People who experience a first attack similar to those seen in people with MS are diagnosed with clinically isolated syndrome (CIS). A proportion of these people go on to develop MS.

Factors that can predict people with CIS who have a higher risk of conversion to MS are important for planning appropriate treatments.

Cerebrospinal fluid is in contact with the nervous system, especially the brain, during its circulation. Therefore, samples of cerebrospinal fluid can provide more information about brain inflammation (usually seen in people with MS) than samples from other parts of the body, such as blood samples. This fluid can be obtained by a procedure called lumbar puncture, by inserting a needle into the lower part of the spine.

In this study from ErasMUS MS Centre in Rotterdam, the Netherlands, investigators tested samples of cerebrospinal fluid of 77 people with CIS and looked at a marker of immune cell activation. They found that this immune cell activation marker (known as soluble CD27) was associated with a higher risk of developing MS during the follow-up period (approximately 54 months). It was also associated with a higher number of MS attacks in those who were diagnosed with MS.

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