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August 2016; 3 (4) ArticleOpen Access

Systemic inflammatory response and neuromuscular involvement in amyotrophic lateral sclerosis

Ching-Hua Lu, Kezia Allen, Felicia Oei, Emanuela Leoni, Jens Kuhle, Timothy Tree, Pietro Fratta, Nikhil Sharma, Katie Sidle, Robin Howard, Richard Orrell, Mark Fish, Linda Greensmith, Neil Pearce, Valentina Gallo, Andrea Malaspina
First published June 1, 2016, DOI: https://doi.org/10.1212/NXI.0000000000000244
Ching-Hua Lu
From the Centre for Neuroscience & Trauma (C.L., F.O., J.K., A.M.) and Centre of Primary Care and Public Health (V.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Sobell Department of Motor Neuroscience and Movement Disorders (C.L., P.F., L.G.), MRC Centre for Neuromuscular Diseases (P.F., L.G.), MRC Unit for Lifelong Health and Ageing (N.S.), Department of Molecular Neuroscience (K.S.), and Department of Clinical Neuroscience (R.O.), UCL Institute of Neurology; Basildon and Thurrock University Hospitals (K.A., A.M.), NHS Foundation Trust, Basildon; William Harvey Hospital (F.O.), Kent; Proteome Sciences plc (E.L.), South Wing Laboratory, Institute of Psychiatry, UK; Neurology (J.K.), University Hospital Basel, Switzerland; Department of Immunobiology (T.T.), King's College London; National Hospital for Neurology and Neurosurgery (N.S., R.H., R.O.), London; Musgrove Park Hospital (M.F.), Taunton; and Department of Medical Statistics (N.P.), London School of Hygiene and Tropical Medicine, UK.
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Kezia Allen
From the Centre for Neuroscience & Trauma (C.L., F.O., J.K., A.M.) and Centre of Primary Care and Public Health (V.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Sobell Department of Motor Neuroscience and Movement Disorders (C.L., P.F., L.G.), MRC Centre for Neuromuscular Diseases (P.F., L.G.), MRC Unit for Lifelong Health and Ageing (N.S.), Department of Molecular Neuroscience (K.S.), and Department of Clinical Neuroscience (R.O.), UCL Institute of Neurology; Basildon and Thurrock University Hospitals (K.A., A.M.), NHS Foundation Trust, Basildon; William Harvey Hospital (F.O.), Kent; Proteome Sciences plc (E.L.), South Wing Laboratory, Institute of Psychiatry, UK; Neurology (J.K.), University Hospital Basel, Switzerland; Department of Immunobiology (T.T.), King's College London; National Hospital for Neurology and Neurosurgery (N.S., R.H., R.O.), London; Musgrove Park Hospital (M.F.), Taunton; and Department of Medical Statistics (N.P.), London School of Hygiene and Tropical Medicine, UK.
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Felicia Oei
From the Centre for Neuroscience & Trauma (C.L., F.O., J.K., A.M.) and Centre of Primary Care and Public Health (V.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Sobell Department of Motor Neuroscience and Movement Disorders (C.L., P.F., L.G.), MRC Centre for Neuromuscular Diseases (P.F., L.G.), MRC Unit for Lifelong Health and Ageing (N.S.), Department of Molecular Neuroscience (K.S.), and Department of Clinical Neuroscience (R.O.), UCL Institute of Neurology; Basildon and Thurrock University Hospitals (K.A., A.M.), NHS Foundation Trust, Basildon; William Harvey Hospital (F.O.), Kent; Proteome Sciences plc (E.L.), South Wing Laboratory, Institute of Psychiatry, UK; Neurology (J.K.), University Hospital Basel, Switzerland; Department of Immunobiology (T.T.), King's College London; National Hospital for Neurology and Neurosurgery (N.S., R.H., R.O.), London; Musgrove Park Hospital (M.F.), Taunton; and Department of Medical Statistics (N.P.), London School of Hygiene and Tropical Medicine, UK.
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Emanuela Leoni
From the Centre for Neuroscience & Trauma (C.L., F.O., J.K., A.M.) and Centre of Primary Care and Public Health (V.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Sobell Department of Motor Neuroscience and Movement Disorders (C.L., P.F., L.G.), MRC Centre for Neuromuscular Diseases (P.F., L.G.), MRC Unit for Lifelong Health and Ageing (N.S.), Department of Molecular Neuroscience (K.S.), and Department of Clinical Neuroscience (R.O.), UCL Institute of Neurology; Basildon and Thurrock University Hospitals (K.A., A.M.), NHS Foundation Trust, Basildon; William Harvey Hospital (F.O.), Kent; Proteome Sciences plc (E.L.), South Wing Laboratory, Institute of Psychiatry, UK; Neurology (J.K.), University Hospital Basel, Switzerland; Department of Immunobiology (T.T.), King's College London; National Hospital for Neurology and Neurosurgery (N.S., R.H., R.O.), London; Musgrove Park Hospital (M.F.), Taunton; and Department of Medical Statistics (N.P.), London School of Hygiene and Tropical Medicine, UK.
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Jens Kuhle
From the Centre for Neuroscience & Trauma (C.L., F.O., J.K., A.M.) and Centre of Primary Care and Public Health (V.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Sobell Department of Motor Neuroscience and Movement Disorders (C.L., P.F., L.G.), MRC Centre for Neuromuscular Diseases (P.F., L.G.), MRC Unit for Lifelong Health and Ageing (N.S.), Department of Molecular Neuroscience (K.S.), and Department of Clinical Neuroscience (R.O.), UCL Institute of Neurology; Basildon and Thurrock University Hospitals (K.A., A.M.), NHS Foundation Trust, Basildon; William Harvey Hospital (F.O.), Kent; Proteome Sciences plc (E.L.), South Wing Laboratory, Institute of Psychiatry, UK; Neurology (J.K.), University Hospital Basel, Switzerland; Department of Immunobiology (T.T.), King's College London; National Hospital for Neurology and Neurosurgery (N.S., R.H., R.O.), London; Musgrove Park Hospital (M.F.), Taunton; and Department of Medical Statistics (N.P.), London School of Hygiene and Tropical Medicine, UK.
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Timothy Tree
From the Centre for Neuroscience & Trauma (C.L., F.O., J.K., A.M.) and Centre of Primary Care and Public Health (V.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Sobell Department of Motor Neuroscience and Movement Disorders (C.L., P.F., L.G.), MRC Centre for Neuromuscular Diseases (P.F., L.G.), MRC Unit for Lifelong Health and Ageing (N.S.), Department of Molecular Neuroscience (K.S.), and Department of Clinical Neuroscience (R.O.), UCL Institute of Neurology; Basildon and Thurrock University Hospitals (K.A., A.M.), NHS Foundation Trust, Basildon; William Harvey Hospital (F.O.), Kent; Proteome Sciences plc (E.L.), South Wing Laboratory, Institute of Psychiatry, UK; Neurology (J.K.), University Hospital Basel, Switzerland; Department of Immunobiology (T.T.), King's College London; National Hospital for Neurology and Neurosurgery (N.S., R.H., R.O.), London; Musgrove Park Hospital (M.F.), Taunton; and Department of Medical Statistics (N.P.), London School of Hygiene and Tropical Medicine, UK.
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Pietro Fratta
From the Centre for Neuroscience & Trauma (C.L., F.O., J.K., A.M.) and Centre of Primary Care and Public Health (V.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Sobell Department of Motor Neuroscience and Movement Disorders (C.L., P.F., L.G.), MRC Centre for Neuromuscular Diseases (P.F., L.G.), MRC Unit for Lifelong Health and Ageing (N.S.), Department of Molecular Neuroscience (K.S.), and Department of Clinical Neuroscience (R.O.), UCL Institute of Neurology; Basildon and Thurrock University Hospitals (K.A., A.M.), NHS Foundation Trust, Basildon; William Harvey Hospital (F.O.), Kent; Proteome Sciences plc (E.L.), South Wing Laboratory, Institute of Psychiatry, UK; Neurology (J.K.), University Hospital Basel, Switzerland; Department of Immunobiology (T.T.), King's College London; National Hospital for Neurology and Neurosurgery (N.S., R.H., R.O.), London; Musgrove Park Hospital (M.F.), Taunton; and Department of Medical Statistics (N.P.), London School of Hygiene and Tropical Medicine, UK.
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Nikhil Sharma
From the Centre for Neuroscience & Trauma (C.L., F.O., J.K., A.M.) and Centre of Primary Care and Public Health (V.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Sobell Department of Motor Neuroscience and Movement Disorders (C.L., P.F., L.G.), MRC Centre for Neuromuscular Diseases (P.F., L.G.), MRC Unit for Lifelong Health and Ageing (N.S.), Department of Molecular Neuroscience (K.S.), and Department of Clinical Neuroscience (R.O.), UCL Institute of Neurology; Basildon and Thurrock University Hospitals (K.A., A.M.), NHS Foundation Trust, Basildon; William Harvey Hospital (F.O.), Kent; Proteome Sciences plc (E.L.), South Wing Laboratory, Institute of Psychiatry, UK; Neurology (J.K.), University Hospital Basel, Switzerland; Department of Immunobiology (T.T.), King's College London; National Hospital for Neurology and Neurosurgery (N.S., R.H., R.O.), London; Musgrove Park Hospital (M.F.), Taunton; and Department of Medical Statistics (N.P.), London School of Hygiene and Tropical Medicine, UK.
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Katie Sidle
From the Centre for Neuroscience & Trauma (C.L., F.O., J.K., A.M.) and Centre of Primary Care and Public Health (V.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Sobell Department of Motor Neuroscience and Movement Disorders (C.L., P.F., L.G.), MRC Centre for Neuromuscular Diseases (P.F., L.G.), MRC Unit for Lifelong Health and Ageing (N.S.), Department of Molecular Neuroscience (K.S.), and Department of Clinical Neuroscience (R.O.), UCL Institute of Neurology; Basildon and Thurrock University Hospitals (K.A., A.M.), NHS Foundation Trust, Basildon; William Harvey Hospital (F.O.), Kent; Proteome Sciences plc (E.L.), South Wing Laboratory, Institute of Psychiatry, UK; Neurology (J.K.), University Hospital Basel, Switzerland; Department of Immunobiology (T.T.), King's College London; National Hospital for Neurology and Neurosurgery (N.S., R.H., R.O.), London; Musgrove Park Hospital (M.F.), Taunton; and Department of Medical Statistics (N.P.), London School of Hygiene and Tropical Medicine, UK.
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Robin Howard
From the Centre for Neuroscience & Trauma (C.L., F.O., J.K., A.M.) and Centre of Primary Care and Public Health (V.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Sobell Department of Motor Neuroscience and Movement Disorders (C.L., P.F., L.G.), MRC Centre for Neuromuscular Diseases (P.F., L.G.), MRC Unit for Lifelong Health and Ageing (N.S.), Department of Molecular Neuroscience (K.S.), and Department of Clinical Neuroscience (R.O.), UCL Institute of Neurology; Basildon and Thurrock University Hospitals (K.A., A.M.), NHS Foundation Trust, Basildon; William Harvey Hospital (F.O.), Kent; Proteome Sciences plc (E.L.), South Wing Laboratory, Institute of Psychiatry, UK; Neurology (J.K.), University Hospital Basel, Switzerland; Department of Immunobiology (T.T.), King's College London; National Hospital for Neurology and Neurosurgery (N.S., R.H., R.O.), London; Musgrove Park Hospital (M.F.), Taunton; and Department of Medical Statistics (N.P.), London School of Hygiene and Tropical Medicine, UK.
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Richard Orrell
From the Centre for Neuroscience & Trauma (C.L., F.O., J.K., A.M.) and Centre of Primary Care and Public Health (V.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Sobell Department of Motor Neuroscience and Movement Disorders (C.L., P.F., L.G.), MRC Centre for Neuromuscular Diseases (P.F., L.G.), MRC Unit for Lifelong Health and Ageing (N.S.), Department of Molecular Neuroscience (K.S.), and Department of Clinical Neuroscience (R.O.), UCL Institute of Neurology; Basildon and Thurrock University Hospitals (K.A., A.M.), NHS Foundation Trust, Basildon; William Harvey Hospital (F.O.), Kent; Proteome Sciences plc (E.L.), South Wing Laboratory, Institute of Psychiatry, UK; Neurology (J.K.), University Hospital Basel, Switzerland; Department of Immunobiology (T.T.), King's College London; National Hospital for Neurology and Neurosurgery (N.S., R.H., R.O.), London; Musgrove Park Hospital (M.F.), Taunton; and Department of Medical Statistics (N.P.), London School of Hygiene and Tropical Medicine, UK.
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Mark Fish
From the Centre for Neuroscience & Trauma (C.L., F.O., J.K., A.M.) and Centre of Primary Care and Public Health (V.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Sobell Department of Motor Neuroscience and Movement Disorders (C.L., P.F., L.G.), MRC Centre for Neuromuscular Diseases (P.F., L.G.), MRC Unit for Lifelong Health and Ageing (N.S.), Department of Molecular Neuroscience (K.S.), and Department of Clinical Neuroscience (R.O.), UCL Institute of Neurology; Basildon and Thurrock University Hospitals (K.A., A.M.), NHS Foundation Trust, Basildon; William Harvey Hospital (F.O.), Kent; Proteome Sciences plc (E.L.), South Wing Laboratory, Institute of Psychiatry, UK; Neurology (J.K.), University Hospital Basel, Switzerland; Department of Immunobiology (T.T.), King's College London; National Hospital for Neurology and Neurosurgery (N.S., R.H., R.O.), London; Musgrove Park Hospital (M.F.), Taunton; and Department of Medical Statistics (N.P.), London School of Hygiene and Tropical Medicine, UK.
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Linda Greensmith
From the Centre for Neuroscience & Trauma (C.L., F.O., J.K., A.M.) and Centre of Primary Care and Public Health (V.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Sobell Department of Motor Neuroscience and Movement Disorders (C.L., P.F., L.G.), MRC Centre for Neuromuscular Diseases (P.F., L.G.), MRC Unit for Lifelong Health and Ageing (N.S.), Department of Molecular Neuroscience (K.S.), and Department of Clinical Neuroscience (R.O.), UCL Institute of Neurology; Basildon and Thurrock University Hospitals (K.A., A.M.), NHS Foundation Trust, Basildon; William Harvey Hospital (F.O.), Kent; Proteome Sciences plc (E.L.), South Wing Laboratory, Institute of Psychiatry, UK; Neurology (J.K.), University Hospital Basel, Switzerland; Department of Immunobiology (T.T.), King's College London; National Hospital for Neurology and Neurosurgery (N.S., R.H., R.O.), London; Musgrove Park Hospital (M.F.), Taunton; and Department of Medical Statistics (N.P.), London School of Hygiene and Tropical Medicine, UK.
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Neil Pearce
From the Centre for Neuroscience & Trauma (C.L., F.O., J.K., A.M.) and Centre of Primary Care and Public Health (V.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Sobell Department of Motor Neuroscience and Movement Disorders (C.L., P.F., L.G.), MRC Centre for Neuromuscular Diseases (P.F., L.G.), MRC Unit for Lifelong Health and Ageing (N.S.), Department of Molecular Neuroscience (K.S.), and Department of Clinical Neuroscience (R.O.), UCL Institute of Neurology; Basildon and Thurrock University Hospitals (K.A., A.M.), NHS Foundation Trust, Basildon; William Harvey Hospital (F.O.), Kent; Proteome Sciences plc (E.L.), South Wing Laboratory, Institute of Psychiatry, UK; Neurology (J.K.), University Hospital Basel, Switzerland; Department of Immunobiology (T.T.), King's College London; National Hospital for Neurology and Neurosurgery (N.S., R.H., R.O.), London; Musgrove Park Hospital (M.F.), Taunton; and Department of Medical Statistics (N.P.), London School of Hygiene and Tropical Medicine, UK.
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Valentina Gallo
From the Centre for Neuroscience & Trauma (C.L., F.O., J.K., A.M.) and Centre of Primary Care and Public Health (V.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Sobell Department of Motor Neuroscience and Movement Disorders (C.L., P.F., L.G.), MRC Centre for Neuromuscular Diseases (P.F., L.G.), MRC Unit for Lifelong Health and Ageing (N.S.), Department of Molecular Neuroscience (K.S.), and Department of Clinical Neuroscience (R.O.), UCL Institute of Neurology; Basildon and Thurrock University Hospitals (K.A., A.M.), NHS Foundation Trust, Basildon; William Harvey Hospital (F.O.), Kent; Proteome Sciences plc (E.L.), South Wing Laboratory, Institute of Psychiatry, UK; Neurology (J.K.), University Hospital Basel, Switzerland; Department of Immunobiology (T.T.), King's College London; National Hospital for Neurology and Neurosurgery (N.S., R.H., R.O.), London; Musgrove Park Hospital (M.F.), Taunton; and Department of Medical Statistics (N.P.), London School of Hygiene and Tropical Medicine, UK.
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Andrea Malaspina
From the Centre for Neuroscience & Trauma (C.L., F.O., J.K., A.M.) and Centre of Primary Care and Public Health (V.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Sobell Department of Motor Neuroscience and Movement Disorders (C.L., P.F., L.G.), MRC Centre for Neuromuscular Diseases (P.F., L.G.), MRC Unit for Lifelong Health and Ageing (N.S.), Department of Molecular Neuroscience (K.S.), and Department of Clinical Neuroscience (R.O.), UCL Institute of Neurology; Basildon and Thurrock University Hospitals (K.A., A.M.), NHS Foundation Trust, Basildon; William Harvey Hospital (F.O.), Kent; Proteome Sciences plc (E.L.), South Wing Laboratory, Institute of Psychiatry, UK; Neurology (J.K.), University Hospital Basel, Switzerland; Department of Immunobiology (T.T.), King's College London; National Hospital for Neurology and Neurosurgery (N.S., R.H., R.O.), London; Musgrove Park Hospital (M.F.), Taunton; and Department of Medical Statistics (N.P.), London School of Hygiene and Tropical Medicine, UK.
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Full PDF
Citation
Systemic inflammatory response and neuromuscular involvement in amyotrophic lateral sclerosis
Ching-Hua Lu, Kezia Allen, Felicia Oei, Emanuela Leoni, Jens Kuhle, Timothy Tree, Pietro Fratta, Nikhil Sharma, Katie Sidle, Robin Howard, Richard Orrell, Mark Fish, Linda Greensmith, Neil Pearce, Valentina Gallo, Andrea Malaspina
Neurol Neuroimmunol Neuroinflamm Aug 2016, 3 (4) e244; DOI: 10.1212/NXI.0000000000000244

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    Figure 1. Principal component analysis (PCA) of patients with amyotrophic lateral sclerosis (ALS) vs controls

    PCA analysis shows a good separation between ALS and controls of the expression levels of the 11 cytokines under investigation, more significant when sex-specific groups are considered. (A) ALS (green squares) and controls (yellow squares), (B) male only ALS (green squares) and controls (yellow squares), and (C) female only ALS (green squares) and controls (yellow squares).

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    Figure 2. Odds ratios (ORs) from the multivariate logistic regression analysis and hazard ratios (HRs) from the Cox regression analysis

    (A) OR (filled circle) and relative 95% confidence interval (CI) (whiskers) of plasma markers in amyotrophic lateral sclerosis (ALS) and controls from mutually adjusted multivariate logistic regression models; dashed line represents null hypothesis (no difference between ALS and controls). (B) HR (filled circles) and relative 95% CI (whiskers) of plasma markers estimating risk of death among patients with ALS from mutually adjusted multivariate Cox regression analysis. The dashed line represents null hypothesis (no association with survival). p < 0.5, 0.5 < p < 0.1, and p > 0.1 are shown in blue, mulberry, and black, respectively. CRP = C-reactive protein; CVD = cardiovascular disease; IFN = interferon; IL = interleukin; TNF = tumor necrosis factor.

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    Figure 3. Longitudinal expression levels of interleukin (IL)–6 for patients with amyotrophic lateral sclerosis (ALS)

    The scatterplots show IL-6 plasma levels (black dots) obtained at each follow-up time point from the 59 patients with ALS included in the longitudinal cohort. Median and quartile ranges at each visit are presented with red bars. Patients were subgrouped according to (A.a, A.b) progression rate calculated at baseline (with a cutoff value of 0.5); (B.a, B.b) sex; (C.a, C.b) site of disease onset; (D.a, D.b) ALS Functional Rating Scale–Revised (ALSFRS-R) score at V1 (cutoff value of 40); and (E.a, E.b) whether they were on riluzole or not. *p Value for Kruskal-Wallis test examining difference between all visits; **p value adjusted for multiple comparison between V1 and V6; ***p value adjusted for multiple comparison between V2 (D only) and V6.

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Neurology: Neuroimmunology & Neuroinflammation
Online ISSN: 2332-7812

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