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. 2014 Jul;85(7):795-8.
doi: 10.1136/jnnp-2013-307042. Epub 2013 Dec 24.

Predicting autoimmunity after alemtuzumab treatment of multiple sclerosis

Laura Azzopardi  1 , Sara A J Thompson  1 , Katherine E Harding  2 , Mark Cossburn  2 , Neil Robertson  2 , Alastair Compston  1 , Alasdair J Coles  1 , Joanne L Jones  1
Affiliations

Predicting autoimmunity after alemtuzumab treatment of multiple sclerosis

Laura Azzopardi et al. J Neurol Neurosurg Psychiatry. 2014 Jul.

Abstract

Objective: We have previously shown that autoimmunity following alemtuzumab treatment of multiple sclerosis can be predicted by high baseline serum interleukin IL-21 (IL-21), as measured using a now 'redundant' enzyme linked immunosorbent assay (ELISA). Here we ask whether currently available ELISAs have similar prognostic value.

Design: Serum IL-21 from 141 individuals with relapsing remitting multiple sclerosis was measured using the now 'redundant' IL-21 ELISA and five further currently available kits. All patients had been treated with alemtuzumab; 61/141 had developed secondary autoimmunity.

Results: The 'redundant kit', and one current kit, confirmed higher baseline serum IL-21 in patients with autoimmunity (542 pg/mL vs. 222 pg/mL and 53.1 pg/mL vs. 9.3 pg/mL respectively) and showed positive correlation. However, only the 'redundant' kit had predictive utility.

Conclusions: Currently available IL-21 ELISA kits should not be used to counsel individuals with multiple sclerosis considering treatment with alemtuzumab.

Keywords: Immunology; Multiple Sclerosis.

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