Evidence map›Paper›PMID 38404586›Full record

ArticleFrontiers in immunology2024

CSF levels of Chitinase3like1 correlate with early response to cladribine in multiple sclerosis.

Damiano Marastoni, Matteo Foschi, Chiara Eccher, Francesco Crescenzo, Valentina Mazziotti, Agnese Tamanti, Albulena Bajrami, Valentina Camera, Stefano Ziccardi, Maddalena Guandalini and 9 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Frontiers in immunology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
4.2field-weighted citation impact, top 6% 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

8 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. A framework for blood biomarker discovery in MS.Multiple sclerosis (Houndmills, Basingstoke, England) · 2026
    Review
  3. Article
  4. Article
  5. Switching from anti-CD20 therapies to cladribine and vice versa - Analysis of a German relapsing multiple sclerosis cohort.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026
    Article
  6. Review
  7. Article
  8. Cladribine tablets in the new multiple sclerosis era.Therapeutic advances in neurological disorders · 2025
    Review
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

19 authors at 5 institutions in 2 countries.

Damiano Marastoni *Neurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Matteo Foschi *Neurology Unit, Department of Neuroscience, Multiple Sclerosis Center, S. Maria delle Croci Hospital, AUSL, Romagna, Ravenna, Italy.
Chiara Eccher *Neurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Francesco CrescenzoNeurology Unit, "Mater Salutis" Hospital, Scaligera AULSS 9, Verona, Italy.
Valentina MazziottiNeurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Agnese TamantiNeurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Albulena BajramiNeurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Valentina CameraNeurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Stefano ZiccardiNeurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Maddalena GuandaliniNeurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Francesca BoselloEye Clinic, Department of Surgery, Dentistry, Maternity, and Infant, University of Verona, Verona, Italy.
Daniela AnniNeurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Federica VirlaNeurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Ermanna TuranoNeurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Michele RomoliNeurology and Stroke Unit, Ospedale "Bufalini", Cesena, Italy.
Raffaella MariottiDepartment of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Francesca Benedetta PizziniRadiology and Neuroradiology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
Bruno BonettiNeurology A, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
Massimiliano CalabreseNeurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
University of Verona · ITAzienda Ospedaliera Universitaria Integrata Verona · ITMater Health Services · AUOspedale “M. Bufalini” di Cesena · ITUniversity of L'Aquila · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Cladribine has been introduced as a high-efficacy drug for treating relapsing-remitting multiple sclerosis (RRMS). Initial cohort studies showed early disease activity in the first year after drug initiation. Biomarkers that can predict early disease activity are needed. Aim: To estimate cerebrospinal fluid (CSF) markers of clinical and radiological responses after initiation of cladribine. Methods: Forty-two RRMS patients (30F/12M) treated with cladribine were included in a longitudinal prospective study. All patients underwent a CSF examination at treatment initiation, clinical follow-up including Expanded Disability Status Scale (EDSS) assessment, and a 3T MRI scan after 6,12 and 24 months, including the evaluation of white matter (WM) and cortical lesions (CLs). CSF levels of 67 inflammatory markers were assessed with immune-assay multiplex techniques. The 'no evidence of disease activity' (NEDA-3) status was assessed after two years and defined by no relapses, no disability worsening measured by EDSS and no MRI activity, including CLs. Results: Three patients were lost at follow-up. At the end of follow-up, 19 (48%) patients remained free from disease activity. IFNgamma, Chitinase3like1, IL32, Osteopontin, IL12(p40), IL34, IL28A, sTNFR2, IL20 and CCL2 showed the best association with disease activity. When added in a multivariate regression model including age, sex, and baseline EDSS, Chitinase 3 like1 (p = 0.049) significantly increased in those patients with disease activity. Finally, ROC analysis with Chitinase3like1 added to a model with EDSS, sex, age previous relapses, WM lesion number, CLs, number of Gad enhancing lesions and spinal cord lesions provided an AUC of 0.76 (95%CI 0.60-0.91). Conclusions: CSF Chitinase 3 like1 might provide prognostic information for predicting disease activity in the first years after initiation of cladribine. The drug's effect on chronic macrophage and microglia activation deserves further evaluation.

Indexed as

Chitinase-3-Like Protein 1CladribineMultiple Sclerosis, Relapsing-RemittingHumansProspective StudiesCHI3L1 protein, humanChitinase-3-Like Protein 1Cladribinebiomarkerschemokinescladribinecytokinesdisease activityrelapsing multiple sclerosis

Identifiers

PMID38404586
PMCPMC10885800
OpenAlexW4391683221

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.