Body fluid biomarkers in multiple sclerosis: how far we have come and how they could affect the clinic now and in the future

Abstract

Multiple sclerosis (MS) is an autoimmune inflammatory disease of the central nervous system, which affects over 2.5 million people worldwide. Although MS has been extensively studied, many challenges still remain in regards to treatment, diagnosis and prognosis. Typically, prognosis and individual responses to treatment are evaluated by clinical tests such as the expanded disability status scale, MRI and presence of oligoclonal bands in the cerebrospinal fluid. However, none of these measures correlates strongly with treatment efficacy or disease progression across heterogeneous patient populations and subtypes of MS. Numerous studies over the past decades have attempted to identify sensitive and specific biomarkers for diagnosis, prognosis and treatment efficacy of MS. The objective of this article is to review and discuss the current literature on body fluid biomarkers in MS, including research on potential biomarker candidates in the areas of miRNA, mRNA, lipids and proteins.

Keywords:

• autoimmunity
• biomarker
• experimental autoimmune encephalomyelitis
• multiple sclerosis
• prognosis
• therapy

Financial & competing interests disclosure

The authors were supported by the National Institute of Health (USA) and National MS Society (USA). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Multiple sclerosis (MS) is a clinically heterogeneous disease of unknown etiology and potentially different pathophysiologic mechanisms.

• Prognosis and response to treatment is variable between individual patients and current diagnostic measures cannot accurately predict individual patient outcomes and treatment responses.

• Despite decades of attempting to identify sensitive and specific biomarkers for diagnosis, prognosis and treatment efficacy of MS, no generally accepted markers or laboratory tests have emerged as of yet.

• Biomarkers are particularly needed to test the efficacy of novel treatments in progressive MS.

• Promising research in the areas of miRNA, mRNA, lipids and proteins suggests that useful biomarkers for MS may be available in the near future.