Blood biomarker test could identify worsening multiple sclerosis

Written by Alex Hyde, Future Science Group

A team of scientists has reported a blood biomarker test that could be used to identify individuals with multiple sclerosis (MS) whose condition is likely to deteriorate in the following year. Such a test could be useful to identify individuals for early intervention.

Study author Ali Manouchehrinia explained: “In a disease like MS that is so unpredictable and varies so much from one person to the next, having a noninvasive blood test like this could be very valuable, especially since treatments are most effective in the earliest stages of the disease.”

The research, published in Neurology, details the use of a blood test to investigate the association between the levels of plasma neurofilament light chain (pNfL) and the risk of worsening MS-associated disabilities.

The biomarker measured in the blood test, pNfL, is a nerve protein that can be detected in the blood when nerve cells die. During the study, scientists measured the levels of pNfL in 4385 individuals with MS and 1026 age- and sex-matched individuals without MS. Participants were then followed to monitor symptoms over the next year and sustained increased levels of disability over 5 years.

On average, individuals with MS had 11.4 pg/ml of the blood biomarker compared with an average of 7.5 pg/ml in the blood of individuals without MS. Taking into account factors that could affect risk of worsening disability, the study found individuals with MS who had elevated levels of the blood biomarker were 40–70% more likely to have worsening disability over the following year.

The research also found that individuals with high blood biomarker levels were 50% more likely to have either moderate disability affecting activities of daily life but not walking, or moderate disability that affects walking but individuals can walk 500m without assistance or rest.

The study did not find, however, any link between elevated levels of the blood biomarker and risk of significant disability or the development of secondary progressive MS.

The team also observed significant variations in levels of the blood biomarker and overlaps in measurements between individuals with and without MS. The scientists recognize this as a limitation of the study, suggesting it is likely that levels of the blood biomarker are influenced by factors not analyzed in the study.

Manouchehrinia explained: “These results suggest that elevated levels of these proteins measured early on in the course of the disease may help us to predict how the disease will develop and monitor how treatment is working. More research is needed before a blood test could be used routinely in the clinical setting, but our results are encouraging.”

Source: Manouchehrinia A, Stridh P, Khademi M et al. Plasma neurofilament light levels are associated with the risk of disability in multiple sclerosis. Neurology. doi:10.1212/WNL.0000000000009571 (Epub ahead of print)(2020);