Body fluid biomarkers in multiple sclerosis

Comabella, Manuel; Montalbán, Xavier

doi:10.1016/s1474-4422(13)70233-3

Cited by 225 publications

(247 citation statements)

References 166 publications

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“…The determination of biomarkers of inflammation and neurodegeneration in body fluids, combined with the use of non-conventional MRI with the ability to detect changes in the normal appearing brain tissue, could assist in the detection of a sequence of cellular and molecular events, inside and out of the CNS, that occur before fulfilling the current definition of NEDA composite. Multiple biomarkers have been identified in MS, but their validation and clinical application have not been established 7, 8 . Teunissen recently discussed the use of biomarkers for MS such as N-acetylaspartate (representing mitochondrial dysfunction and/or neuro-axonal loss), chitinase 3 like-protein 1 (meaning reactive astrogliosis and microglial activity), neurofilament light chain (related to axonal loss) and glial fibrillary acidic protein (representing astrocytic cytoskeleton injury).…”

Section: Background Activity Beyond the Surveillance Of Nedamentioning

confidence: 99%

Evidence of disease control: a realistic concept beyond NEDA in the treatment of multiple sclerosis

Londoño¹,

Mora²

2017

F1000Res

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Although no evidence of disease activity (NEDA) permits evaluation of response to treatment in the systematic follow-up of patients with multiple sclerosis (MS), its ability to accomplish detection of surreptitious activity of disease is limited, thus being unable to prevent patients from falling into a non-reversible progressive phase of disease. A protocol of evaluation based on the use of validated biomarkers that is conducted at an early stage of disease would permit the capture of abnormal neuroimmunological phenomena and lead towards intervention with modifying therapy before tissue damage has been reached.

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Section: Background Activity Beyond the Surveillance Of Nedamentioning

confidence: 99%

Evidence of disease control: a realistic concept beyond NEDA in the treatment of multiple sclerosis

Londoño¹,

Mora²

2017

F1000Res

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“…Indeed, NFL levels seem to correlate with acute axonal damage, 70 while NFH levels may reflect chronic axonal damage and may be more strongly associated with disability progression. 71,72 Furthermore, serum NFL levels appear to correlate with MRI activity and disability scores and may present an easily accessible biomarker predicting disability progression. 73 Although these molecular biomarkers may gain importance in the future, their integration into clinical practice requires further evaluation.…”

Section: Molecular Biomarkersmentioning

confidence: 99%

“…86,87 Moreover, for those markers that have already been validated, usefulness in clinical practice still needs to be demonstrated. 72 Furthermore, many pharmacogenomics studies have tried to identify genetic variants that may predict response to IFNβ or GA. So far, two genome-wide association studies have suggested a role for GPC5, glutamate receptors and ADAR in response to IFNβ.…”

Section: Response To First-line Treatmentsmentioning

confidence: 99%

“…However, to our knowledge, no such biomarkers have been described yet. 72,95 It remains to be investigated whether new imaging techniques such as MTI and diffusion tensor MRI, OCT or positron emission tomography may be useful for this purpose. 95 Response to second-line treatments A promising biomarker which objectively reflects response to second-line treatments is the level of NFs in the CSF.…”

Section: Response To First-line Treatmentsmentioning

confidence: 99%

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The clinical perspective: How to personalise treatment in MS and how may biomarkers including imaging contribute to this?

et al. 2016

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Background: Multiple sclerosis (MS) is a highly heterogeneous disease, both in its course and in its response to treatments. Effective biomarkers may help predict disability progression and monitor patients' treatment responses. Objective: The aim of this review was to focus on how biomarkers may contribute to treatment individualisation in MS patients. Methods: This review reflects the content of presentations, polling results and discussions on the clinical perspective of MS during the first and second Pan-European MS Multi-stakeholder Colloquia in Brussels in May 2014 and 2015. Results: In clinical practice, magnetic resonance imaging (MRI) measures play a significant role in the diagnosis and follow-up of MS patients. Together with clinical markers, the rate of MRI-visible lesion accrual once a patient has started treatment may also help to predict subsequent treatment responsiveness. In addition, several molecular (immunological, genetic) biomarkers have been established that may play a role in predictive models of MS relapses and progression. To reach personalised treatment decisions, estimates of disability progression and likely treatment response should be carefully considered alongside the risk of serious adverse events, together with the patient's treatment expectations. Conclusion: Although biomarkers may be very useful for individualised decision making in MS, many are still research tools and need to be validated before implementation in clinical practice.

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“…Biomarkers in MS are expected to assist in the diagnosis, prediction of disease course, and identification of treatment response. An elegant and detailed review discussed the current state and future use of biomarkers in MS [6]. The challenges in developing and validating new tools to address benefits of a potential MS treatment were discussed.…”

mentioning

confidence: 99%

Review on Recent Advances in Multiple Sclerosis and Related Disorders

Tenembaum¹

2013

J Neurol Neurophysiol

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The scientific world of central nervous system (CNS) neuroinflammatory disorders in general and multiple sclerosis (MS) in particular continues to expand, and 2013 has witnessed interesting advances in many aspects of research. In this review we will discuss research discoveries and results that have contributed to expand our knowledge in diverse areas of the MS field, including new environmental and genetic risk factors, new lines of treatment, and biomarkers of treatment response. Finally, new data on diagnostic biomarkers for neuromyelitis optica (NMO) have emerged, in addition to advances in NMO treatment.Keywords: Multiple sclerosis; Environmental risk factors; Biomarker; Monoclonal antibodies; Neuromyelitis optica; MOG antibodies; AQP4 antibodies; MS treatment; NMO treatment ReviewImportant advances in many aspects of multiple sclerosis (MS) research have been presented during 2013. In this review we will discuss results from a selected group of studies, evaluating their major contribution to MS research.Epidemiological studies have shown that environmental exposures seem to be crucial for the development of MS. Vitamin D insufficiency, remote infection with EBV, and exposure to cigarette smoke have already been proposed as environmental risk factors for both pediatric-and adult-onset MS. In 2013 new published data suggested that components of the daily diet could be considered additional risk factors for MS. Results from two independent studies suggest that high salt intake could trigger tissue inflammation and autoimmune disease. One study investigated environmental factors that directly influence TH17 cells, a newly identified population of interleukin (IL)-17-producing CD4 (+) helper T cells, highly pro-inflammatory cells with a key role in the development of experimental autoimmune encephalomyelitis (EAE), an animal model for MS [1]. The authors found that increases in sodium chloride concentrations markedly promoted the induction of murine and human TH17 cells. In animal models of MS, the TH17 cells generated under high-salt conditions displayed a highly pathogenic and stable phenotype characterized by the up-regulation of pro-inflammatory cytokines. The authors also found that mice fed with a high-salt diet developed a more severe form of EAE, with an increased number of TH17 cells peripherally induced and infiltrating the CNS. The second study showed that even a modest increase in salt concentration enhances TH17 cell differentiation in vitro and in vivo, accelerating the development of autoimmunity by inducing the expression of serum glucocorticoid kinase 1(SGK 1), which has a critical role in the regulation of IL-23R expression, reinforcing the TH17 phenotype [2]. According to these findings, a high-salt diet might represent an environmental risk factor for the development of autoimmune diseases by triggering TH17 cell differentiation and promoting tissue inflammation. Even though the causal association of these preliminary findings should be confirmed, they could be opening an interestin...

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Body fluid biomarkers in multiple sclerosis

Cited by 225 publications

References 166 publications

Evidence of disease control: a realistic concept beyond NEDA in the treatment of multiple sclerosis

Evidence of disease control: a realistic concept beyond NEDA in the treatment of multiple sclerosis

The clinical perspective: How to personalise treatment in MS and how may biomarkers including imaging contribute to this?

Review on Recent Advances in Multiple Sclerosis and Related Disorders

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