Evidence map›Paper›PMID 35260469›Full record

ArticleNeurology(R) neuroimmunology & neuroinflammation2022

Analysis of CSF D-Dimer to Identify Intrathecal Fibrin-Driven Autoimmunity in Patients With Multiple Sclerosis.

Martin A Schaller-Paule, Yavor Yalachkov, Helmuth Steinmetz, Lucie Friedauer, Elke Hattingen, Wolfgang Miesbach, Frank Weber, Konstantin Kirchmayr, Jan Hendrik Schaefer, Christian Foerch

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PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology(R) neuroimmunology & neuroinflammation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
2.6field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 18 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Martin A Schaller-PauleFrom the Department of Neurology (M.A.S.-P., Y.Y., H.S., L.F., J.H.S., C.F.), University Hospital Frankfurt, Goethe-University; Institute of Neuroradiology (E.H.), University Hospital Frankfurt, Goethe-University, Frankfurt am Main; Department of Haemostaseology and Hemophilia Center (W.M.), Medical Clinic 2, Institute of Transfusion Medicine, University Hospital Frankfurt; Neurological Clinic Cham (F.W.), Cham; and punktmed Center for Vascular Medicine and Haemostaseology (K.K.), Nuremberg/Amberg, Germany.ORCID 0000-0003-1447-9908
Yavor YalachkovFrom the Department of Neurology (M.A.S.-P., Y.Y., H.S., L.F., J.H.S., C.F.), University Hospital Frankfurt, Goethe-University; Institute of Neuroradiology (E.H.), University Hospital Frankfurt, Goethe-University, Frankfurt am Main; Department of Haemostaseology and Hemophilia Center (W.M.), Medical Clinic 2, Institute of Transfusion Medicine, University Hospital Frankfurt; Neurological Clinic Cham (F.W.), Cham; and punktmed Center for Vascular Medicine and Haemostaseology (K.K.), Nuremberg/Amberg, Germany.
Helmuth SteinmetzFrom the Department of Neurology (M.A.S.-P., Y.Y., H.S., L.F., J.H.S., C.F.), University Hospital Frankfurt, Goethe-University; Institute of Neuroradiology (E.H.), University Hospital Frankfurt, Goethe-University, Frankfurt am Main; Department of Haemostaseology and Hemophilia Center (W.M.), Medical Clinic 2, Institute of Transfusion Medicine, University Hospital Frankfurt; Neurological Clinic Cham (F.W.), Cham; and punktmed Center for Vascular Medicine and Haemostaseology (K.K.), Nuremberg/Amberg, Germany.
Lucie FriedauerFrom the Department of Neurology (M.A.S.-P., Y.Y., H.S., L.F., J.H.S., C.F.), University Hospital Frankfurt, Goethe-University; Institute of Neuroradiology (E.H.), University Hospital Frankfurt, Goethe-University, Frankfurt am Main; Department of Haemostaseology and Hemophilia Center (W.M.), Medical Clinic 2, Institute of Transfusion Medicine, University Hospital Frankfurt; Neurological Clinic Cham (F.W.), Cham; and punktmed Center for Vascular Medicine and Haemostaseology (K.K.), Nuremberg/Amberg, Germany.
Elke HattingenFrom the Department of Neurology (M.A.S.-P., Y.Y., H.S., L.F., J.H.S., C.F.), University Hospital Frankfurt, Goethe-University; Institute of Neuroradiology (E.H.), University Hospital Frankfurt, Goethe-University, Frankfurt am Main; Department of Haemostaseology and Hemophilia Center (W.M.), Medical Clinic 2, Institute of Transfusion Medicine, University Hospital Frankfurt; Neurological Clinic Cham (F.W.), Cham; and punktmed Center for Vascular Medicine and Haemostaseology (K.K.), Nuremberg/Amberg, Germany.
Wolfgang MiesbachFrom the Department of Neurology (M.A.S.-P., Y.Y., H.S., L.F., J.H.S., C.F.), University Hospital Frankfurt, Goethe-University; Institute of Neuroradiology (E.H.), University Hospital Frankfurt, Goethe-University, Frankfurt am Main; Department of Haemostaseology and Hemophilia Center (W.M.), Medical Clinic 2, Institute of Transfusion Medicine, University Hospital Frankfurt; Neurological Clinic Cham (F.W.), Cham; and punktmed Center for Vascular Medicine and Haemostaseology (K.K.), Nuremberg/Amberg, Germany.
Frank WeberFrom the Department of Neurology (M.A.S.-P., Y.Y., H.S., L.F., J.H.S., C.F.), University Hospital Frankfurt, Goethe-University; Institute of Neuroradiology (E.H.), University Hospital Frankfurt, Goethe-University, Frankfurt am Main; Department of Haemostaseology and Hemophilia Center (W.M.), Medical Clinic 2, Institute of Transfusion Medicine, University Hospital Frankfurt; Neurological Clinic Cham (F.W.), Cham; and punktmed Center for Vascular Medicine and Haemostaseology (K.K.), Nuremberg/Amberg, Germany.
Konstantin KirchmayrFrom the Department of Neurology (M.A.S.-P., Y.Y., H.S., L.F., J.H.S., C.F.), University Hospital Frankfurt, Goethe-University; Institute of Neuroradiology (E.H.), University Hospital Frankfurt, Goethe-University, Frankfurt am Main; Department of Haemostaseology and Hemophilia Center (W.M.), Medical Clinic 2, Institute of Transfusion Medicine, University Hospital Frankfurt; Neurological Clinic Cham (F.W.), Cham; and punktmed Center for Vascular Medicine and Haemostaseology (K.K.), Nuremberg/Amberg, Germany.
Jan Hendrik SchaeferFrom the Department of Neurology (M.A.S.-P., Y.Y., H.S., L.F., J.H.S., C.F.), University Hospital Frankfurt, Goethe-University; Institute of Neuroradiology (E.H.), University Hospital Frankfurt, Goethe-University, Frankfurt am Main; Department of Haemostaseology and Hemophilia Center (W.M.), Medical Clinic 2, Institute of Transfusion Medicine, University Hospital Frankfurt; Neurological Clinic Cham (F.W.), Cham; and punktmed Center for Vascular Medicine and Haemostaseology (K.K.), Nuremberg/Amberg, Germany.
Christian FoerchFrom the Department of Neurology (M.A.S.-P., Y.Y., H.S., L.F., J.H.S., C.F.), University Hospital Frankfurt, Goethe-University; Institute of Neuroradiology (E.H.), University Hospital Frankfurt, Goethe-University, Frankfurt am Main; Department of Haemostaseology and Hemophilia Center (W.M.), Medical Clinic 2, Institute of Transfusion Medicine, University Hospital Frankfurt; Neurological Clinic Cham (F.W.), Cham; and punktmed Center for Vascular Medicine and Haemostaseology (K.K.), Nuremberg/Amberg, Germany.
Goethe University Frankfurt · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesProteins of the coagulation system contribute to autoimmune inflammation in patients with multiple sclerosis (MS). On blood-brain barrier (BBB) disruption, fibrinogen enters the CNS and is rapidly converted to fibrin, unfolding pleiotropic autoimmune mechanisms. Fibrin accumulation leads to subsequent proteolytic degradation that results in D-dimer generation. The primary objective of this study was to determine intrathecal levels of D-dimer in CSF as a measure of intrathecal coagulation cascade activation and to evaluate its diagnostic utility in patients with MS in contrast to healthy subjects. Key secondary objectives included analysis of CSF D-dimer in differential diagnoses of MS and its relation to routine clinical markers of disease activity.

methodsPatients admitted for the assessment of suspected MS were prospectively recruited from October 2017 to December 2020. Blood plasma and citrated CSF samples were analyzed using a highly sensitive luminescent oxygen channeling immunoassay. Intrathecal generation of D-dimer was analyzed by adjusting for CSF/serum albumin (Q

resultsOf 187 patients, 113 patients received a diagnosis of MS or clinically/radiologically isolated syndrome. We found increased intrathecal CSF D-dimer generation levels (Q DISCUSSION: D-dimer in CSF can be reliably determined and correlates with markers of CNS inflammation and CSF fibrinogen levels. Adjusted for BBB dysfunction, CSF D-dimer may allow the identification of intrathecal coagulation cascade activation in patients with MS. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that CSF D-dimer levels are elevated in patients with RRMS.

Indexed as

Multiple SclerosisAutoimmunityBiomarkersFibrinFibrin Fibrinogen Degradation ProductsHumansInflammationBiomarkersFibrinFibrin Fibrinogen Degradation Productsfibrin fragment D

Identifiers

PMID35260469
PMCPMC8906189
OpenAlexW4220779387

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