Approximately 228 million people worldwide suffer from multiple sclerosis (MS) as of 2020. The majority of MS patients experience symptoms that gradually worsen their level of disability. A blood test developed by researchers at the University of California, San Francisco (UCSF) can identify the progression of MS disability up to two years in advance. In 2020, there will be roughly 20.8 million cases of multiple sclerosis (MS), a chronic illness that affects the central nervous system of the body. MS does not currently have a cure, but most patients eventually experience the disease’s progression even though they may initially have few symptoms. Knowing more about when an individual’s MS symptoms might get worse would help medical professionals prescribe disease-modifying treatments, which should help slow the disease’s progression. In support of these efforts, researchers at the University of California, San Francisco (UCSF) have developed a blood test that can identify the progression of multiple sclerosis disability up to two years in advance.
As stated by Dr. Ari J. According to Green, co-senior author of this study and chief of the Division of Neuroimmunology and Glial Biology at the University of California, San Francisco (UCSF), the loss of connections within the nervous system is the biological basis for permanent irreversible neurological dysfunction. According to Dr. Green, “the cumulative effect of the loss of tens of thousands or even millions of axons and connections from the critical circuits that underlie our essential neurological functions is likely to be the cause of progressive disability worsening in MS,” Medical News Today. If neurological function is lost in the midst of a progressive worsening, on the other hand, it is a terminal event that cannot be reversed. We are powerless to stop it if we wait for someone to demonstrate this deterioration. Thus, discovering methods to identify neurological deterioration before it occurs in multiple sclerosis gives us hope that we can intervene to halt or reverse the process,” he said.
The blood biomarker for the test was the neurofilament light chain (NfL), which was the main focus of the researchers. Dr. Ahmed Abdelhak, a physician-scientist, clinical instructor, and co-first author of this study in the Division of Neuroimmunology and Glial Biology at the University of California, San Francisco (UCSF), explained to MNT that neurofilament light chain is one of several unique proteins found mostly in nerve fibers. “Some of this protein or short segments called peptides find a way to enter the blood when nerve fibers (axons) get damaged or lost,” he said. “We can measure this tiny fraction using a digital immunoassay, which is an ultrasensitive technique that measures proteins or peptides like this at incredibly low concentrations,” Dr. Abdelhak went on. Consequently, NfL takes on a significant role as a marker to check for signs of nerve fiber damage. According to him, it more accurately forecasts future declines in the function that gives rise to the symptoms that patients endure than it does actual symptom aggravation.
Drs. Green and Abdelhak, along with their team, examined data from approximately 1,900 MS patients for this investigation. Of those, roughly 570 were categorized as having a disability that kept getting worse, the bulk of them not having relapsed. Relapses, also known as flare-ups, happen when preexisting symptoms get worse or develop new ones. Researchers discovered that a 91 percent increased risk of deteriorating disability with a relapse approximately a year later was linked to elevated NfL levels. A 49 percent higher chance of increasing disability without relapse was associated with elevated NfL levels approximately two years later. Dr. Green stated that they were taken aback by both results, particularly by their scope and the length of time they could detect changes. First, we believe that MS relapses are a rather sudden, acute event that lasts a few days. We have traditionally believed that the immune system attacks a small localized area in the brain, optic nerve, or spinal cord when it becomes activated inappropriately,” he went on. But this research indicates that before people with MS experience a permanent disability as a result of a relapse, there may be damage to nerve fibers occurring more widely throughout the brain or locally at the location of the future relapse. Understanding this process is crucial because it could lead to a paradigm change in how we view MS injuries generally and relapses that result in permanent disability in particular, said Dr. Abdelhak.
It is very exciting to see a biomarker that can predict disability one to two years before occurrence, according to Dr. Lana Zhovtis Ryerson, research director at the Hackensack Meridian Neuroscience Institute at Jersey Shore University Medical Center, Multiple Sclerosis (MS) Center, who reviewed this study and told MNT. “We are beginning to monitor this biomarker in our clinic, and it shows that long-term observation of this data point can have an impact on our patient population,” said Dr. Ryerson. And Bruce F. Drdot. Bebo Junior. , executive vice president of research at the National Multiple Sclerosis Society, told MNT that choosing the best disease-modifying treatment for a patient would be made much easier if it were possible to forecast how their disease would progress. Dr. Bebo stated, “At this time, there is not much information available to help guide the choice of disease-modifying therapy.”. “With this information, the patient and physician could choose a therapy with confidence. A biomarker like sNfL may enable people to begin effective treatment earlier, as we are aware of the many advantages of starting someone on a therapy that works for them.
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