Immunological indicators of disease activity and prognosis in multiple sclerosis

Abstract

The need to ensure an accurate diagnosis and proper treatment for multiple sclerosis patients, considering the various clinical and immunopathological subtypes of the disease, requires the identification of biomarkers that measure disease activity and predict the course of disease development in individual patients. Moreover, the identification of effective indicators will lead not only to optimized patient treatment but also to the development of better tools for evaluating clinical trials. Recent studies focusing on the identification of possible immunological markers in multiple sclerosis will be reviewed.

Soluble vascular cell adhesion molecule (VCAM) is associated with treatment effects of Interferon beta-1b in patients with Secondary Progressive Multiple Sclerosis

“…The most striking effect of IFNβ-1b is a rapid reduction in gadolinium DTPA enhancing lesions as detected by brain MRI [25].Several mechanisms have been described how interferon β could interfere with lesion formation, including reduction of proinflammatory cytokines at the mRNA and protein level [18] and an increase in Th2 cytokines, like IL-10 [1,19]; a reduction of matrix metalloproteinase activity [16] and an increase in soluble adhesion molecule sVCAM [2,22] or the TNF-related apoptosis inducing ligand (TRAIL) [31]. All these observations may be related to the therapeutic effects of IFNβ-1b in multiple ways [7]. Most studies were performed in patients with relapsing remitting MS over a short term and only rarely was the regulation of biomarkers correlated to treatment effects assessed by clinical examination or frequent MRI measurements [26,[29][30][31].…”

Antimyelin antibodies in clinically isolated syndromes correlate with inflammation in MRI and CSF

“…However, neither clinical nor paraclinical markers (biofluid markers, MRI) have up to now allowed the prediction of the course of MS in an individual patient [1,16]. In a recent report patients with serum anti-MOG antibodies (anti-MOG) and anti-MBP antibodies (anti-MBP), determined by Western blot, developed CDMS more often and earlier than dual antibody-negative patients, suggesting that the measurement of these antibodies is a useful tool for predicting early conversion to CDMS [4].…”

Benign multiple sclerosis

“…However, the predictive value of these clinical features is limited, and the search for immunological [15] and genetic markers [12,37] predictive of a benign course has provided inconclusive results. Therefore, the diagnosis of benign MS remains mainly a retrospective one.…”