar Neeraj
Аннотация
BACKGROUND: Role of cytokines as well as matrix metalloproteinases (MMPs) is well defined in various central nervous system inflammatory diseases. However, the role of these cytokines and MMPs in acute transverse myelitis is inadequately studied.
MATERIALS AND METHODS: Patients with acute transverse myelitis, fulfilling the inclusion and exclusion criteria defined by Transverse Myelitis Consortium Working Group, were enrolled along with age and sex matched controls. A detailed clinical evaluation and magnetic resonance imaging of patients was done. Cerebrospinal fluid (CSF) samples both from patients and controls were collected. CSF samples were analyzed for cytokines [interleukin (IL)-6, IL-8, IL-10 and IL-17)] and matrix metalloproteinases (MMP-2, MMP-9). Patients were followed up for 3 months. Disability was assessed using modified Barthel index (MBI).
RESULTS: CSF levels of all cytokines IL-6, IL-8, IL-10, MMP-2 and MMP-9, except IL-17, were significantly higher in patients with acute transverse myelitis (p < 0.001). CSF IL-6 and IL-8 were significantly associated with severity of the disease (MBI ≤ 12). After 3 months, quadriparesis (p = 0.001, odd's ratio 19.5, 95 % CI 2.34-62.39) and long-segment myelitis (p = 0.035, odd's ratio 4.37, 95 % CI 1.17-5.95) were significantly associated with poor outcome. Among cytokines and MMPs, IL-6 levels at baseline correlated significantly with the MBI at 3 months (Spearmen's ρ = -0.335, p = 0.01).
CONCLUSION: In conclusion, both anti-inflammatory and pro-inflammatory cytokines, MMP-2, and MMP-9 are elevated in the acute phase of transverse myelitis. Possibly, IL-6 plays a role in determining the disability.
MATERIALS AND METHODS: Patients with acute transverse myelitis, fulfilling the inclusion and exclusion criteria defined by Transverse Myelitis Consortium Working Group, were enrolled along with age and sex matched controls. A detailed clinical evaluation and magnetic resonance imaging of patients was done. Cerebrospinal fluid (CSF) samples both from patients and controls were collected. CSF samples were analyzed for cytokines [interleukin (IL)-6, IL-8, IL-10 and IL-17)] and matrix metalloproteinases (MMP-2, MMP-9). Patients were followed up for 3 months. Disability was assessed using modified Barthel index (MBI).
RESULTS: CSF levels of all cytokines IL-6, IL-8, IL-10, MMP-2 and MMP-9, except IL-17, were significantly higher in patients with acute transverse myelitis (p < 0.001). CSF IL-6 and IL-8 were significantly associated with severity of the disease (MBI ≤ 12). After 3 months, quadriparesis (p = 0.001, odd's ratio 19.5, 95 % CI 2.34-62.39) and long-segment myelitis (p = 0.035, odd's ratio 4.37, 95 % CI 1.17-5.95) were significantly associated with poor outcome. Among cytokines and MMPs, IL-6 levels at baseline correlated significantly with the MBI at 3 months (Spearmen's ρ = -0.335, p = 0.01).
CONCLUSION: In conclusion, both anti-inflammatory and pro-inflammatory cytokines, MMP-2, and MMP-9 are elevated in the acute phase of transverse myelitis. Possibly, IL-6 plays a role in determining the disability.