B-Cell Activity Predicts Response to Glatiramer Acetate and Interferon in Relapsing-Remitting Multiple Sclerosis.
Neurol Neuroimmunol Neuroinflamm
; 8(3)2021 05.
Article
em En
| MEDLINE
| ID: mdl-33707177
ABSTRACT
OBJECTIVE:
We investigated the predictive value of the enzyme-linked immunospot technique (ELISPOT) in identifying patients with relapsing-remitting multiple sclerosis (RRMS) who will respond to treatment with glatiramer acetate (GA) or interferon-ß (IFN-ß), based on the brain-reactive B-cell activity of peripheral blood cells.METHODS:
In this retrospective, cross-sectional, real-world multicenter study, we identified patients with RRMS in the NeuroTransData MS registry and stratified them based on their documented treatment response (relapse-free in the first 12 months of treatment) to GA or IFN-ß. The GA group comprised 73 patients who responded to GA and 35 nonresponders. The IFN-ß group comprised 62 responders to IFN-ß and 37 nonresponders. Patients with previous or current therapy affecting B-cell activity were excluded. We polyclonally stimulated mononuclear cells from peripheral blood samples (collected after participant selection) and investigated brain-reactive B-cell activity after incubation on brain tissue lysate-coated ELISPOT plates. Validity metrics of the ELISPOT testing results were calculated (Python 3.6.8) in relation to the clinical responsiveness in the 2 treatment groups.RESULTS:
The ELISPOT B-cell activity assay showed a sensitivity of 0.74, a specificity of 0.76, a positive predictive value of 0.78, a negative predictive value of 0.28, and a diagnostic OR of 8.99 in predicting clinical response to GA vs IFN-ß therapy in patients with RRMS.CONCLUSION:
Measurement of brain-reactive B-cell activity by ELISPOT provides clinically meaningful predictive probabilities of individual patients' treatment response to GA or IFN-ß. The assay has the potential to improve the selection of optimal first-line treatment for individual patients with RRMS. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that in patients with RRMS, the brain reactivity of their peripheral-blood B cells predicts clinical response to GA and IFN-ß.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Linfócitos B
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Interferon beta
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Esclerose Múltipla Recidivante-Remitente
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Acetato de Glatiramer
Tipo de estudo:
Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Neurol Neuroimmunol Neuroinflamm
Ano de publicação:
2021
Tipo de documento:
Article