Posted on 10/04/2024 8:59:56 PM PDT by ConservativeMind
A study has identified critical biomarkers that can predict disability worsening in multiple sclerosis (MS). The breakthrough research has the potential to transform treatment.
Dr. Enric Monreal found elevated serum neurofilament light chain (sNfL) levels—a protein indicating nerve cell damage—at the onset of MS can predict both relapse-associated worsening (RAW) and progression independent of relapse activity (PIRA).
Additionally, serum glial fibrillary acidic protein (sGFAP) levels—a protein derived from astrocytes that enters the bloodstream when the central nervous system (CNS) is injured or inflamed—correlate with PIRA in patients with low levels of sNfL.
Using the Single Molecule Array (SIMOA) technique, researchers assessed the prognostic value of sNfL and sGFAP levels to predict RAW and PIRA.
Key findings reveal that higher sNfL levels, indicative of acute inflammation within the CNS in MS, are associated with a 45% increased risk of RAW and a 43% increased risk of PIRA. Patients with high sNfL levels often did not respond well to standard disease-modifying treatments (DMTs) but showed significant benefits from high-efficacy DMTs (HE-DMTs) such as natalizumab, alemtuzumab, ocrelizumab, rituximab, and ofatumumab.
In contrast, patients with high sGFAP levels—which is an indicator of more localized inflammation driven by microglia in the CNS—and low sNfL levels experienced an 86% increased risk of PIRA. This group did not respond to current DMTs.
Interestingly, while sGFAP is known to be associated with progression, high sNfL levels limit the ability of sGFAP to predict this outcome. Specifically, sGFAP values were predictive of PIRA only in patients with low sNfL levels.
"Patients with low levels of both biomarkers had a good prognosis and could be treated with injectable or oral DMTs. However, high sNfL levels indicate a need for HE-DMTs to prevent disability worsening, while patients with high sGFAP levels and low values of sNfL may require new therapeutic approaches.
(Excerpt) Read more at medicalxpress.com ...
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