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Predicting autoimmunity after alemtuzumab treatment of multiple sclerosis
  1. Laura Azzopardi1,
  2. Sara A J Thompson1,
  3. Katherine E Harding2,
  4. Mark Cossburn2,
  5. Neil Robertson2,
  6. Alastair Compston1,
  7. Alasdair J Coles1,
  8. Joanne L Jones1
  1. 1Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
  2. 2Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
  1. Correspondence to Dr Joanne Jones, Department of Clinical Neurosciences, University of Cambridge, Box 165, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK; Jls53{at}medschl.cam.ac.uk.

Abstract

Objective We have previously shown that autoimmunity following alemtuzumab treatment of multiple sclerosis can be predicted by high baseline serum interleukin IL-21 (IL-21), as measured using a now ‘redundant’ enzyme linked immunosorbent assay (ELISA). Here we ask whether currently available ELISAs have similar prognostic value.

Design Serum IL-21 from 141 individuals with relapsing remitting multiple sclerosis was measured using the now ‘redundant’ IL-21 ELISA and five further currently available kits. All patients had been treated with alemtuzumab; 61/141 had developed secondary autoimmunity.

Results The ‘redundant kit’, and one current kit, confirmed higher baseline serum IL-21 in patients with autoimmunity (542 pg/mL vs. 222 pg/mL and 53.1 pg/mL vs. 9.3 pg/mL respectively) and showed positive correlation. However, only the ‘redundant’ kit had predictive utility.

Conclusions Currently available IL-21 ELISA kits should not be used to counsel individuals with multiple sclerosis considering treatment with alemtuzumab.

  • Multiple Sclerosis
  • Immunology

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