Multiprotein panel may help measure disease activity in MS: Paper

A panel of 20 proteins in blood may be used to quantify disease activity, namely relapses and lesions, in people with multiple sclerosis (MS), a new paper proposes.

“A multi-protein panel like the one developed in this study has the capability to capture the state of a patient’s MS from multiple angles, allowing for a fuller picture of their pathophysiology [disease biology],” the researchers wrote.

Ultimately, measuring blood levels of these proteins could potentially provide insights into expected treatment responses before they are visible on imaging scans, according to the team.

The study, “Inflammatory and neurodegenerative serum protein biomarkers increase sensitivity to detect clinical and radiographic disease activity in multiple sclerosis,” was published in the journal Nature Communications.

Panel better than single protein for links to disease activity

In MS, inflammation injures nerve tissue in the brain and spinal cord, resulting in the formation of scarred regions called lesions. In most patients, the disease is marked by relapses where symptoms suddenly worsen, followed by periods of remission in which symptoms ease.

Many efforts have been made to identify blood biomarkers that can help measure or predict MS disease activity. In theory, blood-based tests could be an easy way to monitor the disease between MRI scans, and may even be useful in clinical trials testing new treatments.

Identifying blood biomarkers that accurately predict MS disease activity has proven challenging, but some progress has been made. In particular, there’s increasing evidence that neurofilament light chain (NfL) — a structural protein in nerves that gets released into blood and other bodily fluids when nerves are damaged — may be a marker of MS disease activity.

In this study, the team of scientists analyzed levels of more than 1,400 different proteins in more than 600 blood samples from MS patients across three separate groups. The team then used a battery of statistical tests to look for proteins that could predict MS disease activity.

Specifically, the researchers looked at three measures of disease activity: whether or not patients had actively inflamed lesions at the time the blood sample was collected; whether or not patients were in or near a relapse when the sample was collected; and the annual rates of relapses for each patient.

From these analyses, the team identified a panel of 20 proteins that could consistently predict MS disease activity.

The researchers noted that, among all the proteins tested, NfL showed the strongest association with disease activity. However, the panel of multiple proteins was more accurate than was NfL alone, and the panel retained decent accuracy even when NfL was excluded from the analysis. These results suggest that a panel of multiple proteins is likely to be more useful than just measuring NfL, the researchers said.

Based on the findings, the researchers suggested that this panel of proteins may give insights about treatment responses before those are visible on routine MRI scans. That could “greatly enhance the quality of life and increase the health span of patients with MS and offer insight into patient adherence to their treatment plan.”

The team noted, however, that this was an early analysis, and stated that further research, including long-term studies, are needed to validate the model. The scientists said they are hoping to conduct further tests to confirm the accuracy of this panel, with the ultimate goal of conducting a clinical trial to prove its utility in MS.