Gabriela Stînca

Moldova

Laboratory Biomarkers of Multiple Sclerosis Diagnosis

Gabriela Stinca1, Victoria Simon2

1. Nicolae Testemi?anu State University of Medicine and Pharmacy, Chi?in?u, Republic of Moldova
2. Department of Neurology No.1, Nicolae Testemi?anu State University of Medicine and Pharmacy, Chi?in?u, Republic of Moldova

Abstract

Background

Multiple sclerosis (MS) is a chronic neuroinflammatory disease characterized by disseminated demyelination in the brain and spinal cord. The clinical heterogenity of MS results from varying degrees of inflammation, neurodegeneration, gliosis and repair mechanisms. Currently, the diagnosis of MS primarily relies on MRI scans and the exclusion of other conditions with similar symptoms. Laboratory biomarkers could streamline diagnosis by providing specific, objective evidence and improving the decision making in the process of individualized therapeutics.

Methods

This abstract is based on a comprehensive literature review of multiple sources, including the National Multiple Sclerosis Society, the National Institutes of Health, the World Health Organization, the National Library of Medicine, Wiley Online Library and ScienceDirect.

Results

Biomarkers for MS must identify people who are vulnerable to the disease or susceptible to a high risk of severe attacks and predict which individuals are likely to show a response to treatment. Multiple studies have identified correlations between specific markers and the pathogenesis and clinical features of multiple sclerosis. Key tests for early diagnosis include HLA-DRB1 genotyping, which helps assess genetic risk; cerebrospinal fluid levels of IgG oligoclonal bands and/or kappa free light chains; serum vitamin D levels and the MRZ reaction (antibodies against measles, rubella, and varicella-zoster virus), which suggests a predominantly B-cell-mediated immune response and can guide therapeutic decisions toward immunomodulation. Other indicators are less informative though related to the diagnosis of MS, but their accuracy and practicality are yet to be proven. These include anti Epstein-Barr virus antibodies and markers of axonal damage (e.g., neurofilaments, tau protein).

Conclusions

No single biomarker is effective in determining the diagnosis in terms of sensitivity and specificity because the pathophysiological complexity of MS results in a wide range of potential biomarkers. Further research in the field of multiple sclerosis markers must be directed towards an earlier and accurate diagnosis, providing patients with personalized targeted treatments, hence improving their quality of life by timely intervention.