BLOOD INFLAMMATORY MARKERS IN MND PATIENTS-PATTERN CHANGES OVER TIME ALONG DISEASE PROGRESSION

Biomarkers-based monitoring tools in ALS are not yet appropriate for research and routine clinical practice. The immunologic fingerprint of ALS at a systemic level may not be easily distinguishable, considering the reported strong association of ALS with autoimmune comorbidities. Early ALS pathology is sensed by the innate immune system, with the release of inflammatory markers such as cytokines, C-reactive protein, and ferritin. The possibility to predict the early onset and to find therapeutic markers of ALS is always far to be achieved. In this work, in order to find early new markers of the disease, the principal blood analytes were measured diachronically in plasma of 35 patients with MND1+2 (ALS) and in 30 MND2 patients. ALS subgroups were categorized according to site of disease onset, progression rate, and disease stages. Levels of circulating inflammatory and immune biomarkers, which express the body's inflammatory state, were valuated and correlated with clinical parameters during disease progression. Statistical analysis was performed using Stata software (release 10.0; Stata Corporation, College Station, TX77845, USA). A two-sided p-value <0.05 was considered statistically significant. To establish potential contributors to systemic inflammation, different criteria of analysis were used. 1) A comparison between distinct classes, slow, intermedia and fast disease progression, 2) a matrix of correlation between ALS-FSR and analytes both in ALS and in MND2 3) a direct comparison of analytes at the same extent of ALS-FSR between ALS and MND2 patients. We tested the expression of circulating markers and neuromuscular pathology changes in ALS linked to the progression rate Dati demonstrated a significant difference between slow and the other two categories, analytes specifically altered in ALS respect to MND2 were reported.