Contribution of Metabolomics to Multiple Sclerosis Diagnosis, Prognosis and Treatment

Abstract

Metabolomics-based technologies map in vivo biochemical changes that may be used as early indicators of pathological abnormalities prior to the development of clinical symptoms in neurological conditions. Metabolomics may also reveal biochemical pathways implicated in tissue dysfunction and damage and thus assist in the development of novel targeted therapeutics for neuroinflammation and neurodegeneration. Metabolomics holds promise as a non-invasive, high-throughput and cost-effective tool for early diagnosis, follow-up and monitoring of treatment response in multiple sclerosis (MS), in combination with clinical and imaging measures. In this review, we offer evidence in support of the potential of metabolomics as a biomarker and drug discovery tool in MS. We also use pathway analysis of metabolites that are described as potential biomarkers in the literature of MS biofluids to identify the most promising molecules and upstream regulators, and show novel, still unexplored metabolic pathways, whose investigation may open novel avenues of research.

Molecular Research in Multiple Sclerosis

“…The Special Issue, “Molecular Research in Multiple Sclerosis”, provides a better comprehension of the disease and establishes possible new biomarkers to ensure better care of MS patients in the future. It contains a review of the contribution of metabolomics in MS [ 1 ], the impact of SARS-CoV-2 infection [ 2 ], a review on common microRNAs (miRNAs) in MS and major depression (MD) [ 3 ], the first case of comorbid MS with Phelan McDermid Syndrome (PMcD) with regressive symptoms in a young woman who improved after treatment with methylprednisolone [ 4 ], and a review on intrathecal inflammation in progressive MS [ 5 ].…”

“…The first tool for better comprehension of MS is metabolomics [ 1 ]. The review on the contribution of metabolomics emphasizes that patients have different phenotypes at different time points.…”

“…Regarding the treatment response, metabolomics are a useful tool for describing the response to different drugs such as interferon beta-1a and glatiramer acetate. Another interesting aspect of this review is the meta-analysis conducted to evaluate individual and group effects of metabolites upregulated in different fluids such as CSF, blood, and urine of MS patients and highlight pathways likely to play a role [ 1 ].…”

“…Data integration is a milestone in omics approaches, as demonstrated by Rispoli et al [ 1 ] and Monaco et al [ 5 ] in this Special Issue. By integrating results from metabolomics and neuroimaging data, Rispoli et al showed a significant reduction in arginine plasma concentration in RRMS and a higher concentration of indolepyruvate in SPMS compared to RRMS.…”

“…By integrating results from metabolomics and neuroimaging data, Rispoli et al showed a significant reduction in arginine plasma concentration in RRMS and a higher concentration of indolepyruvate in SPMS compared to RRMS. Also, a higher concentration of myelin basic protein, macrophage-derived chemokine, and 5.6-dihydroxyprostaglandin was highlighted in worse disease progression of SPMS [ 1 ]. In a similar approach, in Monaco et al’s article, focusing on the intrathecal inflammation in PMS, neuropathology and molecular and MRI methodologies were integrated, showing molecules connected to a higher meningeal inflammation and grey matter demyelination, namely IFNγ, TNF, IL2, IL22, CXCL13, CXCL10, LTα, IL6, and IL10 [ 5 ].…”