الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 127 |  |  |
| | | from | 127 | | |
Abstract
Multiple sclerosis (MS) is a chronic autoimmune-mediated demyelinating disease of the central nervous system (CNS) that is usually associated with varying degrees of progressive disability. In most patients the early stages of disease, known as relapsing remitting MS (RRMS) are characterized by clinical exacerbations, or relapses, caused by autoreactive immune cells that traffic into the CNS, resulting in focal inflammation and demyelination often visible as gadolinium-enhancing lesions on magnetic resonance imaging (MRI). Relapses are followed by periods of clinical remission as inflammation resolves and remyelination occurs.
Investigation of cerebrospinal fluid (CSF) in the diagnostic work-up in suspected MS patients has regained attention in the latest version of the diagnostic criteria due to its good diagnostic accuracy and increasing issues with misdiagnosis of MS based on over interpretation of neuroimaging results. The hallmark of MS-specific changes in CSF is the detection of oligoclonal bands (OCB) which occur in the vast majority of MS patients.
Chitinase 3–like protein 1(CHI3L1), has attracted growing attention as a marker of ongoing inflammation and oncogenic transformation. This secreted glycoprotein, belongs to the 18-glycosyl-hydrolase family of proteins but lacks glycolytic activity. Although its biological functions are not fully understood, it is expressed by many cell types, including macrophages, neutrophils, chondrocytes, endothelial cells, microglia, and astrocytes.
The aim of this work was to try to assess the diagnostic accuracy of CHI3L1 versus IgG oligoclonal bands (OCBs) in the CSF of newly diagnosed RRMS patients in an attempt to throw light on a new simpler non subjective potential diagnostic marker in MS.
This is a cross-sectional study of MS patients carried at Ain Shams University Hospitals during the period from January 2021 till January 2022. This group included 40 patients diagnosed as having MS, on the basis of their MRI findings, clinical presentation and according to revised McDonald criteria 2017. The group included 10 males and 30 females; their ages ranged from 20 to 45 years.
The findings of this study of high levels of CHI3L1 in the CSF of MS patients, the significant association between CHI3L1 and oligoclonal bands and the positive correlation between CHI3L1 levels and EDSS score led us to conclude that CHI3L1 could be used as a potential valuable marker of disease progression and development of disability in MS patients.
In this study, we found that a cut off value of CHI3L1 in CSF at 30 ng/ml yielded sensitivity 84.85% and specificity 85.71% for the diagnosis of MS. While the results of the OCB were 82.5% of cases showed positive results, 17.5% of cases were negative.