Multiple Sclerosis Journal - October 2017 - 1484

Multiple Sclerosis Journal 23(11)
Table 3. Correlation of NK (subset) cells and proportions and clinical outcome parameters.
Dependent variable

CD56%
CD56 cells
CD56 bright %
CD56 bright cells
CD56 dim %
CD56 dim cells

Treatment response variable
NEDA

MRI activity

EDSS progression

Relapses

p value

p value

p value

p value

0.08
0.476
0.94
0.288
0.94
0.532

0.025
0.01
0.04
0.707
0.04
0.008

0.546
0.828
0.334
0.483
0.334
0.881

0.834
0.408
0.226
0.371
0.226
0.331

NK cells: natural killer cells; NEDA: No Evidence of Disease Activity; MRI: magnetic resonance imaging; EDSS: Expanded Disability Status Scale; CD56%: proportion of NK cells within the lymphocyte count; CD56 cells: total number of NK cells; CD56
bright%: proportion of bright NK cells within the NK cell count; CD56 bright cells: total number of bright NK cells; CD56 dim%:
proportion of dim NK cells within the NK cell count; CD56 dim cells: total number of dim NK cells. P-values in bold indicate
significant correlations.

Table 4. Correlation of NK (subset) cells and NK subset proportions with MRI activity.
Dependent variable

CD56%
CD56 cells
CD56 bright%
CD56 bright cells
CD56 dim%
CD56 dim cells

MRI activity

No activity
Activity
No activity
Activity
No activity
Activity
No activity
Activity
No activity
Activity
No activity
Activity

Mean

11.5
15.7
0.156
0.212
10.5
8.1
0.014
0.015
89.5
91.9
0.141
0.196

Std. error

1.0
1.5
0.0
0.0
0.6
0.9
0.0
0.0
0.6
0.9
0.0
0.0

95% Confidence interval

p value

Lower bound

Upper bound

9.4
12.6
0.1
0.2
9.2
6.2
0.0
0.0
88.2
90.0
0.1
0.2

13.5
18.7
0.2
0.2
11.8
10.0
0.0
0.0
90.8
93.8
0.2
0.2

0.025
0.01
0.04
0.71
0.04
0.008

NK cells: natural killer cells; MRI: magnetic resonance imaging; CD56%: proportion of NK cells within the lymphocyte count;
CD56 cells: total number of NK cells; CD56 bright%: proportion of bright NK cells within the NK cell count; CD56 bright cells:
total number of bright NK cells; CD56 dim%: proportion of dim NK cells within the NK cell count; CD56 dim cells: total number of
dim NK cells. P-values in bold indicate significant correlations.

Given the difficulty in ascertaining treatment-naive
patients, we chose to use patients that were off any
form of treatment for at least 28 days. However, we do
acknowledge that some residual effects on NK levels
arising from previous treatment may exist in this control cohort. To assess this possibility, we ascertained a
small group of n = 7 patients who were completely
naive to any MS treatment and measured the NK subsets in these patients. The results of this analysis
showed that the mean values for all NK subsets in the
treatment naive sample were not significantly different to the 'off treatment' controls used in the analysis
proper (p > 0.1). This finding justifies using our off
1484

treatment control group and, in turn, supports our
conclusions about treatment effects.
With the large number of disease treatments available
to MS patients, the current dilemma faced by neurologists is not only to make the first treatment choice but
also when to change treatments. There is a trend to
move away from basing treatment decisions on clinical relapses alone. Newer paradigms such as NEDA
criteria including MRI parameters are rapidly taken
up, but there is still a desperate need for biomarkers
predicting treatment response. We explored the possible application of NK cell expression as a tool for
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Table of Contents for the Digital Edition of Multiple Sclerosis Journal - October 2017

Contents
Multiple Sclerosis Journal - October 2017 - Cover1
Multiple Sclerosis Journal - October 2017 - Cover2
Multiple Sclerosis Journal - October 2017 - Contents
Multiple Sclerosis Journal - October 2017 - ii
Multiple Sclerosis Journal - October 2017 - iii
Multiple Sclerosis Journal - October 2017 - 1436
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Multiple Sclerosis Journal - October 2017 - Cover3
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