Review: Identifying patient subtypes in multiple sclerosis and tailoring immunotherapy: challenges for the future

Abstract

The accelerating pace of technological and analytical development in the fields of genetic and phenotypic profiling has ushered in an era of great promise for multiple sclerosis (MS) research. As we continue to identify modest but meaningful associations to MS susceptibility, disease course, treatment response, and other clinical or paraclinical phenotypes, we must begin to (1) embark on the challenging set of studies that will integrate disparate observations into clinical algorithms, and (2) validate their clinical utility. Genetic data are receiving much of the attention today, but they are unlikely to be sufficient to offer a personalized approach to disease management in MS. Rather, the genetic architecture of the disease, once uncovered, will offer a fixed platform upon which more dynamic molecular profiles can be assembled to deconstruct the structure of the patient population that we label with a diagnosis of MS. The tools and methods to gain insight into the heterogeneity of MS patients are available today; we must now realize their potential in enhancing the care of MS patients.

Diffusion basis spectrum imaging for identifying pathologies in MS subtypes

“…Current clinical subtypes of MS do not fully capture its pathological heterogeneity. Identifying pathologically meaningful subtypes of MS are crucial in tailoring immunotherapies and moving toward a personalized medicine approach in the care of people with MS (PwMS) …”