Key result
Positivity for at least one anti-α-glucose IgM antibody in patients after their first neurological event was associated with a significantly higher risk of early relapse within 24 months (OR 4.5).
Why the study?
Do serum anti-alpha-glucose-based glycan IgM antibodies predict early relapse in patients with first presentation of relapsing-remitting multiple sclerosis?
Observational (n=440)
Blinded
Yes
Do serum anti-alpha-glucose-based glycan IgM antibodies predict early relapse in patients with first presentation of relapsing-remitting multiple sclerosis?
Odds Ratio: 4.5 (95% CI 1.5–13.2)
Absolute Event Rate: 38% vs 12%
p-value: p=0.003
Serum anti-alpha-glucose IgM antibodies can differentiate first-presentation MS from other neurological diseases and predict imminent early relapse.
May inform early relapse risk stratification after first event; hypothesis-generating and requires prospective validation before guiding therapy.
BACKGROUND: There is no specific serum-based biomarker for the diagnosis or prognosis of relapsing-remitting multiple sclerosis (RRMS). OBJECTIVE: We investigated whether levels of IgM antibodies to Glc(alpha1,4)Glc(alpha) (GAGA4) or to a panel of four glucose-based glycans could differentiate MS from other neurological diseases (OND) or predict risk of early relapse following first presentation (FP) of RRMS. METHODS: Retrospective analysis of 440 sera samples of three cohorts: A) FP-RRMS (n = 44), OND (n = 44); B) FP-RRMS (n = 167), OND (n = 85); and C) FP (n = 100). Anti-GAGA4 IgM levels were measured by enzyme immunoassay in cohort-A and cohort-B. Cohort-C IgM antibodies to glucose-based glycan panel were measured by immunofluorescence. RESULTS: FP-RRMS had higher levels of anti-GAGA4 IgM than OND patients (cohort-A, P = 0.01; cohort-B, P = 0.0001). Sensitivity and specificity were 27% and 97% for cohort-A; and 26% and 90% for cohort-B, respectively. In cohort-C, 58 patients experienced early relapse (<24 months), 31 had late relapse (> or =24 months), and 11 did not experience second attack during follow-up. Kaplan-Meier curves demonstrated decrease in time to next relapse for patients positive for the antibody panel (P = 0.02, log rank). CONCLUSIONS: Serum anti-GAGA4 IgM discerns FP-RRMS patients from OND patients. Higher levels of serum anti-alpha-glucose IgM in FP patients predict imminent early relapse.
No takes yet. Share an insight, caveat, or question.
Freedman et al. (2009) conducted an observational in Relapsing-remitting multiple sclerosis (RRMS) (n=440). Anti-α-glucose-based glycan IgM antibodies vs. Negative for anti-α-glucose-based glycan IgM antibodies was evaluated on Early relapse (≤24 months) after first presentation (OR 4.5, 95% CI 1.5-13.2, p=0.003). Positivity for at least one anti-α-glucose IgM antibody in patients after their first neurological event was associated with a significantly higher risk of early relapse within 24 months (OR 4.5).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: