Biomarker d'infiammazione precoce nella Sclerosi Laterale Amiotrofica

Are [18F]FDG metabolic alterations in Amyotrophic Lateral Sclerosis (ALS) correlated with chitinases and neurofilaments concentrations? Carlo Gagliani, Davide Fabris, Andrea Osele, Stefania Sperti, Luka Turk, Gianni Sorarù, Annachiara Cagnin, Mariagiulia Anglani, Diego Cecchin, Rossella Simeone Introduction: Amyotrophic Lateral Sclerosis (ALS) is a neurodegenerative disease that affects motor neurons causing loss of muscle control. In affected patients, [18F]FDG metabolic abnormalities have been observed in many areas of the nervous system including brainstem and mesencephalus. Neurofilaments are structural proteins of the neurons and part of the cytoskeleton released after cellular death. Chitinases are enzymes that break down glycosidic bonds in chitin, believed to have an important part in inflammation, angiogenesis, and tumorigenesis. The aim of the present study is to evaluate if there is a correlation between the increase of concentration of these markers and the increase of SUV in the mid-brain, pons and medulla oblongata, measured with [18F]FDG PET-MRI. Methods: The population under examination is composed of 25 patients diagnosed with ALS, who underwent a cerebral [18F]FDG PET-MRI (Siemens Healthcare Biograph mMR) with blood sampling for chitinases and neurofilaments. PET-MRI images have been processed (reoriented and segmented) with the PMOD (PMOD Technologies LLC) software. Pearson correlation coefficient has been used to test the hypothesis. Results: The average, normalized concentrations of neurofilaments and chitinases were higher in patients which showed higher [18F]FDG uptake in mid-brain, pons and medulla. Patients with bulbar amyotrophic lateral sclerosis (ALS) seem to have higher hypermetabolism in medulla oblongata and higher concentrations of neurofilaments although the statistic correlation is not clearly significant Conclusions: Obtained results show that [18F]FDG hypermetabolism in brainstem and medulla oblongata is associated with increased concentrations of neurofilaments and chitinases Neurofilaments, chitinases and [18F]FDG hypermetabolism may be used to predict the severity of the disease, although studies with an increased sample number are mandatory to confirm our results .