New Blood Test Predicts Multiple Sclerosis Before Symptoms Appear

According to a new study from Nature Medicine, researchers have found a method for more straightforward and earlier multiple sclerosis (MS) diagnosis. The researchers detected a distinctive set of antibodies in the blood of people who went on to develop MS that are not found in people without the disease. Researchers are excited to see these results, which can lead to early diagnosis of MS. In the future, if neurologists can diagnose MS earlier, people could start treatment sooner. 

Multiple sclerosis is a neurological disorder that affects around 2.8 million people worldwide. It affects almost three times as many women as men. There are several types, the most common being relapsing-remitting MS, where episodes of new or increasing symptoms are followed by periods of remission, during which symptoms go away partially or totally. 

MS is an autoimmune disorder in which the immune system attacks a person’s own cells. In MS, immune cells attack the myelin sheath that surrounds and protects nerve cells, thereby slowing down the transmission of nerve impulses. Diagnosis is done with an MRI scan of the brain and spinal cord or a lumbar puncture to obtain cerebrospinal fluid for testing, and evoked potential tests are used to measure the speed and accuracy of nervous system responses. 

Researchers of this study identified 250 people who developed MS from more than 10 million US service personnel. They matched these participants for age, sex, race/ethnicity, and year of serum collection with 250 controls who were not diagnosed with MS. 

The researchers validated the serum results against serum and cerebrospinal fluid (CSF) results from an MS cohort at the University of California, San Francisco (ORIGINS) that enrolled patients at clinical onset. They used data from 103 patients from the UCSF ORIGINS study. 

They conducted molecular profiling of autoantibodies and neuronal damage in samples from the 500 participants, measuring serum neurofilament light chain measurement (sNfL) to detect damage to nerve cells. In those who subsequently received an MS diagnosis, levels of sNfL were higher than the control subjects many years before their first flare-up of symptoms, indicating that damage to nerve cells begins a long time before symptom onset. They found that many of those who went on to develop MS had a distinct pattern of autoantibodies, which they termed an ‘immunogenic cluster’ (IC) that remained stable over time — and this was similar to patterns found in the ORIGINS cohort. This ‘autoantibody signature’ was not seen in controls. Given its specificity for MS both before and after diagnosis, an autoantibody serology test against the MSIC peptides could be implemented in a surveillance setting for patients with a high probability of developing MS, or crucially at a first clinically isolated neurologic episode. 

Journal Reference – Zamecnik, C. R., Sowa, G. M., Abdelhak, A., Dandekar, R., Bair, R. D., Wade, K. J., … Wilson, M. R. (2024). An autoantibody signature is predictive of multiple sclerosis.

Retrieved from https://www.nature.com/articles/s41591-024-02938-3