Of multiple sclerosis patients, 10 percent already had antibodies in their blood that indicate the disease five years before diagnosis. This discovery could lead to greater understanding of the cause of the brain disorder.
Ten percent of people with multiple sclerosis (MS) have a striking composition of antibodies in their blood that is strongly linked to the disease. These antibodies appear to have been present in their blood for years before the diagnosis of MS. This was discovered by neurologist Michael Wilson from the University of California San Francisco in the US and his colleagues. They published their findings in the scientific journal Nature Medicine.
MS is a brain disorder in which a lot of unintentional inflammation occurs in the brain and/or spinal cord. This can lead to various complaints, depending on where the inflammation occurs, such as double vision, weakening or stiffening of the muscles, incontinence and tingling in the limbs.
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Blood
To learn more about the disease, Wilson and his colleagues conducted an extensive analysis of the blood of 250 people with MS and 250 people without MS. They collected blood from a database of more than 10 million US military personnel who served during the Gulf War. Thanks to this large database, the researchers were able to study the blood of people five years before their MS diagnosis and one year after the diagnosis.
The team specifically looked at the so-called autoantibodies in the blood of the soldiers. Antibodies are proteins that the body produces to fight invaders such as viruses and bacteria. In some cases, such as with MS, the body also produces antibodies against its own cells. These are called autoantibodies. The immune system attacks its own body with these proteins, as it were.
Autoantibody
The analysis showed that 10 percent of people with MS had a very similar composition of autoantibodies in their blood. These autoantibodies were present not only after the MS diagnosis, but also five years before. The researchers did not encounter this specific composition in people without MS.
To verify their results, the researchers performed the same analysis on another data set containing blood samples from 103 MS patients. This showed that 10 percent again had the same autoantibodies.
It also turned out that these MS patients needed more of the protein neurofilament light in their blood serum compared to the other 90 percent. This indicates that they have more damage to their nerve cells than is the average with MS.
Diagnosis
The researchers hope that their finding will help in early diagnosis of the disease. “Diagnosis is not always easy for MS because we do not yet have a specific biological indicator for the disease,” Wilson said in a press release. ‘We are enthusiastic about anything that can provide more diagnostic certainty at an earlier stage.’
In theory, a simple blood test could now determine in advance whether some people will develop MS in the future. Neurologist Joep Killestein from Amsterdam UMC, who was not involved in the research, wonders whether such a test is useful at this time. There are no medications to prevent the development of the disease, so doctors and researchers are unsure how patients benefit from this information. “If a treatment is not directly linked to it, then there is little you can do with that knowledge,” he says. Such a blood test can also provide a kind of false certainty, ‘because 90 percent of people will test negative with this blood test, while they can still develop MS later.’
Nevertheless, the findings of Wilson and his team are a nice step towards further research, says Killestein. “There is still much uncertainty about the cause of MS,” he says. ‘These types of studies help to understand this better.’ The research suggests that a similar causal factor could be at play in those 10 percent of MS patients. By investigating this further, the disease may become a little clearer for this part of the MS population. And that will ultimately have consequences for the treatment, says Killestein.
