No specific biochemical markers have been available to confirm the diagnosis of multiple sclerosis (MS) – until recently.
A Spanish and French research team developed a decision-tree based on results of analysis of biomarkers in the serum and cerebrospinal fluid (CSF) of MS patients. Lidia Fernandez-Paredes, MD (left), and Silvia Sanchez-Ramon, MD (right), both in the department of clinical immunology at Hospital Clinico San Carlos in Madrid, Spain, co-led the research team.
This lack of biomarkers often resulted in a delay in MS diagnosis and treatment while clinicians waited for a relapse to occur or for results of sequential neuroimaging studies to confirm the presence of disseminated lesions in the central nervous system. This study was conducted to provide clinicians with a means of diagnosing MS by using specific biomarkers.
In a previous, cross-sectional study in 2 independent cohorts of MS patients, the team used biologically plausible pathways to identify a panel of 12 biomarkers that might enable investigators to discriminate between the 2 main forms of MS at disease onset — relapsing-remitting MS (RRMS) and primary progressive MS (PPMS). An ability to discriminate between the 2 forms could enable clinicians to make a more specific diagnosis and provide more appropriate treatment sooner, which could delay the disease from becoming irreversibly disabling.
In the current study, the team determined which biomarkers in this panel could be most useful in diagnosing MS in the early phases of the disease as well as in predicting its course. To do this, they collected serum and CSF samples from 89 patients who were recently diagnosed with MS, 97 patients with other neurological diseases (59 non-inflammatory and 38 inflammatory), and 46 age-matched, healthy controls.