MxA gene expression analysis as an interferon-beta bioactivity measurement in patients with multiple sclerosis and the identification of antibody-mediated decreased bioactivity.

Background: Interferon-beta (IFNbeta) has proven to be an important advance in the therapy of multiple sclerosis (MS), but optimal markers for bioactivity have not been identified. To accurately measure bioactivity in MS patients treated with IFNbeta, we developed and tested a real-time reverse transcriptase (RT)-PCR assay for gene expression of MxA, an IFNbeta-induced gene in the peripheral blood of patients treated with IFNbeta.

Methods: We compared IFNbeta-treated patients with MS to controls in expression of MxA relative to the house-keeping gene, GAPDH. 2'-5'oligoadenylate synthetase (OAS) gene expression was also tested by real-time RT-PCR on RNA from the same patient specimens. Anti-IFNbeta antibody was measured by ELISA and a cytopathic effect assay.

Results: Seven of 54 patients were found to have complete loss of bioactivity. MxA expression correlated well with OAS expression. All patients with lost bioactivity had high levels of binding antibodies or neutralizing antibodies.

Conclusions: This is the first demonstration that a real-time RT-PCR assay can be used to monitor therapy with interferons. These data identify MxA mRNA as an excellent biomarker for INFbeta action on the IFN receptor, and clarify the relationship between anti-IFNbeta antibodies and bioactivity in patients with MS treated with IFNbeta.