Bio-markers of disease activity and response to therapy in multiple sclerosis

Abstract

The pathogenesis of multiple sclerosis (MS) involves immune-mediated as well as neurodegenerative processes, each comprising both acute and chronic phases. The vast variety of cell types playing a part in the cascade of these processes, including lymphocytes, monocytes, glia cells, neurons, and endothelial cells, are sources for many biological activities and mediators [1–6]. Measurement of these activities (as cell proliferation, migration) and related mediators (as cytokines, proteolytic enzymes), conducted at different biological levels such as mRNA, protein level and activity, in accessible body fluids, to characterization of useful bio-markers for MS, has gained much attention in recent years. Aditionally, MS appears to include distinct clinical subtypes. Their main forms are RRMS, which tends to convert, eventually, to an SP form, and PPMS [7,8]. Immuno-pathological as well as neuro-radiological studies point to possible differences in the basic mechanisms underlying these distinct clinical subtypes [9–12]. Thus, the studies of disease-related indicators are directed towards the identification of markers specific to the distinct MS clinical subtypes and underlying pathogenic mechanisms. This review will focus on some of the bio-markers the mea-