Tear analysis in clinically isolated syndrome as new multiple sclerosis criterion

During the last decades, the effort of establishing satisfactory biomarkers for multiple sclerosis has been proven to be very difficult, due to the clinical and pathophysiological complexities of the disease. Recent knowledge acquired in the domains of genomics-immunogenetics and neuroimmunology, as well as the evolution in neuroimaging, has provided a whole new list of biomarkers. This variety, though, leads inevitably to confusion in the effort of decision making concerning strategic and individualized therapeutics. In this paper, our primary goal is to provide the reader with a list of the most important characteristics that a biomarker must possess in order to be considered as reliable. Additionally, up-to-date biomarkers are further divided into three subgroups, genetic-immunogenetic, laboratorial, and imaging. The most important representatives of each category are presented in the text and for the first time in a summarizing workable table, in a critical way, estimating their diagnostic potential and their efficacy to correlate with phenotypical expression, neuroinflammation, neurodegeneration, disability, and therapeutical response. Special attention is given to the “gold standards” of each category, like HLA-DRB1∗ polymorphisms, oligoclonal bands, vitamin D, and conventional and nonconventional imaging techniques. Moreover, not adequately established but quite promising, recently characterized biomarkers, like TOB-1 polymorphisms, are further discussed.

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“…There have been previous efforts in measuring OligoClonal Bands (OCBs) in tears, with results comparable to those of CSF [11]. …”

Section: Methodsmentioning

confidence: 99%

Biomarkers in Multiple Sclerosis: An Up-to-Date Overview

Katsavos

Anagnostouli

2013

Multiple Sclerosis International

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“…The presence of IgM OCB has been reported to correlate with subsequent disability progression [106]. Recently OCB have been detected in the tears of patients with CIS with 100% specificity but less sensitivity than CSF [107]. The presence of mature B cells or plasma blasts (CD19+CD138+) in the CSF correlate with MRI activity [55].…”

Section: Csf Biomarkersmentioning

confidence: 96%

Biomarkers of disease activity in multiple sclerosis

Graber

Dhib‐Jalbut²

2011

Journal of the Neurological Sciences

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“…1 We wonder why these shortcomings affected the identification of tear OCBs, but not that of CSF OCBs (Figure 1) 1 , and how the criterion for OCB positivity, namely at least three OCBs, 1 has been fulfilled without precise OCB numbering.…”

Section: Oligoclonal Bands In Tearsmentioning

confidence: 98%

“…1 OCB existence in tears is lively debated. 1 Calais and colleagues reported to pinpoint such bands in the article ( Figure 1).…”

Section: Oligoclonal Bands In Tearsmentioning

confidence: 99%