Cerebrospinal fluid transferrin levels are reduced in patients with early multiple sclerosis.
BACKGROUND
Previous magnetic resonance imaging (MRI) studies have demonstrated increased iron deposition in the basal ganglia of multiple sclerosis (MS) patients. However, it is not clear whether these alterations are associated with changes of iron metabolism in body fluids.


OBJECTIVE
The purpose of this study was to investigate if iron metabolism markers in cerebrospinal fluid (CSF) and serum of clinically isolated syndrome (CIS) and MS patients differ from controls and how they relate to clinical and imaging parameters.


METHODS
We analysed serum ferritin, transferrin and soluble transferrin-receptor and CSF ferritin and transferrin by nephelometry in non-anaemic CIS (n=60) or early MS (n=14) patients and 68 controls. In CIS/MS we additionally assessed the T2 lesion load.


RESULTS
CSF transferrin was significantly decreased in CIS/MS compared to controls (p<0.001), while no significant differences were seen in serum. Higher CSF transferrin levels correlated with lower physical disability scores (r= -0.3, p<0.05). CSF transferrin levels did not correlate with other clinical data and the T2 lesion load.


CONCLUSIONS
Our biochemical study provides evidence that altered iron homeostasis within the brain occurs in the very early phases of the disease, and suggests that the transporter protein transferrin may play a role in the increased iron deposition known to occur in the brain of MS patients.
Medical University of Graz, Auenbruggerplatz 22, A-8036 Graz, Austria michael.khalil@medunigraz.at.
M
M
Khalil
Medical University of Graz, Austria.
B
B
Riedlbauer
Medical University of Graz, Austria.
C
C
Langkammer
Medical University of Graz, Austria.
C
C
Enzinger
Medical University of Graz, Austria.
S
S
Ropele
Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria.
T
T
Stojakovic
Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria.
H
H
Scharnagl
Medical University of Graz, Austria.
V
V
Culea
MS Center Amsterdam, Free University Medical Center, The Netherlands.
A
A
Petzold
Neurochemistry Lab and Biobank, VU University Medical Center Amsterdam, The Netherlands.
Ce
C
Teunissen
Medical University of Graz, Austria.
J-J
JJ
Archelos
Medical University of Graz, Austria.
S
S
Fuchs
Medical University of Graz, Austria.
F
F
Fazekas
D000328:Adult; D017668:Age of Onset; D005260:Female; D006706:Homeostasis / Q000502:physiology*; D006801:Humans; D007501:Iron / Q000378:metabolism; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid* / Q000378:metabolism / Q000473:pathology; D061250:Transferrins / Q000134:cerebrospinal fluid*
D061250:Transferrins; D007501:Iron
Multiple sclerosis; T2 lesions; cerebrospinal fluid; iron; magnetic resonance imaging; transferrin