The critical analysis of current status in the search of optimal biomarkers in multiple sclerosis was performed. In many cases the clinical as well as MRI patterns are sufficient for the diagnosis. In dubious cases the impact of CSF studies is necessary demonstrating an increase of IgG index indicating an intrathecal production of this proteins as well as the presence of oligoclonal IgG bands. The intensive search for more specific biomarkers continues. However, till now the results are far from satisfactory ones and are not included into the accepted diagnostic tests. Nevertheless, the studies are of a great value for understanding of the disease pathomechanism. The increase of MBP level in the CSF represents a marker of demyelination. An increase in titres of antibodies recognizing myelin proteins manifests no diagnostic value due to significant level differences, similarly as the increase in expression of some cytokines, chemokines and adhesion molecules. The same concerns the relative percentage of superficial antigens of blood mononuclears. Biomarkers tested as predictors of disease progress have a greater future. A very important scientific problem involves the question if it is possible to find genetic markers, which could predict a positive or negative therapeutic response to immunomodulatory or immunosuppressive drugs. Such markers would signify a great advantage in the therapy of multiple sclerosis. 

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Biomarkers in multiple sclerosis

Mieczysław Wender

Affiliation and address for correspondence
Aktualn Neurol 2009, 9 (2), p. 109-115
Abstract

The critical analysis of current status in the search of optimal biomarkers in multiple sclerosis was performed. In many cases the clinical as well as MRI patterns are sufficient for the diagnosis. In dubious cases the impact of CSF studies is necessary demonstrating an increase of IgG index indicating an intrathecal production of this proteins as well as the presence of oligoclonal IgG bands. The intensive search for more specific biomarkers continues. However, till now the results are far from satisfactory ones and are not included into the accepted diagnostic tests. Nevertheless, the studies are of a great value for understanding of the disease pathomechanism. The increase of MBP level in the CSF represents a marker of demyelination. An increase in titres of antibodies recognizing myelin proteins manifests no diagnostic value due to significant level differences, similarly as the increase in expression of some cytokines, chemokines and adhesion molecules. The same concerns the relative percentage of superficial antigens of blood mononuclears. Biomarkers tested as predictors of disease progress have a greater future. A very important scientific problem involves the question if it is possible to find genetic markers, which could predict a positive or negative therapeutic response to immunomodulatory or immunosuppressive drugs. Such markers would signify a great advantage in the therapy of multiple sclerosis. 

Keywords
multiple sclerosis, biomarkers, cytokines, chemokines, pharmacogenetics, antimyelin antibodies

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