Biomarkers in Multiple Sclerosis: a review of diagnostic and prognostic factors

Abstract

Introduction. Multiple Sclerosis (MS) is a chronic, demyelinating disease of the central nervous system which affects mostly young people. Because it leads to disability and cognitive impairment, it is crucial to recognise MS at an early stage.State of the art. Magnetic resonance imaging is the golden standard in MS diagnosis. However, it is not an infallible diagnostic tool, especially at the stage of clinically isolated syndrome. The incorporation of oligoclonal bands in the diagnostic process of MS is a step towards the extension of diagnostic methods. Recently, a lot of research has been carried out on potential biomarkers in blood serum and cerebrospinal fluid that may be useful in the diagnosis of MS.Clinical implications. This article summarises current knowledge on the use of new prognostic factors such as neurofilament light chain, chitinase 3-like 1 and 2, heat shock proteins, and tubulins in MS. Future directions.Despite numerous studies on the use of biomarkers in the diagnosis of MS, more extensive research is needed to determine the clinical usefulness of these molecules and to develop diagnostic tests applicable in everyday practice. This in turn may result in earlier MS detection, faster implementation of treatment, and better therapeutic effects.

A comment on the paper ‘Biomarkers in Multiple Sclerosis: a review of diagnostic and prognostic factors’ by Sapko et al.

“…Firstly, we would like to thank you for the opportunity to respond to the issues raised in Prof. Lewczuk et al 's Letter to the Editors [1] and to clarify the aim of our paper [2].…”

Relationship between blood-brain permeability and antibodies against aquaporins in neuromyelitis optica spectrum disorders and multiple sclerosis patients

“…Early and accurate distinction between these diseases is essential due to different prognosis and treatment strategies, but still remains challenging, despite typical clinical features, laboratory and magnetic resonance imaging (MRI) findings [2,3]. Until now, no specific marker for MS has been found [4]. Although the presence of oligoclonal bands in the cerebrospinal fluid (CSF) is very typical for MS, it is unspecific, because they can also be found in other diseases with white matter lesions, including NMOsd (15-30% of cases) [5].…”

A comment on the paper ‘Biomarkers in Multiple Sclerosis’ by Sapko et al.

“…We read with great interest the review paper recently published by Sapko et al [1]. The article exhaustively presented current perspectives in the development of candidate multiple sclerosis (MS) biomarkers in cerebrospinal fluid (CSF), with very interesting concepts on their diagnostic/relevant interpretations.…”

“…(ii) In addition to the quantitative analysis of the intrathecal immune synthesis, they can also be assessed qualitatively, albeit with greater analytical sensitivity, by a comparison of the patterns of the polyspecific immune reaction in the CSF and serum in isoelectrofocusing (IEF; so called 'olicoglonal IgG bands' or OCB), as correctly pointed out by Sapko et al [1].This method is currently available exclusively for IgG, although efforts are ongoing to extend it to other immunoglobulin classes. According to a still valid interpretational guideline of the European consensus [4], five patterns of the OCB exist.…”

“…A thorough analysis of routine CSF biomarkers is not only of fundamental help in caring for the patient, but also provides a solid basis for the search for novel candidate biomarkers such as those reviewed by Sapko et al [1].…”