Urinary markers of disease activity in multiple sclerosis

Abstract

Numerous markers of disease activity, representing different aspects of the inflammatory cascade and pathogenic process in multiple sclerosis, can be detected in the urine. Urinary monitoring provides distinct advantages over blood and cerebrospinal fluid: it is easier to collect, allows frequent sampling and acts as a natural integrator by capturing the excretion of a substance over a prolonged period of time. We will discuss the principles, advantages, and pitfalls of urinary monitoring in relationship to multiple sclerosis.

Keywords

multiple sclerosis urine neopterin

Get full access to this article

View all access options for this article.

References

Martin R , McFarland HF. (1995) Immunological aspects of experimental allergic encephalomyelitis and multiple sclerosis . Crit Rev Clin Lab Sci 32: 121-182 .

Allen IV. (1991) Pathology and its implications. In: Matthews WB , ed. McAlpine's Multiple Sclerosis.2nd ed. Churchill Livingstone: Edinburgh . 341-378.

Whitaker JN , McFarland HF , Rudge P , Reingold SC. (1995) Outcomes assessment in multiple sclerosis clinical trials: a critical analysis . Multiple Sclerosis 1: 37-47 .

Thompson AJ et al. (1991) Major differences in the dynamics of primary and secondary progressive multiple sclerosis . Ann Neurol 29: 53-62 .

Kidd D et al. (1996) MRI dynamics of brain and spinal cord in progressive multiple sclerosis . J Neurol Neurosurg Psychiatry 60: 15-19 .

Bannister KM , Field MF. (1996). Clinical physiology of the kidney: tests of renal function and structure. In: Weatherall DJ , Ledingham JGG , Warrell DA , (eds.) Oxford Textbook of Medicine.3rded.v.3. Oxford University Press: Oxford . pp 3101-3115.

Koopmans RA et al. (1989) Chronic progressive multiple sclerosis: serial magnetic resonance brain imaging over six months . Ann Neurol 26: 248-256 .

Miller DH et al. (1988) Serial gadolinium enhanced magnetic resonance imaging in multiple sclerosis . Brain 111: 927-939 .

Willoughby EW et al. (1989) Serial magnetic resonance scanning in multiple sclerosis: a second prospective study in relapsing patients . Ann Neurol 25: 43-49 .

10.

Smith ME et al. (1993) Clinical worsening in multiple sclerosis is associated with increased frequency and area of gadopentetate dimeglumine-enhancing magnetic resonance imaging lesions . Ann Neurol 33: 480-489 .

11.

Thorpe JW et al. (1996) Serial gadolinium-enhanced MRI of the brain and spinal-cord in early relapsing-remitting multiple-sclerosis . Neurology 46: 373-378 .

12.

Giovannoni G et al. (1997) Daily urinary neopterin excretion as an immunological marker of disease activity in multiple sclerosis . Brain 120: 1-13 .

13.

Arvidson NG et al. (1994) Circadian rhythm of serum interleukin-6 in rheumatoid arthritis . Ann Rheum Dis 53: 521-524 .

14.

Auzéby A , Bogdan A , Krosi Z , Touitou Y. (1988) Time-dependence of urinary neopterin, a marker of cellular immune activity . Clin Chem 34: 1866-1867 .

15.

Nilsson C et al. (1992) Calcium variation in human cerebrospinal fluid production measured by magnetic resonance imaging . Am J Physiol 262: 20-24 .

16.

Jacobi C , Reiber H , Felgenhauer K. (1986) The clinical relevance of locally produced carcinoembryonic antigen in the cerebrospinal fluid . JNeurol 233: 358-361 .

17.

Hartmann AE. (1994) Nitrogen metabolites and renal function. In: Mitchell CM , (ed.) Clinical Laboratory Medicine. 1st ed. Williams & Wilkins: Baltimore . pp 371-385.

18.

Silbernagl S. (1988) The renal handling of amino acids and oligopeptides . Physiol Rev 68: 911-1007 .

19.

Whitaker JN et al. (1995) Urinary myelin basic protein-like material as a correlate of the progression of multiple sclerosis . Ann Neurol 38: 625-632 .

20.

Matthews WB. (1991) Treatment. In: Matthews WB , (ed.) McAlpine's Multiple Sclerosis. 2nd ed. Churchill Livingstone: Edinburgh . pp 251-298.

21.

Hartmann AE. (1994) Nitrogen metabolites and renal function. In: Mitchell CM , (ed.) Clinical Laboratory Medicine. 1st ed. Williams & Wilkins: Baltimore . pp 371-385.

22.

Giovannoni G , Land JM , Keir G , Thompson EJ , Heales SJR. (1997) Adaptation of the nitrate reductase and Griess reaction methods for the measurement of serum nitrate plus nitrite levels . Ann Clin Biochem 34: 193-198 .

23.

Niederweiser A , Staudenmann W , Wetzel E. (1982) Automatic HPLC of pterins with or without column switching. In: Wachter H , Curtius HC , Pfleider W , (eds.) Biochemical and Clinical aspects of pteridines.v.1. Walter de Gruyter: Berlin . pp 81-102.

24.

Phizackerley PJR , Aldabbagh SA. (1983) The estimation of nitrate and nitrite in saliva and urine . Analyt Biochem 131: 242-245 .

25.

Wubert J , Reder E , Kaser A , Weber PC , Lorenz RL. (1997) Simultaneous solid phase extraction, derivatization, and gas chromatographic mass spectrometric quantification of thromboxane and prostacyclin metabolites, prostaglandins, and isoprostanes in urine . Anal Chem 69: 2143-2146 .

26.

Gella FJ , Capdevila MJ. (1996) Determination of beta(2)- microglobulin in human serum and urine by latex turbidimetry . Pure Appl Chem 68: 1881-1885 .

27.

Stanescu GL , Swick AR , Tuohy VK , Rudick RA. (1991) Sensitive competitive-binding ELISAs for quantifying free kappa and lambda light chains in cerebrospinal fluid . J Clin Lab Anal 5: 206-211 .

28.

Tanaka K , Ishikawa E , Ohmoto Y , Hirai Y. (1987) Sandwich enzyme-immunoassay for human interleukin-1beta (hIL-1beta) in urine . Clinica Chimica Acta 166: 237-246 .

29.

Mansueto S et al. (1997) Alteration of interleukin-2 (IL-2) and soluble IL-2 receptor secretion in the sera and urine of patients with rickettsial boutonneuse fever . J Inf Dis 175: 142-145 .

30.

Casiraghi F et al. (1997) Sequential monitoring of urine-soluble interleukin 2 receptor and interleukin 6 predicts acute rejection of human renal allografts before clinical or laboratory signs of renal dysfunction . Transplantation 63: 1508-1514 .

31.

Stiemer B et al. (1997) Interleukin-8 in urine: A new diagnostic parameter for intra-amniotic infection after premature rupture of the membranes . Br J Obs Gynae 104: 499-502 .

32.

Whitaker JN , McKeehan A , Freeman DW. (1994) Monoclonal and polyclonal antibody responses to the myelin basic protein epitope present in human urine . J Neuroimmunol 52: 53-60 .