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. 2021 Sep 17;11(1):18528.
doi: 10.1038/s41598-021-97543-6.

Cerebrospinal fluid markers in incident pediatric-onset multiple sclerosis: a nationwide study

Kyla A McKay  1   2 , Ronny Wickström  3 , Jan Hillert  4 , Virginija Danylaite Karrenbauer  4   5
Affiliations

Cerebrospinal fluid markers in incident pediatric-onset multiple sclerosis: a nationwide study

Kyla A McKay et al. Sci Rep. .

Abstract

To investigate whether cerebrospinal fluid (CSF) markers differ between pediatric-onset multiple sclerosis (PoMS, onset < 18 years) and adult-onset (AoMS), and whether these markers are associated with clinical outcomes among PoMS. Prospective nationwide registry study of incident MS, including persons with a CSF sample < 3 years post-MS onset. We compared CSF oligoclonal band (OCB) status, immunoglobulin G (IgG) index levels, and mononuclear cell count between PoMS and AoMS. Within the PoMS cohort we analyzed the association between CSF markers, relapse rate and Expanded Disability Status Scale (EDSS) score, using negative binomial regression and generalized estimating equations, respectively. The cohort consisted of 130 PoMS and 3228 AoMS cases. The PoMS group had higher odds of OCB-positivity (odds ratio: 2.70; 95% CI 1.21-7.67). None of the CSF markers were associated with relapse rate in the PoMS cohort; however, OCB-positivity was associated with higher EDSS scores. This study suggested that PoMS more commonly display CSF evidence for intrathecal IgG production than AoMS. Further, we found evidence of a relationship between OCB-positivity and subsequent disability, suggesting that they could play a role in the prognostication of MS in children.

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Conflict of interest statement

KAM receives postdoctoral research support from the CIHR and the Swedish Research Council for Health, Working life and Welfare. RW has received honoraria for serving on advisory boards for Octapharma, Roche and Novartis. He has served as P.I. for a project from Biogen and received financial support from Stockholm City Council. JH has received honoraria for serving on advisory boards for Biogen, Merck, Novartis, Sandoz, Sanofi-Genzyme and Celgene and speaker’s fees from Biogen, Novartis, Merck and Sanofi-Genzyme. He has served as P.I. for projects, or received unrestricted research support from, Celgene, Biogen, Merck, Novartis, Roche and Sanofi-Genzyme. VDK has received financial support from Stockholm County Council (Grant recipient ALF 20160457); Biogen (recipient of grant and scholarship, PI for project sponsored by); Novartis (recipient of scholarship and lecture honoraria); Merck (Scientific Advisory Board member, recipient of lecture honoraria).

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