G. Giovannoni et al., SOLUBLE E-SELECTIN IN MULTIPLE-SCLEROSIS - RAISED CONCENTRATIONS IN PATIENTS WITH PRIMARY PROGRESSIVE DISEASE, Journal of Neurology, Neurosurgery and Psychiatry, 60(1), 1996, pp. 20-26
Objective-To concentrations of soluble E-selectin (sE-selectin), an im
munological marker of endothelial activation, were correlated with gad
olinium-DPTA enhancement on MRI in patients with multiple sclerosis. M
ethods-Serial sE-selectin concentrations were measured in 28 patients
with multiple sclerosis undergoing monthly gadolinium (Gd) enhanced MR
I of the brain and spinal cord, and in 10 control subjects. C reactive
protein (CRP), von Willebrand factor (vWF), and tumour necrosis facto
r-alpha (TNF alpha) were also determined. Results-Primary progressive
patients had significantly increased sE-selectin concentrations compar
ed with the relapsing remitting and secondary progressive patients who
had normal sE-selectin concentrations (22.2 (SD1 6.1) ng/ml v 9.8 (SD
2.1) ng/ml and 7.7 (SD 2.7) ng/ml, respectively, P = 0.03). This diff
erence was attributable to five of the 10 primary progressive patients
who had persistently raised sE-selectin concentrations, with relative
ly inactive MRI studies. No correlation could be found between sE-sele
ctin concentrations and Gd enhancement on MRI, but a close correlation
existed between mean concentrations of sE-selectin and TNF alpha (r =
0.71, P < 0.001). Despite raised sE-selectin and TNF alpha concentrat
ions, primary progressive patients had normal CRP concentrations (1.03
(SD 1.14) mg/l), which were significantly lower than the relapsing re
mitting (3.16 (SD 2.54) mg/l) and secondary progressive patients (2.28
(SD 2.1) mg/l, P = 0.03). Raised CRP concentrations did correlate det
ermine whether with infectious episodes, clinical relapse, and Gd enha
ncement, and were significantly raised when no MRT activity was found.
Concentrations of vWF were normal in all patient groups. Conclusions-
The results further highlight the differences between patients with pr
imary progressive and those with relapsing remitting/secondary progres
sive multiple sclerosis.