Cerebrospinal fluid sulfatide isoforms lack diagnostic utility in separating progressive from relapsing-remitting multiple sclerosis

Background: Multiple sclerosis (MS) is an immune-mediated demyelinating disorder of the central nervous system. The glycosphingolipid sulfatide, a lipid particularly enriched in the myelin sheath, has been shown to be involved the maintenance of this specific membrane structure. Sulfatide in cerebrospinal fluid (CSF) may reflect demyelination, a dominating feature of MS. We investigated the diagnostic utility of CSF sulfatide isoform levels to separate different courses or phenotypes of MS disease. Material and methods: This was a mono-center, cross-sectional study of relapsing-remitting MS (RRMS) (n = 45) and progressive MS (PMS) (n = 42) patients (consisting of primary PMS (n = 17) and secondary PMS (n = 25)) and healthy controls (n = 19). In total, 20 sulfatide isoforms were measured in CSF by liquid chromatographymass spectrometry. Results: CSF total sulfatide concentrations, as well as CSF sulfatide isoform distribution, did not differ across the study groups, and their levels were independent of disease course/phenotype, disease duration, time to conversion to secondary PMS, age, and disability in MS patients. Conclusion: CSF sulfatide isoforms lack diagnostic and prognostic utility as a biomarker for progressive MS.

Automated summary

The diagnostic utility of cerebrospinal fluid (CSF) sulfatide isoform levels in different courses or phenotypes of multiple sclerosis (MS) was investigated. The results showed that there was no difference in CSF total sulfatide concentrations and isoform distribution among the study groups, and the levels were independent of disease course/phenotype, disease duration, time to conversion to secondary progressive MS, age, and disability.