Six of seven patients who were able to walk 10 m with or without walking aids showed sustained improvement in the 10 m walking time (Physique 3A, lower left)

Six of seven patients who were able to walk 10 m with or without walking aids showed sustained improvement in the 10 m walking time (Physique 3A, lower left). CSF levels of CXCL10, neopterin, total protein, cell counts, and anti-HTLV-1 antibody titer were compared before and after steroid therapy. Levels of all CSF markers, with the exception of cell count, were significantly decreased after treatment. Nine of the 13 patients (69.2%) showed improvement in OMDS and were considered responders. Pre-treatment CSF levels of CXCL10 and anti-HTLV-1 antibody titer in responders were higher than those in non-responders (= 0.020 and = 0.045, respectively). Patients who continued low-dose oral prednisolone maintenance therapy after methylprednisolone pulse therapy showed sustained improvement in OMDS and CSF CXCL10 and neopterin levels lasting for 2 years. In contrast, OMDS and the CSF marker levels in patients who discontinued treatment returned to pre-treatment levels. This rebound phenomenon was also observed in patients who discontinued oral prednisolone therapy independently of pulse therapy. Our findings suggest that CSF CXCL10 may serve as a therapy-response and therapy-predictive marker for HAM/TSP. In addition, since decrease in CSF CXCL10 level was associated with good functional prognosis, CSF CXCL10 is usually a Mouse monoclonal to PPP1A potential surrogate marker for treatment of HAM/TSP. = 6) received oral prednisolone therapy (Table 1). Since the dose of oral BI-4464 prednisolone was gradually tapered, Table 1 shows both the starting dose and the 2-12 months dose. In this paper, a series of treatments implemented at the two hospitals are collectively described as steroid therapy. In four patients (nos. 19C22), 3C5 mg of oral prednisolone was administered daily for at least 6 months. Disease Evaluation Data pertaining to OMDS, (Table 2) and 10 m timed walk were collected as clinical outcome steps. The OMDS was evaluated before treatment and 1 month after treatment at both the university hospitals. Subjects whose OMDS improved 1 month after treatment compared with that at baseline were defined as responders, and those who BI-4464 did not show improvement were defined as nonresponders. Subsequently, OMDS was measured every month for at least 6 months. Only patients who were able to walk for 10 m with or without walking aids underwent the 10 m timed walk. We could collect the data on 10 m timed walk before and about 2 weeks after treatment was performed in both hospitals. Since the 10 m timed walk was not performed regularly at the Fukuoka University Hospital, there are numerous missing data in this respect. TABLE 2 Osame motor disability score. = 11 or 12). As shown in Physique 1 (left), the levels of CXCL10, neopterin, total protein, and anti-HTLV-1 antibody in CSF of HAM/TSP patients who received steroid therapy were significantly reduced 2 weeks after treatment, compared with the pre-treatment levels (= 0.0005, = 0.0005, = 0.0059, and = 0.0078, respectively). CSF cell counts also tended to decrease; however, the difference was not significant (= 0.0645). When comparing the pre- and post-treatment levels for each hospital, significant reduction was observed only for two out of the five CSF markers (CXCL10 and neopterin) (data not shown). In contrast, none of the five markers showed a significant reduction in HAM/TSP patients (= 5) who were not treated with steroids or interferon- (Physique 1, right). Open in a separate window Physique 1 Effects of steroid therapy on Cerebrospinal fluid (CSF) markers. Left: Comparison of pre-treatment levels of the following five CSF markers with those approximately 2 weeks after steroid therapy (mean standard deviation (SD): 2.5 0.9 weeks from the first day of pulse therapy): C-X-C motif chemokine 10 (CXCL10), neopterin, total protein, anti-HTLV-1 antibody (Ab) titer, and cell count. Post-treatment CSF markers were not available for one or two patients among the 13 patients who received methylprednisolone pulse therapy (= 12: CXCL10, neopterin, and BI-4464 anti-HTLV-1 antibody titer; = 11: total protein and cell count). Right: Comparison of the same five CSF markers between two time points (mean SD: 16.4 5.7 months) in five patients who did not receive any steroid treatment and interferon alpha treatment. Statistical analysis was performed using a Wilcoxon signed rank test. Ab, antibody. Predictors of Response to Steroid Therapy HTLV-1-associated myelopathy/tropical spastic paraparesis patients who showed improvement in OMDS were defined as responders (9 out of 13 patients). In order.