Dr. Comabella’s results are consistent with those of other recent investigations of the protein. Using a similar proteomic approach, Hinsinger et al identified chitinase 3-like-1 protein as one of the best predictors of conversion to MS. They identified 189 ng/ml as the cutoff that best classified protein levels as high or low. Levels above the cutoff were associated with shorter time to MS, based on the 2005 McDonald criteria. Also, Modvig’s study of patients with optic neuritis found that chitinase 3-like-1 protein, MRI, and age together were the best predictor of clinically definite MS. The protein also predicted long-term cognitive impairment in that study.
Do Biomarker Combinations Improve Predictions?
Combinations of biomarkers may improve prognostic predictions for patients with CIS, compared with individual biomarkers, said Dr. Comabella. He and his colleagues are investigating the predictive value of the combination of chitinase 3-like-1 protein, dipeptidase, and semaphorin 7A. Data suggest that this combination is better at distinguishing between patients with CIS who convert to MS and those who do not, compared with each biomarker considered individually.
Dr. Comabella’s group also is investigating the potential neurotoxic effect of chitinase 3-like-1 protein. They are adding the protein to primary cultures of neurons at the concentrations above and below the cutoff of 170 ng/ml. Preliminary data suggest that the protein is neurotoxic.
—Erik Greb