1670
Multiple Sclerosis Journal 20(12)
Despite such success the role and value of the specialist nurse is often questioned in times of financial pressure with specialist nurses being asked to take on other duties, downgraded or posts frozen. More studies in this area could show that continuation of MSSN posts provides a good return on investment. Conflict of interest None declared.
References 1. UK Multiple Sclerosis Specialist Nurse Association (UKMSSNA). Multiple sclerosis specialist nurses: Adding value and delivering targets. UKMSSNA, 2006; Ledbury, UK. 2. Nuffield Trust. Trends in emergency admission 2004–9: Is greater efficiency breeding inefficiency? Nuffield Trust, 2010; London, UK. 3. Health and Social Care Information Centre. Hospital episode statistics, www.hesonline.nhs.uk/Ease/servlet/ContentServ er?siteID=1937&categoryID=202 (2012, accessed August 2012).
Debbie Quinn1,2, Amy Bowen1 and Alison Leary3 1Multiple Sclerosis Trust, UK 2Northamptonshire Healthcare NHS Foundation Trust, UK 3London Southbank University, UK Corresponding author: Alison Leary, London Southbank University, 103 Borough Rd, London, SE1 0AA, UK. Email: [email protected]
No evidence for an association of osteopontin plasma levels with disease activity in multiple sclerosis We read with interest the article by Kivisäkk et al.1 in which they evaluated the plasma levels of osteopontin in a cohort of patients with multiple sclerosis (MS). Kivisäkk and colleagues measured higher plasma osteopontin levels in MS patients than in controls, but they could not demonstrate any significant association of osteopontin with disease activity. Osteopontin is a multifunctional molecule that has been proposed as a biomarker for disease activity in MS. It has been hypothesized to be involved in relapses in MS for several reasons: osteopontin has been found to be one of the genes with the most common transcripts in MS lesions. In experimental autoimmune encephalomyelitis (EAE) models, administration of osteopontin induced relapse and inhibited spontaneous recovery. In patients with relapsing–remitting
MS, levels of osteopontin were higher during relapses than during remission.2 One study showed that osteopontin levels were increased 1 month before the appearance of a new lesion on brain magnetic resonance imaging (MRI),3 and although this study had some methodological shortcomings, its results added to the suggestion of osteopontin as a possible biomarker for MS disease activity. We have conducted a prospective longitudinal study in which we measured osteopontin plasma levels every 8 weeks in 58 relapsing–remitting MS patients. Patients were followed for a mean of 1.6 years. Osteopontin levels were measured using a commercially available enzyme-linked immunosorbent assay (ELISA; IBL International, Hamburg, Germany). The association between osteopontin levels and the relapse risk in the first, second, third and fourth week after sampling were calculated using generalized linear mixed-effects models. In this prospective study, we found no association between osteopontin levels and relapse risk. We also found no difference in osteopontin levels between patients with active and stable disease and no association of osteopontin with EDSS score. There was also no difference between interferon treated and non-treated patients, and no association with infections. With this, we confirm the results of the crosssectional study by Kivisäkk et al. that no association was found between osteopontin and clinical disease activity, even in a prospective study with frequent plasma measurements. Although these results do not rule out a role for osteopontin in MS pathophysiology, we conclude that as a biomarker for MS disease activity, osteopontin does not seem useful. Conflicts of interest None declared.
Funding The research of ErasMS is funded by the Dutch MS Research Foundation.
References 1.
Kivisakk P, Healy BC, Francois K, et al. Evaluation of circulating osteopontin levels in an unselected cohort of patients with multiple sclerosis: relevance for biomarker development. Mult Scler 2013. PMID: 24005026. [Epub 2013/09/06. Eng]. 2. Steinman L. A molecular trio in relapse and remission in multiple sclerosis. Nat Rev Immunol 2009; 9: 440–447. PMID: 19444308. [Epub 2009/05/16. Eng.]’. 3. Vogt MH, Floris S, Killestein J, et al. Osteopontin levels and increased disease activity in relapsing–remitting multiple sclerosis patients. J Neuroimmunol 2004; 155: 155–160. PMID: 15342207. [Epub 2004/09/03. Eng.].
Downloaded from msj.sagepub.com at University of Texas at El Paso on December 28, 2014
1671
Bigi et al. Tessel F Runia,1 Marjan van Meurs,2 Kazem Nasserinejad3 and Rogier Q Hintzen4 1Department of Neurology, Erasmus MC, Rotterdam, The Netherlands 2Department of Immunology, Erasmus MC, Rotterdam, The Netherlands 3Department of Biostatistics, Erasmus MC, Rotterdam, The Netherlands
Corresponding author: Tessel F Runia, Department of Neurology, Erasmus MC, Rotterdam, Kamer Ee2230 faculteit, Erasmus MC, Postbus 2040, 3000 CA Rotterdam, The Netherlands. Email: [email protected]
Downloaded from msj.sagepub.com at University of Texas at El Paso on December 28, 2014
Multiple Sclerosis Journal 20(12)
Despite such success the role and value of the specialist nurse is often questioned in times of financial pressure with specialist nurses being asked to take on other duties, downgraded or posts frozen. More studies in this area could show that continuation of MSSN posts provides a good return on investment. Conflict of interest None declared.
References 1. UK Multiple Sclerosis Specialist Nurse Association (UKMSSNA). Multiple sclerosis specialist nurses: Adding value and delivering targets. UKMSSNA, 2006; Ledbury, UK. 2. Nuffield Trust. Trends in emergency admission 2004–9: Is greater efficiency breeding inefficiency? Nuffield Trust, 2010; London, UK. 3. Health and Social Care Information Centre. Hospital episode statistics, www.hesonline.nhs.uk/Ease/servlet/ContentServ er?siteID=1937&categoryID=202 (2012, accessed August 2012).
Debbie Quinn1,2, Amy Bowen1 and Alison Leary3 1Multiple Sclerosis Trust, UK 2Northamptonshire Healthcare NHS Foundation Trust, UK 3London Southbank University, UK Corresponding author: Alison Leary, London Southbank University, 103 Borough Rd, London, SE1 0AA, UK. Email: [email protected]
No evidence for an association of osteopontin plasma levels with disease activity in multiple sclerosis We read with interest the article by Kivisäkk et al.1 in which they evaluated the plasma levels of osteopontin in a cohort of patients with multiple sclerosis (MS). Kivisäkk and colleagues measured higher plasma osteopontin levels in MS patients than in controls, but they could not demonstrate any significant association of osteopontin with disease activity. Osteopontin is a multifunctional molecule that has been proposed as a biomarker for disease activity in MS. It has been hypothesized to be involved in relapses in MS for several reasons: osteopontin has been found to be one of the genes with the most common transcripts in MS lesions. In experimental autoimmune encephalomyelitis (EAE) models, administration of osteopontin induced relapse and inhibited spontaneous recovery. In patients with relapsing–remitting
MS, levels of osteopontin were higher during relapses than during remission.2 One study showed that osteopontin levels were increased 1 month before the appearance of a new lesion on brain magnetic resonance imaging (MRI),3 and although this study had some methodological shortcomings, its results added to the suggestion of osteopontin as a possible biomarker for MS disease activity. We have conducted a prospective longitudinal study in which we measured osteopontin plasma levels every 8 weeks in 58 relapsing–remitting MS patients. Patients were followed for a mean of 1.6 years. Osteopontin levels were measured using a commercially available enzyme-linked immunosorbent assay (ELISA; IBL International, Hamburg, Germany). The association between osteopontin levels and the relapse risk in the first, second, third and fourth week after sampling were calculated using generalized linear mixed-effects models. In this prospective study, we found no association between osteopontin levels and relapse risk. We also found no difference in osteopontin levels between patients with active and stable disease and no association of osteopontin with EDSS score. There was also no difference between interferon treated and non-treated patients, and no association with infections. With this, we confirm the results of the crosssectional study by Kivisäkk et al. that no association was found between osteopontin and clinical disease activity, even in a prospective study with frequent plasma measurements. Although these results do not rule out a role for osteopontin in MS pathophysiology, we conclude that as a biomarker for MS disease activity, osteopontin does not seem useful. Conflicts of interest None declared.
Funding The research of ErasMS is funded by the Dutch MS Research Foundation.
References 1.
Kivisakk P, Healy BC, Francois K, et al. Evaluation of circulating osteopontin levels in an unselected cohort of patients with multiple sclerosis: relevance for biomarker development. Mult Scler 2013. PMID: 24005026. [Epub 2013/09/06. Eng]. 2. Steinman L. A molecular trio in relapse and remission in multiple sclerosis. Nat Rev Immunol 2009; 9: 440–447. PMID: 19444308. [Epub 2009/05/16. Eng.]’. 3. Vogt MH, Floris S, Killestein J, et al. Osteopontin levels and increased disease activity in relapsing–remitting multiple sclerosis patients. J Neuroimmunol 2004; 155: 155–160. PMID: 15342207. [Epub 2004/09/03. Eng.].
Downloaded from msj.sagepub.com at University of Texas at El Paso on December 28, 2014
1671
Bigi et al. Tessel F Runia,1 Marjan van Meurs,2 Kazem Nasserinejad3 and Rogier Q Hintzen4 1Department of Neurology, Erasmus MC, Rotterdam, The Netherlands 2Department of Immunology, Erasmus MC, Rotterdam, The Netherlands 3Department of Biostatistics, Erasmus MC, Rotterdam, The Netherlands
Corresponding author: Tessel F Runia, Department of Neurology, Erasmus MC, Rotterdam, Kamer Ee2230 faculteit, Erasmus MC, Postbus 2040, 3000 CA Rotterdam, The Netherlands. Email: [email protected]
Downloaded from msj.sagepub.com at University of Texas at El Paso on December 28, 2014
