New MS biomarker

[erash]

See article --basically a new blood test that can determine disease activity and monitor DMT response that may replace spinal taps

SUMMARY AND COMMENT

Multiple Sclerosis Serum Biomarker Predictive of Disability and Disease Activity

Robert T. Naismith, MD Reviewing Disanto G et al., Ann Neurol 2017 Jun 81:857

Serum neurofilament light chain level is a clinically significant marker of axonal destruction.

July 7, 2017

Multiple Sclerosis Serum Biomarker Predictive of Disability and Disease Activity

Robert T. Naismith, MD Reviewing Disanto G et al., Ann Neurol 2017 Jun 81:857

Serum neurofilament light chain level is a clinically significant marker of axonal destruction.

Investigators used a highly sensitive single-molecule array assay suitable for use in blood rather than cerebrospinal fluid (CSF). Previously, CSF-based assays were required because serum neurofilament light chain (sNfL) concentration is 42-fold lower than in CSF. This study included a longitudinal cohort of 246 multiple sclerosis (MS) patients, a cross-sectional cohort of 142 MS patients who also had CSF available for comparison, and 254 healthy controls.

Serum NfL levels correlated well with CSF NfL (r=0.8, P<0.001) and increased with increasing numbers of T2 and enhancing lesions in brain and spinal cord. Serum NfL level also was independently associated with Expanded Disability Status Scale score and recent relapse and inversely with time on disease modifying therapy. Those with high sNfL had increased annualized relapse rate in the next 1 to 2 years and increased odds of worsening EDSS in the next 12 months. Serum NfL levels were higher for patients starting natalizumab and rituximab compared with those starting interferon, glatiramer acetate, and fingolimod. The levels decreased over time with all of these treatments. Serum NfL remained high in MS patients with progressive disease

NfL appears to be a viable serum biomarker of current and future disease activity and may be an indicator of treatment response. Obtaining serial CSF studies for NfL determination is difficult; the availability of this sensitive blood assay is a big breakthrough. Since NfL indicates neuronal or axonal injury, an important question is whether this marker can be a sensitive and early biomarker of neuroprotection for progressive MS. We can anticipate more information as clinical trials incorporate this assay into their outcome assays

National Multiple Sclerosis Society; National Institutes of Health

Citation(s):

Disanto G et al. Serum neurofilament light: A biomarker of neuronal damage in multiple sclerosis. Ann Neurol 2017 Jun; 81:857. (dx.doi.org/10.1002/ana.24954)

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[WAshingtongirl]

Thanks, erash . Wouldn't it be great if they could do this across the board and be able to help all of us? 💕

[SueAB]

@erash Wow! You are always a great source of MS info! Thanks for taking such good care of us!

[jimeka]

erash thank you, try and get some sleep 😴

[erash in reply to jimeka]

jimeka 😴

[greaterexp]

@erash, you always have great information. Thank you for sharing this. I wonder how long it will be before the test becomes a standard diagnostic or determiner of prognosis and may replace LPs.

[Iona60]

erash Sure wish they could just speed up all things that look beneficial for MS! Thanks for posting this.

[StacyHayward]

Anything that replaces spinal taps would be great