Contributions
Abstract: 99
Type: Oral
Multiple sclerosis (MS) is a heterogeneous disease with a complex pathophysiology, involving inflammation and neurodegeneration. Demographic and clinical characteristics poorly predict disability progression of the disease at the individual level. MRI has become an important tool for early diagnosis and prognosis. In direct link with the brain, cerebrospinal fluid (CSF) has been widely investigated because of its ability to reflect the inflammatory and neurodegenerative processes involved in MS. Serum, white blood cells, miRNA (miR) also provided new candidate biomarkers of MS thanks to new ultra-sensitive techniques like proteomics, genomics or single molecule array. Biomarkers identified as predictive of conversion to clinically definite MS (CDMS) after a clinically isolated syndrome (CIS) include IgG-oligoclonal bands (OCBs), IgM-OCBs, kappa free-light chain (k-FLC), IgGs against neurotropic viruses, chitinase-3 like protein 1 (CHI3L1), neurofilament light chain (NF-L), soluble CD27 and others. Several markers have been associated with disability progression (e.g. presence of IgG-OCBs, high CSF levels of CHI3L1, NF-L, glial fibrillary acidic protein (GFAP), low serum vitamin D levels) and with time to secondary progressive MS (NF-L). Numerous biomarkers have been identified as predictive of MS evolution, but their individual value was rarely compared in large studies (e.g. IgG-OCBs, NF-L, CHI3L1). Up to now, the prognostic value of IgG-OCBs seems to resist quite well to all recently published biomarkers and lumbar puncture is still widely performed at disease onset. New prognostic biomarkers of MS should be tested against MRI and IgG-OCBs in large cohorts to justify their implementation in routine. Finally, several biomarkers have been associated with the therapeutic response in MS or to the risk of serious adverse events like progressive multifocal leucoencephalopathy (high titers of IgGs against the JC virus and previous exposure to immunosuppressant drugs). In the near future, algorithms including MRI and best CSF and/or serum biomarkers should guide neurologists among different therapeutic strategies (escalation or induction) from disease onset.
Disclosure: ET has participated in meetings sponsored by or received honoraria for acting as an advisor/speaker for Biogen Idec, Genzyme-Sanofi, Merck, Novartis, Roche, and TEVA.
Abstract: 99
Type: Oral
Multiple sclerosis (MS) is a heterogeneous disease with a complex pathophysiology, involving inflammation and neurodegeneration. Demographic and clinical characteristics poorly predict disability progression of the disease at the individual level. MRI has become an important tool for early diagnosis and prognosis. In direct link with the brain, cerebrospinal fluid (CSF) has been widely investigated because of its ability to reflect the inflammatory and neurodegenerative processes involved in MS. Serum, white blood cells, miRNA (miR) also provided new candidate biomarkers of MS thanks to new ultra-sensitive techniques like proteomics, genomics or single molecule array. Biomarkers identified as predictive of conversion to clinically definite MS (CDMS) after a clinically isolated syndrome (CIS) include IgG-oligoclonal bands (OCBs), IgM-OCBs, kappa free-light chain (k-FLC), IgGs against neurotropic viruses, chitinase-3 like protein 1 (CHI3L1), neurofilament light chain (NF-L), soluble CD27 and others. Several markers have been associated with disability progression (e.g. presence of IgG-OCBs, high CSF levels of CHI3L1, NF-L, glial fibrillary acidic protein (GFAP), low serum vitamin D levels) and with time to secondary progressive MS (NF-L). Numerous biomarkers have been identified as predictive of MS evolution, but their individual value was rarely compared in large studies (e.g. IgG-OCBs, NF-L, CHI3L1). Up to now, the prognostic value of IgG-OCBs seems to resist quite well to all recently published biomarkers and lumbar puncture is still widely performed at disease onset. New prognostic biomarkers of MS should be tested against MRI and IgG-OCBs in large cohorts to justify their implementation in routine. Finally, several biomarkers have been associated with the therapeutic response in MS or to the risk of serious adverse events like progressive multifocal leucoencephalopathy (high titers of IgGs against the JC virus and previous exposure to immunosuppressant drugs). In the near future, algorithms including MRI and best CSF and/or serum biomarkers should guide neurologists among different therapeutic strategies (escalation or induction) from disease onset.
Disclosure: ET has participated in meetings sponsored by or received honoraria for acting as an advisor/speaker for Biogen Idec, Genzyme-Sanofi, Merck, Novartis, Roche, and TEVA.