Advances in biomarker research in multiple sclerosis.

Abstract

Development of novel biomarkers in multiple sclerosis (MS), needed to assess long-term prognosis, develop personalised treatment plans and facilitate earlier diagnosis, has so far been limited since potential candidates have often lacked specificity, reproducibility and accessibility. Despite considerable academic endeavour over many years, the only robust markers commonly utilised in current practice remain MRI and cerebrospinal fluid (CSF) oligoclonal bands, both of which provide limited essential prognostic information. More recently a number of alternative potential biomarkers have been proposed including chitinase-3 like 1 and neurofilament light chains both of which are based on analysis of CSF but have so far failed to be applied in clinical practice. In this month’s journal club, we examine three recent papers investigating biomarkers in MS. The first study uses a candidate approach assessing serum B cell-activating factor (BAFF) in relation to treatment response and disease course. The second study applies a broad proteomics approach to assess extremes of disease outcome. The third study looks at genetic variants in patients on disease modifying treatments (DMT) to identify markers predictive of treatment response. These three approaches highlight the collaborative effort and extensive biobank resources required for biomarker discovery in this field.