Urinary trypsin inhibitor levels are reduced in cerebrospinal fluid of multiple sclerosis and neuromyelitis optica patients during relapse

Abstract

Background: Neutrophil-mediated inflammation plays an important role in the pathogenesis of multiple sclerosis (MS) and neuromyelitis optica (NMO). Concentrations of urinary trypsin inhibitor (UTI) have attracted attention as a useful index of the status of inflammatory response. Evidence suggests serum UTI levels are increased in some inflammatory diseases, but little attention has been paid to cerebrospinal fluid (CSF) levels of UTI.

Objective: To measure CSF concentration of UTI and determine its relationship with disease activity in MS and NMO.

Methods: CSF UTI was measured by an enzyme-linked immunosorbent assay in 18 MS patients, 28 NMO patients and eight controls.

Results: CSF UTI concentrations in MS and NMO groups were both significantly lower than those in controls. Expanded disability status scale scores of MS and NMO revealed a trend of increased disease disability with decreased CSF UTI level. The CSF UTI concentrations were not significantly associated with CSF white blood cell counts, total protein, glucose and chlorine concentrations in MS and NMO subgroups.

Conclusions: Our results indicate a reduced UTI level in CSF of MS and NMO patients. The levels were associated with the severity of the two demyelinating diseases during relapse.

Keywords: Cerebrospinal fluid; Multiple sclerosis; Neuromyelitis optica; Urinary trypsin inhibitor.