title: Cerebrospinal fluid detection of interleukin-1β in phase of remission predicts disease progression in multiple sclerosis.
abstract: BACKGROUND
  Absence of clinical and radiological activity in relapsing-remitting multiple sclerosis (RRMS) is perceived as disease remission. We explored the role of persisting inflammation during remission in disease evolution.
  
  
  METHODS
  Cerebrospinal fluid (CSF) levels of interleukin 1β (IL-1β), a major proinflammatory cytokine, were measured in 170 RRMS patients at the time of clinical and radiological remission. These patients were then followed up for at least 4 years, and clinical, magnetic resonance imaging (MRI) and optical coherence tomography (OCT) measures of disease progression were recorded.
  
  
  RESULTS
  Median follow-up of RRMS patients was 5 years. Detection of CSF IL-1β levels at the time of remission did not predict earlier relapse or new MRI lesion formation. Detection of IL-1β in the CSF was instead associated with higher progression index (PI) and Multiple Sclerosis Severity Scale (MSSS) scores at follow-up, and the number of patients with sustained Expanded Disability Status Scale (EDSS) or Multiple Sclerosis Functional Composite worsening at follow-up was higher in individuals with detectable levels of IL-1β. Patients with undetectable IL-1β in the CSF had significantly lower PI and MSSS scores and a higher probability of having a benign MS phenotype. Furthermore, patients with undetectable CSF levels of IL-1β had less retinal nerve fiber layer thickness and macular volume alterations visualized by OCT compared to patients with detectable IL-1β.
  
  
  CONCLUSIONS
  Our results suggest that persistence of a proinflammatory environment in RRMS patients during clinical and radiological remission influences midterm disease progression. Detection of IL-1β in the CSF at the time of remission appears to be a potential negative prognostic factor in RRMS patients.
authors.forename: Silvia
authors.initials: S
authors.lastname: Rossi
authors.forename: Valeria
authors.initials: V
authors.lastname: Studer
authors.forename: Caterina
authors.initials: C
authors.lastname: Motta
authors.forename: Giorgio
authors.initials: G
authors.lastname: Germani
authors.forename: Giulia
authors.initials: G
authors.lastname: Macchiarulo
authors.forename: Fabio
authors.initials: F
authors.lastname: Buttari
authors.forename: Raffaele
authors.initials: R
authors.lastname: Mancino
authors.forename: Maura
authors.initials: M
authors.lastname: Castelli
authors.forename: Valentina
authors.initials: V
authors.lastname: De Chiara
authors.forename: Sagit
authors.initials: S
authors.lastname: Weiss
authors.forename: Gianvito
authors.initials: G
authors.lastname: Martino
authors.forename: Roberto
authors.initials: R
authors.lastname: Furlan
authors.affiliation: Clinica Neurologica, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Via Montpellier 1, 00133 Rome, Italy. centonze@uniroma2.it.
authors.forename: Diego
authors.initials: D
authors.lastname: Centonze
mesh_terms: D000328:Adult; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D053583:Interleukin-1beta / Q000134:cerebrospinal fluid*; D007558:Italy; D016015:Logistic Models; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid* / Q000175:diagnosis* / Q000473:pathology; D011237:Predictive Value of Tests; D012008:Recurrence; D018709:Statistics, Nonparametric; D041623:Tomography, Optical Coherence
chemical_list: D053583:Interleukin-1beta