A candidate biomarker of glial fibrillary acidic protein in CSF and blood in differentiating multiple sclerosis and its subtypes: A systematic review and meta-analysis

Sun, Menghong; Liu, Ning; Xie, Qin; Li, Xiaoling; Sun, Jing; Wang, Hongxia; Wang, Manxia

doi:10.1016/j.msard.2021.102870

Cited by 48 publications

(36 citation statements)

References 21 publications

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“…Other emerging evidence indicates that the gut microbiome may be altered in MS, suggesting another potential biomarker of the prodrome (48). Other potential molecular biomarkers include serum/CSF glial fibrillary acidic protein, and serum-based microribonucleic acids (miRNAs) (49)(50)(51). Finally, abnormal visual evoked responses (52,53) and optical coherence tomography (54) may be biomarkers associated with abnormalities in the visual pathways.…”

Section: Serum Csf and Other Opportunities For Biomarker Discoverymentioning

confidence: 99%

The Multiple Sclerosis Prodrome: Evidence to Action

2022

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A growing body of work points toward the existence of a clinically symptomatic prodromal phase in multiple sclerosis (MS) that might span 5–10 years or more. A prodrome is an early set of signs or symptoms predating the onset of classical disease, which in turn predates a definitive diagnosis. Evidence for a prodromal phase in MS could have major implications for prevention, earlier recognition and treatment, as well as an improved disease course or prognosis. This Perspective provides a succinct overview of the recent advances in our understanding of the MS prodrome and current key challenges. Many of the MS prodromal features characterized thus far are non-specific and are common in the general population; no single feature alone is sufficient to identify an individual with prodromal MS. Biomarkers may increase specificity and accuracy for detecting individuals in the MS prodromal phase, but are yet to be discovered or formally validated. Progress made in the elucidation of prodromal phases in other neurological and immune-mediated diseases suggests that these barriers can be overcome. Therefore, while knowledge of a prodromal phase in MS remains nascent, how best to move from the rapidly growing evidence to research-related action is critical. Immediate implications include refining the concept of the MS continuum to include a prodromal phase. This will help inform the true “at risk” period when considering exposures that might cause MS. Major long-term implications include the earlier recognition of MS, improved prognosis, through earlier disease management, and the future possibility of MS disease prevention.

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Section: Serum Csf and Other Opportunities For Biomarker Discoverymentioning

confidence: 99%

The Multiple Sclerosis Prodrome: Evidence to Action

2022

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“…Several studies [ 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ] have demonstrated significant differences in CSF GFAP levels between healthy controls and MS patients, also among different disease subtypes. A most recent meta-analysis [ 37 ] has shown a mean difference in CSF GFAP levels of 0.62 (95% CI = 0.56–0.88, p < 0.001) between the whole MS cohort and healthy controls (HC). A mean difference of 0.63 (95% CI = 0.39 to 0.86; p < 0.001) was observed between RRMS patients and HCs, meanwhile an enormous difference of 103.83 (95% CI = 68.09 to 139.57; p < 0.001) was seen between RRMS patients in remission and during a relapse.…”

Section: Fluid Biomarkers Of Multiple Sclerosismentioning

confidence: 99%

Emerging Biomarkers of Multiple Sclerosis in the Blood and the CSF: A Focus on Neurofilaments and Therapeutic Considerations

Biernacki

Kokas

Sandi

et al. 2022

IJMS

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Introduction: Multiple Sclerosis (MS) is the most common immune-mediated chronic neurodegenerative disease of the central nervous system (CNS) affecting young people. This is due to the permanent disability, cognitive impairment, and the enormous detrimental impact MS can exert on a patient’s health-related quality of life. It is of great importance to recognise it in time and commence adequate treatment at an early stage. The currently used disease-modifying therapies (DMT) aim to reduce disease activity and thus halt disability development, which in current clinical practice are monitored by clinical and imaging parameters but not by biomarkers found in blood and/or the cerebrospinal fluid (CSF). Both clinical and radiological measures routinely used to monitor disease activity lack information on the fundamental pathophysiological features and mechanisms of MS. Furthermore, they lag behind the disease process itself. By the time a clinical relapse becomes evident or a new lesion appears on the MRI scan, potentially irreversible damage has already occurred in the CNS. In recent years, several biomarkers that previously have been linked to other neurological and immunological diseases have received increased attention in MS. Additionally, other novel, potential biomarkers with prognostic and diagnostic properties have been detected in the CSF and blood of MS patients. Areas covered: In this review, we summarise the most up-to-date knowledge and research conducted on the already known and most promising new biomarker candidates found in the CSF and blood of MS patients. Discussion: the current diagnostic criteria of MS relies on three pillars: MRI imaging, clinical events, and the presence of oligoclonal bands in the CSF (which was reinstated into the diagnostic criteria by the most recent revision). Even though the most recent McDonald criteria made the diagnosis of MS faster than the prior iteration, it is still not an infallible diagnostic toolset, especially at the very early stage of the clinically isolated syndrome. Together with the gold standard MRI and clinical measures, ancillary blood and CSF biomarkers may not just improve diagnostic accuracy and speed but very well may become agents to monitor therapeutic efficacy and make even more personalised treatment in MS a reality in the near future. The major disadvantage of these biomarkers in the past has been the need to obtain CSF to measure them. However, the recent advances in extremely sensitive immunoassays made their measurement possible from peripheral blood even when present only in minuscule concentrations. This should mark the beginning of a new biomarker research and utilisation era in MS.

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“…It has been observed that the expression of the intermediate filament protein of mature astrocytes GFAP increases in MS plaques, which would be expected to relate to a high level of astrocyte damage [ 165 , 166 ]. A higher level of GFAP was measured in CSF of patients with SPMS than in patients with RRMS, indicating greater neurological dysfunction in this type of MS, as well as a greater progression of disability [ 167 ]. Furthermore, MS patients with greater disabilities have higher GFAP levels compared to patients with lesser disabilities [ 124 ].…”

Section: Classification Of Biomarkersmentioning

confidence: 99%

Potential Biomarkers Associated with Multiple Sclerosis Pathology

Mathur

Mishra

Rout

et al. 2021

IJMS

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Multiple sclerosis (MS) is a complex disease of the central nervous system (CNS) that involves an intricate and aberrant interaction of immune cells leading to inflammation, demyelination, and neurodegeneration. Due to the heterogeneity of clinical subtypes, their diagnosis becomes challenging and the best treatment cannot be easily provided to patients. Biomarkers have been used to simplify the diagnosis and prognosis of MS, as well as to evaluate the results of clinical treatments. In recent years, research on biomarkers has advanced rapidly due to their ability to be easily and promptly measured, their specificity, and their reproducibility. Biomarkers are classified into several categories depending on whether they address personal or predictive susceptibility, diagnosis, prognosis, disease activity, or response to treatment in different clinical courses of MS. The identified members indicate a variety of pathological processes of MS, such as neuroaxonal damage, gliosis, demyelination, progression of disability, and remyelination, among others. The present review analyzes biomarkers in cerebrospinal fluid (CSF) and blood serum, the most promising imaging biomarkers used in clinical practice. Furthermore, it aims to shed light on the criteria and challenges that a biomarker must face to be considered as a standard in daily clinical practice.

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A candidate biomarker of glial fibrillary acidic protein in CSF and blood in differentiating multiple sclerosis and its subtypes: A systematic review and meta-analysis

Cited by 48 publications

References 21 publications

The Multiple Sclerosis Prodrome: Evidence to Action

The Multiple Sclerosis Prodrome: Evidence to Action

Emerging Biomarkers of Multiple Sclerosis in the Blood and the CSF: A Focus on Neurofilaments and Therapeutic Considerations

Potential Biomarkers Associated with Multiple Sclerosis Pathology

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