演題詳細
Oral
神経炎症と炎症性神経疾患
Neuroinflammation and Inflammatory Disease in Nervous System
| 開催日 | 2014/9/13 |
|---|---|
| 時間 | 15:00 - 16:00 |
| 会場 | Room I（311+312） |
| Chairperson(s) | 吉良 潤一 / Jun-ichi Kira (九州大学大学院医学研究院 神経内科学 / Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyusyu University, Japan) 錫村 明生 / Akio Suzumura (名古屋大学環境医学研究所 神経免疫 / Department of Neuroimmunology, Research Institute of Environmental Medicine, Nagoya University, Japan) |
Clinically isolated syndromeの自然経過
Natural history of clinically isolated syndrome on conversion to multiple sclerosis: a meta-analysis
- O3-I-3-3
- 木下 真幸子 / Masako Kinoshita:1 大封 昌子 / Masako Daifu:2 田中 惠子 / Keiko Tanaka:3 田中 正美 / Masami Tanaka:2
- 1:宇多野病院・神経内科 / Department of Neurology, Utano National Hospital, Japan 2:宇多野病院・多発性硬化症センター / Multiple Sclerosis Center, Utano National Hospital, Japan 3:金沢医科大・神経内科 / Department of Neurology, Kanazawa Medical University, Japan
Background: Though clinically isolated syndrome (CIS) heralds clinically definite multiple sclerosis (CDMS), the precise timeline of its conversion to CDMS is unknown. Positive oligoclonal IgG bands (OCBs) of CIS are known predictive factor for the conversion in European patients, however, it has not been established whether that is also applicable to Japanese patients. The objective of this study was to investigate natural history of CIS on conversion to CDMS using a meta-analysis, and to evaluate the impact of positive OCBs in the cerebrospinal fluid on the conversion in Japanese patients.
Methods: Using data obtained by a systematic literature review, the ratio of the CDMS conversion against each time point was analyzed by curve-fitting. Twenty six consecutive Japanese CIS patients were enrolled to analyze the relationship between positive OCBs and the ratio of the CDMS conversion.
Results: Thirteen articles were included and 19 time points were analyzed. A sigmoid curve, which has a horizontal asymptote, was the most suitable model to represent the empirical data (p<0.001, R2=0.73). Based on the model, up to 61.9% of CIS patients converge to CDMS and 80.2% of the conversion occurred within 5 years, and 43.7% of CIS patients converge to CDMS in 38 months. In Japanese, OCBs were positive in 5% of all CIS patients, and 40% of CIS patients with positive OCBs and 5% of CIS patients with negative OCBs developed CDMS in 38 months after the onset of CIS.
Conclusions: The current study suggest that Japanese CIS patients with positive OCBs have an equivalent risk, whereas those with negative OCBs have a low risk, of developing CDMS as compared to the estimate deduced from literature.