WESTPORT, CT (Reuters Health) Feb 06 - Measurement of myelin basic protein-like material in urine may be a new, inexpensive means of monitoring axonal loss and central nervous system atrophy in patients with advanced, progressive multiple sclerosis, according to researchers in the US.
Dr. John N. Whitaker, of the University of Alabama at Birmingham, and a multicenter team looked at the correlations between urine levels of myelin basic proteinlike material and the volume of black holes/hypointense lesions, as measured by magnetic resonance imaging, in 662 patients with various stages of MS. The patients were enrolled in a clinical study of roquinimex (Linomide) and all assessments were taken at enrollment.
The two measurements were significantly correlated, but only in patients with advanced MS, particularly patients with an Expanded Disability Status Score of 5.5 or higher. By comparison, no significant correlation between the urine marker and the volume of black holes on MRI was observed in patients with relapsing-remitting MS.
This disparity "implies a pathological difference between the clinical expressions of relapses and progression," the authors say in the January issue of Archives of Neurology.
Elsewhere in the journal, Dr. J. Theodore Phillips, of Baylor University Medical Center in Dallas, remarks that there is an urgent need for a new, inexpensive marker for disease progression in MS, and that urine myelin basic proteinlike material could be such a marker.
Dr. Phillips adds that the time has come for renewed interest in modifying the progressive course of MS. "Currently available disease-modifying therapies need to be aggressively and proactively used with renewed attention to preventing disease progression," he says. "Future therapies...should target progressive pathological conditions either through direct intervention or through neuroprotective strategies."
Arch Neurol 2001;58:30-31,49-54.
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