BACKGROUND Extracellular vesicles (EVs), a recently described mechanism of cell communication, are released from activated microglial cells and macrophages and are a candidate biomarker in diseases characterized by chronic inflammatory process such as multiple sclerosis (MS). METHODS We explored cerebrospinal fluid extracellular vesicle (CSF EV) of myeloid origin (MEVs), cytokine and chemokine levels in patients with clinically isolated syndrome (CIS). RESULTS We found that CSF MEVs were significantly higher in CIS patients than in controls and were inversely correlated to CSF CCL2 levels. MEVs level were significantly associated with an shorter time to evidence of disease activity (hazard ratio: 1.01, 95% confidence interval: 1.00-1.02, p < 0.01) independently from other known prognostic markers. CONCLUSION After a first demyelinating event, CSF EVs may improve risk stratification of these patients and allow more targeted intervention strategies.

中文翻译：

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第一次脱髓鞘事件后脑脊液细胞外囊泡和疾病活动风险

背景细胞外囊泡 (EV) 是最近描述的细胞通讯机制，从活化的小胶质细胞和巨噬细胞中释放出来，是多发性硬化症 (MS) 等以慢性炎症过程为特征的疾病的候选生物标志物。方法 我们研究了临床孤立综合征 (CIS) 患者的髓源性 (MEV) 脑脊液细胞外囊泡 (CSF EV)、细胞因子和趋化因子水平。结果 我们发现 CIS 患者的 CSF MEV 显着高于对照组，并且与 CSF CCL2 水平呈负相关。MEV 水平与疾病活动证据的较短时间显着相关（风险比：1.01，95% 置信区间：1.00-1.02，p < 0.01），独立于其他已知的预后标志物。结论 在第一次脱髓鞘事件后，