New Biomarkers Identified to Forecast Disability Progression in Multiple Sclerosis
New Delhi: A group of researchers has discovered crucial biomarkers that can predict the worsening of disability in individuals with multiple sclerosis (MS) — a chronic autoimmune disorder impacting the central nervous system (CNS).
Their findings could significantly change treatment approaches for millions of MS patients globally, while also paving the way for more personalized and effective treatment plans.
The researchers from Hospital Universitario Ramon y Cajal in Spain carried out an observational study involving 725 MS patients across 13 hospitals in Spain and Italy.
They discovered that elevated levels of serum neurofilament light chain (sNfL)—a protein that signals nerve cell damage—at the onset of MS could predict both relapse-associated worsening (RAW) and progression independent of relapse activity (PIRA).
Additionally, serum glial fibrillary acidic protein (sGFAP)—a protein from astrocytes that enters the bloodstream when the central nervous system (CNS) is injured or inflamed—correlates with PIRA in patients with low sNfL levels. Elevated sGFAP levels indicated localized inflammation driven by microglia in the CNS and are also linked to disease progression.
Dr. Enric Monreal and his team at the Hospital analysed blood samples from the 725 MS patients collected within 12 months of disease onset.
Their findings reveal that higher sNfL levels are indicative of acute inflammation within the CNS in MS. These were associated with a 45 per cent increased risk of RAW and a 43 per cent increased risk of PIRA.
While people with high sNfL levels often did not respond well to standard disease-modifying treatments (DMTs), they showed significant benefits from high-efficacy DMTs such as Natalizumab, Alemtuzumab, Ocrelizumab, Rituximab, and Ofatumumab.
Monreal, a researcher in MS, suggested measuring both sNfL and sGFAP levels at disease onset, which will help tailor treatment strategies for MS patients more effectively.
The researcher explained that this will mean people with low levels of both biomarkers, who show good prognosis, can be treated via injectable or oral DMTs.
Current DMTs primarily target the peripheral adaptive immune system without affecting CNS immunity. Thus, finding people “with higher levels of peripheral inflammation is crucial for preventing disability and improving patient outcomes," Monreal said
The results were presented at the 40th European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS 2024) Congress in Copenhagen, Denmark.