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Multiple sclerosis (MS) is a chronic disease of the central nervous system that affects the brain, spinal cord, and optic nerves. In MS, the immune system attacks the myelin sheath, which is the protective covering of nerve cells in the brain, optic nerve, and spinal cord. This damage to the myelin sheath can cause a range of symptoms, including blurred vision, muscle weakness, loss of balance, numbness, and bowel or bladder control problems. The symptoms of MS can vary greatly from person to person and over the course of the disease, depending on the location of affected nerve fibers. The cause of MS is unknown, but it is thought to be an autoimmune disorder. There are several possible triggers for MS, including genetic factors, environmental factors, and infectious agents, such as viruses. MS is typically diagnosed through a complete health history and neurological exam, along with imaging tests, such as MRI. While there is no cure for MS, several drug therapies can limit nerve damage and slow the disease's progression.

MS also presents with significant inter- and intraindividual heterogeneity. There are several biomarkers under research for diagnosis of MS, disease evolution, and response to medication. While most of them are still being researched, some are already well-established. Here are some of the biomarkers for MS:

• Oligoclonal bands: They present in the cerebrospinal fluid (CSF) of most MS patients and are used as a diagnostic criterion.
• IgG index: It is used as a marker of intrathecal production of immunoglobulins. A value of IgG index greater than 0.7 is an indicator of an increased intrathecal synthesis of IgG and is used as a diagnostic criterion.
• Chitinase 3-like proteins: They are used as diagnostic and prognostic biomarkers of MS.
• GFAP: Levels of GFAP seem to be a useful biomarker for highly active acute inflammation in patients with relapsing-remitting MS and those with CIS.
• CSF proteome analysis: It is used to identify potential biomarkers of neurodegeneration in MS patients.
• MRI: White matter lesions on MRI are frequently used in MS diagnosis and treatment management.

The validation of new molecular biomarkers should examine whether serum or plasma detection is as suitable as CSF detection. While these biomarkers are commonly used in MS treatment, there are still limitations to their use, such as the heterogeneity of MS patients and the lack of established biomarkers for disease progression and treatment response. The search for a reliable biomarker to predict disease progression and monitor response to therapy remains a challenge.

References

Multiple sclerosis biomarkers. Wikipedia. August 18, 2023. Accessed October 17, 2023. https://en.wikipedia.org/wiki/Multiple_sclerosis_biomarkers.

Paul A, Comabella M, Gandhi R. Biomarkers in multiple sclerosis. Cold Spring Harbor perspectives in medicine. March 1, 2019. Accessed October 17, 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6396336/.

Ziemssen T, Akgün K, Brück W. Molecular biomarkers in multiple sclerosis - journal of Neuroinflammation. BioMed Central. December 23, 2019. Accessed October 17, 2023. https://jneuroinflammation.biomedcentral.com/articles/10.1186/s12974-019-1674-2.

Yang J, Hamade M, Wu Q, et al. Current and future biomarkers in multiple sclerosis. International journal of molecular sciences. May 24, 2022. Accessed October 17, 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9180348/.

Author links open overlay panelWilliam J. Housley a, a, c, et al. Biomarkers in multiple sclerosis. Clinical Immunology. July 2, 2015. Accessed October 17, 2023. https://www.sciencedirect.com/science/article/pii/S1521661615002193.

Biomarkers in multiple sclerosis. Practical Neurology. Accessed October 17, 2023. https://practicalneurology.com/articles/2018-sept/biomarkers-in-multiple-sclerosis.