Wednesday, 24 June 2015

Discriminating claims about discriminating forms of MS

Plasma biomarkers discriminate clinical forms of multiple sclerosis.Tejera-Alhambra M, Casrouge A, de Andrés C, Seyfferth A, Ramos-Medina R, Alonso B, Vega J, Fernández-Paredes L, Albert ML, Sánchez-Ramón S.PLoS One. 2015 Jun 3;10(6):e0128952. doi: 10.1371/journal.pone.0128952. eCollection 2015.

Multiple sclerosis, the most common cause of neurological disability in young population after trauma, represents a significant public health burden. Current challenges associated with management of multiple sclerosis (MS) patients stem from the lack of biomarkers that might enable stratification of the different clinical forms of MS and thus prompt treatment for those patients with progressive MS, for whom there is currently no therapy available. In the present work we analyzed a set of thirty different plasma cytokines, chemokines and growth factors present in circulation of 129 MS patients with different clinical forms (relapsing remitting, secondary progressive and primary progressive MS) and 53 healthy controls, across two independent cohorts. The set of plasma analytes was quantified with Luminex xMAP technology and their predictive power regarding clinical outcome was evaluated both individually using ROC curves and in combination using logistic regression analysis. Our results from two independent cohorts of MS patients demonstrate that the divergent clinical and histology-based MS forms are associated with distinct profiles of circulating plasma protein biomarkers, with distinct signatures being composed of chemokines and growth/angiogenic factors. With this work, we propose that an evaluation of a set of 4 circulating biomarkers (HGF, Eotaxin/CCL11, EGF and MIP-1β/CCL4) in MS patients might serve as an effective tool in the diagnosis and more personalized therapeutic targeting of MS patients.

This study looked at cytokines in different stages of MS some when up in progressive MS

Some went down

What is evident that if you took the results of any individual you would be hard pressed to know if they were RRMS or PMS because there is so much over lap and this is a common problem of many so-called biomarkers reported. On a whole group analysis you can see differences but on an individual level it is hard to make a call. In this study they report if you look at 4 cytokines it helps to discriminate, but the question is.....Would you base a treatment decision on this? I wouldn't, as there is not enough sensitivity and specificity in the system maybe NDG as a view

1 comment:

  1. Agree with your arguments. Differences between groups' means do not always translate into differences between individuals, if there is overlap. However, isn't it what we always do? assuming that difference between efficacy outcome of two drugs would provide a better response to one drug in an individual patient?

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