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CSF interleukin-6 level predicts recovery from neuromyelitis optica relapse
  1. Akiyuki Uzawa1,
  2. Masahiro Mori1,
  3. Yasunori Sato2,
  4. Saeko Masuda1,
  5. Satoshi Kuwabara1
  1. 1Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
  2. 2Clinical Research Center, Chiba University Hospital, Chiba, Japan
  1. Correspondence to Akiyuki Uzawa, Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan; a-uzimp1204{at}

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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 …

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  • Funding This work was partly supported by research grants from the Ministry of Education, Science and Technology (AU), and the Ministry of Health, Labor and Welfare of Japan (SK).

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Ethics Committee of the Chiba University School of Medicine, Chiba, Japan.

  • Provenance and peer review Not commissioned; externally peer reviewed.