Assessing tissue damage in multiple sclerosis: a biomarker approach
Version of Record online: 24 FEB 2014
© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Acta Neurologica Scandinavica
Volume 130, Issue 2, pages 81–89, August 2014
How to Cite
Assessing tissue damage in multiple sclerosis: a biomarker approach. Acta Neurol Scand 2014: 130: 81–89. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd., , , , , .
- Issue online: 23 JUL 2014
- Version of Record online: 24 FEB 2014
- Manuscript Accepted: 21 JAN 2014
- Lars Tenerz, the Selander foundation
- Åke Löwnertz foundation
- MÅH Ländell foundation
- Uppsala University Hospital
- Swedish Research Council
- Swedish State Support for Clinical Research. Grant Number: ALFGBG-144341
- multiple sclerosis;
- magnetic resonance imaging;
- myelin basic protein;
- glial fibrillary acidic protein
Magnetic resonance imaging (MRI) of the brain and spinal cord is the gold standard for assessing disease activity in multiple sclerosis (MS). MRI is an excellent instrument for determination of accumulated damage to the brain and spinal cord, but tells us little about ongoing tissue damage. In this study, biomarkers of oligodendrocyte, axonal and astrocyte injury were related to MRI and clinical findings and used to assess tissue damage in MS.
Materials and methods
Cerebrospinal fluid from 44 patients with relapsing-remitting MS, 20 with secondary progressive MS and 15 controls were investigated with ELISA to determine levels of myelin basic protein (MBP), neurofilament light (NFL) and glial fibrillary acidic protein (GFAp). Patients underwent MRI of the brain and spinal cord, and gadolinium enhancing lesions, T1 lesions and T2 lesions were counted.
Patients in clinical relapse and patients with nonsymptomatic gadolinium enhancing lesions had high levels of MBP and NFL, indicating ongoing damage to oligodendrocytes and axons. The level of MBP dropped quickly within a week from the onset of a relapse, whereas NFL remained elevated for several weeks and GFAp slowly rose during the course of a relapse. Relapsing-remitting MS patients without gadolinium enhancing lesions had values of MBP, NFL and GFAp similar to controls, while patients with secondary progressive disease had moderately increased values of all biomarkers.
Analysis of MBP, NFL and GFAp provides direct means to measure tissue damage and is a useful addition to our methods for evaluation of MS.