Wednesday, 25 January 2012

Research:Biomarkers for MS


Background:
The complex pathogenesis of multiple sclerosis, combined with an unpredictable prognosis, requires identification of disease-specific diagnostic and prognostic biomarkers.Objective: To determine whether inflammatory proteins, such as neurofilament light chain (marker of nerves), myelin oligodendrocyte glycoprotein and myelin basic protein (markers of myelin), and neurodegenerative proteins, such as tau (distressed nerves) and glial fibrillary acidic protein (active astrocytes), can serve as biomarkers for predicting the clinical subtype and prognosis of MS.

Methods: Cerebrospinal fluid and serum samples were collected from patients with a diagnosis of clinically isolated syndrome (n = 46), relapsing-remitting MS (n = 67) or primary-progressive MS (n = 22) along with controls having other non-inflammatory neurological disease (n = 22). Western blot analyses were performed for the listed proteins. Protein levels were compared among different clinical subtypes using one-way analysis of variance analysis.

Results: The results showed that each of tau, GFAP, MOG and NFL protein concentrations differed significantly (p less than 0.001) in multiple sclerosis clinical subtypes compared with the controls. Levels of the proteins also differed between the multiple sclerosis clinical subtypes, which may be associated with the underlying disease process. Classification studies revealed that these proteins might be useful for identifying multiple sclerosis clinical subtypes.

Biomarkers We showed that select biomarkers may have potential in identifying multiple sclerosis clinical subtypes. We also showed that the predictive value of the prognosis increased when using a combination of the proteins versus using them individually.

Radar diagram of the value of differnt proteins in predicting relapisng remitting primary progressive non converting clinically isolated sydromes and CIS converting to MS and other neurological controls.

Although many of the markers were higher in the MS groups compared to control samples when they the results from analysis of 4 different proteins were compared they had a 95% chance of detecting MS from other neurological condidtions and analysis of three of them together had a 95% chance of predicting whether you are PP MS or RRMS. It this can be repeated then it may be of value in selecting MSers for treatments that may work verses those that do not work on PPMS for example.

3 comments:

  1. I think it would be hard on someone to say ' we think you've got a 95% chance of being PPMS and so we aren't going to give you any DMD's as they won't work. Aren't they going to say 'I might be in the 5%'? Unless you're going to use this test further down the line when you believe from their history they're PPMS, and it's just a confirmation.

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  2. Gosh, it seems hard on those with PPMS to be dealt with such a hopeless blow.

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  3. At present the current DMT for MS have not been shown to be effective in PPMS/SPMS.

    Would you want to be enrolled in a study (lasting 3 years) getting a drug that is unlikely to be of use to you, when you could be enrolled on another study with a drug that may be of use?

    You say where are the the treatments for PPMS?

    I believe there are a number in trial at the moment, there are certainly more in the pipeline so not at all hopeless.

    It should not be seen as a negative. (a) as this study has yet to be validated it could be pants and it is (b) how you use the information which is always the issue. As you say 95% one way is 5% wrong the other way.

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