Abstract Details

Title In early MS, the vasopressin peptide copeptin in serum is not a suitable surrogate for hypothalamo-pituitary-adrenal axis activity

Topic Multiple Sclerosis

Presentation(s) P13 - Poster Session 13 (8:00 AM-9:00 AM)

Poster/Presentation
Number 3-016

Background Activation of the HPA axis has been observed in MS by using the DexCRH-test, and may affect pathogenesis and clinical course. Vasopressin (AVP) costimulates ACTH secretion with CRH, but is not inhibited by dexamethasone.

Objective To determine if a single measurement of copeptin, the C-terminal part of the AVP precursor (CT-proAVP), a stable and sensitive surrogate for AVP release, may serve as a more simply acquired substitute for the more cumbersome combined dexamethasone-corticotropin-releasing hormone test (DexCRH-test) to assess hypothalamo-pituitary-adrenal (HPA) axis activity in MS.

Design/Methods Open, monocenter study, 44 HC, 55 patients with early relapsing-remitting MS (RRMS), 10 patients with clinically isolated syndrome (CIS). DexCRH-test (1.5 mg oral dexamethasone at 2300h the evening before; 100 µg i.v. synthetic hCRH at 1502h; serum ACTH and cortisol between 1500h and 1615h). Copeptin serum concentration before CRH application, and in a subset at 0900h before dexamethasone. Calculation of AUC for ACTH and cortisol output according to the trapezoidal rule. Independant samples t test, linear regression.

Results

In HC (n=19) and MS (n=51), copeptin before and after dexamethasone correlated significantly, more stringently in HC (Pearson correlation, r²=0.627) than in MS (r²=0.301, both p<0.001). No correlation was found between copeptin (before or after dexamethasone) and DexCRH test variables in either HC or MS (AUC of ACTH or cortisol secretion; p 0.13-0.35). Copeptin, AUC-ACTH and AUC-cortisol were not significantly different between HC and RRMS/CIS (p=0.35-0.42).

Conclusions In HC and MS, copeptin appears equally affected by dexamethasone. Our sample of early RRMS patients predominantly on DMT did not display significant activation of the HPA axis, and had a fairly homogeneous HPA axis activity. At least in this setting, a single measurement of copeptin did not appear suitable as a surrogate marker of HPA axis activity. A sample including more advanced stages and different courses of MS may be more informative.

Authors/Disclosures
PRESENTER	No disclosure on file
Muriel Stoppe	Muriel Stoppe has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Florian Then Bergh, MD (University of Leipzig, Klinik u. Poliklinik fuer Neurologie)	Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Actelion. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Genzyme. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Then Bergh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Fresenius. The institution of Dr. Then Bergh has received research support from Actelion. The institution of Dr. Then Bergh has received research support from Novartis. The institution of Dr. Then Bergh has received research support from DFG (German Science Fund). Dr. Then Bergh has received personal compensation in the range of $10,000-$49,999 for serving as a Member of the Institutional Ethics Board with University of Leipzig, Medical Faculty.