A new way to predict the progression of multiple sclerosis is in the works.
A potential biomarker — the ratio of antibody proteins in cerebrospinal fluid at the time of diagnosis — was seen to predict which multiple sclerosis patients will progress into full-blow disability some five years after being diagnosed in a new study.
If confirmed in larger clinical studies, this biomarker could to help to identify those MS patients who have poor prognosis and might benefit from early and more aggressive treatment, and possibly spare those with a better prognosis treatments known to have potentially serious side effects.
The study “Cerebrospinal fluid immunoglobulin light chain ratios predict disease progression in multiple sclerosis” was published in the Journal of Neurology, Neurosurgery & Psychiatry.
MS severity and progression varies widely between patients; some suffer multiple attacks and move quickly to marked disability, while others show only a first clinical episode of the disease — known as clinically isolated syndrome.
“Although there are now a wide range of therapies available for the treatment of multiple sclerosis, the specific choice of treatment in any individual patient is not made in a very evidence-based way,” Michael Douglas, honorary professor at the University of Birmingham and the study’s lead author, said in a university press release.
Finding long-term prognostic markers would help guide the therapeutic choices, but currently “we do not have reliable long-term outcome predictors for individual patients to guide their choice between more potent therapies with potentially greater side effects, and more gentle therapies which may not fully control the condition,” Douglas said.
Biomarkers that might “predict future risk of disability” are for this reason important — they could work “to ensure that individual patients receive the right treatment at the right time,” he added.
The researchers asked whether the cerebrospinal fluid — a liquid that flows within the brain and spinal cord — could hold the key to predicting MS progression.
They analyzed the spinal fluid from MS patients undergoing an elective lumbar puncture at two timepoints: when they were diagnosed and five years later. They then quantified the amount of immune B-cells found; these cells are responsible for producing antibodies.
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