158 CSF T-cell counts in multiple sclerosis diagnosis and prognosis

Background Identifying diagnostic and prognostic biomarkers in multiple sclerosis (MS) remains challenging. Cerebrospinal fluid (CSF) is a potentially valuable source. Aim Test association between CSF cell counts and (i) neuroinflammatory diagnosis, (ii) early MS disease activity. Methods CD4+/CD8+ T-cells were counted using flow cytometry in CSF collected from 162 patients. Clinical data were collected for 12–52 months. Cell counts were tested for association with: 1) diagnostic group: MS (n=63), clinically isolated syndrome (CIS, n=11), other inflammatory disorders (n=8) and non-inflammatory disorders (NID, n=75)); 2) time to next relapse/treatment commencement; 3) MS initial course. Area under receiver operator characteristic curve (AUC) was calculated for diagnostic utility. Results CSF CD4+ and CD8+ counts were higher in MS vs CIS (e.g. CD4+: p=0.0063, AUC=0.76) and NID (e.g. CD4+: p=1.4×10–6, AUC=0.74). NHS laboratory CSF white cell counts (WCC) were also higher in MS vs CIS (p=0.049, AUC=0.68) and NID (p=8.9×10–10, AUC=0.73). In logistic regression models of MS vs CIS in OCB negative patients, NHS WCC explained the greatest proportion of the variance (16.5%, p=0.03, AUC=0.70), but the optimal model also included CD4+ and CD8+ counts. Cell counts did not predict initial course or clinical outcomes. Conclusions CSF cell counts could aid diagnosis of MS. CSF cell counts alone did not predict early MS disease activity in this size cohort, but prognostic utility in combination with other biomarkers should be tested in a larger cohort.