biomarkers for disease activity

A forum to discuss research on the origins of MS and its development.

biomarkers for disease activity

Postby frodo » Sun Oct 08, 2017 4:34 am

Fluid biomarkers for disease activity in multiple sclerosis

http://journals.sagepub.com/doi/10.1177 ... 8517736151

Multiple sclerosis (MS) is an inflammatory and degenerative central nervous system (CNS) disease. There is accumulating evidence that the inflammatory activity is responsible for nervous tissue degeneration and disability development, especially during the early phases of MS.

The rate of inflammation or disease activity is reflected in relapses and lesion formation on magnetic resonance imaging (MRI) and subsequently in residual disability and atrophy development. Experience from two decades of therapeutic interventions in relapsing–remitting (RR) MS shows that immunomodulatory and immunosuppressive drugs reduce disease activity, and there seems to be an effect also on the rate of disease progression. Thus, disease-modifying therapies (DMTs) reduce CNS inflammation and change the clinical course and prognosis of MS.

Currently, patient assessment for treatment decisions in clinical practice is based almost entirely on clinical and MRI measures. However, to predict disability development, degeneration and therapeutic response, the development of biomarkers that reflect disease activity, meaning inflammatory activity and the intensity of the axonal injury process, is essential.
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Re: biomarkers for disease activity

Postby frodo » Wed Nov 22, 2017 7:34 am

Other biomarker for activity and progression: OCT

OCT as a window to the MS brain: The view becomes slightly clearer

http://www.neurology.org/content/early/ ... 0000004755

Optical coherence tomography (OCT) has been applied to multiple sclerosis (MS) to investigate retinal neuroaxonal loss.

Reductions in peripapillary retinal nerve fiber layer (pRNFL) thickness have been reported in different MS-related subtypes from clinically isolated syndromes1 to secondary progressive MS.

A recent meta-analysis additionally confirmed atrophy of the ganglion cell–inner plexiform (GCIP) layer in MS.3 Associations between OCT-derived retinal thicknesses (pRNFL and GCIP) and cerebral atrophy quantified by MRI have also been reported,4,5 leading to the suggestion of using OCT as a biomarker of MS disease progression in the clinic.

Despite challenges and lingering questions, several recent studies suggest potential for clinical value. For example, a recent retrospective study provided evidence for differential rates of GCIP atrophy according to DMT usage. Natalizumab-treated patients with MS exhibited the lowest atrophy rates (−0.16 μm/y), similar to healthy controls (−0.14 μm/y), whereas those treated with interferon-β and glatiramer acetate had more atrophy (−0.28 to −0.54 μm/y).

An earlier study found faster GCIP annualized thinning rates associated with clinical or radiologic MS activity in 161 patients.7 In addition, a recent cohort study identified a cutoff of 88 μm for the pRNFL to predict twice the risk of disability worsening at 2 years and 4 times higher risk at 5 years for the patients (many being treated) below this cutoff.

This literature implies a potential role for OCT in the clinical monitoring of MS in the future.

and as complement, OCT shows that MS damage structure differs from NMO:

High resolution retinal scanning reveals regional structural differences between MS and NMOSD

https://www.sciencedirect.com/science/a ... 0X17344507
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two more biomarkers

Postby frodo » Mon Dec 11, 2017 1:18 am

Two more biomarkers. This time for microglial activation and axonal injury. This article is a review but it refers to the original research articles, in case you want to read the primary sources.

Fluid biomarkers for microglial activation and axonal injury in multiple sclerosis

Source: http://onlinelibrary.wiley.com/doi/10.1 ... 12845/full

Abstract

Although it is clear that the immune system is an important disease driver in multiple sclerosis (MS), it is presently unknown what initiates the process. Infections have been mentioned as potential triggers, which is specifically dealt with in other articles of this volume. Here, I give an overview of two fluid biomarkers that reflect key elements of the MS process: microglial activation (cerebrospinal fluid [CSF] sTREM2) and axonal injury (CSF and serum/plasma neurofilament light). I review recent data on how these markers are altered in MS, how they change in relation to disease progression and treatment and, finally, how they can be used as tools in MS research.

Some quotes:

"Microglia are the innate immunity cells of the brain"
"some data suggest that microglial activation may precede T-cell infiltration and demyelination"
"[microglia] may also respond to a wide range of CNS infections"
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