Ultra-small Super Paramagnetic Iron Oxide predicts higher disease activity in clinically isolated syndrome
Résumé
Background: Macrophages are important components of inflammatory processes in
multiple sclerosis, closely linked to axonal loss, and can now be observed in-vivo using
Ultra-Small super-Paramagnetic Iron Oxide (USPIO). We aimed to determine the
prevalence of macrophage infiltration and to assess the predictive value on disease
activity and tissue injury after one year in clinical isolated syndrome patients.
Methods: Thirty-five patients were imaged using conventional-MRI, magnetization
transfer ratio (MTR) to assess tissue destructuration, gadolinium (Gd) to probe blood
brain barrier integrity, and USPIO to study macrophage infiltration.
Results: At baseline, patients showed 17 USPIO-positive lesions reflecting infiltration
of macrophages present from the onset. This infiltration was associated with higher
local tissue destructuration as emphasized by lower MTR values of USPIO-positive/Gdpositive
lesions compared to USPIO-negative/Gd-positive and to non-enhanced lesions,
at baseline and Month-12, and no difference between USPIO-negative/Gd-positive and
non-enhanced lesions. While at baseline T2-lesion load of patients with USPIOenhancement
compared to patients with Gd-enhancement was not different, it was
higher at Month-12. T1-lesion load was also higher at Month-12 in patients with
USPIO-enhancement.
Conclusion: Infiltration of activated macrophages evidenced by USPIO enhancement,
is present at the onset of MS and is associated with higher local and global progression
of tissue destructuration.
Domaines
Neurosciences [q-bio.NC]| Origine | Fichiers produits par l'(les) auteur(s) |
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