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Neuromyelitis optica (NMO) is an anti-aquaporin-4 antibody-mediated inflammatory disorder which is clinically characterised by severe involvement of the optic nerves and spinal cord1 and is considered distinct from multiple sclerosis based on immunological findings.2 3 Various cytokines/chemokines are associated with the pathogenesis of NMO.2 Recently, we showed that cerebrospinal fluid (CSF) interleukin (IL)-1ra, IL-6, IL-8, IL-10, IL-13, granulocyte colony-stimulating factor (G-CSF) and interferon-γ-inducible protein-10 (IP-10) levels during disease relapse were significantly elevated in patients with NMO than in patients with multiple sclerosis and other neurological non-inflammatory diseases.2 CSF IL-6 levels were most correlated with NMO clinical characteristics and laboratory findings; hence, we speculated that CSF IL-6 levels could be a useful biomarker for NMO. However, a prognostic marker for NMO patients has been scarcely elucidated to date. Here we investigated improvements in the Expanded Disability Status Scale (EDSS) (ΔEDSS) and relapse-free proportions after relapse in NMO patients to reveal the association between CSF cytokine/chemokine levels, particularly CSF IL-6 levels, and prognosis of NMO.
We analysed 28 NMO patients (all women; median age 46.4 years; range 27.9–71.7) who were observed for more than 1 year after relapse from a group of 31 NMO participants of a previous study.2 Twenty-one (75%) patients presented seropositivity for the anti-aquaporin-4 antibody. All patients had received therapy for relapse (23 with intravenous high-dose methylprednisolone alone, 2 with plasmapheresis alone, 3 with plasmaphaeresis after intravenous high-dose methylprednisolone). Thirteen …