A new study found that in about 10% of multiple sclerosis cases, the body begins producing a distinct set of antibodies against its own proteins years before symptoms appear. “Multiple sclerosis is a complex and difficult-to-diagnose autoimmune disease,” Colin Zamecnik, researcher at UC San Francisco and lead author of the paper, told Yahoo Life. “We believe that a subset of patients who develop MS, about 10%, develop antibodies against a common protein domain that is prevalent in humans and the viruses that infect us.”
This patient population exhibits antibodies many years before the onset of MS. Zamecnik says that when they are tested at the time of the first outbreak of the disease, antibodies appear in both the blood and cerebrospinal fluid. “We believe it is possible that these patients have a cross-reactive response to a previous infection, which is in line with much current work in the literature on MS disease progression,” he says.
Scientists already know that B cells – the cells that produce antibodies – are crucial to the progression of MS disease. Because of this, UCSF researchers believed that profiling antibodies in people who have or will develop multiple sclerosis would give them insight into the disease and reveal a possible biomarker – a measurable signal they could observe.
“From the largest cohort of blood samples on the planet, we obtained blood samples from patients with multiple sclerosis years before the onset of symptoms and profiled the antibodies against themselves – autoantibodies – that are associated with the diagnosis of multiple sclerosis,” says Zamecnik. . “We found the first molecular marker of MS that appears in the blood up to five years before diagnosis.”
Why is it important
Although the biomarker is associated with a subset of MS patients when tested at the time of first flare or relapse, 100% of people exhibiting the biomarker eventually develop MS. “This could be a useful tool to help triage and diagnose patients with non-specific neurological symptoms and prioritize them for closer surveillance and possible treatment,” says Zamecnik.
Dr.neurologist at Ohio State University’s Wexner Center, agrees that the findings could help diagnose MS earlier and lead to earlier treatment.
“We know from data in Canada looking retrospectively at people in emergency room visits and health system visits that many people have a prodromal phase of MS, where they have a lot of symptoms before they are actually diagnosed and we don’t know have good biomarkers. or ways to identify people who are at risk of having MS or who will develop MS,” says Harrington. “I think any advances in this area will be helpful for diagnosis because symptoms at the beginning tend to be somewhat nonspecific.”
The biomarker could also help a category of people who have a radiologically isolated syndrome, meaning they have changes in the white matter of the brain – an indication of MS – but do not have classic MS relapses.
“They do not meet the criteria for MS, but some of them are at risk of developing MS, so the potential use of these biomarkers in this patient population could be useful in determining which of these people will develop MS or [have an] increased risk of developing MS,” says Harrington.
The same can occur with people who have had a clinical relapse of MS but do not meet the full criteria for MS, as well as people who have relatives with MS and also have changes in the white matter in the brain.
“Not everyone who has a first-degree relative develops MS, but the risk is higher in these individuals, and so potentially also applying it to those people with a first- or second-degree relative could be helpful,” says Harrington.
Who is at risk for MS?
According to National Multiple Sclerosis Society, most people are diagnosed with MS between the ages of 20 and 50. However, it can also occur in younger people. Although MS can affect anyone from any ethnic group, in the US the condition most commonly occurs in white people of Northern European descent. It is not believed that MS is passed on to family members. However, 200 genes have been identified that make a minor contribution to a person’s overall risk of developing MS.
Research shows that the following factors contribute to the development of MS:
What are the early signs of MS?
Common symptoms of EM include the following:
Early diagnosis of MS makes a big difference
Emerging data shows that treating MS early with more effective therapies is better in terms of reducing long-term disability.
“If people are not diagnosed early in their symptoms or have a late diagnosis, we are missing that critical therapeutic window where we can make a difference by suppressing inflammation and preventing the formation of new lesions,” says Harrington.
Several ongoing trials are investigating the impact of using early aggressive therapy versus a stepwise approach, which involves starting treatment with a less effective therapy and moving to more aggressive therapy when a person has a relapse or new lesion.
“I think this field is changing in terms of [scientists’] thought and that early, more aggressive treatment is beneficial in the long term for people with MS in terms of prognosis and outcome,” says Harrington.
The best way to do this, according to Zamecnik, may be a simple, highly specific antibody test for MS. “This signature will be the focus of future work investigating how the immune system recognizes cross-talk between pathogens and itself in the context of autoimmune diseases,” he says.
