Normal intrathecal leukocyte cell number and composition do not decrease the incidence of post-lumbar puncture headache.

Abstract

The pathogenesis of post-lumbar puncture headache (PLPH) has remained unclear. A beneficial role of CSF cells in the repair of a post-traumatic dural CSF leak has been suggested. The primary purpose of this study was to investigate the effects of 8weeks of induction therapy with high-dose PF-00547659 on the cellular elements of CNS immune surveillance in patients with active Crohn's Disease and a history of immunosuppressive therapy (Clinicaltrials.govNCT01387594). PF-00547659 is a human monoclonal antibody that binds to mucosal addressin-cell adhesion molecule 1 (MAdCAM-1) on endothelial cells and blocks its interaction with beta7-integrin expressing lymphocytes. The study was executed in three parts or cohorts under two protocols. The incidence of a PLPH was 35% after the initial lumbar puncture, and 26% following the second lumbar puncture. After initiation of PF-00547659 anti-MAdCAM-1 therapy, there was a small and non-significant increase in the numbers of overall CSF leukocytes, and in lymphocyte subsets (CD3+, CD4+, and CD8+ T cells). The lymphocyte composition was unaltered by PF-00547659 anti-MAdCAM-1 therapy. Our observations suggest that normal numbers and composition of intrathecal leukocytes do not decrease the incidence of PLPH.

• Authors: Olaf Stüve, Fabio Cataldi, Vivek Pradhan, Kenneth J Gorelick
• Journal: Journal of neuroimmunology (J Neuroimmunol) Vol. 310 Pg. 69-71 (09 15 2017) ISSN: 1872-8421 [Electronic] Netherlands
• PMID: 28778448 (Publication Type: Journal Article)
• Copyright: Copyright © 2017. Published by Elsevier B.V.

Chemical References

• Antibodies, Monoclonal, Humanized
• Antigens, CD
• CADM1 protein, human
• Cell Adhesion Molecule-1
• Cell Adhesion Molecules
• Immunoglobulins
• Immunologic Factors
• ontamalimab

Topics

• Antibodies, Monoclonal, Humanized (therapeutic use)
• Antigens, CD (metabolism)
• Cell Adhesion Molecule-1
• Cell Adhesion Molecules (metabolism)
• Cohort Studies
• Crohn Disease (drug therapy)
• Female
• Humans
• Immunoglobulins (metabolism)
• Immunologic Factors (therapeutic use)
• Incidence
• Leukocytes (drug effects, pathology)
• Male
• Post-Dural Puncture Headache (cerebrospinal fluid, drug therapy, epidemiology)