Blood-brain barrier damage associates with glia-related cytokines in the cerebrospinal fluid of patients with Multiple Sclerosis.

BACKGROUND: The presence of Blood-Brain Barrier (BBB) dysfunction is defined by albumin quotient (QALB) and characterize a group of Multiple Sclerosis (MS) patients at clinical onset. We evaluated the concentration in cerebrospinal fluid (CSF) of 87 cytokines, to better characterize the CSF inflammatory pattern in presence of BBB damage. MATERIALS AND METHOD: In an exploratory cohort, CSF cytokines were evaluated by means of Multiplex technology (Bio-Plex Pro-Human Cytokine, GF and Diabetes 27-Plex Panel, Bio-Plex Pro-Human Chemokines 40-Plex Panel, Bio-Plex Pro-Human Inflammation Assays 37-Plex Panel) in a cohort of Other Not Inflammatory Neurological Disorders (ONIND) and in cohort of patients with MS, stratified according to BBB damage into QALB+ and QALB- MS patients. In the validation cohort, we evaluated the relevant molecules in a cohort of MS patients, stratified again into QALB+ and QALB-, including also Neurofilament Light (NfL) and Chitinase 3-like 1 (CHI3L1) CSF concentration. RESULTS: While MIP-1α, CXCL-13, and CCL-22 CSF concentrations were higher in both MS groups compared to ONIND, in QALB+ MS CSF concentrations of CXCL-9 (17.85 ± 4.69 pg/mL), CXCL-10 (476.5 ± 324.3 pg/mL), and IL-16 (96.08 ± 86.17 pg/mL) were higher than in QALB- MS (8.98 ± 5368 pg/mL, p < 0.005, 281.0 ± 180.9 pg/mL, p < 0.05, and 47.35 ± 36.87 pg/mL, p < 0.005, respectively) and ONIND (8.98 ± 5368 pg/mlL, p < 0.005, 281.0 ± 180.9 pg/mL, p < 0.005, and 47.35 ± 36.87 pg/mL, p < 0.001, respectively). A strong correlation was observed between CXCL-9 and CXCL-10 in all MS groups (all r>0.75, all p < 0.001). In the validation cohort again CXCL-10 CSF concentration were higher in QALB+ MS than in QALB- MS (94.25 ± 64.75 vs 153.8 ± 99.52, p < 0.05), while no difference was observed in serum. CSF NfL (1642 ± 1963 vs 3231 ± 3492 pg/mL, p < 0.05) and CHI3L1 (183.9 ± 86.62 vs 262 ± 137.5 ng/mL, p < 0.05) were increased in QALB+ MS. CONCLUSIONS: BBB damage in MS is linked to a specific CSF cytokines pattern (CXCL-9, CXCL-10, IL-16), that are also involved in astrocyte-microglia interaction. To what extent their continuous production in the CNS may mark a more severe disease course merits to be investigated.

Chemical composition of Schiff's reagent crystals.

Crystals were prepared by adding 0.04 M sulfuric acid to a Schiff's reagent made with 2.5 g pararosaniline (PR) chloride dissolved in a saturated SO2 solution. Elemental analysis of the crystals gave the composition C19H21N3S2O7.4H2O which corresponds to the sulfate of pararosanilinesulfonic acid (PRSA) tetrahydrate. The moisture content was ca. 5%. A reagent reconstituted by dissolving 0.2 grams of crystals in HCl 0.1 N contains ca. 3.5 x 10(-3) M or 0.11% PR. A solution prepared with 2.5 g PR in 100 ml O.1 N HCl plus 0.04 M M K2S2O5 gave only a few crystals after 0.04 M sulfuric acid was added. The PR content, determined colorimetrically, was 0.25% compared with 1.35% in saturated SO2. The per cent dye loss during charcoal purification was also higher. The low concentration of PR, caused both by the lower solubility and by the larger loss during charcoal purification explains the poor yield of crystals of a reagent prepared in HCl/K2S2O5, compared to a reagent prepared in saturated SO2. After crystallization is complete, the crystals are in equilibrium with a concentration of 0.2% of PR in the supernatant: when the initial concentration is close to this value crystallization is negligible or completely fails.