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Multiple sclerosis-associated retrovirus in early multiple sclerosis: a six-year follow-up of a Sardinian cohort

Institute of Clinical Neurology, University of Sassari, Viale San Pietro 10, 07100, Sassari, Italy, stesot{at}hotmail.com

G Arru

Institute of Clinical Neurology, University of Sassari, Viale San Pietro 10, 07100, Sassari, Italy

G Mameli

Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/B, 07100, Sassari, Italy

C Serra

Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/B, 07100, Sassari, Italy

M Pugliatti

Institute of Clinical Neurology, University of Sassari, Viale San Pietro 10, 07100, Sassari, Italy

G Rosati

Institute of Clinical Neurology, University of Sassari, Viale San Pietro 10, 07100, Sassari, Italy

A Dolei

Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/B, 07100, Sassari, Italy

The human endogenous retroviruses (HERV)-W family contains an extracellular particle detected in multiple sclerosis (MS) patients and designated as MS-associated retrovirus (MSRV). Through nested RT-PCR assays specific for pol MSRV gene, we preliminary reported that its presence in the cerebrospinal fluid (CSF) of early MS patients could be indicative of a poor prognosis upon a three-year follow-up. In the present clinical study, we enlarged our blind observation up to six years. At study entry, 10 MS patients were MSRV^- and eight were MSRV⁺ in the CSF, both groups having a similar mean age and Expanded Disability Status Scale (EDSS) score. After six year follow-up, the mean EDSS significantly differed between the MSRV^- and MSRV⁺ cohorts (4.3 versus 2.2; P = 0.004), as did the annual relapse rate (0.5 in the MSRV^- versus 0.3 in the MSRV⁺; P = 0.01). Finally, two MSRV^- patients entered the progressive phase, whilst none of the MSRV⁺ group entered this phase, and 9/10 MSRV^- versus 2/8 MSRV⁺ patients were treated with immunomodulatory or immunosuppressive drugs (P = 0.009). In conclusion, we found that the presence of MSRV virions in the CSF at the onset of MS is associated, not only with disability accumulation, but also with a higher rate of clinical re-exacerbations. With the known potential pathogenic effects of MSRV given in the literature, further investigations on MSRV are warranted.

Key Words: cerebrospinal fluid • endogenous retrovirus • MSRV • multiple sclerosis • prognosis

Multiple Sclerosis, Vol. 12, No. 6, 698-703 (2006)
DOI: 10.1177/1352458506070773


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